Logo
    Search

    Podcast Summary

    • A Social Worker's Devotion to Psychodynamic TherapySocial worker Alison Maxwell found deep meaning in psychodynamic therapy's exploration of human behavior and the unconscious mind, leading to improved patient outcomes and a rewarding career.

      Alison Maxwell, a social worker and PhD candidate, chose to specialize in psychodynamic and psychoanalytic therapy due to its deep exploration of human behavior and the unconscious mind. She was drawn to this approach during her MSW studies and was inspired by her professor's teaching on defense mechanisms, transference, and countertransference. Despite the challenges of ongoing training and skepticism from some colleagues, she believes that this approach offers significant benefits for patients, allowing for the exploration of unconscious thoughts and improving the therapeutic relationship. Maxwell's dedication to this method has led to improved patient outcomes and a fulfilling career in psychotherapy.

    • Understanding the origins and value of psychodynamic therapyFreud's groundbreaking approach to treating mental health conditions with empathy and understanding, influenced by ancient philosophers and literature, is still valuable in modern psychodynamic therapy, focusing on emotional responses.

      Psychodynamic therapy, which originated from the work of Sigmund Freud, has been misunderstood and dismissed by some due to misconceptions about its origins and effectiveness. Freud's theories were groundbreaking for their time, as he approached treating patients with conditions like hysteria, borderline personality disorder, somatization disorder, and PTSD with empathy and understanding, rather than neurological interventions or isolation. Freud's methods, which included exploring the unconscious mind and interpreting dreams, were influenced by ancient philosophers and literature. While randomized controlled trials have become the gold standard for scientific discovery in recent decades, Freud's approach relied on in-depth case studies and narrative analysis. Understanding the historical context and influences on Freud's work can help modern practitioners appreciate the value of psychodynamic therapy, which focuses on affect, the emotional response, as a crucial aspect of treatment.

    • Exploring Emotions in Psychodynamic PracticePsychodynamic practice emphasizes emotional connection and exploration, focusing on understanding and empathizing with patients' emotions and recognizing transference and countertransference.

      In psychodynamic practice, affect, or a person's emotional state, plays a significant role in the therapeutic process. Therapists focus on understanding and connecting with their patient's emotions, as well as their own emotional reactions towards the patient, known as transference and countertransference. Emotions can be complex and conflicting, and recognizing and empathizing with them can lead to deeper understanding and healing. Transference is the patient's emotional reaction towards the therapist, while countertransference is the therapist's emotional reaction towards the patient. Both are important to acknowledge and explore in the therapeutic relationship. Additionally, there is an unconscious process at play, with both the patient and therapist having unconscious fantasies and reactions towards each other. Overall, psychodynamic practice emphasizes the importance of emotional connection and exploration in the therapeutic process.

    • Unconscious dynamics in therapyUnderstanding and addressing power struggles and unmet needs in therapy can promote connection and lasting change

      In therapy, there can be unconscious dynamics at play between the therapist and patient that can hinder progress if not acknowledged. These unconscious dynamics may involve power struggles, unmet needs, or unresolved emotions. For instance, a patient may try to intimidate or manipulate the therapist to maintain a sense of control, creating emotional distance and hindering connection. As a therapist, it's essential to reflect on these power struggles psychodynamically and understand the underlying deficits that prevent the patient from connecting with others outside of the therapy office. By addressing vulnerability and acknowledging the true, imperfect person, the therapist can help the patient build healthier relationships and challenge their false projected image. This process can be uncomfortable, but it's crucial for effective therapy and promoting lasting change.

    • Therapeutic relationship's role in healing complex emotional issuesDeep emotional connection in therapy is crucial for patients with complex emotional issues. Therapist's personal history and experiences can influence the process. Enactments, unconscious patterns, require awareness to maintain boundaries and facilitate growth.

      The therapeutic relationship, characterized by deep emotional connection and unconscious enactments, plays a crucial role in healing patients with complex emotional issues. The therapist's personal history and experiences can influence the therapeutic process, making it essential to acknowledge and address the underlying emotional dynamics. Traditional cognitive-behavioral approaches may not be sufficient for such patients, as they often require a more relational and healing therapeutic context. Enactments, which are unconscious patterns of behavior, can pull therapists into the patients' dramas, and it's crucial to be aware of these dynamics to maintain professional boundaries and facilitate growth. Patients may evoke similar situations to potentially have different outcomes, and acknowledging and discussing these enactments can lead to profound realizations and healing.

