Psychoanalytic/psychodynamic internships?

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Tosca10

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Can anyone recommend some pre-doctoral internships in the Northeast with quality psychodynamic/psychoanalytic training?
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I would also caution against only ascribing to one theoretical model. Although my basic theoretical orientation is psychodynamic and I tend to focus on interpersonal factors, I would be remiss in my treatments if I didn't use the well-researched principles from other models. The challenge is how to integrate various models effectively and in my opinion a solid understanding how the brain functions and is affected by various stimuli (including relationships as well as events or triggers) will really help with that. I also think that knowing how to address existential issues effectively is necessary since patients have these from time to time, as well.
 
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PsychBiker said:
http://www.apadivisions.org/division-39/leadership/committees/grad-students/internships.aspx

http://www.sectionfive.org/students/psychoanalytic-internship-search

May I recommend you try CBT instead? Its better validated, as well as easier to teach and learn.
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Thanks! Yes, I've already done a bunch of training in CBT, IPT, & CPP, but my passion is for insight oriented modalities. Ultimately, I hope to be able to integrate components from all of the models I've learned.
 
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When will we drop psychoanalysis as an acceptable training modality? I can accept psychodynamic as having little support but psychoanalytic is just straight up hooey. Not only is there no support but the theory behind it is almost completely accepted as being bonkers. Doesn't every intro psych course nowadays basically acknowledge that all the stages and parent sexual stuff of Freud's as a wacky artifact of the past?
 
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DynamicDidactic said:
When will we drop psychoanalysis as an acceptable training modality? I can accept psychodynamic as having little support but psychoanalytic is just straight up hooey. Not only is there no support but the theory behind it is almost completely accepted as being bonkers. Doesn't every intro psych course nowadays basically acknowledge that all the stages and parent sexual stuff of Freud's as a wacky artifact of the past?
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As long as gullible people with lots of money want to blame their parents for everything and deny any responsibility for their actions, psychoanalysis will have a seat at the table. :)
 
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smalltownpsych said:
I would also caution against only ascribing to one theoretical model. Although my basic theoretical orientation is psychodynamic and I tend to focus on interpersonal factors, I would be remiss in my treatments if I didn't use the well-researched principles from other models. The challenge is how to integrate various models effectively and in my opinion a solid understanding how the brain functions and is affected by various stimuli (including relationships as well as events or triggers) will really help with that. I also think that knowing how to address existential issues effectively is necessary since patients have these from time to time, as well.
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Just to add to this, a common trap for trainees is to pick and choose interventions while ignoring the (possibly conflicting) tenets underlying each theoretical model. To borrow a building analogy: The amateur handyman uses various tools (interventions) and ignore the instructions (theory) about how/when to use the tools. The results are akin to try to build a house using a welding torch, screw driver, and paint brush. There needs to be a master blueprint (treatment plan) that includes a timeline, tools, materials, etc. and a general contractor who knows how to make it all fit.

Now I want to go build some cabinets.
 
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Asking for advice about psychodynamic and psychoanalytic approaches on this board is like asking a Baptist message board where to find the best Catholic churches.
 
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DynamicDidactic said:
When will we drop psychoanalysis as an acceptable training modality? I can accept psychodynamic as having little support but psychoanalytic is just straight up hooey. Not only is there no support but the theory behind it is almost completely accepted as being bonkers. Doesn't every intro psych course nowadays basically acknowledge that all the stages and parent sexual stuff of Freud's as a wacky artifact of the past?
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https://www.psychologytoday.com/sit...ts/134230/shedler-2006-was-then-is-now-r9.pdf

Don't bash something you know nothing about. I thought this was a forum for positive support, not a place to be criticized without providing any helpful advice. I do not ascribe to Freud's psychosexual theories of development.
 
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I'd have to disagree with this statement when i'm online (when i'm offline...who cares, right?).

I don't have time to upgrade you all on "Freud's theories" right now...(but heads up, psychodynamic and analytic theories have evolved...and "if it's not one thing, it's your mother " is passe' and fun to continue stereotyping - I mean, sometimes the shoe does fit ), so I'll be back in defense (no pun intended) soon enough to ponder your positions...

