Best 126 quotes in «psychotherapy quotes» category

Because DID requires the presence of amnesia, DID patients are, by DSM-5 definition (American Psychiatric Association, 2013), unaware of some of their behavior in different states. Progress in treatment includes helping patients become more aware of, and in better control of, their behavior across all states. To those who have not had training in treating DID, this increased awareness may make it seem as if patients are creating new self-states, and “getting worse,” when in fact they are becoming aware of aspects of themselves for which they previously had limited or no awareness or control. Although some DID patients create new self-states in adulthood, clinicians strongly advise patients against so doing (Fine, 1989; ISSTD, 2011; Kluft, 1989).

Being Scared-off by Evil Lastly, we deny the presence of evil because we are terrified by the horrendously hurtful, cruel, and bloody kinds of evil people tell us about—if we are willing to listen. This was poignantly brought home during an interdisciplinary case conference involving a resident who was counseling for the first time a woman who had been sexually abused. As we worked with him, it became clear that he was resisting entering what he called the 'psychic cave" of her sealed—off experience from which she was shouting for assistance. Because of his resistance, he was not providing her the support and guidance she so desperately needed, and he was not facilitating her working through the abuse and hurt that were continuing to impact her life. As he was confronted about this at one point in the conference, he stated tearfully: "I'm afraid if I help her move into her memories. I will have to go with her, and if I go with her, my view of the world as a basically good and safe place will be shattered. I'm not sure I can handle that for myself, or be able to think about the fact that my wife and kids may be more vulnerable living in this world than I can be comfortable believing" (Means 1995, 299).

Besides stage magic props and settings, ritually abusing groups use technology, such as that described by Katz and Fotheringham. Military/political groups have the most sophisticated technologies, and much training or programming is now done with virtual reality equipment. Movies and holograms are used to deceive a child into believing in things that are unreal. When a client says to you “I don't know if it's real; how can it be real?” remember that there are several options, not just two: (1) It happened just as s/he remembers; (2) it did not happen at all; (3) something happened, but due to technology and/or trickery it was not what s/he thinks it was; (4) the thought that the memory must be unreal is itself a program, as described in Chapter Twelve, “Maybe I made it up." p55

Bowlby's conviction that attachment needs continue throughout life and are not outgrown has important implications for psychotherapy. It means that the therapist inevitably becomes an important attachment figure for the patient, and that this is not necessarily best seen as a 'regression' to infantile dependence (the developmental 'train' going into reverse), but rather the activation of attachment needs that have been previously suppressed. Heinz Kohut (1977) has based his 'self psychology' on a similar perspective. He describes 'selfobject needs' that continue from infancy throughout life and comprise an individual's need for empathic responsiveness from parents, friends, lovers, spouses (and therapists). This responsiveness brings a sense of aliveness and meaning, security and self-esteem to a person's existence. Its lack leads to narcissistic disturbances of personality characterised by the desperate search for selfobjects - for example, idealisation of the therapist or the development of an erotic transference. When, as they inevitably will, these prove inadequate (as did the original environment), the person responds with 'narcissistic rage' and disappointment, which, in the absence of an adequate 'selfobject' cannot be dealt with in a productive way.

Can a therapist make me not want to get pregnant? Can a therapist undo the trouble with my eggs, my hormones, and whatever else isn't working? I can't help it, but it feels like an insult for the doctor to send me there. Like telling people with cancer they can think themselves healthy if they try hard enough to visualize their immune cells as little sharks gobbling up the tumor. It's just blaming the victim.

Every client presents a practitioner with a novel and unique problem to solve. A therapist has to be a general problem-solver, and part of this expertise is grounded in an experimental style of reasoning originally developed for scientific purposes.

Dissociation is the ultimate form of human response to chronic developmental stress, because patients with dissociative disorders report the highest frequency of childhood abuse and/or neglect among all psychiatric disorders. The cardinal feature of dissociation is a disruption in one or more mental functions. Dissociative amnesia, depersonalization, derealization, identity confusion, and identity alterations are core phenomena of dissociative psychopathology which constitute a single dimension characterized by a spectrum of severity. Clinical Psychopharmacology and Neuroscience 2014 Dec; 12(3): 171-179 The Many Faces of Dissociation: Opportunities for Innovative Research in Psychiatry

Everything in the cosmos now proves to be relative. Nothing is autonomous in itself. All things in the world betray their interdependence with each other. Metaphysics ceases to be an abstract system of thought and becomes an experiential reality. Not beings in the world but the world itself comes to be questioned.