    • Psychodynamic therapies proven effective through scientific studiesStudies show substantial progress in mood symptoms, functionality, and reduced hospitalizations for individuals using psychodynamic therapies, with effect sizes ranging from 1 to 1.8 standard deviations

      Psychodynamic therapies, including mentalization-based therapy, short-term psychodynamic psychotherapy, and transference-focused therapy, have been proven effective through scientific studies. These therapies, which focus on emotions, mentalization, and the therapeutic relationship, have led to significant improvements in mood symptoms, functionality, and reduced hospitalizations for individuals with various mental health conditions. Effect sizes from these studies range from 1 to 1.8 standard deviations, indicating substantial progress in treatment groups compared to control groups. These findings challenge the common belief that psychodynamic therapies are not evidence-based and provide valuable insights into the benefits of these approaches.

    • Rebuilding the ego through therapeutic relationshipPsychodynamic therapy helps individuals thrive in relationships and find meaningful work by rebuilding the ego through the therapeutic relationship, promoting interpersonal growth and self-discovery.

      Psychodynamic therapy, as practiced by Jonathan Schedler and others, can lead to long-term improvements in patients' wellbeing and resolution of symptoms. This approach focuses on rebuilding the ego through the therapeutic relationship and can lead to outward growth and service to others. Psychodynamic therapy is not just about ending depression or anxiety, but helping individuals thrive in relationships and find meaningful work. It can be particularly helpful for those who feel stuck or inhibited in pursuing their own goals. The therapist's role is to provide a safe space for growth and self-discovery, much like an empathic mother would. Psychodynamic theory emphasizes the importance of interpersonal growth and can benefit those who struggle with vulnerability and putting themselves out there. Through the therapeutic relationship, individuals can gain the confidence and self-awareness to launch their own projects and pursue their calling.

    • The impact of therapeutic relationship on therapeutic processEmpathetic and patient therapists create a safe space for exploration and growth, leading to profound self-awareness, confidence, and overall wellness.

      The quality of the therapeutic relationship can greatly impact the therapeutic process. The speaker shares her experience of feeling shamed and unheard in her previous therapy, which left her feeling stuck and unsatisfied. In contrast, she found profound growth and healing through her current analytic therapy with an empathic and patient analyst. This shift in therapeutic relationships allowed her to feel seen, understood, and validated, leading to a greater sense of self-awareness, confidence, and overall wellness. It's important for therapists to be attuned to the emotional experiences of their clients and create a safe and supportive space for exploration and growth.

    • The human connection in therapy is vitalEmpathy, patience, and self-awareness help therapists create a healing environment by understanding patients' emotions and reducing feelings of shame, allowing for deeper connections and preventing burnout.

      The human connection in therapy is crucial and cannot be replicated by AI. Empathy, curiosity, and kindness from a therapist can help patients feel understood and reduce feelings of shame, allowing them to continue sharing their stories. This connection not only benefits the patient but also prevents burnout for the therapist. Good supervision and self-awareness are essential tools for therapists to maintain this connection and effectively understand their patients' emotions. When patients dissociate or seem boring in sessions, it may indicate underlying distress or shame, which the therapist can address by reducing judgment and understanding the meaning behind the patient's behavior. Overall, the human connection in therapy is vital, and therapists must prioritize empathy, patience, and self-awareness to create a healing environment for their patients.

    • Understanding underlying emotionsAcknowledging and validating hidden feelings can create relational epiphanies and facilitate healing from trauma.

      Effective therapy sometimes requires therapists to go beyond the surface level and address the underlying emotions that words cannot express. In this example, a therapist recognized her own feelings of fatigue and used it as an opportunity to connect with a patient who had been expressing her own sense of being "dead" or disconnected from life. By acknowledging and validating the patient's feelings, the therapist created a relational epiphany that allowed the patient to open up and begin the process of healing from relational trauma. Listening to the "music behind the words" and creating a trusting, understanding relationship can be crucial in untangling the complexities of trauma.

