1/ In one clinical psychology doctoral program where I taught, students were explicitly instructed to "choose a theoretical orientation" in 1st year. None had enough background to have a clue what they were choosing & rejecting. These career-defining "choices" were based on
2/ stereotypes, ignorance, superficial passing impressions, and above all, on which particular faculty member they found charismatic. And from that moment forward, operating from utter ignorance, they knew & what to irrationally idealize and "follow," and who & what to
3/ denigrate, sneer at, and turn a deaf ear to.
It was institutionally-sanctioned training in *not* being a critical thinker, & in mindless conformity to "our" cause & mindless derogation of "their" cause. Most of the faculty—*doctoral* faculty, at least in name— seemed to
4/ think this was perfectly reasonable and fine. Which lead me to wonder whether they themselves had ever been in actual doctoral programs, vs. doctoral programs in name only. It's an established, "respectable" graduate program. I can count on my fingers the number of graduates
5/ I'd trust to treat a loved one or family member. I can still feel the stain on my soul.

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More from @JonathanShedler

11 Jan
1/ Many therapists have difficulty discussing fees & payments because they gravitate to the role of caretaker/nurturer and focus on patients' needs to the relative exclusion of their own.

Discussing fees puts the uncomfortable truth front & center: the therapist has needs too.
2/ Therapists are humans, not saints or martyrs. Most have good hearts & truly want to help. Nevertheless, therapists do not do this work *purely* out of the goodness of our hearts. Therapists need to make a living. Most need to feel they are doing something meaningful & valuable
3/ with their time & their lives (which is why it can feel so demoralizing to work with pts who are uninterested in psychological change or in making use of their therapy).
Ultimately, the therapy relationship—like all successful human relationships—must work for TWO people.
Read 4 tweets
8 Jan
Under-thinking is also not especially conducive to happiness. And herein (yet again) is the problem with simplistic one-liners, falsely represented as "psychology." [thread continues... 1/7]
Some personality styles are characterized by impulsive choices & actions, without sufficient thought about consequences—which can and does lead to disaster. The last thing they need is advice not to "overthink." Some personality styles are characterized by intellectualization
2/7
("overthinking"), inhibition, and inaction, and the last thing they need is advice to think about things more. Some personality styles oscillate between the two, sometimes acting impulsively, sometimes stuck in rumination and unable to take action when necessary.
3/7
Read 8 tweets
8 Jan
Under-thinking is also not especially conducive to happiness. And herein (yet again) is the problem with simplistic one-liners, falsely represented as "psychology."
2/ Some personality styles are characterized by impulsive choices & actions, without sufficient thought about consequences. It can be disastrous, and the last thing they need is advice to not "overthink" things. Some personality styles are characterized by intellectualization
3/ ("overthinking"), inhibition, and inaction, and the last thing they need is advice to think things through. Some personality styles oscillate between the two, sometimes acting impulsively, and sometimes stuck in rumination and unable to act when necessary.
Read 6 tweets
7 Jan
See this paper. The studies sanctioned/cited by academic researchers consider only brief, time-limited (8-12 session) therapies conducted by instruction manual ("manualized" therapy). Which, in the eyes of expert clinicians, are not psychotherapy.
bit.ly/3Fo9Y7q
*Hmm, web page seems to be down at the moment. Here's link to a pdf of the paper
jonathanshedler.com/wp-content/upl…
Also see this paper, on how and why therapy research goes wrong
jonathanshedler.com/wp-content/upl…
Read 4 tweets
5 Jan
Psychoanalytic therapists posting on Twitter often use theoretical/technical terms not understood by general public, or name-drop about theorists unknown to public. Untrained/uninformed Insta-therapists are communicating clearly, legit professionals are not.

We must change this.
/2 I can’t count no. of times I’ve described a psychoanalytic *concept* or *idea* on Twitter—in a straightforward way accessible to anyone—only to have a colleague respond by naming an individual theorist—& thereby steering thread in an arcane direction accessible only to a TINY
Read 13 tweets
4 Jan
1/ The goal of psychoanalytic (or psychodynamic) psychotherapy is not to get patient to "accept" anything. Goal is to help person to better know their own mind—and so make freer choices. It therefore serves interests of the patient alone, not the state & not an institution.
2/ This stands in contrast to treatments based on diagnoses & disorders that have goals other than self-knowledge & self-awareness—which may be set by someone/something other than the patient.
Psychodynamic therapy therefore requires that therapist work for the patient alone,
3/ not for an institution/service/health insurance co. This may be one reason psychoanalytic therapy rarely finds a happy home in institutional settings (with some notable exceptions)—& perhaps why health insurers/state-funded health care systems are so often dead set against it.
Read 5 tweets

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