Expunction of pain, deviant, or oppositional behaviors does not indicate healing, but it can signify successful conditioning.

Feelings are not to be suppressed or fixed — they’re to be acknowledged.

Dissociative Disorders have a high rate of responsiveness to therapy and that with proper treatment, their prognosis is quite good.

First, the physiological symptoms of post-traumatic stress disorder have been brought within manageable limits. Second, the person is able to bear the feelings associated with traumatic memories. Third, the person has authority over her memories; she can elect both to remember the trauma and to put memory aside. Fourth, the memory of the traumatic event is a coherent narrative, linked with feeling. Fifth, the person's damaged self-esteem has been restored. Sixth, the person's important relationships have been reestablished. Seventh and finally, the person has reconstructed a coherent system of meaning and belief that encompasses the story of trauma.

For example, in order to identify these schemas or clarify faulty relational expectations, therapists working from an object relations, attachment, or cognitive behavioral framework often ask themselves (and their clients) questions like these: 1. What does the client tend to want from me or others? (For example, clients who repeatedly were ignored, dismissed, or even rejected might wish to be responded to emotionally, reached out to when they have a problem, or to be taken seriously when they express a concern.) 2. What does the client usually expect from others? (Different clients might expect others to diminish or compete with them, to take advantage and try to exploit them, or to admire and idealize them as special.) 3. What is the client’s experience of self in relationship to others? (For example, they might think of themselves as being unimportant or unwanted, burdensome to others, or responsible for handling everything.) 4. What are the emotional reactions that keep recurring? (In relationships, the client may repeatedly find himself feeling insecure or worried, self-conscious or ashamed, or—for those who have enjoyed better developmental experiences—perhaps confident and appreciated.) 5. As a result of these core beliefs, what are the client’s interpersonal strategies for coping with his relational problems? (Common strategies include seeking approval or trying to please others, complying and going along with what others want them to do, emotionally disengaging or physically withdrawing from others, or trying to dominate others through intimidation or control others via criticism and disapproval.) 6. Finally, what kind of reactions do these interpersonal styles tend to elicit from the therapist and others? (For example, when interacting together, others often may feel boredom, disinterest, or irritation; a press to rescue or take care of them in some way; or a helpless feeling that no matter how hard we try, whatever we do to help disappoints them and fails to meet their need.)

For people who are depressed, and especially for those who do not receive enough benefit from medication of for whom the side effects of antidepressants are troubling, the fact that placebos can duplicate much of the effects of antidepressants should be taken as good news. It means that there are other ways of alleviating depression. As we have seen, treatments like psychotherapy and physical exercise are at least as effective as antidepressant drugs and more effective than placebos. In particular, CBT has been shown to lower the risk of relapsing into depression for years after treatment has ended, making it particularly cost effective.

from the foreword by Dan Bloom: It[this book] is a call for us gestalt therapists to welcome our patients as fellow beings-in the embodied life-word where we meet in a "primordial contact," that is, in an "embodied perception" that makes knowing one anotehr, contact one another, possible. Kennedy inevitably takes this a step further. [it is in the trust of this meeting that the healing happens. It is this dialogic contact in their shared world, an embodied meeting, that heals not only the client but the therapist also.

Fui acusado de ser um utópico, de querer eliminar o desprazer do mundo e defender apenas o prazer. Contudo, tenho declarado claramente que a educação tradicional torna as pessoas incapazes para o prazer encouraçando-as contra o desprazer. Prazer e alegria de viver são inconcebíveis sem luta, experiências dolorosas e embates desagradáveis consigo mesmo. A saúde psíquica não se caracteriza pela teoria do nirvana dos iogues e dos budistas, nem pela hedonismo dos epicuristas, nem pela renúncia monástica; caracteriza-se, isso sim, pela alternância entre a luta desprazerosa e a felicidade, o erro e a verdade, o desvio e a correção da rota, a raiva racional e o amor racional; em suma, estar plenamente vivo em todas as situações da vida. A capacidade de suportar o desprazer e a dor sem se tornar amargurado e sem se refugiar na rigidez, anda de mãos dadas com a capacidade de aceitar a felicidade e dar amor.

Howard: Sometimes a betrayal can be so subtle that it clouds the whole thing. Nita: It would have to be a real betrayal. Not like canceling an appointment. It would be like you’d end the relationship in the middle. Howard: Why would I call it off? Nita: I don’t know!