As it may be over potentially-rigid minds to ponder our's (position). Oooooo...not meant to be a low blow but sure sounded like one.‎

QAsPsych: "I will taunt you another time" ~ said‎ in the spirit of the French Soldier in Monty Python and the Holy Grail to King Arthur.

CheetahGirl ;)
‎
QAsPsych said:
Asking for advice about psychodynamic and psychoanalytic approaches on this board is like asking a Baptist message board where to find the best Catholic churches.
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‎‎
 
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Tosca10 never said they only wanted to practice psychodynamic therapy!

If you are a clinician working in the Northeast and have an attitude of "down with psychodynamic therapy," you are generally going to be thought of as less competent than someone who integrates treatment approaches. There is solid research demonstrating the effectiveness of some psychodynamic interventions. Even if you are a strictly CBT therapist, you will come across very badly if you categorically dismiss psychodynamic therapists.
 
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Peacemaker36 said:
Tosca10 never said they only wanted to practice psychodynamic therapy!

If you are a clinician working in the Northeast and have an attitude of "down with psychodynamic therapy," you are generally going to be thought of as less competent than someone who integrates treatment approaches. There is solid research demonstrating the effectiveness of some psychodynamic interventions. Even if you are a strictly CBT therapist, you will come across very badly if you categorically dismiss psychodynamic therapists.
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Oh my gosh, thank you! I already do try to take an integrative approach with my clients :)
 
CheetahGirl said:
‎I'd have to disagree with this statement when i'm online (when i'm offline...who cares, right?). I don't have time to upgrade you all on "freud's theories" right now...(but heads up, psychodynamic and analytic theories have evolved...and 'if it's not one thing, it's your mother is passe' and fun to continue stereotyping) so I'll be back in defense (no pun intended) soon enough to ponder your positions...

As it maybe over potentially rigid minds to ponder ours (position). Oooooo...not meant to be a low blow but sure sounded like one.‎

QAsPsych: "I will taunt you another time" ~ said‎ in the spirit of the French Soldier in Monty Python and the Holy Grail to King Arthur.

CheetahGirl ;)‎
‎
‎..
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CheetahGirl, I'm with you completely (well, not completely....), all I was saying is I find this board a bit hostile to certain empirically supported but unpopular approaches ;)
 
Sweet! Nicely stated.
Peacemaker36 said:
Tosca10 never said they only wanted to practice psychodynamic therapy!

If you are a clinician working in the Northeast and have an attitude of "down with psychodynamic therapy," you are generally going to be thought of as less competent than someone who integrates treatment approaches. There is solid research demonstrating the effectiveness of some psychodynamic interventions. Even if you are a strictly CBT therapist, you will come across very badly if you categorically dismiss psychodynamic therapists.
Click to expand...
 
Peacemaker36 said:
Tosca10 never said they only wanted to practice psychodynamic therapy!

If you are a clinician working in the Northeast and have an attitude of "down with psychodynamic therapy," you are generally going to be thought of as less competent than someone who integrates treatment approaches. There is solid research demonstrating the effectiveness of some psychodynamic interventions. Even if you are a strictly CBT therapist, you will come across very badly if you categorically dismiss psychodynamic therapists.
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For me anyone who doesn't take into account the complexity of interpersonal dynamics and family dynamics as it plays a role in current behaviors and ability to regulate emotion is not using the full array of tools. Just as someone who only focused on the interpersonal and family factors would be doing a disservice by not using progressive exposure therapy for trauma or exposure-response prevention for OCD.
 
Tosca10 said:
Oh my gosh, thank you! I already do try to take an integrative approach with my clients :)
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Can you or anyone recommend me books/articles/ that describe how to use an integrative approach? Thanks!
 
Childdoconeday said:
Can you or anyone recommend me books/articles/ that describe how to use an integrative approach? Thanks!
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I am not a fan of this new fad of "Integrative."

