Best 126 quotes in «psychotherapy quotes» category

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.

Somehow the disorder hooks into all kinds of fears and insecurities in many clinicians. The flamboyance of the multiple, her intelligence and ability to conceptualize the disorder, coupled with suicidal impulses of various orders of seriousness, all seem to mask for many therapists the underlying pain, dependency, and need that are very much part of the process. In many ways, a professional dealing with a multiple in crisis is in the same position as a parent dealing with a two-year-old or with an adolescent's acting-out behavior. (236)

Someone's got to do some more research, but I would really like to know: when a CBT therapist really gets distressed, who does he go see?

...some patients resist the diagnosis of a post-traumatic disorder. They may feel stigmatized by any psychiatric diagnosis or wish to deny their condition out of a sense of pride. Some people feel that acknowledging psychological harm grants a moral victory to the perpetrator, in a way that acknowledging physical harm does not.

Some survivors have found small metallic “implants” in their teeth or ears, and believe these were designed to monitor their location or to broadcast their words or thoughts to the abusers. Such technology has been developed recently for keeping task of animals or persons with dementia. But to what extent it was used years ago by mind controllers is unknown at this point. At least some of it may be similar to the “bombs” in the stomach, a trick to convince survivors that their abusers monitor them continuously. The presence of an object does not mean it is capable of collecting complex information and sending it back to abusers, or even sending them signals, for twenty or more years as some survivors believe. As with other apparently bizarre beliefs of our survivor clients, we must acknowledge that something happened, and remain open both to the possibility that there was such technology and the possibility that it is yet another deception to convince survivors they cannot escape the grip of their abusers. p205

Somewhere here I want to bring in a learning which has been most rewarding, because it makes me feel so deeply akin to others. I can word it this way. What is most personal is most general. There have been times when in talking with students or staff, or in my writing, I have expressed myself in ways so personal that I have felt I was expressing an attitude which it was probable no one else could understand, because it was so uniquely my own…. In these instances I have almost invariably found that the very feeling which has seemed to me most private, most personal, and hence most incomprehensible by others, has turned out to be an expression for which there is a resonance in many other people. It has led me to believe that what is most personal and unique in each one of us is probably the very element which would, if it were shared or expressed, speak most deeply to others. This has helped me to understand artists and poets as people who have dared to express the unique in themselves.

The "apparently normal personality" - the alter you view as "the client" You should not assume that the adult who function in the world, or who presents to you, week after week, is the "real" person, and the other personalities are less real. The client who comes to therapy is not "the" person; there are other personalities to meet and work with. When DID was still officially called MPD, the "person" who lived life on the outside was known as the "host" personality, and the other parts were known as alters. These terms, unfortunately, implied that all the parts other than the host were guests, and therefore of less importance than the host. They were somehow secondary. The currently favored theory of structural dissociation (Nijenhuis & Den Boer, 2009; van der Hart, Nijenhuis, & Steele, 2006), which more accurately describes the way personality systems operate, instead distinguishes between two kinds of states: the apparently normal personality, or ANP, and the emotional personality, or EP, both of which could include a number of parts. p21

Switching is the term in dissociation theory used to refer to the change of state, or moving from one part or alter to another. Some writers use the word splitting when referring to switching, creating a further confusion.

[S]urely the mysterious inner world of the psyche as such still offers an important forum where religions can meet, leaving their dogmas at the door, and pursue together the elusive quest for a common humanity that transcends religious differences.

[T]he formless self is free from all suffering even as it compassionately ‘takes on’ the suffering of all.

