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.

“Don’t call it a comeback, I’ve been here for years” - Psychoanalysis

The unconscious, the effect of early childhood on later experiences, internal conflict as a normal state of affairs, the complexities of attachment, phases of development, and the ubiquity of anxiety are ideas we practically find in our drinking water. - Summers, Barber, & Zilcha-Mano (2024)

1/2 “Not all long analyses imply stalemates. Some analyses are born long, some achieve longness, and some have longness thrust upon them. We can learn from every case, but no case can set the law explaining all others.” - Warren Poland

I suspect that both our way of listening and our preference for theories are primarily consequences of our way of seeing ourselves. It may be true that theory shapes technique, but, to a far greater extent, character shapes theoretical preference. - Lee Grossman

🧵 1/4 The use of jargon when presenting psychoanalytic theory is a complex issue. All disciplines have jargon that people need to reckon with. However, the excessive use of jargon tends to draw a sharp line between “insiders” and “outsiders.” I think part of the solution is knowing your audience.

“The ability to say no to yourself, to be the authority to yourself and to say: ‘Look, this is wrong, I’m not going to go there.’…This is a bit of a lost art…To set limits on oneself.” - Donald Carveth ipaoffthecouch.org/2023/09/03/e...

🧵 1/3 Some of my favorite quotes speak to the paradoxes inherent in psychotherapy: If the analyst cannot be experienced as a new object, analysis never gets under way; if he cannot be experienced as an old one, it never ends. - Jay Greenberg

Attachments are necessary for a fulfilling life. “Dependence” is not a dirty word but a complex word.

A psychodynamic clinician at the latest acronym training

🧵 1/3 “Patients usually come to therapy in significant distress. What they want in that state, by and large, is a solution to the suffering they are experiencing…And this solution, they often imagine, is advice about what to do. But again, real change needs to come from the patient…”

The demand to “know” and intervene quickly interferes with receptive listening and observation. Without that, in-depth understanding and case formulation moves further out of reach. The irony is that trying to “know” quickly may prevent us from ever knowing at all.

These days, early-career therapists almost have to de-educate themselves of the need to be busy and productive in the room employing techniques, just to settle in, be present, draw clients out and identify enough with their life problems and dilemmas. - Enrico Gnaulati

The most dedicated department on any university campus is Parking Enforcement.

One of my patients came back to see me several years after she had terminated…I asked her what she had found most helpful, and she replied, “Each day when I came to your office, you were there.” She evidently failed to recall any of my carefully formulated interpretations. - Glen Gabbard

I wonder if the psychodynamic people and the menswear guy need to team up for “The Interpretation of Seams”

When I was new to psychoanalytic ideas, I appreciated the writings of Glen Gabbard, Nancy McWilliams, and Jonathan Shedler. The psychoanalytic community has to work all the more to be welcoming because: a) The theory can be quite daunting; b) Psychoanalysis has a bad reputation for arrogance

1/2 🧵 “Of all the elements of therapy, the frame is among the most caricatured, from cartoons to movie spoofs. This may be because the therapeutic relationship 𝑖𝑠 different from regular social relationships - and for good reason…”

1/2 🧵 “Humility is not self-deprecation…Humility is knowing you are smart, but not all-knowing. It is accepting that you have personal power, but are not omnipotent…The opposite of humility is arrogance - the belief that we are wiser or better than others…”

A rapid improvement is not necessarily a lasting improvement. - Strupp & Binder

The papers I vowed to read over the summer.

“I am reminded of a video of Bion at Tavistock. He’s with a group of professionals who are concerned about a boy they’re assessing. They tell Bion that, although intelligent, the boy does not know that 2+2=4. Bion responds by asking what the boy does think 2+2 equals. No one had asked the boy this.”