1. I don't think some approaches are able to "integrated" with each other lest they be contradicting each other. Can you "integrate" CBT and ACT? I dont know? Maybe, kinda? You can easily do both, I can see that.

2. I doubt most actually DO integrate them. Likely just using some here and some there.

3. To be truly "integrative" in your therapeutic process, you have to not only be competent in each one, but extremely knowledgeable/skilled in each one. And lets be real. Most newly minted psychologist are just not there yet.
 
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smalltownpsych said:
For me anyone who doesn't take into account the complexity of interpersonal dynamics and family dynamics as it plays a role in current behaviors and ability to regulate emotion is not using the full array of tools. Just as someone who only focused on the interpersonal and family factors would be doing a disservice by not using progressive exposure therapy for trauma or exposure-response prevention for OCD. .
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Note: I consider my main orientations to be CBT/DBT, and have limited exposure to psychodynamic approaches. Luckily, I don't live in the Northeastern United States, so this orientation has worked out fine for me. ;)

Smalltownpsych: I'm reading the above as implying that one cannot take into account interpersonal dynamics in a CBT framework--which may not have been your intention. If not, can you clarify what you did mean?

I think the CBT model lends itself quite well to understanding interpersonal dynamics/family dynamics. For example, using a CBT framework I can work with clients in understanding interconnections between thoughts-feelings-behaviours in interpersonal interactions (and even the thoughts-feelings-behaviours of multiple people; see CBT for couples)... And I can also help them to understand interpersonal reinforcers of behaviour and emotion regulation (e.g., what is keeping them stuck). Both of these ways of conceptualizing lend themselves easily to interventions that I've found are very effective. So I'm stuck on why I would want/need to "integrate" other approaches here. My sense is that bringing in other conceptualizations might be confusing for my clients, since I'm pretty transparent about what model I'm using and I want them to be able to use the model themselves after we're done our work together.
 
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erg923 said:
I am not a fan of this new fad of "Integrative."

1. I don't think some approaches are able to "integrated" with each other lest they be contradicting each other. Can you "integrate" CBT and ACT? I dont know? Maybe, kinda? You can easily do both, I can see that.

2. I doubt most actually DO integrate them. Likely just using some here and some there.

3. To be truly "integrative" in your therapeutic process, you have to not only be competent in each one, but extremely knowledgeable/skilled in each one. And lets be real. Most newly minted psychologist are just not there yet.
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I feel the same way...but am very curious. I truly would be interested to learn more about the integrated approach, but do not know where to start (which theorist/readings to look into). Also, I want to know which approaches are able to be integrated.
 
Tosca10 said:
https://www.psychologytoday.com/sit...ts/134230/shedler-2006-was-then-is-now-r9.pdf

Don't bash something you know nothing about. I thought this was a forum for positive support, not a place to be criticized without providing any helpful advice. I do not ascribe to Freud's psychosexual theories of development.
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Pay no mind. There are those on this forum who love to do nothing but derail original posts in an effort to "inform you". While I generally agree that you do not want a site in which you will only receive psychodynamic training, I do not believe a small rotation or conceptualizing a few patients from this modality would be harmful. I do not have a specific site to offer you, however I do know that there is a heavy emphasis and major following of both dynamic and analytic approaches in the Philadelphia area. Hell, there's even a place called the Psychoanalytic Center where you can receive training after you receive your doctorate to become an analyst. Maybe start your search there?
 
Childdoconeday said:
I feel the same way...but am very curious. I truly would be interested to learn more about the integrated approach, but do not know where to start (which theorist/readings to look into). Also, I want to know which approaches are able to be integrated.
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John C. Norcross has published quite a bit on integrative models for supervision and integrated approaches to psychotherapy, so you should probably start with his work. Norcross & Goldfried wrote, "Handbook of Psychotherapy Integration", which I don't own…but I've heard good things about. I find Norcross' work to be very accessible (from a learning perspective).
 