The first thing you need to know if you are a survivor is that parts of you have probably been trained to create a variety of symptoms and behaviours. Abusers actually train child parts to cut the body, to make other parts cut, to attempt suicide, to create flashbacks by releasing pieces of visual or auditory memories, to create body memories of pain or electroshock, and to create depression, terror, anxiety, and despair by releasing the emotional components of memories to the rest of the personality system. The front person and most of the rest of the system do not know that this is the source of these feelings and behaviours. p126

The mental health system is filled with survivors of prolonged, repeated childhood trauma. This is true even though most people who have been abused in childhood never come to psychiatric attention. To the extent that these people recover, they do so on their own.[21] While only a small minority of survivors, usually those with the most severe abuse histories, eventually become psychiatric patients, many or even most psychiatric patients are survivors of childhood abuse.[22] The data on this point are beyond contention. On careful questioning, 50-60 percent of psychiatric inpatients and 40-60 percent of outpatients report childhood histories of physical or sexual abuse or both.[23] In one study of psychiatric emergency room patients, 70 percent had abuse histories.[24] Thus abuse in childhood appears to be one of the main factors that lead a person to seek psychiatric treatment as an adult.[25]

Theirs was the eternal youth of an alternating self, a youth with the constant although unfulfilled promise of growing up

The loss of my child broke my spirit.

The most effective weapon a parent has to control a child is the withdrawal of love or its threat. A young child between the ages of three and six is too dependent on parental love and approval to resist this pressure. Robert's mother, as we saw earlier, controlled him by "cutting him out." Margaret's mother beat her into submission, but it was the loss of her father's love that devastated her. Whatever the means parents use, the result is that the child is forced to give up his instinctual longing, to suppress his sexual desires for one parent and his hostility toward the other. In their place he will develop feelings of guilt about his sexuality and fear of authority figures. This surrender constitutes an acceptance of parental power and authority and a submission to the parents' values and demands. The child becomes "good", which means that he gives up his sexual orientation in favor of one directed toward achievement. Parental authority is introjected in the form of a superego, ensuring that the child will follow his parents' wishes in the acculturation process. In effect, the child now identifies with the threatening parent. Freud says, "The whole process, on the one hand, preserves the genital organ wards off the danger of losing it; on the other hand, it paralyzes it, takes its function away from it.

The most important study is the practical and sincere study of one’s self: Know Thyself. It is more important to know the truth about one's self than trying to find out the truth about heaven and hell." —Sepideh Irvani, PsyD

[T]here are more and more Western scholars who [...] strive to experience Buddhism directly in the Eastern countries where it has long been a central element of cultural tradition. They must be clearly distinguished from those Westerners who, unable or unwilling to confront themselves with their own Western tradition, frivolously escape to any different world.

The purpose behind discerning the nature of love is not to satisfy ivory tower discussions or to produce fodder for academic delectation. Instead, as our work makes all too clear, the world is full of live men and women who encounter difficulty in loving or being loved, and whose happiness depends critically upon resolving that situation with the utmost expediency.

There are a great number of ego defenses, and the combinations and circumstances in which we use them reflect on our personality. Indeed, one could go so far as to argue that the self is nothing but the sum of its ego defenses, which are constantly shaping, upholding, protecting, and repairing it. The self is like a cracked mask that is in constant need of being pieced together. But behind the mask there is nobody at home.

The redirection of orientation and attention can be as simple as asking clients to become aware of a "good" or "safe" feeling in the body instead of focusing on their physical pain or elevated heart rate. Or the therapist can ask clients to experiment with focusing attention away from the traumatic activation in their body and toward thoughts or images related to their positive experiences and competencies, such as success in their job. This shift is often difficult for clients who have habituated to feeling pulled back repetitively into the most negative somatic reminders of their traumatic experiences. However, if the therapist guides them to practice deeply immersing themselves in a positive somatic experience (i.e., noting the changes in posture, breath, and muscular tone that emerge as they remember their competence), clients will gain the ability to reorient toward their competencies. They experience their ability to choose to what they pay attention and discover that it really is possible to resist the somatic claims of the past.

This was truly to be a radical milestone: the world’s first-ever marathon nude psychotherapy session for criminal psychopaths. Elliott’s raw, naked, LSD-fueled sessions lasted for epic eleven day stretches. The psychopaths spent every waking moment journeying to their darkest corners in an attempt to get better. There were no distractions—no television, no clothes, no clocks, no calendars, only a perpetual discussion (at least one hundred hours every week) of their feelings. When they got hungry, they sucked food through straws that protruded through the walls. As during Paul Bindrim’s own nude psychotherapy sessions, the patients were encouraged to go to their rawest emotional places by screaming and clawing at the walls and confessing fantasies of forbidden sexual longing for one another...

