Let's Learn Together - Psychotherapy by Smith

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	Full Title:	Psychotherapy A Practical Guide
	Author(s):	Jeffery Smith
	Publishing / Edition:	Springer, 2017

Click here for the Table of Contents of the book

Chapter 1.

Chapter 2.

2.1 Jack 7
2.2 Dividing the Problem 8
2.3 Jack's Personality 8
2.4 Dealing with Jack's Reluctance 9
2.5 Jack's Panic Attack 10
2.6 Asking Why 11
2.7 A Third Module 11
2.8 A More Complete Picture 12
2.9 The Basic Unit of Pathology 13
2.10 Advantages of the EDP Concept 13
2.11 Resisting Positive Change 15
2.12 A Fresh Approach to Jack's Treatment 16
2.13 Integrated, Modular Treatment 17
References 18

Chapter 3.

3.1 Affect Avoidance 19
3.2 Use of the Word Affect 20
3.3 The Mind as a Control Structure 20
3.4 A Silver Lining 22
3.5 Affect Avoidance Is Not a New Concept 22
3.6 What Is the Role of Pleasure? 23
3.7 What About Biology? 24
3.8 Relating the Affect Avoidance Model to Other Therapies 25
3.9 Compatibility with Other Models 26
3.10 The Detailed Structure of EDPs 28
3.11 The Nonconscious Problem Solver 30

3.11.1 Potential Behaviors 30
3.11.2 Helpers 31
3.11.3 Symptoms 32

3.12 How Protections Become Problems 32
3.13 The Gifts of Consciousness 34
3.14 The Affect Avoidance Model Applied to Psychotherapy 34
3.15 A Unifying View of Psychotherapy 35
3.16 Making Use of Different Therapies 36
3.17 Putting It All Together 36
3.18 Modular Therapy 37
3.19 Cyclical Therapy 37
3.20 Conclusion 38
References 39

Chapter 4.

4.1 What Shapes Avoidance Patterns? 41
4.2 The New Science of Memory 42
4.3 Practical Application 43
4.4 Procedural Memory 44
4.5 A Catalog of EDPs 45

4.5.1 Dysfunctional Behaviors 45
4.5.2 Helpers 47
4.5.3 Symptoms 48
4.5.4 Anxiety-Based Symptoms 48

4.6 Conclusion 49
References 50

Chapter 5.

5.1 Breaking the Chain 51
5.2 How Healing Works 52
5.3 Extinction 53
5.4 Reconsolidation 54
5.5 Anna O.: A Case of Reconsolidation 55
5.6 Healing in the Real World 56
5.7 Repetition 56
5.8 From Words to Healing 57
5.9 Healing Beyond Trauma 57

5.9.1 Pride, Guilt, and Shame 57
5.9.2 Attachment 58
5.9.3 Ideas 58
5.9.4 Psychological Development 58

5.10 Conclusion 59
References 60

Chapter 6.

6.1 A Prototype 61
6.2 The Ubiquity of Emotional Healing 62
6.3 Are There Exceptions? 63
6.4 Mindfulness 63
6.5 A Proposed Explanation of Mindfulness 64
6.6 When a Witness Is Necessary 64
6.7 What if the Therapist Is Overwhelmed 65
6.8 What About Involuntary EDPs? 65
6.9 Conclusion 66
References 66

Chapter 7.

7.1 The Special Situation of the Trainee 67
7.2 What Makes Patients Seek Therapy? 67

7.2.1 The Chief Complaint 67
7.2.2 Location of the Problem 68
7.2.3 Hopes and Expectations 68
7.2.4 Eliciting Expectations 68
7.2.5 The Inner Child 69

7.3 Hope and the SEEKING System 69
7.4 Outside Motivation 70

7.4.1 Leverage 71
7.4.2 When There Is No Leverage 71

7.5 Why Do Patients Stay? 71
7.6 Why Do Patients Quit? 72

7.6.1 Missing Sessions 72
7.6.2 Deciding to Quit 72

7.7 Internal Resistance to Change 73
7.8 Biological Motivation 73
7.9 Timing and Motivation 73
7.10 The Therapist as Motivator 73
7.11 "Cat and Mouse" 74
7.12 The Patient Is Part of a System 75
7.13 Enabling 76
7.14 Patients Don't Tell Us Unless We Ask 76
References 77

Chapter 8.