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I integrate all day long. I just can't help myself, I've learned a lot of things that are helpful in my conceptualizations and treatment and every day I come up against an issue or problem that I am not sure what to do next. Even when applying a straightforward, well-researched approach, it doesn't always work for that individual and then you have to try something else. That is the job we do and to pretend that there is a formula that treatment A works with disorder A is where some clinicians own narcissistic defense against feelings of inadequacy begin to show. This tends to be a bigger problem with medications or grad students or the really old dogs in the field than the bulk of psychologists that I have worked with over the years. Also, the non-empirically informed EMDR or "whatever feels good" crowd are a much bigger problem.
 
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thewesternsky said:
Smalltownpsych: I'm reading the above as implying that one cannot take into account interpersonal dynamics in a CBT framework--which may not have been your intention. If not, can you clarify what you did mean?
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What I meant was that there is typically a difference in focus with the two approaches. I don't believe that the two are mutually exclusive in any way. We used to have arguments in grad school about the difference between a schema and patterns of interpersonal relating verses internalized object relations. I tend to focus more on how the brain actually works and use that to guide my conceptualization and treatment. Concepts such as attunement and emotional regulation and CNS arousal and attachment and brain structures and how they interact with each other all seem to play out with my patients every day and helping them form new patterns of relating, behaving, and thinking all come together to form different function in the brain.
 
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PsychBiker said:
May I recommend you try CBT instead? Its better validated, as well as easier to teach and learn.
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I'm sorry. It's my bad for assuming people would identify my sarcasm. I didn't mean to start an orientation war (or maybe I did).

DynamicDidactic said:
When will we drop psychoanalysis as an acceptable training modality? I can accept psychodynamic as having little support but psychoanalytic is just straight up hooey. Not only is there no support but the theory behind it is almost completely accepted as being bonkers. Doesn't every intro psych course nowadays basically acknowledge that all the stages and parent sexual stuff of Freud's as a wacky artifact of the past?
Click to expand...

There is something fundamentally incorrect in each and every of your sentences... Try not to confuse your bias with reality.


Moving on, I think it is irresponsible (and somewhat unethical) to provide only one psychologically-orientated model to patients in consideration of the varying spectrum of problems found in clinical practice. Moreover, it is "bonkers" to discredit much of what is found in psychodynamic (aka psychoanalytic) theories as most, if not all, current modes of therapy have grown out of it (e.g. compare Cognitive Distortions to Defense Mechanisms). There is no "one" correct way, and I do not think major theorist has ever suggested their model was the only way (okay, except maybe Freud, and everyone understands he was arrogant, narcissistic, and condescending).

Its not that I don't like CBT or any most other models (considering I use them), I just take personally issue with those who use one model as the end-all for everything.
 
PsychBiker said:
I just take personally issue with those who use one model as the end-all for everything.
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Agreed. This is also my issue w/ BPD supervisor from the other thread (who is also CBT-oriented). The narrow frame from which to serve the patients seems harmful to me. Why can't several finely-tailored approaches (i.e., integrated) be applied to interventions, rather than 'my way or the highway'?!?
 
Although I agree that the old fashioned classical analytical model of treatment is deeply flawed, I don't think that means that everything that has grown out of the concepts is flawed or that Freud did not engender a revolution in Western thought and culture. It might be difficult for many of us to see that cognitive behavioral psychology grew out of Freud because we take the post-Freudian view of the world as "normal" or just the way it is. I have been working recently with people who are less affected by the post-Freudian culture and I can tell you there is a world of difference in how they conceptualize psychological distress.
 
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WisNeuro said:
I respect some of the empirically supported dynamic work, but I'm with DD on analysis. Show me some good efficacy studies and I may change my mind, but I have yet to see them.
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Is what we subjectively believe in no longer matter? Is something only meaningful if we can substantiate it empirically? Yes, I realize personal bias (among others) is an issue, but some phenomena may never be explained in any objective way, so do we just discard our beliefs?

