bitesizetherapy.bsky.social - Profile | ThreadSky | a Reddit-style client for Bluesky

One of the key components to successfully 𝑠𝑝𝑒𝑎𝑘𝑖𝑛𝑔 𝑡𝑜 𝑡ℎ𝑒 𝑠𝑝𝑙𝑖𝑡𝑠 is inviting patients to slow down enough so that they can examine what might be under the surface of their automatic responses. - Patricia Gianotti

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Ok, who’s got room to take on Trump and Musk for couples therapy?

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There is a post going around The Other Place™️ suggesting that “therapy doesn’t work.” This is like saying that cooking doesn’t work.

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Most of our methods of meeting our emotional needs are executed unconsciously, which requires us to return them to consciousness in order to change them. - Mark Solms

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An arbor care company for therapists called “Tree Association”

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How a therapist uses theory matters more than the theory they use.

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We may cling to our favorite theoretical models of explanation like a drowning man clings to the wreckage of his boat. We long for universal truths. - Glen Gabbard

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Hold theory lightly. - Donna Orange

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Be as supportive as you can be, so that you can be as expressive or exploratory as you need to be…Support and deep exploration are not antithetical…A warmly supportive stance is the best facilitator of the capacity to explore previously warded-off thoughts, feelings, and wishes. - Paul Wachtel

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🧵 1/2 We want to encourage play in psychotherapy. A curious, “I don’t know,” is a lovely way to invite mutual exploration. “That’s an intriguing idea,” “Let’s see what emerges next,” “What do you think?” are others as well…

submitted 6 days ago • 1 comment

No mortal can keep a secret. If his lips are silent, he chatters with his fingertips; betrayal oozes out of him at every pore. - Sigmund Freud

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Appearances really aren’t deceiving, you just have to know where to look. - Edgar Levenson

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It is particularly important to deal with negative transferences in the earliest sessions; otherwise, the patient may not come back. Clients often need a sense of permission to put words to what may seem “impolite” or “inappropriate” to say in other contexts. - Nancy McWilliams

submitted 8 days ago • 2 comments

A clinician who believes that they have it all figured out probably has a lot to learn.

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The tightrope of psychotherapeutic practice.

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It hardly needs to be stressed that all published clinical data reflects a carefully selected segment…This selectiveness results in conveying an idealized and unrealistic conception of the true nature of psychoanalytic work. - Otto Kernberg

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Clinical literature vs. Clinical reality

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When we have someone that we’re close to, and we want to refer them for care, we don’t refer to people based on their theoretical allegiances. We refer to people based on our sense of their character. - Lee Grossman

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The quality of attachment influences learning - secure relationships support flexible, adaptive learning. This is why establishing a therapeutic relationship - a secure attachment - is the alpha and omega of psychotherapy. - Cozolino & Santos (2014)

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Chatbots/Artificial Therapists aren’t capable of relational repair (as there is no real relationship to begin with). They can correct factual mistakes and use apologetic language. Information is not relation.

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🧵 1/3 Small ruptures probably occur in every therapeutic hour in subtle ways. Imagine a therapist making a comment that does not feel quite right to the client, who says “It’s more like this…” and offers a different version…

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Most practitioners believe that psychotherapy should be based on scientific research and not just clinical anecdote…But therapy’s being based on research is different from its being conducted like research. - Nancy McWilliams

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I am sure all analysts were warned not to disturb the transference. I have often thought that, if only I knew an easy way to disturb the transference, I would bottle it and get rich. - Herbert Schlesinger

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The client’s emotional impact on the therapist is arguably the most neglected area in therapist training. - Karen Maroda

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You can have principles that inform techniques and practice, but you can’t go from principles to manualization. - Scott Miller

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“We all wear masks” Ok, but this is kind of a lot.

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Keeping the structure of therapy a mystery does the patient a disservice. We need to be explicit with our patients about what we expect of them and what they can expect of us. The therapeutic relationship is a unique one with no parallel in ordinary social interaction. - David Wallin

submitted 17 days ago • 1 comment

I don’t think that my personal qualities disappear in the consulting room nor do I believe that personal qualities of other therapists disappear in the consulting room….I would intuit that there is less discrepancy between who they are as people outside their office versus inside. - Morris Eagle

submitted 18 days ago • 1 comment