🧵 1/2 “Healthy narcissism: how is that different from a mode of relating characterized by a relative lack of concern for others and a use of them to enhance one’s self esteem? I don’t have an official definition, but for me healthy narcissism is having a sense of self…”

Watching drive-by supervision on social media

I have long believed that I should start each session on time, 𝑤𝑖𝑡ℎ 𝑜𝑟 𝑤𝑖𝑡ℎ𝑜𝑢𝑡 𝑡ℎ𝑒 𝑝𝑎𝑡𝑖𝑒𝑛𝑡, thus spending the first part of the session, at least, wondering what the lateness or absence might mean. - Patrick Casement

“What matters is not what the therapist says but what the patient carries away from the interaction with the therapist. A significant part of what the patient internalizes is the function of the therapist’s verbal messages - usually not the effect of a single one but their cumulative value…”

It doesn’t take very long in practice before we discover that ways of seeing and being do not yield easily to disputation or logic. - Teri Quatman

There’s a saying that age and wisdom often come together. Sometimes age shows up all by itself. - Louis Cozolino

Psychotherapy is the name we give efforts to study and improve one’s experience and view of things - one’s subjectivity - with the help of another’s subjectivity. - Leston Havens, 𝐴 𝑆𝑎𝑓𝑒 𝑃𝑙𝑎𝑐𝑒

To a large extent the self is shaped by interaction with others. Indeed, the baby find a self by looking in the eyes of the mother…We are now tethered to our devices and may be losing the art of human interaction. We are now facing an era of connectivity and its discontents. -Glen Gabbard

“Much has been written about “sycophancy” as a risk factor—that is, the way that LLMs are designed to flatter users and keep them connected.” @psychunseen.bsky.social www.psychologytoday.com/us/blog/psyc...

1/2 “Sometimes the people around us, our family and our friends and even our enemies, guess things about our personality of which we are entirely unaware. If we listen to the opinions of those about us, we shall not hear the whole truth, but we shall hear some of it…”

Understanding must be demonstrated, not claimed; indeed, it is best felt. - Leston Havens

I just took a peek at The Other Place™️ and apparently Nancy McWilliams has fallen out of favor?! It’s like watching the GM trade your star player.

An important aspect of the clinical role, as every supervisee unhappily learns, is how to impart unwelcome information. - Nancy McWilliams

Even under the best of circumstances, the practice of psychotherapy is accompanied by a good deal of uncertainty…Unfortunately, some psychotherapy instructors think it will impress their students if they act like they know exactly how to deal with every clinical situation that arises. - Glen Gabbard

I heard someone say that it’s unnecessary to have more than 7 sessions. I heard another person say that it’s 40 sessions just to get started. I find myself disagreeing with both of them. I think all we can say confidently is that we don’t know how many sessions it will take. No one size fits all.

“Most training programs tell you "it’s the relationship" and then they leave you alone. They don’t really say much more about it, so you’re left to figure it out for yourself... [Students] don’t get trained in it. They don’t get trained in being able to listen.” - Lou Cozolino

The placement of linguistic barriers in front of psychoanalytic ideas is akin to placing a velvet rope outside of a condemned building. Modern day clinicians long for a more in-depth understanding of the clinical landscape. Don’t give them a maze when they are eager for a map.

Contemporary psychoanalysis can be summed up in a single sentence: We treat ourselves as we were treated, and the only way to really learn to treat ourselves differently is to be treated differently. There’s nothing magical or unscientific about this. - Michael Karson

Patient: I’m terrified of the Backstreet Boys Therapist: Tell me why

Freudian, Kleinian, Bionian, Lacanian… How about clinic𝑖𝑎𝑛?

There is nothing wrong with being a Freudian, a relationalist, an interpersonalist, a self psychologist, or whatever, as long as one does not succumb to the delusion that their school has a monopoly on truth and there is nothing to be learned from other approaches. - Arnold Richards

Harry Stack Sullivan is purported to have said, “God keep me from a clever psychoanalyst!” Truly, humility is the beginning of wisdom. - Edgar Levenson