I don't know the answers. I feel like if anyone is absolutely certain of what is the correct way, perceives the mind (as we currently understand it) as a static object instead of something that is always fluctuating (i.e. dynamic). I see several logical fallacies in this, but my point is still the same regardless of how I present it.
 
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Yeah, total straight up hooey, look at all these phony internship sites that are listed as supporting psychoanalytic/psychodynamic training. Bellevue? Columbia? Who has ever even heard of these places, and why don't they know about those compelling, bulletproof efficacy studies???
New York
Albany Psychology Internship Consortium — Albany (APA Accredited)
Albert Einstein College of Medicine/Montefiore Medical Center — Bronx (APA Accredited)
N.Y.U Bellevue Hospital — New York (APA Accredited)
Beth Israel Medical Center — New York (APA Accredited)
Columbia University Medical Center — New York (APA Accredited)
Fordham Counseling Center — Bronx (APA Accredited)
Jacobi Medical Center — Bronx (APA Accredited)
Jewish Board of Family & Children's Services — New York (APA Accredited)
Kings County Hospital Center — Brooklyn (APA accredited) (APA Accredited)
Lenox Hill — New York (APA Accredited)
Long Island Jewish Medical Center – Glen Oaks (APA Accredited)
Lincoln Medical and Mental Health Center — Bronx (APA Accredited)
Manhattan Psychiatric Center — New York (APA Accredited)
Maimonides Medical Center — New York (APA Accredited)
Nassau University Medical Center — East Meadow (APA Accredited)
New York Presbyterian Hospital/ Weill-Cornell — New York (APA Accredited)
North Bronx Healthcare Network — Bronx (APA Accredited)
St. Luke's Roosevelt Hospital Center — New York (APA Accredited)
Stony Brook Counseling Center — Stony Brook (APA Accredited)
Woodhull Medical and Mental Health Center — Brooklyn (APA Accredited)
 
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PsychBiker said:
Is what we subjectively believe in no longer matter? Is something only meaningful if we can substantiate it empirically? Yes, I realize personal bias (among others) is an issue, but some phenomena may never be explained in any objective way, so do we just discard our beliefs?
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PGGage said:
Yeah, total straight up hooey, look at all these phony internship sites that are listed as supporting psychoanalytic/psychodynamic training. Bellevue? Columbia? Who has ever even heard of these places, and why don't they know about those compelling, bulletproof efficacy studies???
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PsychB, when it comes to treatment, no, I don't care about your subjective beliefs as a clinician. I care about proven treatment methods. In Tanzania, people kill Albinos because they subjectively believe that using their body parts as charms will give them powers. Should we honor those beliefs? What about those they believe in reperative therapy for homosexuals? Do we let them go too? Study it all you want, wax philosophical about it, just don't pass it off as a treatment until you can show some efficacy above and beyond no treatment or placebo.

And Gage, yes, dynamic treatment does have some empirical support. Still looking for those analytic RCT's though.
 
Wis, you see the logically fallacies and the absurdity in your comparisons, yes? Beyond that, reparative therapy can and has been proven as ineffective, can the same be said about analytic therapies?

Check out Doidge (1997) and Bachrach (1991); age and lack of RCTs does not make something invalid.
 
Just as absurd as the argument they are against, which was the point. Those are not RCT's. Some evidence, but biased and lack the rigor of the gold standard. Any "treatment" can have an effect. You need adequate comparison studies. Show me some RCT's, some comparisons against other treatments. Show me that there is an added value that justifies long-term (e.g., years) of therapy. Invalid, maybe not. Ineffective, probably.
 
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WisNeuro said:
Just as absurd as the argument they are against, which was the point. Those are not RCT's. Some evidence, but biased and lack the rigor of the gold standard. Any "treatment" can have an effect. You need adequate comparison studies. Show me some RCT's, some comparisons against other treatments. Show me that there is an added value that justifies long-term (e.g., years) of therapy. Invalid, maybe not. Ineffective, probably.
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I could not do years of therapy. I almost always have a few patients on my case load that our work together is going to take about a year. Severe early childhood trauma with NSSI and chronic suicidality, i.e., borderline traits. A few sessions building rapport and providing psychoeducation, then a month or so dealing with the SI, then the NSSI, then we get to the trauma work. Usually patient is having some serious nightmares at that point. It's probably no accident that when the patient stops using the maladaptive coping, the trauma comes to the forefront. Then we begin developing the non-sick identity (kind of existential stuff in a way or I guess you could call it forming new schemas) and then process termination.

