1/ A sure sign of bad therapy is that the client or patient leaves therapy sessions feeling better—but continues living their life the same way, repeating the same self-defeating patterns and getting the same unhappy outcomes Real psychotherapy is not meant to be a feel-good

"Recovery [from trauma] can take place only within the context of relationships; it cannot occur in isolation. In renewed connections with other people, the survivor recreates the psychological faculties damaged or deformed by the traumatic experience." -Judith Herman

“We don't do therapy for the sake of doing therapy. Meaningful therapy has a purpose. It's supposed to lead somewhere.” 👇

1/ I’ve never had a “noncompliant” therapy patient. I don't even find the word helpful. It implies therapist brings an agenda for patient to follow, but that’s not how good therapy works. Good therapy means a “working alliance”—a shared understanding & agreement about the purpose

1/ Ten “vital signs” of psychotherapy progress* 🧵 1️⃣Greater attachment security / sense of safety in relationships 2️⃣More integrated & coherent experience of self & others 3️⃣Increased sense of personal agency 4️⃣More realistically-grounded & reliable self-esteem (video at end)

Thanks to @TEDTalks for giving me a chance to discuss the current state of debate around The Anxious Generation, and some new ways of thinking about the vast opportunity cost of phone-based life ted.com/talks/jonathan…

1/ “One undesirable side effect of the mental [health] movement has been the development among educated persons... of what I call the ‘spun-glass theory of the mind.’ This is the doctrine that the human organism… is constituted of such frail material, is of such exquisite

Training in psychotherapy begins in earnest when it finally sinks in that giving advice doesn't help And it sinks in that common-sense solutions haven’t helped and won’t help now Meaningful psychotherapy is not an extension of common sense. It is something else entirely.

It's shocking how widely accepted Maslow's Hierarchy of Needs is in both the psych field & public consciousness… 70 years after its inception… Given the little empirical support it actually has. Here's what his then student Elliot Aronson had to say about his theory:🧵

Psychopathology, in the final analysis, may be best described as existing on a curvilinear continuum from too little to be generative to too much to be stable. Just the right amount of cray-anxiety, dependency, detachment, openness, etc - is the way. This is actually well…

If there were no theory behind it, the psychotherapy session would be a very strange meeting. - Lawrence Friedman ➕ Most patients do not give a damn about theory. The simply want to get over their suffering. - Glen Gabbard 🟰 Theory anchors therapists but can drown the patient.

Maybe the fate of humanity doesn’t hang on your every word after all. Maybe you are not, in fact, spearheading the revolution. Maybe you’re just not that important in the scheme of things. Maybe you could just live your life & let others live theirs & try to be a little kinder 🤷🏻‍♂️

Efficiency > effectiveness (more accurately, the illusion of efficiency)

1/ I made a list a while ago, about therapy🚩 that should make you think long & hard about whether you’re seeing right therapist Starting another, please add -agrees with nearly everything you say -diagnoses people in your life -gives you advice -mawkish displays of “empathy"

This is the actual meaning of “neutrality” (maybe not quite what they told you… ?) 👇

Many are deaf, dumb & blind to the hate & cruelty that resides within them Instead, they project it onto another person or group & vilify them Once they've created their villain via projection, they can then unleash their hate & cruelty on them… *in the guise of virtue* 🧵

I'm sorry, I know I need to move on, but I went down a rabbit hole and, well, I guess I didn't appreciate that there are whole communities on this platform that are literally just thousands of individuals sharing anecdotal experiences with each other and calling that "research."

“We are seduced by the lingo of brain science. It sounds like have learned something new when speaking about what ‘the brain’ wants and how it works, but quite often we’re just substituting for the word ‘person’ the term ‘the brain’ or ‘the nervous system’” —O Stahl

1/ We are the “authors” of all our thoughts & actions. We claim ownership of some of our thoughts and actions and disclaim ownership of others When we claim ownership, we tend to use the word “I.” I did this. I said that When we disclaim ownership, we tend to use the word “it”

“It seems to me that the overarching theme among psychodynamic approaches to helping people is that the more honest we are with ourselves, the better our chances for living a satisfying and useful life.” - McWilliams, N. (2004). Psychoanalytic Psychotherapy.