ADVANCED DBT MECHANISMS OF CHANGE - CHAPTER 5

CITATION: McWilliams, N. (2005). Preserving our humanity as therapists. Psychotherapy: Theory, Research, Practice, Training, 42(2), 139–151. https://doi.org/10.1037/0033-3204.42.2.139

ABSTRACT: Psychotherapists have traditionally embraced core values and beliefs that differ significantly from many values and beliefs that pervade contemporary, commercially oriented Western cultures. With their clients, therapists often question or challenge the culture's materialism, consumerism, appeals to vanity and greed, disdain of dependency and vulnerability, and abetment of narcissistic entitlement. Currently, however, psychotherapy is being reshaped by descriptive psychiatric diagnosis, pressures from powerful corporate interests, and antagonism from influential academic psychologists and is threatened with becoming the servant of the surrounding culture rather than its participant/observer and critic. The author notes symptoms of this trend and offers ideas about reversing it.

COVER ART: www.AlexGrey.com

PRESERVING OUR HUMANITY AS THERAPISTS

THE EFFICACY OF PSYCHODYNAMIC PSYCHOTHERAPY

THEORY AS STORY

CITATION: Wheelis, J. (2010). Mending the Mind. Psychoanalytic Dialogues, 20, 325-336. https://doi.org/10.1080/10481885.2010.483958

ABSTRACT: Cognitive behavior therapy (CBT) offers an alternative paradigm to psychoanalysis for understanding human behavior and the mechanisms of change. Dialectical behavior therapy (DBT) grew out of this tradition conceived originally for the treatment of suicidal patients with borderline personality disorder. Unlike psychoanalysis, DBT does not recognize unconscious meanings or motivations and instead focuses on sequences of measurable behavior and the contingencies that reinforce them. The treatment protocol emphasizes a deficit model and is structured around specific targets and goals combined with “skills” training (i.e., specific skill sets to help with emotional, cognitive, and behavior dysregulation) Combining an overarching dialectical philosophy, emphasis on the therapeutic relationship and mindfulness, DBT offers a comprehensive therapeutic approach including individual sessions and group work. The directive methods of CBT have often been viewed as antithetical to analytic reflection; such active therapeutic techniques on the part of the psychoanalyst are often seen as impeding the necessary free associative processes necessary for the acquisition of insight and for change. Whereas psychoanalysts help patients recognize dysfunctional patterns of behavior within the transference and alternative ways to view the transaction, they often do not help a patient implement new behaviors into their lives in systematic ways. Both psychoanalysis and DBT have much to offer and to gain. In time translation and mutual inclusion of new ideas may help bridge the gap.

IMAGE CREDIT: www.AlexGrey.com

MENDING THE MIND

CITATION: Shedler, J. (2021). The personality syndromes. In R. Feinstein (Ed.), A Primer on Personality Disorders: Multi-Theoretical Viewpoints. Oxford: Oxford University Press.
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KEY POINTS:

Personality refers to an individual’s characteristic patterns of thought, feeling, behavior, motivation, defense, interpersonal functioning, and ways of experiencing self and others. Clinical knowledge accrued over generations has given rise to a taxonomy of familiar personality syndromes. Personality syndromes exist on a continuum of functioning from healthy to severely disturbed. There is no discontinuity between normal and pathological personality.

Understanding personality syndromes requires an understanding of underlying personality processes such as inner conflicts, defenses, and motives. A diagnostic prototype is provided for each personality syndrome, which describes the syndrome in its “ideal” or pure form. A practical diagnostic method based on pattern recognition is provided, whereby clinicians consider the overall resemblance between patients and diagnostic prototypes.

The personality constructs provide the broad strokes of clinical case formulations. They can explain and contextualize presenting symptoms and disorders. Each personality syndrome is a distinct pathway to depression and requires a different treatment focus.
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Read by: Isabel P.

SoundLab Export

THE PERSONALITY SYNDROMES

January 12th, 2024: Dr. Christopher Deussing, Jenny Collard, Allison Whitmore, & Olumide Ajulo discussed the intersectionality & dialectical tensions between: (a) adherent Dialectical Behavior Therapy (DBT), (b) DBT-informed therapy, & (c) non-DBT therapy. Afterwards, there was Q & A.

