Best 126 quotes in «psychotherapy quotes» category

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

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

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.

Even you, the professional helper, often mistaken for the enlightened Guru or Staretz, can become lost in your thoughts that you must be competent without fault. You may become enthralled with your identity as a professional, even the pressures of the culture of mastery that expects you to heal your clients without fail. Never mind all of the variables over which you have no control, it is up to you, according to the canons of mastery, to control the health and well-being of those for whom you provide professional care. This potentiates a furthering alienation between you and your clients. You are at risk to become, if you have not already, the one who does to your clients; to be the one the active subject acting upon the passive and receptive objects, your clients; to be the one in possession of special knowledge, technique and mastery. All of this conspires to coax or coerce you into treating your client as reduced, a mere case. Unawareness to these influences gives you little chance to consider their influence on your practice in the clinical setting, much less give attentive efforts to resist or change them.

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.

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.

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.

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.

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.

„ 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.

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!

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

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.

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 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.

In the cult, the people in power dictate what cult members are to do. Children raised in cults are systematically stripped of their own autonomous power and forced to feel powerful only in the destructive context allowed by the cult, and always under the power of the leader. Ritual abuse survivors have had to learn to be outer oriented - to perceive what is expected of them and do that, whether it is healthy for them or not. When a therapist creates a context in which he or she is the leader, and the client is to listen, learn, and follow what the therapist says, the therapist has inadvertently replicated the power system of the cult. That is not to say that the therapist has no power; the therapist has a lot of power, but the power the therapist has resides in authority based upon his or her expertise, knowledge, training and sensitivity. The point is to use this authority in a way in which the client can also begin to feel his or her own authority, and begin to develop a healthy feeling of power. The word used quite often now is "empowerment." How do you empower a client?

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.

Ironically your greatest spiritual asset is what appears to be your greatest obstacle: your obsession with yourself. Today we live in the age of individualism. – Richard Harvey

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

Is suffering in a dream real? Within the dream it sure as hell is! Dukkha is real, seemingly the only reality, while I am dreaming. Once I wake up, however, where is dukkha? What happens when I wake up? I awaken to the fact that the whole complex—for example, in a nightmare, the scary figure chasing me and myself scared—was all just a dream. Everything in the dream, including myself in the dream, was just a dream. The entire dream world was just a dream, including rivers and mountains, space-time, life-death, health-illness. Now awake, it is all gone without remainder.

It has been fashionable in some psychiatric and lay circles to blame the mother for whatever goes wrong in development. [...] If blame must be assessed it should be placed on the human condition which requires such prolonged dependence on one individual for development to take place. This makes the child extraordinarily vulnerable to the idiosyncrasies of that person (the mother). On the other hand, the prolonged dependence on this relationship also provides the potential for the richness of the human personality. It is a mistake, in my judgment, in psychotherapy to encourage or side with the patient's hostility to the mother. The patient has to become aware of and express it in therapy in order to grow but whatever the source of this hostility is in the past -- be it an actual memory or a fantasy to rationalize a feeling state -- the problem is now the patient's responsibility and he must work it out.

I recently consulted to a therapist who felt he had accomplished something by getting his dissociative client to remain in her ANP throughout her sessions with him. His view reflects the fundamental mistake that untrained therapists tend to make with DID and DDNOS. Although his client was properly diagnosed, he assumed that the ANP should be encouraged to take charge of the other parts at all times. He also expected her to speak for them—in other words, to do their therapy. This denied the other parts the opportunity to reveal their secrets, heal their pain, or correct their childhood-based beliefs about the world. If you were doing family therapy, would it be a good idea to only meet with the father, especially if he had not talked with his children or his spouse in years? Would the other family members feel as if their experiences and feelings mattered? Would they be able to improve their relationships? You must work with the parts who are inside of the system. Directly.

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.

It seems like someone new is here?" I nodded. "Is it okay to talk to you?" I nodded again. "Are you the one who doesn't like the grocery store? "Yes," came the same soft voice. "What is it about the grocery store?" "It's not the store; it's the people. We get scared that some big person is going to hurt us. So we don't let her go places where there are lots of people." I felt dizziness in my head and then a different voice—a little stronger but still young—came out: "And then there's all that noise. We won't let her go in places with too much noise." "Is there someone new here?" "Yes." Is it okay if we talk together?" "Yes." "What's the problem with the noise?" "It was always noisy. A lot of yelling and crying. There was too much going on." "Is that the same kind of problem, the other part has?" "Yes. It's too hard for her to watch everyone to figure out who is going to hurt us next." "Don't you think Olga can take care of you?" "We want to think that, but we aren't sure." "Why is that?" "Because she couldn't take care of us before." "Do you all know what year it is?" "1968?" "Oh, I see. No, it's 1996, and Olga is big now. You all live inside her, and she has learned about you. She is also learning how to stop people from hurting you. She is strong and powerful. Were you there when she stopped the woman in the office from yelling at you?" It's 1996? She's big?" I paused to let the information sink in to all the parts that were listening. "She stopped people from yelling at us?" "Yes." Dr. Summer watched and waited. Home had been so chaotic. I had to watch Popi, Mike, Alex, and my mom very carefully. But I don't live there anymore. I'm grown up now.

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.

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.

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.

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.

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

¿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.

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.

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