The majority of my patients I work with for a few months so about 8 to 10 sessions, symptom relief and usually a significant positive change or two in their lives during that process. End a bad marriage, change jobs, start school, come out of the closet, etc. About a third of those might see me for closer to 6 months about 18-20 sessions because they want to or need to make a few more changes or they wanted a little more support through those changes. Then there are the crisis intervention types that I see for one or two sessions, they get some empathy and a cognitive tip or two and are on their way.

The only patients that I have seen be in therapy for years with other therapists seem to be stably mildly to moderately sick and I am not sure if they want to improve or not. I was transferred a few of these patients from another psychologist once and we didn't get along too well. I think my expectation for them to want to improve made them too uncomfortable. One reason that I often prefer adolescents, they tend to be more motivated to change.

Some of my experience fits pretty solidly with the research, although I am not sure what the research says about the "chronic patients" and what to do about them. I often wonder how much of their clinical presentation is iatrogenic as my intuitive sense is that it plays a role.
 
Therapist4Chnge said:
Just to add to this, a common trap for trainees is to pick and choose interventions while ignoring the (possibly conflicting) tenets underlying each theoretical model. To borrow a building analogy: The amateur handyman uses various tools (interventions) and ignore the instructions (theory) about how/when to use the tools. The results are akin to try to build a house using a welding torch, screw driver, and paint brush. There needs to be a master blueprint (treatment plan) that includes a timeline, tools, materials, etc. and a general contractor who knows how to make it all fit.

Now I want to go build some cabinets.
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Awesome point and one that seems grossly under-appreciated these days as we are awash in a tide of alphabet-soup protocols for specific conditions--don't get me wrong, protocols/operationalization of therapy is in general a good thing, as is structure but I'm a fan of 'flexibility within fidelity' and the dissemination of competencies in empirically-supported principles/procedures of behavior change (e.g., cognitive restructuring, behavioral activation, contingency management) that are applicable across a broad range of conditions.

One of the things I am finding these days as I dust off older texts in cognitive and behavioral therapies (e.g., Beck's Cognitive Therapy and the Emotional Disorders, or Meichenbaum's classic cognitive-behavioral therapy book) is that these books are wonderfully rich in the underlying theory (grounded in empirical research, mind you) as compared to most modern treatments of the topic that read like aircraft repair manuals at times...do this, here is a list of x,y,z, 'here is a form to do that'. Both theoretical and nuts and bolts info are useful but I fear that (unless they go to a good program that teaches theory and case formulation) the trainees these days may not get a sufficient grounding in theory--which is critical and indispensable in helping know how to apply the nuts and bolts. And don't forget the importance of the therapeutic alliance/relationship--if you ain't paying attention to that, then you ain't doing CBT :).
 
CheetahGirl said:
I'd have to disagree with this statement when i'm online (when i'm offline...who cares, right?).

I don't have time to upgrade you all on "Freud's theories" right now...(but heads up, psychodynamic and analytic theories have evolved...and "if it's not one thing, it's your mother " is passe' and fun to continue stereotyping - I mean, sometimes the shoe does fit ), so I'll be back in defense (no pun intended) soon enough to ponder your positions...

As it may be over potentially-rigid minds to ponder our's (position). Oooooo...not meant to be a low blow but sure sounded like one.‎

QAsPsych: "I will taunt you another time" ~ said‎ in the spirit of the French Soldier in Monty Python and the Holy Grail to King Arthur.

CheetahGirl ;)
‎
‎.‎.
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Does your 'mother smell of elderberries?'