Two articles were used to frame the discussion:

1) Chapman, A., Turner, B., & Dixon-Gordon, K. (2011). To integrate or not to integrate DBT with other therapy approaches? Clinical Social Work Journal, 39, 170–179. Retrieved from: https://lnkd.in/emUvtFhd

2) Wheelis, J. (2010). Mending the mind. Psychoanalytic Dialogues, 20, 325-336. Retrieved from: https://lnkd.in/etr3bRDk

This event was sponsored by www.IntegrativeDBT.com.
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SPEAKERS:

Dr. Christopher Deussing:
www.linkedin.com/comm/mynetwork/discovery-see-all?usecase=PEOPLE_FOLLOWS&followMember=dr-christopher-deussing-dsw-lcsw-c-dbt-70617b215

Allison Whitmore:
https://www.linkedin.com/in/allison-whitmore-b38935270

Jenny Collard:
https://www.linkedin.com/in/jenny-collard-therapist

Olumide Ajulo:
https://www.linkedin.com/in/olumide-ajulo-mbacp-accred-msfdbt-61a40895

DIALECTICAL BEHAVIOR THERAPY INTEGRATION - PANEL DISCUSSION (1/12/2024)

On the 1st episode of "THE TALKING CURE (with Dr. D)" podcast, 3 of Philadelphia's leading psychedelic therapy experts -- Karen L. Smith, & Dr. Sophia Brandstetter, & Dr. Christopher Deussing -- participated in a spirited panel discussion on: (a) Ketamine-Assisted Psychotherapy, (b) psychedelic therapist training, & (c) Karen's new book, "Prepare Your Self, Your Clients, & Your Practice for Ketamine-Assisted Psychotherapy: A Step-by-Step Guide" ... which can be purchased at: http://amazon.com/YourSelf-Practice-Ketamine-Assisted-Psychotherapy-ebook/dp/B0CQ9GRJLF.

This live podcast was proudly sponsored by The Ko-Op Collective, Full Living: A Psychotherapy Practice, Growth thru Change, Ketamine Kollaborations, and Integrative DBT & Psychotherapy LLC.
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Integrative DBT & Psychotherapy LLC:
http://IntegrativeDBT.com

Karen Smith:
https://linkedin.com/in/karenlsmith

Dr. Sophia Brandstetter:
https://linkedin.com/in/dr-sophia-brandstetter-lcsw-psyd-a0129311

Dr. Christopher Deussing:
https://linkedin.com/in/dr-christopher-deussing-dsw-lcsw-c-dbt-70617b215/
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The Ko-Op Collective:
http://PsychedelicTherapists.co

Full Living - A Psychotherapy Practice:
http://FullLiving.com

Growth Thru Change:
http://GrowthThruChange.com

THE TALKING CURE 1: KETAMINE THERAPY (1/17/24)

Kayla DeAngelis (Tulane University) reads the classic short story, "The Yellow Wallpaper."

THE YELLOW WALLPAPER

1/30/2024: Dr. Christopher Deussing & his clinical team discussed the article -- "WISE MIND & THE 7 ATTITUDES OF MINDFULNESS" -- co-authored by himself & Allison Whitmore, M.Ed. Read their #MediumArticle here: https://medium.com/@Dr.Deussing/7-wise-mind-attitudes-e0397349a467.

We learned about the Dialectical Behavior Therapy (DBT) concept of "Wise Mind" & how to use this DBT skill along with mindful attitudinal shifts in practical ways to live a life worth living. Afterwards, there was Q&A. This panel discussion was hosted by www.IntegrativeDBT.com.

7 WISE MIND ATTITUDES (01302024)

CITATION: Chu, J. A. (1988). Ten traps for therapists in the treatment of trauma survivors. Dissociation 1(4), 24-32.

ABSTRACT: Trauma survivor patients, particularly those who have experienced early childhood trauma & abuse, stand out in the clinical experience of many therapists as being among the most difficult patients to treat. These patients have particular patterns of relatedness, along with intense neediness & dependency which make them superb testers of the abilities of their therapists. They often push therapists to examine the rationales & limits of their therapeutic abilities, & frequently force therapists to examine their own personal issues & ethics. A conceptual framework for understanding treatment traps is presented, along with ten traps which these patients present, consciously or unconsciously, in the course of treatment. Included are traps around trust, distance, boundaries, limits, control, responsibility, denial, projection, idealization, & motivation. These are certainly not the only traps which occur in the course of treatment, but they highlight the experience of treatment & the difficulties which are encountered between the therapist & the patient. This paper is intended to be clinical in orientation to help prepare & support therapists in their work.

