Filtered by category: Clinical Topics Clear Filter

New Year's Resolutions

You … and some of your clients … have set goals for 2023 in the form of obligatory “New Year’s Resolutions” … many of which may be broken prior to January 30.  Have you considered setting up some mini-goals to assist in the process?  If resolutions are established annually, why not divide things up into more manageable monthly goals?

Read More

Reframing Repetition Compulsion

As students, those of us who were pursuing a career as psychodynamic psychotherapists learned about the repetition compulsion.  The Oxford Reference (www.oxfordreference.com) defines this phenomenon as “a tendency to place oneself in dangerous or distressing situations that repeat similar experiences from the past.” Webster’s Seventh New Collegiate Dictionary describes a compulsion as “an irresistible impulse to perform an irrational act.”

Read More

The Perfect Language of Couples Complaints

All psychotherapists know the importance of language.  We pay close attention to exactly what our clients say and how they say it.  In this post, I will share a case that illustrates how the perfect language of couples’ complaints provide the roadmap for their treatment.

Read More

The Language of Gratitude

“If you don’t know the language of gratitude, you’ll never be on speaking terms with happiness.” Chopra 

Read More

The Neurobiopsychological Mechanisms of Couples Systems

Most forms of couples therapy are focused on resolving conflicts in the present-day lives of couples who seek treatment.  Some methods do delve into the historical antecedents of those conflicts, but their primary goal remains helping couples meet their current needs.

Read More

The Delicate Balancing of the Couples Therapist

Most forms of psychotherapy require that the therapist perform a “delicate balancing act” between competing forces.  Some authors refer to this skill as dialectical thinking–the ability to mentally (and emotionally) hold seemingly opposite factors in dynamic tension in service of moving a system toward higher functioning.  In Neurodynamic Couples Therapy, there are primarily three areas in which the delicate balancing of the couples therapist is required for therapeutic success.

Read More

Healing a Traumatized World

Healing a Traumatized World was is central as we move forward through resiliency and growth during these times.  The American Board of Clinical (ABCSW) Social Work inaugural conference was timely as it conducted a variety of sessions.  The work of clinicians was captured through professional workshops such suicide prevention in law enforcement personnel and implementation of PTSD treatments. 
Read More

The Difference Between Hurt and Harm

A frequent complaint that therapists hear from couples when they enter treatment is that they have felt hurt by each other.  They want to tell us all about the pain that their partner has inflicted on them, and they often seem to want the therapist to declare which one of them has been the “most” hurt.

Read More

Reliving Rage

What is rage?  My sweet little cairn terrier taught me what rage is.  One day I put down her feeding bowl, and she started her meal.  I needed to move the bowl slightly to get it out of my way.  As I reached my hand down toward her bowl, she bit me!  She had never bitten anyone before.  Since I hadn’t spoken before reaching down, I think she might not have even been aware that it was my hand.

Read More

Group Perspective to Current Events

Watching the recent upheaval in our society, more specifically watching the January 6th hearings, I began asking myself the question: Is the interaction in the group a product of individual behavior, or is the group understandable as an intact entity suggesting behavior is a product of the group?

Read More

Reliving Terror

At the end of my last post, I wrote about the shame connected to childhood abuse that must be relived in couple relationships.  Couples in which one or both partners were victims of childhood abuse will likely also be reliving terror.

Read More

Reliving Shame

Because the emotion of shame usually derives from having done something “wrong” in the eyes of significant others, it is inevitably part of every important relationship.  That look of disapproval or disgust that accompanies shame-filled experiences is such a blow to our self-esteem that creates so much subjective pain; it is no wonder we avoid this feeling.  This leads to unmetabolized shame that is going to be relived in couple relationships.

Read More

The Dysregulated Emotions of Trauma

When couples come to us for treatment, they have frequently been struggling with the dysregulated emotions of trauma.  Their right brains have been correctly mutually creating an outlet for these unmetabolized emotions through their recycling dramas, but the partners usually do not know what to do with them and have almost always developed a sizable amount of fear around their expression.

Read More

Why Relationships MATTER

To mask or not to mask? Anti-vax or total vax? What will we most remember from the COVID crises?  “Relationship deprivation” may be the primary memory for many. Just how vital are connections to our sense of well-being?

Read More

Elements of Treatment Success Beyond our Control

Another way of thinking about this post might be the old adage, “You can lead a horse to water, but you can’t make him drink.”  Couples therapists are not responsible and cannot control the timing of a couple’s desire to be together or their readiness to use therapy.  Every person’s right brain (nonconscious) is completely in charge of their ability to tolerate the unearthing of childhood experiences and feelings.  Our brains are programmed to protect themselves, and they are absolutely correct every time about what might create mental disintegration.  So, our clients’ right brains are in charge of the treatment; not us therapists.

Read More

Roadblocks in Therapy

Every skilled couples therapist needs to have some ideas about what to do when the treatment doesn’t seem to be working.  Fears of failure begin to creep into even the most experienced of us, so knowing how to identify the roadblocks in therapy can help us redirect the work and reduce feelings of responsibility for elements of treatment success that are beyond our control.

Read More

Love.....and Relationships

Love is patient

Read More

Clinician Need and COVID Fatigue

After nearly 24 months of life turned upside down by the worldwide COVID-19 pandemic, how are you doing? I’m certain you regularly ask others a similar question, but when was the last time someone asked you, or you even asked yourself? As clinicians, we pivoted from in-person to telehealth multiple times as the numbers grew or diminished. We altered policies and practices, learned new modalities, and experienced uncertainties personally and professionally. As social workers, we have been challenged with personal health and financial concerns, feelings of loss, guilt, and have at times felt ill equipped by our training to navigate the unprecedented changes which have been required. Social workers struggled to meet the needs of clients through virtual settings and to address complicated social justice issues which have been exacerbated by the pandemic. The many challenges associated with the pandemic require us as social workers to recognize the personal and professional toll this has taken. 

Read More

Mining Conflicts

In previous posts, I have explained why it is countertherapeutic to shut down the repetitive conflicts that bring couples to therapy.  Within those conflicts are the unmetabolized feelings that their right brains have been waiting to experience and voice.  The therapist’s job is to mine their conflicts for every possible ounce of meaningful emotions that the couple has been trying to bring to consciousness.

Read More

Self-Reflection

What makes social workers successful? What do we strive for? How do we find contentment in our profession? After almost 10 years as an active duty social worker in the Air Force, my search for the answers to these questions is still a work in progress. What remains meaningful to me are the core things that brought me to the profession--my passion for helping, my desire to advocate for social justice issues and for those in need to receive appropriate support and services.  Some days I am more successful than other days and I must admit making time to observe my thoughts does not always come naturally.  

Read More