Psychotherapy Quotes

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).

Joseph Schwartz

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]

Judith Lewis Herman

As you may already know, post-traumatic stress disorder is extremely complex. Each client has a unique, perhaps virtually unbelievable, set of experiences, and an almost equally set of reactions to those experiences.

Aphrodite Matsakis

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.

Diane Mandt Langberg

I say, thirteen is too many dogs for good mental health. Five is pretty much the limit. More than five dogs and you forfeit your right to call yourself entirely sane.Even if the dogs are small.

E. Lockhart

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?

IRVIN D.YALOM

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!

Sarah E. Olson

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.

Sarah E. Olson

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.

Aphrodite Matsakis

A man shrinks or expands into the degree and nature of his ambition. Ambition needs to be cultivated and refined, and yet has no teachers.

Neel Burton

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

Richard S. Hallam

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.

Richard S. Hallam

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

Marlene Steinberg

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.

Carol Broad

Because drugs have become so profitable, major medical journals rarely publish studies on nondrug treatments of mental health problems.31 Practitioners who explore treatments are typically marginalized as “alternative.” Studies of nondrug treatments are rarely funded unless they involve so-called manualized protocols, where patients and therapists go through narrowly prescribed sequences that allow little fine-tuning to individual patients’ needs. Mainstream medicine is firmly committed to a better life through chemistry, and the fact that we can actually change our own physiology and inner equilibrium by means other than drugs is rarely considered.

Bessel A. van der Kolk

Why Cults Terrorize and Kill Children – LLOYD DEMAUSEThe Journal of Psychohistory 21 (4) 1994"Extending these local figures to a national estimate would easily mean tens of thousands of cult victims per year reporting, plus undoubtedly more who do not report.(2) This needn’t mean, of course, that actual Cult abuse is increasing, only that-as with the increase in all child abuse reports-we have become more open to hearing them. But it seemed unlikely that the surge of cult memories could all be made up by patients or implanted by therapists. Therapists are a timid group at best, and the notion that they suddenly begin implanting false memories in tens of thousands of their clients for no apparent reason strained credulity. Certainly no one has presented a shred of evidence for massive “false memory” implantations.

Lloyd DeMause

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

Alison Miller

Treating Abuse Today (Tat), 3(4), pp. 26-33Freyd: 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.

David L. Calof

Tempting as it may be to draw one conclusion or another from my story and universalize it to apply to another's experience, it is not my intention for my book to be seen as some sort of cookie-cutter approach and explanation of mental illness, It is not ab advocacy of any particular form of therapy over another. Nor is it meant to take sides in the legitimate and necessary debate within the mental health profession if which treatments are most effective for this or any other mental illness. What it is, I hope, is a way for readers to get a true feel for what it's like to be in the grips of mental illness and what it's like to strive for recovery.

Rachel Reiland

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.

Neel Burton

...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.

Will Schwalbe

Being Scared-off by EvilLastly, 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).

J. Jeffrey Means

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.

Scott E. Spradlin

Although the client-centered approach had its origin purely within the limits of the psychological clinic, it is proving to have implications, often of a startling nature, for very diverse fields of effort.

Carl Rogers

Good therapy, gently but firmly, moves people out of denial and compartmentalization. It helps clients to develop richer inner lives and greater self-knowledge. It teaches clients to live harmoniously with others and it enhances Existential consciousness, and allows people to take responsibility for their effects on the world at large. For me , happiness is about appreciating what one has. Practically speaking,this means lowering expectations about what is fair, possible and likely. It means,finding pleasure in the ordinary.

Mary Pipher

Perfectionism is adaptive if you are mindful of your humanhood.

Asa Don Brown

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.

Alison Miller

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.

Alison Miller

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

Alison Miller

There are essentially three types of people: those who love life more than they fear it, those who fear life more than they love it, and those who have no clue what I'm talking about.

Neel Burton

The acknowledgement of having suffered evil is the greatest step forward in mental health.

Stefan Molyneux

There is no external solution to the problem of insecurity.

Stefan Molyneux

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

Jane Hersey

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

Elizabeth F. Howell

Unfortunately, there is no expiration date on grief

Elizabeth Czukas

When those you love die, the best you can do is honor their spirit for as long as you live. You make a commitment that you’re going to take whatever lesson that person or animal was trying to teach you, and you make it true in your own life… it’s a positive way to keep their spirit alive in the world, by keeping it alive in yourself.

Patrick Swayze

All you need is one safe anchor to keep you grounded when the rest of your life spins out of control

Katie Kacvinsky

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

American Pregnancy Association

Healing doesn’t mean forgetting or making the memories insignificant. Healing means refocusing

American Pregnancy Association

The loss of my child broke my spirit.

Asa Don Brown

Allow yourself to be an anchor and anchored by others.

Asa Don Brown

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

Alison Miller

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

Alison Miller

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

Robert Plutchik

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): 171-179The Many Faces of Dissociation: Opportunities for Innovative Research in Psychiatry

Verdat Sar

Treatment for DID should adhere to the basic principles of psychotherapy and psychiatric medical management, and therapists should use specialized techniques only as needed to address specific dissociative symptomatology.Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision

James A. Chu

The primary treatment modality for DID is individual outpatient psychotherapy.Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision

James A. Chu

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.

Asa Don Brown

Admitting the need for help may also compound the survivor's sense of defeat. The therapists Inger Agger and Soren Jensen, who work with political refugees, describe the case of K, a torture survivor with severe post-traumatic symptoms who adamantly insisted that he had no psychological problems: "K...did not understand why he was to talk with a therapist. His problems were medical: the reason why he did not sleep at night was due to the pain in his legs and feet. He was asked by the therapist...about his political background, and K told him that he was a Marxist and that he had read about Freud and he did not believe in any of that stuff: how could his pain go away by talking to a therapist?

Judith Lewis Herman

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.

Cameron West

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

Patricia Love

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

Jennifer Lane

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.

Jeremy Holmes

Complexity is a product of unawareness and simplicity a result of awareness! Uncomplex yourself, Live Life!

Ramana Pemmaraju

Therapy isn't Radio.We don't need to constantly fill the air with sounds. Sometimes, when its quite, surprising things happen.

Mary Pipher

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.)

Edward Teyber

In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?

Carl R. Rogers

The manic relief that comes from the fantasy that we can with one savage slash cut the chains of the past and rise like a phoenix, free of all history, is generally a tipping point into insanity, akin to believing that we can escape the endless constraints of gravity, and fly off a tall building. “I’m freeeee… SPLAT!”.

Stefan Molyneux

The pleasure of living and the pleasure of the orgasm are identical. Extreme orgasm anxiety forms the basis of the general fear of life.

Wilhelm Reich

Only the liberation of the natural capacity for love in human beings can master their sadistic destructiveness.

Wilhelm Reich

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