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How We Can Practice Effective Therapy Even Without Neuroscience

Steve Andreas on the Pitfalls of Over-relying on Brain Science in Therapy

Therapists were doing helpful work long before neuroscience made its official debut and the field developed a collective case of “brain fever.” Good therapists have always known that to help people change the way they feel and behave, we have to help them change the way they use their brains every day, not tell them about their neural processes. By actively creating vivid, impactful therapeutic experiences, we can transform our clients’ perceptions of their own reality, shifting the way they think and feel about themselves and their capacity for change.

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How Affairs Can Reveal and Even Heal Relationship Dysfunction

Tammy Nelson's Three-Step Process for Recovering from Infidelity

Even though our ideas about sex and sexuality have greatly advanced over the last half-century, our culture still holds a double standard about infidelity: we still tend to pathologize women or shame them for having affairs. In my view, far from being evidence of pathology or marital bankruptcy, a woman’s affair can be a way of expressing a desire for an entirely different self, either separate from the marriage altogether or still in it. By understanding this, therapists have an opportunity to help troubled couples create a new relationship with better communication, fuller intimacy, and realistic hope for a better future together.

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Treating Violent Children with a Therapist's Warmth

Wisconsin's Mendota Treatment Center Offers Violent Youths a Path to Recovery

The word "psychopath" distinguishes hard-bitten predators. Research shows a treatment center---run by shrinks, not wardens---has reduced new violent offenses by 50 percent. What accounts for the Mendota Treatment Center’s success? Its founders argue that “prosocial” bonds help deter crime by giving people a stake in society, and thus a reason to work to control themselves. At the center, no one ever calls a kid a psychopath. At most, the center’s therapists will speak of someone as having “psychopathic traits.” Inmates are rigorously referred to as “youth.” Faith in the possibility of redemption is embedded in the language.

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VIDEO: Inspiration for the Season from Tara Brach

Deliberate Practice and Inner Transformation

Being compassionate and trusting is fundamental to our nature. But according to noted mindfulness teacher Tara Brach, it can be hard to stay true to our highest selves in a world that’s fragmented and fragmenting. In this address from the 2013 Symposium, she shares a moving personal example of how deliberate practice leads to inner transformation.

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Why It's Tough to Talk about Sex

Editor's Note

Overall, putting together the new video course and the magazine issue was an oddly touching experience, because I felt that there was a deep sense of camaraderie, common discovery, and shared vulnerability. I had the sense that whether we felt uncomfortable, exhilarated, or just fascinated by what is, after all, an endlessly fascinating topic, we were all in this project together. And by “this project,” I mean not just our exploration of sex, but the whole human project.

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Using Science to Determine Why Relationships Succeed or Fail

John and Julie Gottman and the 'Four Horsemen' of the Relationship Apocalypse

The couples we see are often in terrible distress. Don’t they deserve the best we can give them? Couples therapy, like any form of psychotherapy, is an art form at its best. But underlying the art, we need methods built on the truth of what couples need to succeed, rather than those based in myths patched together out of stereotypes. So we come to our first principle for doing effective couples therapy: use research-based methods to treat couples. Science is the avenue that can best lead us toward truth. After studying more than 3,000 couples and participating in studies of 3,500 more, here's a summary of everything our couples have taught us.

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Rediscovering the Therapeutic Sanctuary of the Wilderness

How a Wilderness Pilgrimage Helped One Man Reclaim Mindfulness and Connection

Standing in my bedroom one evening more than a dozen years ago, I made an announcement to my wife: "I've got to go to the wilderness. Alone. It's been something I've been carrying in the back of my mind most of my life, and if I don't do it now, while I'm still able, I'll never do it." So a dozen years ago, I began making an annual two- to three-week pilgrimage into the wilderness to reacquaint myself with the rivers, mountains, and lands that we share with fellow creatures, and---in this vast expanse of silence---to do something I don't normally do in my busy life: just stop and listen.

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Confronting Racism as a Social Disease

Deborah Peterson Small on the Need to Hone Our Therapeutic Focus

When you talk about mental health and racism, bear two things in mind. One is the obvious harm that racism causes to the black and brown people who are the objects of racial discriminatory behavior, but the other part---never really talked about---is the harm that comes to white people from living in a racist society and the way in which it distorts their perspectives of themselves. It doesn’t matter so much how people acquired the condition of racism. Instead, the relevant questions are how we contain it and how we prevent it from being passed on to the next generation.