    Recent Episodes from Psychiatry & Psychotherapy Podcast

    Reflective Functioning: The Key to Attachment with Dr. Howard Steele

    Reflective Functioning: The Key to Attachment with Dr. Howard Steele

    In this episode, we discuss “reflective function,” which is a precursor to the concept of mentalization. Reflective function is best understood not as synonymous with mentalization, but as a scale from -1 to 9, based off certain adult attachment interview questions that measure the person’s ability to describe their own and others’ internal states, motivations, and articulate a nuanced and unique understanding of life from 0 to 12 years old. This scale was developed by attachment researchers at the University of London, including Dr. Howard Steele and Dr. Peter Fonagy.

    Bruce Perry on the Healing Power of Human Connection and Resilience in Trauma

    Bruce Perry on the Healing Power of Human Connection and Resilience in Trauma

    In today’s episode, we talk with Dr. Bruce Perry who co-authored, The Boy Who Was Raised As A Dog, Born For Love: Why Empathy is Essential and Endangered, and What Happened to You? Conversations on Trauma, Resilience, and Healing (2021). We are also joined by Megan White Zappitelli, M.D., a child and adolescent psychiatrist, and Maddison Hussey, M.D., a child and adolescent fellow. 

    Early Psychosis: Detection and Treatment

    Early Psychosis: Detection and Treatment

    In this episode, we are joined by a panel of experts to discuss treatment of psychosis. Experiences of psychosis are common. When these experiences lead to interference in achieving life goals and/or distress, individuals can benefit from seeking evidenced-based care. The earlier individuals experiencing psychosis come to treatment, the better the outcomes. We are all allies in connecting these young people to care and services. Recovery is possible—people living with psychosis experiences can lead full, meaningful, and fulfilling lives. 

    Q&A with Dr. Michael Cummings

    Q&A with Dr. Michael Cummings

    In this episode, we welcome back fan favorite Dr. Michael Cummings and ask questions sent in by listeners. Topics include Schizophrenia, Social Media Trends, and the SSRI controversy. We are thrilled to dedicate an episode that allows individuals to ask pointed questions and glean from Dr. Cummings' expertise. 

    What People Want From Therapy with Linda Michaels

    What People Want From Therapy with Linda Michaels

    Therapies of depth, insight, and relationship have been missing from, if not pushed out of, the public conversation on mental health treatment. After decades of attack from multiple fronts, these therapies are misunderstood, undervalued, and overlooked by the general public. In order to address this challenge and change this trajectory, we must start by listening to the public and understand their needs, values, and preferences about therapy. Dr. Linda Michaels and colleagues conducted an extensive research project, leveraging qualitative and quantitative tools and techniques widely used in the corporate world, focused on “listening” to the public and understanding what people want and need from therapy. 

    Linda Michaels, PsyD, MBA, is a clinical psychologist in private practice in Chicago. She is also chair and co-founder of the Psychotherapy Action Network (PsiAN), a non-profit that advocates for quality therapy. 

    Link to blog here.

    5 Factors and Domains of Psychiatric Care

    5 Factors and Domains of Psychiatric Care

    In this Episode, Dr. David Puder, Dr. Adam Borecky, and Joanie Burns discuss the 5-factor approach to holistic, patient-centered psychiatric care. This approach takes into account that each individual who seeks care is unique in their physiological and psychological make-up and that multiple factors influence both physical and mental health (for better or worse). 

    The 5-factor approach to treatment is based on the importance of sensorium and its pivotal role in regulating thoughts, feelings, and overall mental health. Sensorium is a lens to understand how we focus on various things. Sensorium is total brain function, which fluctuates throughout the day and depends on a number of factors, including sleep, stress levels, and more.

    Mentalization Based Therapy (MBT), with Dr. Anthony W. Bateman, MA, FRCPSYCH and Dr. Peter Fonagy, Ph.D., FBA

    Mentalization Based Therapy (MBT), with Dr. Anthony W. Bateman, MA, FRCPSYCH and Dr. Peter Fonagy, Ph.D., FBA

    In this episode, we are joined by Dr. Anthony W. Bateman and Dr. Peter Fonagy to discuss their expertise on Mentalization. 