LOL...I love that movie :)
 
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smalltownpsych said:
I could not do years of therapy. I almost always have a few patients on my case load that our work together is going to take about a year. Severe early childhood trauma with NSSI and chronic suicidality, i.e., borderline traits.
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NSSI?
 
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Non-suicidal self-injury methinks
 
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WisNeuro said:
I respect some of the empirically supported dynamic work, but I'm with DD on analysis. Show me some good efficacy studies and I may change my mind, but I have yet to see them.
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Thank you, it seems like folks did not read my post accurately.

DynamicDidactic said:
I can accept psychodynamic as having little support but psychoanalytic is just straight up hooey. Not only is there no support but the theory behind it is almost completely accepted as being bonkers.
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I guess I could have said Freudian psychoanalysis. However, while not hooey the actually therapeutic portions (as opposed theoretical) of ego psychology, self psychology, etc are pretty worthless as well.

Notice, that is not what I say for psychodynamic.

If someone is treated with IPT for depression, I can completely see the merit of doing so.

If someone attempts to treat eating disorders psychoanalytically (or psychodynamically) I call foul.
http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2013.12121511

If someone has a suicidal client with BPD and does not use DBT, I call foul.
http://www.ncbi.nlm.nih.gov/pubmed/16818865

Sorry for derailing this thread.
 
Fan_of_Meehl said:
Non-suicidal self-injury methinks
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Yup. Cutting or scratching and sometimes burning. I wonder if there has ever been a study that correlates severity of self-harm with severity or type of trauma. My experience has been that the deeper the scars are then the deeper the scars. Also, I find that the DBT method of focusing on the immediate triggers for the self harm in painstaking detail to be very useful. Also, I find that the natural reaction of most staff or family members is to try to control the behavior or to minimize or invalidate the behavior as "attention seeking" (a phrase I hate by the way) and this tends to make the condition and behavior to increase. Linehan is spot on with the concept of dialectics and radical acceptance cause when that is going on I have a remarkable success rate of getting behavior to decrease and then begin addressing the true needs in healthier ways. As you were saying earlier is that most people don't understand the underlying theory and then the application of the technique is kind of like a parrot speaking English. It's not the same thing. It is really painfully bad with DBT with most people who say they do it not being able to articulate anything intelligible about the theory. A good test is just to ask them to describe why it is called dialectical.
 
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smalltownpsych said:
Yup. Cutting or scratching and sometimes burning. I wonder if there has ever been a study that correlates severity of self-harm with severity or type of trauma. My experience has been that the deeper the scars are then the deeper the scars. Also, I find that the DBT method of focusing on the immediate triggers for the self harm in painstaking detail to be very useful. Also, I find that the natural reaction of most staff or family members is to try to control the behavior or to minimize or invalidate the behavior as "attention seeking" (a phrase I hate by the way) and this tends to make the condition and behavior to increase. Linehan is spot on with the concept of dialectics and radical acceptance cause when that is going on I have a remarkable success rate of getting behavior to decrease and then begin addressing the true needs in healthier ways. As you were saying earlier is that most people don't understand the underlying theory and then the application of the technique is kind of like a parrot speaking English. It's not the same thing. It is really painfully bad with DBT with most people who say they do it not being able to articulate anything intelligible about the theory. A good test is just to ask them to describe why it is called dialectical.
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I'm interested in your (and others') opinion regarding utilizing some of Linehan's philosophy and techniques with folks who don't formally meet criteria for BPD but who have emotional dysregulation as a core feature of their case forumulation. I really like her model of prioritization of therapy targets (goes something like (1) life-threatening behaviors, (2) therapy-interfering behaviors, and (3) {general targets of intervention? can't remember the terms right now}...I think that this is a great generic scheme to utilize with all clients presenting with (1) and/or (2) which must be addressed before progressing on to (3).
 
as I say in another thread, I think generally speaking psychologists are bad at doing their jobs. To be more behaviorally specific bad means the following:

1. http://pps.sagepub.com/content/9/4/355.short

2. the consequences of ineffective treatments are small for psychologists. The worst, usually, is the client quitting. If psychologists were sued more often or suicide was a more common occurrence, we would definitely see practitioners shape up or ship out.