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Healing Early Attachment Injuries by Listening to Our Trauma

Using Sensorimotor Psychotherapy to Speak with Shameful Inner Parts

As therapists, we often encounter clients who are so mired in self-hatred that our best efforts to support a sense of self-worth only seem to dig the hole of judgment and self-loathing deeper. Eventually, I began to wonder if the resulting clinical quagmire might be a reflection of a kind of "internal attachment disorder" mirroring the emotional injuries of early childhood. Was it possible that alienation from self and others had become an essential survival strategy early in life? Using Sensorimotor Psychotherapy, I guide my clients in "befriending" the parts they unconsciously disown.

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Using Therapy Skills to Make Business More Insightful and Humane

A Therapist-Turned-Executive Coach on How to Repair Toxic Work Environments

For most of my life, the world of business seemed off-limits to me. But eventually, I began to think about how I might work with corporations and business leaders to make work settings more humane and bring more balance to the lives of the decision-makers who shaped the work environments in which most people earned their livings. Eventually, I decided to switch my focus from doing individual and family therapy to consulting to business leaders on how to be more self-aware and compassionate. Here's what I found out in the process.

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Confronting Our Reluctance to Have an Honest Conversation About Race

A White New Yorker Shares Some Personal Reflections on American Race Relations

Whenever a public outcry or riot’s been triggered by yet another racially motivated assault on a black man or woman, politicians inevitably utter (and commentators then endlessly and faux-earnestly repeat), “We need to have a national conversation about race.” Even if I had the chance, I doubt I’d even try to engage in a cross-racial conversation about race. I’d be too afraid that I’d trip over my own words and say something provocative, offensive, stupid. And as far as I know, the people I know---white people---are in the same strange and astonishing boat.

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Is "Resistance" in the Therapy Room Really Dead?

Using Resistance as a Chance to Improve Your Therapy Skills

By Clifton Mitchell - With all the recent developments in research, theory, and practice, we have more treatment options to choose from than ever before. Why then do so many practitioners still find client “resistance” a regular companion in their consulting rooms? After many years, I’ve learned that rather than seeing our clients’ frustrating reactions as obstacles that we need to overcome, we can use them as valuable information with which to steer the therapeutic conversation more skillfully.

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The Secret Ingredients for Effective Therapy in Inner-City Communities

Thelma Dye on Inspiring Hope at Harlem's Northside Center

When you do therapy in poor, underserved, inner-city communities, it’s important to be aware of the message your program communicates. For example, we never underestimate how important it is for people in the community to see our the environment at Northside Center for Child Development---a community-based agency in Harlem that’s provided outpatient mental health and educational services to children and families for 70 years---as a place that’s well cared for, inviting, and reflective of their culture. Regardless of training, the most important thing our therapists bring to the table is the strong belief that clients can get better, despite life circumstances.

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The Secret to Helping Agitated Couples Reel in Emotional Arousal

How Oxytocin Stimulates Trust and Connection, and Helps Relationships Heal

When clients are emotionally worked up, caught in fight-flight-freeze mode, all their hard-earned skills in empathic listening and responsible (and responsive) speaking go out the window. Nothing therapeutic is going to happen until they feel calm enough and safe enough to reengage with each other. But by teaching behavior that helps clients' brains release oxytocin, a naturally occurring hormone which stimulates feelings of bonding and trust, and reduces fear and anxiety, we can create potent catalysts of psycho-physiological change.

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Confronting Western Definitions of Sexuality and Intimacy

Michael Ventura on Sexuality and Romance as a Personal Journey into the Self

Today, sexuality still seems to be a territory as private and filled with fear as ever it was. We haven't advanced far in our ability to talk of our own sexuality one with another. Part of what makes sexuality scary is that it's a realm all its own: one in which the rational and the measured are overwhelmed and subsumed. It's where we meet ourselves most directly, without filters, without verbiage, and, if we go far enough, without fixed roles. It's where we meet ourselves with and through the Other, a partner as fluid we are.

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Helping Therapy Clients Cope with the Reality of Death

Clinical Wisdom to Combat Fear, Anxiety, and Grief at the End of Life

For 17 years, managing responses to death has become part of my work, whether originally my intention or not. I’ve aspired to helping families hang tough through medical crisis, but now spend some of my time hanging crepe. I’ve now accepted the variety of ways people react to their dying. All of these ways of facing death are utterly ordinary and human. Throughout it all, I've learned that as difficult and awkward as confronting death can be, this work also gives me a richer sense of my client, the cast of characters in their world, and the drama of their life.