TEN TRAPS FOR THERAPISTS IN THE TREATMENT OF TRAUMA SURVIVORS

Kayla DeAngelis reads her term paper on the history of "hysteria."

Connect with Kayla: www.linkedin.com/in/kayla-deangelis-b79723279.
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"Hysteria is history's clearest example of how the male-dominated #medical establishment has systematically misdiagnosed women – and continues to do so."

HYSTERIA (by Kayla DeAngelis)

Three incredible mental health copywriters (Brandon Grill, Ashley Darnall, & Eilis Olson) shared their wisdom on how they help "CREATE KICKASS WEBSITES FOR THERAPISTS" through Search Engine Optimization (SEO) & other strategies. After the panel discussion there was Q & A.

This event was hosted by Dr. Christopher Deussing & Integrative DBT & Psychotherapy LLC.
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Eilis Olson: www.EilisOlsonAgency.com
Brandon Grill: www.BGcopywriter.com
Ashley Darnall: www.CopyWithAshley.com
Dr. Christopher Deussing: www.IntegrativeDBT.com

THE TALKING CURE 2: MENTAL HEALTH COPYWRITING (2/15/24)

On 2/22/2024, Olumide Ajulo, Chris Bradshaw, Dr. Christopher Deussing, & Dr. Justin Garber participated in a panel discussion covering a wide range of topics on men's mental health. Afterwards, there was a rich discussion with the panelists & attendees.

This event was sponsored by Integrative DBT & Psychotherapy LLC (http://IntegrativeDBT.com) & Restorative Psychological Services LLC (https://RestorativePsychServices.com).

To watch our 1st men's mental health panel that was in December, go to: 
https://youtu.be/VgRF8aZY5CY.

THE TALKING CURE 3: MEN'S MENTAL HEALTH (2/22/24)

THE ALIVENESS OF BEING (by Mike Moss)

3/4/2024: Kayla DeAngelis (Tulane University), Dr. Christopher Deussing, & the interns from Integrative DBT & Psychotherapy LLC (www.IntegrativeDBT.com) discussed Kayla's paper on hysteria & its connections to the classic short story, "The Yellow Wallpaper."

HYSTERIA - PANEL DISCUSSION (3/4/2024)

3/4/2024: On the 4th episode of "THE TALKING CURE with Dr. D" podcast,  Ashley Carmen, LMFT & Dr. Christopher Deussing, DSW, LCSW discussed some of the dynamics & intersectionality between the natural, clinical, & spiritual realms in the practice of of psychedelic psychotherapy.

Dr. Deussing's guest, Ashley Carmen, LMFT, is a leading expert in psychedelic therapy. She is the founder of the Psychedelic Guide Network (PGN), whose mission is to unite psychedelic guides through multi-disciplinary peer circles.

This event was sponsored by the Psychedelic Guide Network (PGN) & Integrative DBT & Psychotherapy LLC.

To connect with Ashley, go to https://PsychedelicGuideNetwork.com.
To connect with Dr. Deussing, go to http://IntegrativeDBT.com.

THE TALKING CURE 4: INTEGRATIVE PSYCHEDELIC THERAPY (3/4/24)

Jonathan Haidt discusses the deleterious effects of smartphone & digital technology addiction on Generation Z. This audio recording of the article is AI-generated. It's 53 minutes long, & disturbingly worth it.

Retrieved from:
https://www.theatlantic.com/technology/archive/2024/03/teen-childhood-smartphone-use-mental-health-effects/677722

END THE PHONE-BASED CHILDHOOD NOW (by Jonathan Haidt)

In this article, Thomas Maeder explores how the "helping professions", notably psychotherapy & the ministry, appear to attract more than their share of the emotionally unstable. 
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CITATION: Maeder, T. (January 1989). Wounded healers. The Atlantic Monthly, 37-47.