However, if you do not believe your clients, they may sense your doubt and never fully trust you. As Bruce Goderez (1986), director of a PTSD inpatient unit says, "It is important for the clinician and counselor to be willing to be made a fool." In other words, it is better that you believe a client who is lying or distorting the truth than to disbelieve a hurting trauma survivor who may never seek help again if your attitude is one of disbelief or disdain. Even if that client were to continue in therapy, they would never fully trust you.

Human emotions have deep evolutionary roots, a fact that may explain their complexity and provide tools for clinical practice. The Nature of Emotions (2001)

I am willing for the participant to commit or not commit himself to the group. If a person wishes to remain psychologically on the sidelines, he has my implicit permission to do so. The group itself may or may not be willing for him to remain in this stance but personally I am willing. One skeptical college administrator said that the main things he had learned was that he could withdraw from personal participation, be comfortable about it, and realize that he would not be coerced. To me, this seemed a valuable learning and one that would make it much more possible for him actually to participate at the next opportunity. Recent reports on his behavior, a full year later, suggest that he gained and changed from his seeming nonparticipation.

„ I do not ask or demand for anything to be different to the way it is, and yet I know I have to play my part in making things as best I can. I learn to work in line with what is right and I try to let the world shine for all it is worth in order to be part of its light while I am alive. I know that becoming what I am will sometimes be glorious and sometimes odious and I have peace with it all, no matter what. Losing my father makes me more aware of being a child of life rather than a child of my parents. He is slightly ahead of me in the inexorable coming and going of life, but I now recognize the path and can see its end lit up in the distance. The paradox is always there: in life we are in death. It is not for us to meddle with. I cannot demand a rearrangement. And as I let myself face death, I rediscover life. [...] My leap of faith is to trust that life will give me the exact experiences that are most apt for learning to live. And sometimes such experiences will be difficult. At times they may even seem catastrophic. But in transcending them and learning from them we make them into moments of truth.

Maybe I needed that somebody else could cry over my pain, to become able to cry over it myself. Nobody ever cried or was moved when I suffered as a child. (Lisa)

I must assume that knowing is better than not know, venturing better than not venturing; and that magic and illusion, however rich, however alluring, ultimately weaken the human spirit. I take with deep seriousness Thomas Hardy's words, 'If a way to the Better there be, it exacts a full look at the Worst.

In bottom-up approaches [to processing trauma], the body's sensation and movement are the entry points and changes in sensorimotor experience are used to support self-regulation, memory processing, and success in daily life. Meaning and understanding emerge from new experiences rather than the other way around. Through bottom-up interventions, a shift in the somatic sense of self in turn affects the linguistic sense of self.

Indeed, analyst Robert Bak calls orgasm "the perfect promise between love and death," the means by which we repatriate separation of mother and child through the momentary extinction of the self. It is true that few of us consciously climb into a lover's bed in the hope of finding our mommy between the sheets. But the sexual loss of our separateness (which may scare people so badly they cannot have orgasm) brings us pleasure, in part, because it unconsciously repeats our first connection.

In one sense, all causes of a problem are 'current', although many of them represent the residue of earlier learning or unprocessed memories.

In our normal, everyday forms of consciousness, we suffer form what [William] James calls a 'lifelong habit of inferiority to our full self.' Insofar as the self that encases the seed of a wider consciousness like a husk is seen as 'conventionally healthy,' cracking it open to uncover the higher part leaves the individual exposed to neurosis; but then, as James reminds us and as Jung himself knew, this may well be the chief condition for receptivity to these higher realms.

In simple, the past is a time gone by and no longer exists in the present moment, but we choose to allow this past to occupy our minds, our bodies and our very existence.

In such a self-centered society, many people have gone to the extreme of narcissism—being solely concerned about their own personal well-being and agendas while excluding and exploiting others. Narcissism is not only epidemic but is also a pandemic of our times that has been normalized and accepted. Self-serving, narcissistic people are incapable and unwilling to love due to a lack of authentic self and love for one’s self and others.” — Sepideh Irvani, PsyD

It is so much more threatening to have something out of hand than to believe that at any moment I can stop (I started to say "This foolishness") any time I need to. When I wrote the previous letter, I had made up my mind I would show you how I could be very composed and cool and not need to ask you to listen to me nor to explain anything to me nor need any help. By telling you that all this about the multiple personalities was not really true but just put on, I could show, or so I thought, that I did not need you. Well, it would have been easier if it were put on. But the only ruse of which I'm guilty is to have pretended for so long before coming to you that nothing was wrong. Pretending that the personalities did not exist has now caused me to lose about two days. Three weeks later Sybil reaffirmed her belief in the existence of her other selves in a letter to Miss Updyke, the school nurse of undergraduate days.

