A therapeutic brand for every human nook and cranny is the profession chasing its own tail. Rather than collecting tools for every situation, we should focus on fundamentals that work in most situations. www.psychiatrymargins.com/p/the-age-of...

“We don’t refer to people based on their theoretical allegiances. We refer to people based on our sense of their character.” - Lee Grossman (2023) We are all more human than otherwise and, in the consulting room, we are probably more ourselves than otherwise.

I have referred to the importance of economy in making interpretations…Most things that we think of to say, even quite complicated things, can be pruned. - Nina Coltart

It is always important that we leave room for a patient to do something with an interpretation beyond just agreeing with it or disagreeing. - Patrick Casement

Insights occur when a person feels safe to have them. - Alan Rappoport (1997)

Defenses, even when they have painful consequences, are comfortable in the sense that they lower anxiety. Forgoing the defenses raises anxiety, so there is discomfort inherent in therapeutic progress. - Nat Kuhn

The supply of interpretations far exceeds the demand. - Harry Stack Sullivan

It is much easier to talk about psychotherapy than it is to do it. www.psychiatrymargins.com/p/from-here-...

Salman Akhtar’s definition of humility:

In the collegial sphere, the majority of eye-rolling events can be traced back to the nearest better-knower. This is the person who travels with a portable lectern so that they can speechify on-the-go. www.psychiatrymargins.com/p/from-here-...

Humility is often mentioned as 𝘢𝘯 important quality in a therapist, but given its impact on the other virtues, it might be 𝘵𝘩𝘦 most important quality in a therapist.

There is a difference between sharing knowledge and being a know-it-all; the first is a bid for connection, the second is a barrier to it.

Psychotherapy is an ongoing education in humility. -Nancy McWilliams

I knew I had been reading too much psychoanalytic literature when I said the clocks regressed by one hour.

Truly humble people, I suspect, never describe themselves as such; rather, they worry about their own pride, arrogance, and hubris. - Donna Orange

I was super excited to get a “Firefighters 2026 Calendar” but it turned out to be an IFS thing.

The seven primary emotional systems: SEEKING, RAGE, FEAR, LUST, CARE, GRIEF, PLAY - Jaak Panksepp

If only this were a cardigan, he could be “Therapist Batman”

This conversation captures what psychoanalytic thought has to offer, which is an understanding beyond the seemingly rational. youtu.be/a4b6XBVG034

Psychoanalysis is the disciplined study of whatever it is the patient does not want to know about himself. - Warren Poland

🧵 1/2 The envious person, instead of being aware of his envy, tries, usually unconsciously, to stir it up in other people, making others aware of his particular qualities and capacities…Of course, it creates further problems…

How people think psychotherapists look vs. how they actually look

The crucial element for becoming competent at any complicated endeavor is to experience feedback as desirable - feedback from supervisors, clients, colleagues, students, from reality. A pitch you cannot hit is itself a master teacher, not a humiliation. - Michael Karson

Accessible writing opens the door. It extends the reach of psychoanalytic theory to non-analytic clinicians. From there, people can seek out what fits with their interests and taste. Now kick back and relax with a copy of Bion’s “The Grid and Caesura”

There is always in our work a dimension that is beyond words…In all of us there are some things which will never be within our reach; there is always a mystery at the heart of every person, and therefore in our job as analysts. - Nina Coltart

“We tend to underestimate the power of the unspoken affect organizing our viewpoint…Our dreams reveal to us our demands and terrors, as do our sudden rages, longings, reveries, bursts of laughter, or quietly unsettling angst; a key analytic idea starting with Freud.” - Darren Haber

Man can no more survive psychologically in a psychological milieu that does not respond empathically to him, than he can survive physically in an atmosphere that contains no oxygen. - Heinz Kohut

The desire to excel must be differentiated from the desire to be perfect. - Glen Gabbard

A paper about making psychodynamic theory accessible is now accessible - free until October 24th guilfordjournals.com/doi/10.1521/...

Identity is important not because we are always the same - if we were, we would scarcely think about our identities…It is precisely because we can be so different in different contexts that we need to ask ourselves “who am I?” - Paul Wachtel

MARTIN SHORT: Who’s sexier, me or Steve Martin? DIANE KEATON: I mean, you’re both idiots.

On being realistic about session frequency: “If my analyst asked me how often do you want to come, I would have said once a year. If you can promise to change my life if I come once a year, why come more often?” - Sheldon Bach

An encomium for the late Jonathan Lear, and thoughts on his books and those of others, including Laplanche on Freud and sex, Bion on psychosis, and Todd McGowan on Hegel and alienation--and many others! booksinpsychotherapy.blogspot.com/2025/10/an-e...

For therapy to be therapeutic, it is more important for the clinician to understand people than to master specific treatment techniques…Unless one understands someone’s unique, personal subjectivity, one cannot infer the best treatment approach for that individual. - Nancy McWilliams

The impact of AI on psychotherapy is no joke. The practice next door is now a “Spirit Halloween”

I don’t know why psychoanalysts get blamed for talking about penis envy when Taylor Swift is clearly the person responsible.

Reflection is under siege. We have devices in our pocket that allow top of mind thoughts to be broadcast in an instant. Since “hot takes” tend to be popular, impulsivity gets rewarded, making reflection even less likely. Thinking gets replaced by checking notifications.

Trying to unearth the meaning of a psychoanalytic paper

🧵 1/2 Managed care and short-term behaviorally based treatments have privileged symptom reduction and undervalued in-depth approaches, sometimes resulting in clinical impasses…

After some time most beginners become more comfortable as their self expands to fit their new role…The high art of psychotherapy requires that one be true to oneself (i.e. to one’s selves) while at the same time putting oneself at the disposal of another. - H. Schlesinger

No two people truly speak the same language. Rather, they have enough denotation and connotation to succeed, on the whole surprisingly well, in sharing ideas. Well, but only “on the whole.” - Warren Poland

Keep an eye on the anxiety thermometer; too little makes for pleasant conversation but not much therapy, too much creates excessive discomfort for the patient. - Summers, Barber, & Zilcha-Mano (2024)

Psychology word of the day: De-escalation.

“What different fears have in common is the experience of anxiety generated by the feeling of being cut off from, and not having immediate and direct access to, home or a safe base.” - Morris Eagle

If psychoanalytic communication is not useful to a reasonable number of practitioners, it becomes not only exclusive but also exclusionary by definition. guilfordjournals.com/doi/10.1521/...

The theoretical and clinical potency of psychoanalysis is out of sync with its flaccid public profile. We live in an era when depth therapy is under attack. Brilliance may not be enough; psychoanalysis needs to be heard and understood.