8.1 Developmental Theory 79
8.2 Knowledge Brings Compassion 80
8.3 An EDP Most of Us Have 80
8.4 Young and Adult Thinking Mixed 81
8.5 Working with Rationalizations 81
8.6 Developmental Challenges 82

8.6.1 Self-Other Differentiation 82
8.6.2 Attachment and Separation 83
8.6.3 Power Struggles 84
8.6.4 Crime and Punishment 85
8.6.5 The Rules 86
8.6.6 Someday 87
8.6.7 Later Childhood 88
8.6.8 Adolescence 88
8.6.9 Young Adulthood 89
8.6.10 Adulthood 89
8.6.11 Old Age 90

References 91

Chapter 9.

9.1 Do We Need to Ask Why? 96
9.2 Working with Uncertainty 96
9.3 Beginning the Session 97
9.4 Show, Don't Tell 98
9.5 Listening for Style and Content 98
9.6 Formulating Questions 99
9.7 Following Leads 99
9.8 The Patient's Mind Has the Map 100
9.9 The "Chief Complaint" 100
9.10 Spiral Organization 101
9.11 Listening for What We Don't Know 102
9.12 To Get Feelings, Ask for Facts 102
9.13 What if You Get an Evasive Answer? 102
9.14 Trauma and Substance Abuse 103
9.15 Beginning to Wrap Up 103
9.16 Assembling the Data 103
9.17 Building a Hypothesis 105
9.18 Making a Plan 106
9.19 Walking in Thick Fog 108
9.20 Arriving at an Agreement 108
References 109

Chapter 10.

111

10.1 Putting the Patient in Charge 112
10.2 Every Session Has a Topic 112
10.3 A Third Participant 113
10.4 The Frame 114
10.5 First Follow the Flow 115
10.6 When to Intervene 115
10.7 The "Three-Step Dance" 116
10.8 The Three-Step Dance in Perspective 117
10.9 Second Priority: Understanding 118
10.10 Many Kinds of EDP 119
10.11 The Value of Listening 119
10.12 Beyond the Three-Step Dance 120
10.13 Putting Words to Feelings 120
10.14 Tell, Don't Ask 121
10.15 When Not to Tell 121
10.16 Ending a Session 121
10.17 Phases of Therapy 122
10.18 Long-Term Resistance 122
10.19 Discovery, Emotional Healing, and Behavior Change: Three Tasks 123
10.20 How Long Does Change Take? 124
10.21 Conclusion 124

Chapter 11.

125

11.1 The Therapist's Role 125
11.2 Boundaries 126
11.3 Effective Boundary Management 127
11.4 The Frame 128
11.5 Flexibility 128
11.6 Attunement 129
11.7 How to Achieve Empathy 129
11.8 Two Exceptions 129
11.9 Breaks in Empathy 130
11.10 Eliciting Feedback 130
11.11 Maximum Empathy, Optimal Expectancy 131
11.12 Agreement Between Patient and Therapist 132
11.13 Matching Stages of Change 133
11.14 Matching Culture, Religion, and Spirituality 134
11.15 Matching Gender and Sexual Orientation 135
11.16 Therapists' Feelings About Patients 135
11.17 Liking or Not Liking the Patient 136
11.18 The Working Alliance 137
11.19 What Doesn't Work 137
11.20 Terminating the Therapeutic Relationship 138
11.21 Goals of Termination Sessions 138
References 139

Chapter 12.

141

12.1 History of the Inner Child Concept 143
12.2 Before Meeting the Inner Child 143
12.3 How to Recognize the Inner Child 144
12.4 A Word of Caution 145
12.5 Adult Temper Tantrums 146
12.6 Accepting Unmet Needs 147
12.7 Containment 147
12.8 Schema Therapy 148
12.9 The Manipulative Patient 148
12.10 The Self-Sufficient Patient 148
12.11 Compassion 149
12.12 The Corrective Emotional Experience 149
References 150

Chapter 13.

