What are the defining characteristics of good psychotherapy? Increasingly, the answers are filtered through the lens of incomplete research or, worse, via buzzwords popularized by wellness websites. Despite what many people are led to believe, “evidence-based” psychotherapeutic approaches have significant limitations for both clinicians and clients.
On this episode of Transforming Trauma, Emily welcomes author, consultant, researcher, and clinical educator Jonathan Shedler, PhD, to discuss the widening chasm between the research conducted by academic psychologists and real-life psychotherapy. The pair also examine the importance of forming a therapeutic alliance and misconceptions about psychological concepts such as transference and countertransference.
“The field of psychology is very compartmentalized,” Dr. Shedler concedes. As one of the relatively few professionals who can successfully navigate mental health research and clinical practice, he asserts that the divide has contributed to a quantity-over-quality proliferation of mainly short-term, CBT-informed approaches; and more recently, web-based platforms. “People think the crisis is about access to therapy.” In reality, he says, there’s a glut of therapists in the field. Instead, “it's about access to meaningful, serious psychotherapy––and that takes time.”
Speed isn’t an effective treatment for mental health challenges. “That’s the disease,” explains Dr. Shedler. “The goal is to slow things down and create freedom.” Addressing issues like complex PTSD requires a commitment to comprehensive, and generally longer-term therapeutic models like NARM. “We don't work magic,” Dr. Shedler says. “These patterns that clients have taken a lifetime to develop are flat-out not going to just go away in a matter of weeks.”
Time is a powerful ally. Given enough of it, patients will inevitably recreate their problematic relationship patterns with their therapists, which is what psychologists have traditionally referred to as transference. “Our unavoidable participation in these patterns provides the crucial window into their inner world,” says Dr. Shedler, referring to what psychologists have traditionally referred to as countertransference. In alignment with relational psychodynamic models, Dr. Shedler considers the therapeutic relationship central to the healing that takes place in effective psychotherapy, and which can’t be replaced by protocols, homework or artificial intelligence. Stressing how important the relationship is between therapist and client, he says that “the last thing we want to do is shut that out! I wanna take that information that arises in the [transference and] countertransference, and I wanna make use of it constructively.”
Transforming Trauma appreciates Dr. Jonathan Shedler's continued efforts in bridging the gap between psychotherapeutic research and real-life practice. We also thank him for calling attention to the worrisome trend toward so-called “evidence-based” therapies, as well as other short-term approaches that maximize profits at the expense of our profession’s credibility. Dr. Shelder is a fierce advocate in shifting the dominating narrative that these short-term approaches are more effective than relational, depth-oriented, longer-term psychotherapeutic models like NARM.
MENTIONED IN THIS EPISODE
Shedler-Westin Assessment Procedure for Personality Diagnosis and Clinical Case Formulation (SWAP)
Psychodynamic Diagnostic Manual - PDM-2
GUEST CONTACT AND BIO
Jonathan Shedler, PhD, is a psychologist known internationally as an author, consultant, researcher, and clinical educator. Dr. Shedler’s research and writings are shaping contemporary views of personality styles and their treatment. He is the author of over 100 scientific and scholarly articles, the creator of the Shedler-Westin Assessment Procedure For Personality, Diagnosis And Clinical Case Formulation, and co-author of the Psychodynamic Diagnostic Manual. He has more than 25 years experience teaching and supervising psychologists, psychiatrists, and psychoanalysts.
You can listen to this episode on the Transforming Trauma website, on Apple Podcasts or Spotify.
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