3. Psychologists have a hammer and see the world as a nail. If I learned X treatment/approach then every problem is solvable with the singular approach.

4. The field is constantly changing and practitioners do not keep up. What you learned in graduate school 40 years ago is often not applicable today.

5. Education is a mess. Either we are diluting science training creating practitioners lacking the skills to properly judge rigor and efficacy of treatments or we are creating scientist who cannot provide treatment.

There are probably more and these are on average, obviously not applicable to every individual.
 
smalltownpsych said:
Yup. Cutting or scratching and sometimes burning. I wonder if there has ever been a study that correlates severity of self-harm with severity or type of trauma. My experience has been that the deeper the scars are then the deeper the scars. Also, I find that the DBT method of focusing on the immediate triggers for the self harm in painstaking detail to be very useful. Also, I find that the natural reaction of most staff or family members is to try to control the behavior or to minimize or invalidate the behavior as "attention seeking" (a phrase I hate by the way) and this tends to make the condition and behavior to increase. Linehan is spot on with the concept of dialectics and radical acceptance cause when that is going on I have a remarkable success rate of getting behavior to decrease and then begin addressing the true needs in healthier ways. As you were saying earlier is that most people don't understand the underlying theory and then the application of the technique is kind of like a parrot speaking English. It's not the same thing. It is really painfully bad with DBT with most people who say they do it not being able to articulate anything intelligible about the theory. A good test is just to ask them to describe why it is called dialectical.
Click to expand...

Sort of:

http://www.ncbi.nlm.nih.gov/pubmed/20386254
 
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Cool, thanks, I'll check the article out (looks good). BRAT's a good journal--they were willing to publish some of the studies on thought suppression and psychopathology in the late 1990's back when the faculty at my doctoral training program (most of them) admonished me that Daniel Wegner's (now at Harvard) model of thought suppression (which involved the paradoxical effects of attempted thought suppression and came from the cognitive/experimental and social psychological realms and had empirical support [as well as making logical sense]) was 'too psychodynamic' (it wasn't psychodynamic at all, they were just unfamiliar with it [I tried] and didn't get that it was an information-processing model that elegantly cut across diagnostic domains to articulate a core process with direct relevance to psychopathology). My core training and practice is along traditional behavioral (including behavior analytic), cognitive-behavioral, and (Beckian) cognitive therapies. This experience with the faculty who basically told me (and my mentor) that if I pursued (as intended) to empirically investigate the topic of 'thought suppression and psychopathology' (this was around 1998 so it was prior to the 'success' of that paradigm in clinical psychology and the mindfulness/ACT wave) I would probably not graduate (despite being a solid, oft praised grad student in the program) struck me as extremely odd given their professed zeal for scientific reasoning and practice. I think they simply had a 'knee-jerk' reaction to the term 'suppression' (which in Wegner's model was more about repeatedly re-directing one's attention until that re-direction became an automatic/overlearned cognitive process) and associated it with psychodynamic/psychoanalytic schools (which it had no association with). In the early 2000's, thought suppression and psychopathology, as I recall, was the theme of an entire issue of Behavior Research and Therapy.
 
DynamicDidactic said:
Thank you, it seems like folks did not read my post accurately.


I guess I could have said Freudian psychoanalysis. However, while not hooey the actually therapeutic portions (as opposed theoretical) of ego psychology, self psychology, etc are pretty worthless as well.

Notice, that is not what I say for psychodynamic.

If someone is treated with IPT for depression, I can completely see the merit of doing so.

If someone attempts to treat eating disorders psychoanalytically (or psychodynamically) I call foul.
http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2013.12121511

If someone has a suicidal client with BPD and does not use DBT, I call foul.
http://www.ncbi.nlm.nih.gov/pubmed/16818865

Sorry for derailing this thread.
Click to expand...

What about mentalization therapy for BPD? It has some good support behind it.
 
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