It's not ideas, nor vision, nor tools that truly matter in therapy. If you debrief patients at the end of therapy about the process, what do they remember? Never the ideas—it's always the relationship.

It wasn't a sign of weakness to tell what happened to me. I feel guilt no longer, only regret. The other emotions are coming around too. How much further do I need to go? I'm not sure, but there is comfort in the fact that I am in the hands of expert guides, both in the doctor's office and at home with Sue.

I wanted to go to a few therapy sessions and be back to normal. As I saw it, the panic attacks were the problem. What I really wanted was to stop having them. I genuinely thought I could do that. I didn't want to think about the past.

I wish I had a magic wand to make things better, but therapy doesn't work that way.

Nita: I think I overdid the vulnerability stuff in this last letter. and that’s why I’m having an anxiety attack. Howard: With the vulnerability comes the possibility that you’ll be betrayed. Now that you’ve laid yourself wide open, I am the agent of this betrayal? It’s not my style. Nita: I’ve thought it wasn't other people’s style, too.

One of my teachers at the psychoanalytic institute where I trained used to say, only half humorously, that 'the most important prerequisite for a vocation as a psychotherapist is a depressed mother'; based on my history, I think that a suffering but inaccessible father and a damaged sibling should be added to the list of qualifications.

One of the most frightening aspects of this alleged technology is the possibility of mind control by “remote control,” that is, through such technology as microwaves and radio waves. There are many stories about this, coming primarily from survivors, although we do know from a variety of reliable websites and mainstream news that such technology is being developed, or at least the technological groundwork laid. Once again, however, we do not know whether this was in place when today's survivors were programmed. It is difficult at this point to determine how much of this is genuine, and how much comes from false beliefs deliberately induced to make survivors feel powerless, much like the “one huge and invincible cult” of whose existence survivors convinced therapists twenty years ago. I know that one of my mind control survivor clients was convinced of technological monitoring during a psychotic period several years ago, but as he healed he discarded such beliefs, along with many other bizarre ones in favor of recognizing that he had been abused by real human beings whose identity he knew. If some of this remote control it is genuine, we may need to develop technological means to combat it. However, we should not be intimidated. Even if “voices” are induced in the head by remote control rather than through alters doing jobs, survivors can learn to disobey such voices just as they do those of alters. Competent and compassionate therapy for the dissociation can help survivors to heal. Meanwhile, there are numerous survivors whose mind control is of the kind that can be treated through psychotherapy. p205-206

Perfectionists are not all negative, miserable, unhappy and over controlling individuals

Perfectionism is adaptive if you are mindful of your humanhood.

Psychotherapy isn't a twentieth-century artifice imposed on nature, but the reinstatement of a natural healing process.

Psychotherapy works for the treatment of depression, and the benefits are substantial. In head-to-head comparisons, in which the short-term effects of psychotherapy and antidepressants are pitted against each other, psychotherapy works as well as medication. This is true regardless of how depressed the person is to begin with. Psychotherapy looks even better when its long-term effectiveness is assessed. Formerly depressed patients are far more likely to relapse and become depressed again after treatment with antidepressants than they are after psychotherapy. As a result, psychotherapy is significantly more effective than medication when measured some time after treatment has ended, and the more time that has passed since the end of treatment, the larger the difference between drugs and psychotherapy.

Psychoanalysis has suffered the accusation of being “unscientific” from its very beginnings (Schwartz, 1999). In recent years, the Berkeley literary critic Frederick Crews has renewed the assault on the talking cure in verbose, unreadable articles in the New York Review of Books (Crews, 1990), inevitably concluding, because nothing else really persuades, that psychoanalysis fails because it is unscientific. The chorus was joined by philosopher of science, Adolf Grunbaum (1985), who played both ends against the middle: to the philosophers he professed specialist knowledge of psychoanalysis; to the psychoanalysts he professed specialist knowledge of science, particularly physics. Neither was true (Schwartz, 1995a,b, 1996a,b, 2000). The problem that mental health clinicians always face is that we deal with human subjectivity in a culture that is deeply invested in denying the importance of human subjectivity. Freud’s great invention of the analytic hour allows us to explore, with our clients, their inner worlds. Can such a subjective instrument be trusted? Not by very many. It is so dangerously close to women’s intuition. Socalled objectivity is the name of the game in our culture. Nevertheless, 100 years of clinical practice have shown psychoanalysis and psychotherapy not only to be effective, but to yield real understandings of the dynamics of human relationships, particularly the reality of transference–countertransference re-enactments now reformulated by our neuroscientists as right brain to right brain communication (Schore, 1999).