    Mentalization refers to the capacity to reflect upon and understand one's own state of mind and the states of mind of others.  This involves recognizing and making sense of one's own and others’ emotions, beliefs, needs and desires.  People use this tool consciously and unconsciously to make sense of others and themselves. Often done automatically, a person may form beliefs about the people they interact with, making assumptions about their mental states. These beliefs tend to have a strong influence on the mental state of the person, whether or not they are correct.

     

    Beginning the Treatment with Jonathan Shedler, PhD

    Beginning the Treatment with Jonathan Shedler, PhD

    Dr. Jonathan Shedler is well known for his work on the efficacy of psychodynamic therapy. He has highlighted the importance of the initial phase of therapy in establishing a foundation for successful treatment. Dr. Shedler strongly believes the consultation phase is crucial to developing a working alliance between client and therapist and building a treatment frame and structure. Without this foundation, there is no mutual understanding about the goal or the purpose of treatment, and psychotherapy should not move forward. Join us in this episode as Dr. Shelder discusses how to create a firm starting foundation in clinical practice.

    Adverse Childhood Experiences Part 2: Measurement, Impact on Future Mental Health, Dissociation, and Timing of Trauma

    Adverse Childhood Experiences Part 2: Measurement, Impact on Future Mental Health, Dissociation, and Timing of Trauma

    In this week’s episode of the podcast, we will continue our discussion regarding adverse childhood experiences (ACEs) and their influence on the development of future mental health disorders. The greatest predictive factor of the relationship between ACEs and future mental health disorders has to do with the severity, duration, and number of traumatic events. We’ll explore the Childhood Trauma Questionnaire and the data of how ACEs increase the risk of certain personality disorders and psychiatric conditions.

    Link to blog: 

    https://www.psychiatrypodcast.com/psychiatry-psychotherapy-podcast/episode-204-adverse-childhood-experiences-part-2-measurement-impact-on-future-mental-health-dissociation-and-timing-of-trauma

    Related Episodes

    Therapeutic Alliance Part 5: Emotion

    Therapeutic Alliance Part 5: Emotion

    People often think of emotions as ethereal, complicated depths that are difficult to explore. They are actually adaptive physical reactions to stimuli. There are a few main categories, and as we will discover, they are concrete, identifiable, and usually in a healthy therapeutic alliance, they can be discussed and even when emotions are painful to express or come with shame or linked with traumatic memories, can be disarmed and understood. 

     

    Link to Resource Library.

    Psychodynamic Psychotherapy with Jonathan Shedler, PhD

    Psychodynamic Psychotherapy with Jonathan Shedler, PhD

    In this episode, Dr. Puder interviews Jonathan Shedler, Ph.D. Their conversation covers the ideal length of therapy treatment, the efficacy of psychodynamic therapy, and the role of psychodynamic processes in multiple therapeutic modalities.

    Link to Blog here

    Link to Webinars here

    Affective Neuroscience in Psychotherapy with Francis Stevens, Ph.D.

    Affective Neuroscience in Psychotherapy with Francis Stevens, Ph.D.

    On this week’s episode, Dr. Puder interviews Francis Stevens, Ph.D., a clinical psychologist and author of the new book, Affective Neuroscience in Psychotherapy: A Clinician’s Guide for Working With Emotions. Dr. Stevens trained as a therapist under cognitive behavioral and psychodynamic theories, as well as completing a postdoctoral degree in neuroscience. The lack of emphasis on emotion in these two approaches led Dr. Stevens to begin research on the neurobiological basis of emotion and to ultimately compile this book.

    Link to Blog.

    Link to Resource Library. 

     

    Cuties and the Oversexualization of Children in Our Culture

    Cuties and the Oversexualization of Children in Our Culture

    Netflix has recently come under fire for its release of the French film "Cuties." While critics have praised the movie for exploring themes of the oversexualization of children, audience members are consistently appalled at the provocative situations that the 11-year-old characters are put through. In this episode, I discuss our culture's saturation with the oversexulization of children in media with Maddie Ulrich B.S., Randy Stinnett, Psy.D., ABPP, and Caroline Osorio M.D.

    Link to Blog.

    Link to Resource Library.