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Challenging the Stereotype of the Paralyzed Trauma Victim

A Review of Jim Rendon's Upside: The New Science of Post-Traumatic Growth

In Jim Rendon’s new book, Upside: The New Science of Post-Traumatic Growth, he challenges an all-too-common stereotype: that most trauma survivors remain forever stuck in place, embittered, broken in core ways. As psychotherapists know, the emotional (and sometimes physical) damage may sometimes be so vast and entrenched that repair comes slowly, if at all. But as therapists also know, this isn’t always the case. Many trauma victims have managed to make life go on---and even thrive.

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Pornography on the Rise: A Growing Mental Health Problem

Wendy Maltz on the Need to Address Porn Addiction as a Public Health Threat

Nearly 40 million Americans visit Internet porn sites at least once a month. Not surprisingly, concerns about the effect of porn on individuals and relationships are also on the rise. Changes in how people access and use pornography have taken the therapeutic community by surprise. Many therapists don't yet comprehend the extent of the problems porn can cause, or how deeply its use can harm individuals and their intimate partners. What's more, pornography is quickly moving from an individual and couples' problem to a public health problem, capable of deeply harming the emotional, sexual, and relationship well-being of millions of men, women, and children.

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A Brain Science Strategy for Overwriting Traumatic Memories

Creating Juxtaposition Experiences to Relieve Trauma Symptoms

What we clinicians have learned in recent years about the intricacies of the brain's implicit memory systems has certainly helped us better recognize the linkage between distressing or traumatic experiences and many of the previously puzzling symptoms clients bring to our offices. But now brain science is beginning ...

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Fine-Tuning Your Therapy Approach for Male Clients

Understanding Shame as a Threat to Perceptions of Manhood

The field of counseling and psychotherapy hasn't done a particularly good job of creating a user-friendly environment for male clients. The problem begins with a lack of awareness about the profound impact of shame. Most men will do whatever it takes to prove their manhood. Furthermore, there's a mismatch between the relational style of many men and the touchy-feely atmosphere of most counseling and psychotherapy. As therapists, we have two choices: shoehorn men into a process that's traditionally been more user-friendly for females, or reshape what we do and how we present it to better reach male clients.

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Educating Therapy Clients Beyond the Consulting Room

Online Clinical Resources to Bolster Psychoeducation

While it may not occur to many therapists, their best clinical ally can be the Internet---particularly for a client who needs more educational and interactive help than you can provide in one weekly, 50-minute session. Psychoeducation is always some part of the therapeutic experience, but even if you've explained the nature of depression or anxiety or obsessive-compulsive disorder to your client, many more questions, doubts, and uncertainties about what it all means will still remain. With your guidance, the Internet can serve as a trustworthy source of information about therapy or the client's particular difficulties.

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Therapy Lessons from Men's Relationship with Sports

Using Athletics to Tap into Male Emotions, Relationships, and Aggression

I understand and relate to the passion that many men have for sports. At the same time, I'm aware of a counternarrative held by many of my psychotherapist colleagues: sports breeds competition, which causes decreased empathy, which foments injustice. Still, there's so much more here: rich drama, with which to understand the strivings, insecurities, and identities of many of our male clients. Sports can teach us about trust, relationships, teamwork, and our power to regulate feelings.

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Black Unlike Me

Some Uncomfortable Reflections on Growing Up White

rtwrtwertAt a time when many are calling for a renewed national conversation about race, an aging, liberal, white New Yorker---who admits he’s never been a party to any such conversation, not with a black person anyway---shares some highly uncomfortable, extremely personal reflections.

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VIDEO: Moving Forward When Treatment Seems to Make a Problem Worse

Chris Germer on shifting the focus from fixing a problem to embracing it with compassion

What someone resists persists. It’s a paradoxical dynamic that you’ve probably seen in the course of your own clinical work. In this video, Chris explains how “fixing” approaches can backfire and then he shares an example from his own life of self-compassion’s ability to soften resistance and heal a deep, persistent issue.

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The View From Black America

Listening to the Untold Stories

Many poor, young, black people see themselves as trapped behind a wall-less prison with no exits. They know all too well that their daily experience---whether it’s going to lousy schools, succumbing to drug use and abuse, or being the victims of crime and lack of employment prospects---doesn’t matter unless it disrupts the lives of the white mainstream.

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