There is no greater grief, than when a parent losses a child.

The shame, embarrassment, feeling of low self-worth, and scores of "labels" we give ourselves are not fitting. I am beginning to see how I had no control over the situation. He was a big man, I was a little boy.

The United States alone sports an inventive spectrum of psychotherapeutic sects and schools: Freudians, Jungians, Kleinians; narrative, interpersonal, transpersonal therapists; cognitive, behavioral, cognitive-behavioral practitioners; Kohutians Rogerians, Kernbergians; aficionados of control mastery, hypnotherapy, neurolingustic programming, eye movement desensitization- that list does not even complete the top twenty. The disparate doctrines of these proliferative, radiating divisions, often reach mutually exclusive conclusions about therapeutic propriety: talk about this, not that; answer questions, or don’t; sit facing the patient, next to the patient, behind the patient. Yet no approach has ever proven its method superior to any other. Strip away a therapist’s orientation, the journal he reads, the books on his shelves, the meetings he attends- the cognitive framework his rational mind demands – and what is left to define the psychotherapy he conducts? Himself. The person of the therapist is the converting catalyst, not his order or credo, not his spatial location in the room, not his exquisitely chosen words or denominational silences. So long as the rules of a therapeutic system do not hinder limbic transmission - a critical caveat - they remain inconsequential, neocortical distractions. The dispensable trappings of dogma may determine what a therapist thinks he is doing, what he talks about when he talks about therapy, but the agent of change is who he is. (186/7)

The word dialectic (in dialectical behavior therapy) means to balance and compare two things that appear very different or even contradictory. In dialectical behavior therapy, the balance is between change and acceptance (Linehan, 1993a). You need to change the behaviors in your life that are creating more suffering for yourself and others while simultaneously also accepting yourself the way you are. This might sound contradictory, but it’s a key part of this treatment. Dialectical behavior therapy depends on acceptance and change, not acceptance or change.

Those who are aware of their condition and experience themselves as "multiple" might refer to themselves as "we" rather than "I." I shall use the term "multiple" at times, in respect for their internal experience. It is important to point out, however, that I recognize that someone who is multiple is actually a single fragmented person rather than many people. On the outside, a multiple is probably not visibly different from anyone else. But that image is only an imitation: people who are multiple cannot think like the rest of us, and we cannot think like them. (In fact, since it is difficult for the multiple to understand how singletons think, some of them might think that is is you who are strange). Just as a singleton cannot become a multiple at will, a multiple cannot become a singleton until and unless the barriers between the parts of the self are removed. Those barriers were put up to enable the child to tolerate, and so survive, unavoidable abuse. p20 [Multiple: a person with dissociative identity disorder (DID) or DDNOS. Singleton: a person without DID or DDNOS, i.e with a single, unified personality]

There needs to be a nationwide awareness programme for all NHS staff, to educate them about dissociative disorders. Diagnoses need to be more obtainable within the NHS; people's lives should be placed ahead of funding restraints and bureaucratic red tape. We need minimum standards of care and treatment agreed and implemented within the NHS to end the current nightmare of the postcode lottery—not just guidelines that can be ignored but actual regulations.

This reorienting is not an attempt to avoid or discount clients' pain and ongoing suffering. Rather, it is a means to help them observe, firsthand, how their chronic orienting tendencies toward reminders of the past recreate the trauma-related experience of danger and powerlessness, whereas choosing to orient to a good feeling can result in an experience of safety and mastery. As clients become able to do so the new objects of orientation often become more defined and & Goodman 1951). Rather than attention being drawn repeatedly to physical pain or traumatic activation, the good feeling becomes more prominent in the client's awareness. This exercise of reorienting toward a positive stimulus can surprise and reassure clients that they are not imprisoned indefinitely in an inner world of chronic traumatic reexperiencing, and that they have more possibilities and control than they had imagined. These orienting exercises need to be practiced again and again for mastery.