"What asylum doctor has not had his own attack of madness by dint of continual association with madmen? ... But before that, what obscure inclination, what dreadful fascination had made him choose that subject?” -Marcel Proust

WOUNDED HEALERS

Dr. Christopher Deussing (aka DR. D) moderated a panel discussion with Maria Reardon, Bonnie Kowaliuk, & Amanda Cottrell on the trials, tribulations, challenges, & celebrations of being a mother.

This "THE TALKING CURE with DR. D" podcast event was sponsored by Integrative DBT & Psychotherapy LLC (http://IntegrativeDBT.com).

THE TALKING CURE 5: MOTHERHOOD (4/11/24)

DISSERTATION DEFENSE - UNEDITED (3/6/2023)

Ilgin Gulkan, senior intern at Integrative DBT & Psychotherapy LLC (http://IntegrativeDBT.com), presented their term paper on theory of mind & the connections between human consciousness & artificial intelligence (#AI). Afterwards, Dr. Christopher Deussing & other attendees participated in an open discussion about Ilgin's paper. 🤖 🤔 🧠

A.I. VS. THE HUMAN BRAIN (4/15/2024)

4/18/2024: Olumide Ajulo (Leeds Beckett #University), Chris Bradshaw (Saybrook University), Dr. Christopher Deussing (University of Pennsylvania) & Dr. Justin Garber (Roosevelt University) did their third #PanelDiscussion on #MensMentalHealth.

The panelists continued their #exploration of various topics about #masculinity & #mens #MentalHealth. Topics included: (a) #male #psychology & #identity formation, (b) defining various types of "masculinities", (c) the #psychological #strengths & #vulnerabilities of men, & (d) the #challenges in talking openly as #men. Afterwards, there was a #SafeSpace for a dynamic #GroupDiscussion including #panel participants & attendees.

This 6th episode of the #podcast "THE TALKING CURE with DR. D" was sponsored by Integrative #DBT & #Psychotherapy LLC (http://IntegrativeDBT.com) & #Restorative Psychological Services LLC (https://restorativepsychservices.com).

THE TALKING CURE 6: MEN'S MENTAL HEALTH (4/18/24)

CITATION: Baum-Baicker C. & Sisti D. (2012). Clinical wisdom in psychoanalysis & psychodynamic psychotherapy: A philosophical & qualitative analysis. Journal of Clinical Ethics, 23(1): 13-27.

ABSTRACT: To precisely define wisdom has been an ongoing task of philosophers for millennia. Investigations into the psychological dimensions of wisdom have revealed several features that make exemplary persons “wise.” Contemporary bioethicists took up this concept as they retrieved and adapted Aristotle’s intellectual virtue of phronesis for applications in medical contexts. In this article, we build on scholarship in both psychology & medical ethics by providing an account of clinical wisdom qua phronesis in the context of the practice of psychoanalysis & psychodynamic psychotherapy. With the support of qualitative data, we argue that the concept of clinical wisdom in mental healthcare shares several of the key ethical dimensions offered by standard models of phronesis in medical ethics & serves as a useful, albeit overlooked, reference point for a broader development of virtue-based medical ethics. We propose that the features of clinical wisdom are pragmatic skills that include, but are not limited to, an awareness of balance, the acceptance of paradox, & a particular clinical manner that maintains a deep regard for the Other. We offer several suggestions for refining training programs & redoubling efforts to provide long-term mentorship opportunities for trainees in clinical mental healthcare in order to cultivate clinical wisdom.

CLINICAL WISDOM IN PSYCHOANALYSIS & PSYCHODYNAMIC PSYCHOTHERAPY

CITATION: Watson, J. (2011). Treatment failure in humanistic & experiential psychotherapy. Journal of Clinical Psychology, 67(11), 1117-28.

ABSTRACT: In this article, treatment failure in humanistic & experiential psychotherapy is defined & explored. Several markers that indicate when treatment is not going well are outlined. Factors that contribute to failure include client factors, for example, emotional processing capacities, shame, & impoverished narratives, as well as therapist factors including lack of empathic attunement & inflexibility. Treatment failure is illuminated with a case example drawn from humanistic / experiential psychotherapy, & clinical strategies for dealing with failures are recommended.

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