153

13.1 How Much to Talk 153

13.1.1 Arguments for Active Therapist Communication 153
13.1.2 Pros and Cons of Less Talk 154
13.1.3 Liabilities of More Talk 154
13.1.4 Some Goals Furthered by Speaking Up 155

13.2 Using Language to Regulate Emotional Arousal 155

13.2.1 Emotion-Heightening Words 156
13.2.2 Emotion-Lowering Words 156

13.3 How Much Support? 156
13.4 How Much Authority? 157
13.5 Adapting to Attachment Style 158
13.6 Internalizing vs. Externalizing 159
13.7 Length and Frequency of Sessions 159

13.7.1 Length of Sessions 160

13.8 How Much Structure? 160
13.9 Use of Homework 160
13.10 Frame as a Variable 161
References 162

Chapter 14.

165

14.1 Eight Behavioral Avoidance Patterns 165

14.1.1 Simple Avoidance 166
14.1.2 Nonverbal Schemas 167
14.1.3 Reenactment 171
14.1.4 Acting Out 172
14.1.5 Hidden Agendas 173
14.1.6 Guilty Quests 176
14.1.7 Developmental Arrest 178

References 181

Chapter 15.

183

15.1 Baffling, Cunning, and Powerful 183
15.2 Why Do Some People Get Addicted? 184
15.3 Secondary Psychopathology 184
15.4 The Role of Value Systems 184
15.5 Codependency in Five Easy Lessons 185
15.6 Treatment Principles 186
- 15.6.1 Hitting Rock Bottom 186
- 15.6.2 Key Questions 186
- 15.6.3 External Motivation Is Acceptable 187
- 15.6.4 Leverage 187
- 15.6.5 Anti-craving Medications 188
- 15.6.6 The Role of the Therapist 188
- 15.6.7 Motivational Interviewing 189
- 15.6.8 Pitting Biology Against Biology 189
- 15.6.9 Positive Prognostic Signs 190
References 191

Chapter 16.

193

16.1 Introduction: The Three Helpers 193
16.2 EDP #9: Emotions as Helpers 194
16.3 Sadness and Tears 195
16.4 Helplessness and Hopelessness 197
16.5 Anger 197
16.6 Panic, Fear, and Anxiety 199
16.7 Impulses 200

Chapter 17.

203

17.1 Values, Attitudes, Ideals, and Prohibitions 204
17.2 Neurophysiology of the Conscience 204
17.3 Becoming Aware of the Conscience 205
17.4 Like a Justice System 205
17.5 Pathology of the Conscience 206
17.6 Shame vs. Guilt 206
17.7 Internalization of Values 207
17.8 Internalization, Fast and Slow 208
17.9 Internal Electric Fences 208
17.10 Adult Internalization 209
17.11 Resistance to Change 209
17.12 Values Are Permanent 209
17.13 Self-Contradictory Values 210
17.14 Treatment Principles 210

17.14.1 Tread Lightly 210
17.14.2 New Values vs. Old Ones Recovered 211
17.14.3 Education 211
17.14.4 Modeling Positive Values and Attitudes 211
17.14.5 Working with Shame 212
17.14.6 "Civil Disobedience" 212

References 213

Chapter 18.

215

18.1 Thoughts as Helpers 215
18.2 The Contents of Influencer Thoughts 217
18.3 Avoiding Thoughts Makes Them Stronger 217
18.4 Treatment Principles 218

18.4.1 Consciousness Raising 218
18.4.2 Distinguishing Healthy Thoughts from Unhealthy Ones 218
18.4.3 Resistance 218
18.4.4 Mindfulness 219
18.4.5 Other Techniques 219

References 220

Chapter 19.