To make matters worse, everyone she talks to has a different opinion about the nature of his problem and what she should do about it. Her clergyperson may tell her, “Love heals all difficulties. Give him your heart fully, and he will find the spirit of God.” Her therapist speaks a different language, saying, “He triggers strong reactions in you because he reminds you of your father, and you set things off in him because of his relationship with his mother. You each need to work on not pushing each other’s buttons.” A recovering alcoholic friend tells her, “He’s a rage addict. He controls you because he is terrified of his own fears. You need to get him into a twelve-step program.” Her brother may say to her, “He’s a good guy. I know he loses his temper with you sometimes—he does have a short fuse—but you’re no prize yourself with that mouth of yours. You two need to work it out, for the good of the children.” And then, to crown her increasing confusion, she may hear from her mother, or her child’s schoolteacher, or her best friend: “He’s mean and crazy, and he’ll never change. All he wants is to hurt you. Leave him now before he does something even worse.” All of these people are trying to help, and they are all talking about the same abuser. But he looks different from each angle of view.

To be aware is to be responsible. In Gestalt therapy, this word is used in two ways. First, we are responsible if we are aware of what is happening to us. To take responsibility means, in part, to embrace our existence as it occurs. The other and related meaning of responsibility is that we own up to our acts, impulses, and feelings. We identify with them, accepting all of what we do as ours. These are distinct and different meanings. We are responsible for things we clearly do - for being angry, or obstinate, or irresponsible; for breaking dishes and giving gifts. We are responsible as well for the injuries inflicted on us, and the presents we receive, for what is done to us. Here we are responsible for our part in the event - for the pain we feel and the taking of the gift. When it rains, we get wet. While we didn't make it rain, we are responsible for being wet. We are also responsible for our middle mode experiences, for the things we participate in and give ourselves to. We do not make ourselves love, or hate, but they are the feelings we have. We are responsible for having those feelings, not because we caused them to be, but because they are our existence at this moment.

To psychotherapists, I say, don't just leave us abandoned because you think you don't know enough to help us, or because the world doesn't believe in what we went through, or because our trauma is too awful to hear about.

Too often the survivor is seen by [himself or] herself and others as "nuts," "crazy," or "weird." Unless her responses are understood within the context of trauma. A traumatic stress reaction consists of *natural* emotions and behaviors in response to a catastrophe, its immediate aftermath, or memories of it. These reactions can occur anytime after the trauma, even decades later. The coping strategies that victims use can be understood only within the context of the abuse of a child. The importance of context was made very clear many years ago when I was visiting the home of a Holocaust survivor. The woman's home was within the city limits of a large metropolitan area. Every time a police or ambulance siren sounded, she became terrified and ran and hid in a closet or under the bed. To put yourself in a closet at the sound of a far-off siren is strange behavior indeed—outside of the context of possibly being sent to a death camp. Within that context, it makes perfect sense. Unless we as therapists have a good grasp of the context of trauma, we run the risk of misunderstanding the symptoms our clients present and, hence, responding inappropriately or in damaging ways.

Top-down cortically mediated techniques typically use cognition to regulate affect and sensorimotor experience, focusing on meaning making and understanding. The entry point is the story, and the formulation of a coherent narrative is of prime importance. A linguistic sense of self is fostered this process, and experience changes through understanding

Underlying the attack on psychotherapy, I believe, is a recognition of the potential power of any relationship of witnessing. The consulting room is a privileged space dedicated to memory. Within that space, survivors gain the freedom to know and tell their stories. Even the most private and confidential disclosure of past abuses increases the likelihood of eventual public disclosure. And public disclosure is something that perpetrators are determined to prevent. As in the case of more overtly political crimes, perpetrators will fight tenaciously to ensure that their abuses remain unseen, unacknowledged, and consigned to oblivion. The dialectic of trauma is playing itself out once again. It is worth remembering that this is not the first time in history that those who have listened closely to trauma survivors have been subject to challenge. Nor will it be the last. In the past few years, many clinicians have had to learn to deal with the same tactics of harassment and intimidation that grassroots advocates for women, children and other oppressed groups have long endured. We, the bystanders, have had to look within ourselves to find some small portion of the courage that victims of violence must muster every day. Some attacks have been downright silly; many have been quite ugly. Though frightening, these attacks are an implicit tribute to the power of the healing relationship. They remind us that creating a protected space where survivors can speak their truth is an act of liberation. They remind us that bearing witness, even within the confines of that sanctuary, is an act of solidarity. They remind us also that moral neutrality in the conflict between victim and perpetrator is not an option. Like all other bystanders, therapists are sometimes forced to take sides. Those who stand with the victim will inevitably have to face the perpetrator's unmasked fury. For many of us, there can be no greater honor. p.246 - 247 Judith Lewis Herman, M.D. February, 1997