Psychotherapy is the cornerstone of a multidisciplinary treatment plan for dissociative disorders and other trauma-related disorders and must be incorporated into the interventional strategy; whether the mode of psychotherapy is supportive or psychodynamic in nature, or some combination of various approaches, the treatment must be based on the quality and acuity of the patient’s symptoms.

Punishment symptoms Many of the other types of programming produce psychiatric symptoms, usually administered as punishments by insiders who are trained to administer them, if the survivor has breached security or disobeyed the abusers' instructions in other ways. These symptoms serve a variety of purposes, such as disrupting therapy, getting the survivor into hospital, or getting the survivor to return to the perpetrators to have the programming reinforced. p126

Respect your needs and limitations as you work through your grief and begin to heal

Rikki looked over at me. “Why now?" she asked, looking back at Arly. “Why is this happening now?" "Hard to say." Arly [therapist] replied. "DID usually gets diagnosed in adulthood. Something happens that triggers the alters to come out. When Cam's father died and he came in to help his brother run the family business he was in close contact with his mother again. Maybe it was seeing Kyle around the same age when some of the abuse happened. Cam was sick for a long time and finally got better. Maybe he wasn't strong enough until now to handle this. It's probably a combination of things. But it sure looks like some of the abuse Cam experienced involved his mother. And sexual abuse by the mother is considered to he one of the most traumatic forms of abuse. In some ways it's the ultimate betrayal.

¿Sabe lo que es saber que, cuando muera, pueden pasar días o semanas sin que se descubra mi cuerpo, antes de que el olor fétido atraiga a algún extraño? Intento consolarme. A veces, cuando me siento más solo, hablo conmigo mismo.No demasiado alto, porque temo mi propio eco vacío.

Scientism proposes that scientific investigation is nothing more than the accumulation of ‘facts’. The question thus arises: what actually are ‘facts’? They are not simply existing there, waiting for scientific investigation. Only a little phenomenological reflection reveals that they show themselves as facts because of the construction of, or at least the correlation with, what is usually called mind. Mind thus is a fundamental fact. It is psychology that reveals this truth.

Secondary structural dissociation involves one ANP and more than one EP. Examples of secondary structural dissociation are complex PTSD, complex forms of acute stress disorder, complex dissociative amnesia, complex somatoform disorders, some forms of trauma-relayed personality disorders, such as borderline personality disorder, and dissociative disorder not otherwise specified (DDNOS).. Secondary structural dissociation is characterized by divideness of two or more defensive subsystems. For example, there may be different EPs that are devoted to flight, fight or freeze, total submission, and so on. (Van der Hart et al., 2004). Gail, a patient of mine, does not have a personality disorder, but describes herself as a "changed person." She survived a horrific car accident that killed several others, and in which she was the driver. Someone not knowing her history might see her as a relatively normal, somewhat anxious and stiff person (ANP). It would not occur to this observer that only a year before, Gail had been a different person: fun-loving, spontaneous, flexible, and untroubled by frightening nightmares and constant anxiety. Fortunately, Gail has been willing to pay attention to her EPs; she has been able to put the process of integration in motion; and she has been able to heal. p134

Sigmund Freud founded virtually all of psychotherapy on introspection, so one would expect him to be able to explain his own feelings, no matter how primitive. In one area, however, he baffled himself: He could not explain group loyalty. He wrote that he was “irresistibly” bonded to Jews and Jewishness, by “many obscure and emotional forces, which were the more powerful the less they could be expressed in words, as well as by a clear consciousness of inner identity, a deep realization of sharing the same psychic structure.” Freud was writing about powerful feelings of kinship to an entire people. These are the feelings of nationalists and fanatics—and of ordinary people—and do not lend themselves to precise analysis. By refusing to take seriously that which they cannot analyze, social scientists misunderstand how real societies work.