221

19.1 Grief: A Healthy Response 221

19.1.1 Loss and the SEEKING System 222
19.1.2 Pathological Grief 222

19.2 EDP #12: Depression 223

19.2.1 Some Good News 224
19.2.2 Focusing on "Major Depression" 224
19.2.3 Some Bad News 224
19.2.4 Financial Influences 225

19.3 Melancholic Depression 225

19.3.1 Unique Aspects of Melancholic Depression 226
19.3.2 Bipolar Illness 226
19.3.3 Two Vicious Cycles 227
19.3.4 First Work with the Biological Dysregulation 227
19.3.5 The Behavioral Aspect of Depression 228
19.3.6 The Emotional Aspect of Depression 229
19.3.7 Emotional Components of Milder Depressions 230
19.3.8 Agitated Depression and Mania 230

19.4 Conditions That Look Like Depression but Are Not 231

19.4.1 Stuck in an Unhealthy Lifestyle 231
19.4.2 Grief 231
19.4.3 Not Getting One's Way 231
19.4.4 Miscellaneous Symptoms 232

19.5 Treatment Principles 232

19.5.1 Antidepressant Medication 232
19.5.2 Psychotherapy 233
19.5.3 The Behavioral Approach to Depression 233
19.5.4 The Emotional Approach to Treatment 233

References 236

Chapter 20.

237

20.1 Two Layers of EDP 237

20.1.1 The Surface Layer EDP 238
20.1.2 The Deeper Layer of EDP 239

20.2 A Brief Catalog of Anxiety-Related Syndromes 241

20.2.1 Anxiety 241
20.2.2 Panic 241
20.2.3 Obsessions and Compulsions 242
20.2.4 Somatization 243

20.3 Treatment Principles 244

20.3.1 Trying to Control Anxiety Makes It Worse 244
20.3.2 Medication Treatment 244
20.3.3 The Behavioral Approach to the Preoccupation 245
20.3.4 The Emotional Approach to Preoccupation 245
20.3.5 Mindfulness Helps 246
20.3.6 Healing the Deeper Layer of EDP 247
20.3.7 Time Sometimes Heals 247

References 248

Chapter 21.

251

21.1 Taking the Mystery Out of Dissociation 251
21.2 PTSD and Dissociation 252
21.3 Complex Trauma 253
21.4 The Nature of Dissociation 253
21.5 Multiple Personalities 254
21.6 Treatment Principles 256

21.6.1 The Flight-Fight Cycle 256
21.6.2 Accessing Dissociated Facts and Feelings 256
21.6.3 Basic Healing 257
21.6.4 Building a Perspective and Narrative 257

References 258

Chapter 22.

259

22.1 For the New Therapist 259

22.1.1 Psychotherapy Is Still Best Learned Experientially 260

22.2 For the Seasoned Practitioner 260
22.3 For Knowledge Seekers and Researchers 261

22.3.1 Some Specific Questions for Investigation 261

22.4 For Students and Teachers 262

22.4.1 Today's Teaching Model 263
22.4.2 Moving Out of the Middle Ages 263
22.4.3 We Can't Afford to Waste Resources 263

22.5 Conclusion 264
References 264

265

Content Review

The thing that made me want to read this textbook was actually the Foreword written by Dr. James A. Bourgeois, which you can read for free on the Springer website. My eyes widened as I read that the author "...takes a stance that can be considered "atheoretical," or respectful of many different psychotherapy traditions." and that the book offers "...a remarkably unifying theoretical framework of understanding of disorders of emotions, thoughts, and behaviors, which translates into a cogent and patient-centered approach to psychotherapy." These things are germane to my own research and I am always excited to explore them.

My respect for Dr. Smith increased as I found a few free resources that he provides so as to make the information easier to assimiliate. This includes a 89-page PDF booklet, The Common Infrastructure of Psychotherapy, that gives a general overview of what the textbook contains, an even more condensed 9-page PDF "infographic" that summarizes it, and a 26-episode podcast that covers the textbook chapter-by-chapter. If you make use of any of this, I humbly suggest reading the 89-page PDF first and then working through the textbook, listening to the podcast episodes in order to review each chapter as you do so.

[In Progress...]

Related Resources

• Purchase the PDF/EPUB from Springer $

• Books about similar topics:

McMinn, Mark R., and Clark D. Campbell. Integrative Psychotherapy. InterVarsity Press, 2007.