To truly "show up" means making room for labelling your thoughts and emotions and seeing them for what they are: information rather than facts or directives. This is what allows us to step out to create distance from and gain perspective on our mental processes, which then defangs their power over us.

Treating Abuse Today (Tat), 3(4), pp. 26-33 Freyd: I see what you're saying but people in psychology don't have a uniform agreement on this issue of the depth of -- I guess the term that was used at the conference was -- "robust repression." TAT: Well, Pamela, there's a whole lot of evidence that people dissociate traumatic things. What's interesting to me is how the concept of "dissociation" is side-stepped in favor of "repression." I don't think it's as much about repression as it is about traumatic amnesia and dissociation. That has been documented in a variety of trauma survivors. Army psychiatrists in the Second World War, for instance, documented that following battles, many soldiers had amnesia for the battles. Often, the memories wouldn't break through until much later when they were in psychotherapy. Freyd: But I think I mentioned Dr. Loren Pankratz. He is a psychologist who was studying veterans for post-traumatic stress in a Veterans Administration Hospital in Portland. They found some people who were admitted to Veteran's hospitals for postrraumatic stress in Vietnam who didn't serve in Vietnam. They found at least one patient who was being treated who wasn't even a veteran. Without external validation, we just can't know -- TAT: -- Well, we have external validation in some of our cases. Freyd: In this field you're going to find people who have all levels of belief, understanding, experience with the area of repression. As I said before it's not an area in which there's any kind of uniform agreement in the field. The full notion of repression has a meaning within a psychoanalytic framework and it's got a meaning to people in everyday use and everyday language. What there is evidence for is that any kind of memory is reconstructed and reinterpreted. It has not been shown to be anything else. Memories are reconstructed and reinterpreted from fragments. Some memories are true and some memories are confabulated and some are downright false. TAT: It is certainly possible for in offender to dissociate a memory. It's possible that some of the people who call you could have done or witnessed some of the things they've been accused of -- maybe in an alcoholic black-out or in a dissociative state -- and truly not remember. I think that's very possible. Freyd: I would say that virtually anything is possible. But when the stories include murdering babies and breeding babies and some of the rather bizarre things that come up, it's mighty puzzling. TAT: I've treated adults with dissociative disorders who were both victimized and victimizers. I've seen previously repressed memories of my clients' earlier sexual offenses coming back to them in therapy. You guys seem to be saying, be skeptical if the person claims to have forgotten previously, especially if it is about something horrible. Should we be equally skeptical if someone says "I'm remembering that I perpetrated and I didn't remember before. It's been repressed for years and now it's surfacing because of therapy." I ask you, should we have the same degree of skepticism for this type of delayed-memory that you have for the other kind? Freyd: Does that happen? TAT: Oh, yes. A lot.

...two different kinds of Japanese psychotherapies, one based on getting people to stop using feelings as an excuse for their actions and the other based on getting people to practice gratitude.

Unfortunately, there is no expiration date on grief

We are all the product of our past and have to live with our memories and personality they cannot be erased.

What daily life is like for “a multiple” Imagine that you have periods of “lost time.” You may find writings or drawings which you must have done, but do not remember producing. Perhaps you find child-sized clothing or toys in your home but have no children. You might also hear voices or babies crying in your head. Imagine that you can never predict when you will be able to have certain knowledge or social skills, and your emotions and your energy level seem to change at the drop of a hat, and for no apparent reason. You cannot understand why you feel what you feel, and, if you are in therapy, you cannot explore those feelings when asked. Your life feels disjointed and often confusing. It is a frightening experience. It feels out of control, and you probably think you are going crazy. That is what it is like to be multiple, and all of it is experienced by the ANPs. A multiple may also experience very concrete problems, even life-threatening ones.

