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Daniel J. Winarick, Ph.D. Profile picture
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Mar 7 • 4 tweets • 2 min read
#Betterhelp evidently warns patients about the signs of #countertransference and instructs them what to say should it come up. What they are instructed to do is to terminate. When I saw this at first, I just thought it was beyond stupid. Upon further reflection, it’s worse. It’s… twitter.com/i/web/status/1…
Research on the therapeutic relationship & alliance has shown that it predicts outcomes of therapy. Recent research has looked more closely at this & found therapy marked by a “V curve” in the therapeutic relationship is what determines therapy outcome. V curve - good outcome. No… twitter.com/i/web/status/1…
The V curve refers to a rupture-repair dynamic, meaning the relationship is strong, there is a rupture (almost by definition involving countertransference and negative transference). Then patient and therapist work through it and repair the relationship and the alliance is back… twitter.com/i/web/status/1…
By scaring patients about countertransference & basically attempting to outlaw it, Betterhelp ensures the therapy they provide won’t work. 3/3

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More from @DrWinarick

Daniel J. Winarick, Ph.D. Profile picture
Mar 7
If you want to know how much or if your insurance will cover your psychotherapy or psychological testing with a licensed psychologist, here are some tips to use when you call your insurance company to find out: 1/
1. You will be asked which CPT codes are going to be used. Here are the answers: If therapy, ask about 90834 and 90837.

2. You will be asked what is dx code for the procedure referred to by said CPT codes (this question is obviously incoherent bc u can’t know the dx

2/
until after meeting with the person). Here is how to answer it:
For therapy, it’s F41.1.

3. CPT codes for testing are 96130 and 96131. Ask how many hours of 96131 are covered? 5? 10? 15? 20?

4. Dx code for testing is F90.0.

(Again the codes mean nothing it’s just to figure 3/
Read 8 tweets
Daniel J. Winarick, Ph.D. Profile picture
Mar 5
The history of Gordon Allport editorship of the journal during this period is also rather interesting in the context of an apparent power struggle at Harvard or Stanford w famous psychologist Boring who gave the chair job to Allport around the same time he took over editorship.
Boring evidently was not a fan of the Jews which imo explains why AA Roback, whose books on the history of psychology, psychiatry, and personality are by far the most scholarly, comprehensive, detailed & impressive accounts I’ve ever encountered, never became recognized as big.
Which is neither here nor there but telling about the polarity in political inclinations within academic psychology ca ww2 and the good guys won.
Read 5 tweets
Daniel J. Winarick, Ph.D. Profile picture
Aug 24, 2022
The capacity for guilt, ambivalence, agency, empathy, and being alone are core concepts in psychodynamic theory. These are always the “goals” of #psychodynamic therapy regardless of what DSM symptom profile a patient may display.
Steps:
1. Enhance meaning-making & the capacity to symbolize experience by using techniques aimed at getting someone curious about their own mental life (clarify, paraphrase, validate, explore, interpret) by being curious about their mental life & modeling reflective functioning.
2. Encourage empathic abilities by getting someone interested in the mental lives of people they are in close interpersonal relationships with.
3. Facilitate the expression & analysis of mixed feelings aka in vivo ambivalence tolerance skills training.
Read 5 tweets
Daniel J. Winarick, Ph.D. Profile picture
Aug 22, 2022
Some controversy over the historical record here. Did Freud get passes for his sisters to leave Nazi Germany?

Word on the street is yes but it was a luke warm effort and too late by the time he did try to get them out.

Maybe Freud hate-scholar @PeterDKramer knows more on this?
A few other questions:

1. What was Freud’s perception of rising authoritarianism-fascism-genocide in Germany and Vienna before he left for London?

2. How did it show up in his writing other than as a mangled concept known as the death instinct?
3. What - if any - antifascist actions did Freud take leading up to or after his fleeing Nazi Germany?

4. Did the Nazis really let him transport his entire office - furniture and all etc?
Read 6 tweets
Daniel J. Winarick, Ph.D. Profile picture
Aug 22, 2022
THREAD 🧵

“Schizoidia Everywhere” by Dr. W

#Solitary individuals may experience a variety of different emotional experiences & internal conflicts that would not be readily observable from behavior because generally the #solitary look they same because they are #solitary.

1/n
However, clinical experience & empirical research have shown that distinctions among #solitary types in connection to emotional functioning, social needs, and attachment-related dynamics vary considerably and have diagnostic implications.

2/n
Some #solitary individuals desperately want to belong but fear rejection and embarrassment so strongly that they isolate. This is what is commonly known as #shyness from a normative view & social #anxiety through a pathology lens in children.

3/n
Read 13 tweets
Daniel J. Winarick, Ph.D. Profile picture
Aug 22, 2022
One major difference in clinical training for ppl who go to CBT oriented versus psychodynamic schools is in connection to the supervisory process which has implications for therapist skill and ability at the post doctoral level & beyond. The difference involves process notes.1/n
In hardcore psychodynamic supervision, you might be asked to write a process note for each session which just about the worst possible task ever. It involves literally writing down every thing, every utterance from the session you can remember in like movie script form.2/n
Each process note should be long enough so that when read aloud verbatim, it can consume 45 minutes of a supervision session if need be. Usually 10 min or less of a note is read before an issue get identified, processed, & worked though. 3/n
Read 5 tweets

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