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Living With The Devil We Know - Page 5


As therapists, we need to improve our models, techniques, and methods and rethink our compulsive need—in the interests of being kind and helpful—to doing something, anything, to make things all better as soon as possible, before we fully comprehend what our patients want. We need to become a little more savvy about the contradictions and paradoxes of human nature.

Once again, none of these new techniques negates the tremendous accomplishments of those who developed CBT and other new forms of psychotherapy. However, if we learn to deal skillfully with the patient’s resistance before trying any techniques drawn from any school of therapy, our efforts to help will become far more effective. We may finally find ways to connect with the remaining 50 percent or more of patients who aren’t making satisfactory or meaningful progress, even when treated with the best medications and, presumably, the best psychotherapy treatments.

David Burns, M.D., is adjunct clinical professor of psychiatry and behavioral sciences at the Stanford University School of Medicine. His books Feeling Good and Feeling Good Handbook have sold more than five million copies worldwide.

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  • Comment Link Tuesday, 29 January 2013 21:15 posted by Sophie Benoit

    I have found this article very meaningful and thorough. Many interesting reflection points personally and professionally. I have been telling my patients for sometime that whatever is here and bothering them is there for a reason and that once, this part of themselves has been given a space to 'say what it needs to say' it will go by itself. I have found the way Dr. Burns talks about resistance and what they say about a person, will give me a new direction for looking at my work and difficult cases. Thank you

  • Comment Link Monday, 28 January 2013 16:26 posted by jeffrey von glahn

    Completely agree with Michele re: the "hidden emotion technique" and the influence of manualized therapy. Burns' examples confirms my own view of therapy. 1) The cause and the resolution of the client's problems resides in the client, not in any theory. So keep inviting the client to say more, and which prevents the therapist from getting ahead of the client. 2) The most effective resolution for the most typical problems is the client re-visiting the hurtful event that caused it, BUT ONLY IF that experiencing emerges as a manifestation of the support the client receives for his experiencing. See my short article in May/June 2012.

  • Comment Link Thursday, 24 January 2013 15:01 posted by Michele Rivette

    I have to say as a psychoanalyst, that Dr. Burns "hidden emotion technique", with all due respect, sounds very familiar. Sadly, with the move to manualized treatments in recent decades, therapists are not trained in exploring the unconscious or pre-conscious fears, motivations, conflicts (i.e. sources for resistance to change), so this may seem like a new idea. Understanding the deeper meanings of why patients remain stuck in painful feelings or behaviors despite conscious discomfort or desire to change is the focus of psychodynamics. I am so grateful to have this deeper training because it makes my work so much more rich and patients feel validated and curious about their own psyches.