We're strong for each other ! It's what women do!" said Zelda to Pearl "He Counts Their Tears" by Mary Ann D'Alto

We therapists often make inaccurate assumptions about people living with DID and DDNOS. They often appear to be “just like us,” so we often assume their experience of life reflects our own. But this is profoundly untrue. It results in a communication gap, and, as a consequence, treatment errors. Because the dominant culture is one of persons with a single sense of self, most with multiple “selves” have learned to hide their multiplicity and imitate those who are singletons (that is, have a single, non-fragmented personality). Therapists who do not understand this sometimes describe their clients' alters without acknowledging their dissociation, saying only that they have different “moods.” In overlooking dissociation, this description fails to recognize the essential truth of such disorders, and of the alters. It was difficult for me to comprehend what life was like for my first few dissociative clients.

Whatever the theory, it is important to note that clinicians such as Kluft draw attention to the clinical error of insisting that all alters talk as one or that only the alter with the legal name should be validated. 'Such stances are commonly associated with therapeutic failure'.

When Clients say they're wrestling with depression, what I choose to hear is that they're in a state of decompression -- in a deserved limbo, taking a little time to recover from a something that set them back... I don't see the hopelessness of the here-and-now. I see the hope in what's to come.

[W]hat would be more reliable than the East and the West? Perhaps a concept of the world, the universe, or the cosmos. Our age can be characterized by the growing consciousness of the world as a whole. Our historical era is in essence cosmological.

What people don't understand about depression is how much it hurts. It's like your brain is convinced that it's dying and produces an acid that eats away at you from the inside, until all that's less is a scary hollowness. Your mind fills with dark thoughts; you become convinced that your friends secretly hate you, you're worthless, and then there's no hope. I never got so low as to consider ending it all, but I understand how that can happen to some people. Depression simply hurts too much.

When clients are hyperaroused or overwhelmed emotionally, voluntarily narrowing their field of consciousness allows them to assimilate a limited amount of incoming information, thereby optimizing the chance for successful integration. For example, as one client began to report her traumatic experience, her arousal escalated: Her heart started to race, she felt afraid and restless, and had trouble thinking. She was asked to stop talking and thinking about the trauma, to inhibit the images, thoughts, and emotions that were coming up, and orient instead to her physical sensation until her arousal returned to the window of tolerance. With the help of her therapist, she focused on her body and described how her legs felt, the phyisical feeling of anxiety in her chest, and the beating of her heart. These physical experiences gradually subsided, and only then was she encouraged to return to the narrative.

When emotions turn and stay sour, when thoughts become cynical and judgmental, good and compassionate treatment is on the line. Helpers who become sour and cynical tend to begrudge their high need clients for their neediness. There is a risk that helpers become too well-practiced at taking a bleak view of those they have avowed to assist. There is a temptation to begin to blame clients for their failure to improve. If treatment ends pre-maturely, with either a client never returning to treatment or a helper 'firing' them out of frustration, there is a tendency for the client to take the fall. Of course what we are talking about here are signs of burnout.

While professionals and patients can be blamed for 'believing' in an illness or having one, patients also report problems when they are believed. Some professionals, they commented, have worryingly simplistic ideas of 'integration'. Ignoring the separately named alters in effect offers a psychic death sentence rather than aiding integration. If anything it can create a compliant false-self 'main person' who answers to [his or] her name and keeps all other 'states' in silent terror internally.

When psychotherapy began, it was about the practitioner listening to a patient and interpreting what the patient said, in order to afford the patient insights about his or her psyche. But now we understand that the main curative part of psychotherapy is the relationship itself. It appears not to be relevant which psychology school the practitioner belongs to. What matters is the quality of the relationship and the practitioner's belief in what he or she is offering.