Etikett: Patricia Coughlin

ISTDP ACADEMY våren 2023


För fjärde terminen i rad kör vi ett samarbete med vår systerförening i Danmark (Dansk Selskab for ISTDP, www.istdp-danmark.dk) med syfte att anordna digitala kvällsföreläsningar om ISTDP. En uttalad ambition är att bjuda in presentatörer från Norden och andra delar av världen samt att visa på bredd i olika tillämpningar av ISTDP. Alla presentationer sker på engelska med undertexter på filmklippen. Föreläsningarna kommer ske via Zoom och ligger kvällstid kl 17.00-19.30

Vårens schema ser ut så här: 

1:a februari: Patricia Coughlin (US)
1:a mars: Brian Kok Ravn (DK)
5:e april: Jody Clarke (CA)
3:e maj: Tami Chelew (US)
7:e juni: Niklas Rasmussen (SE)

Kostnaden är 1200 kr för alla fem föreläsningarna för medlemmar i Svenska Föreningen för ISTDP. Är du ännu inte medlem i föreningen kan du bli det i samband med anmälan. Medlem i föreningen blir du här: https://registreringar.istdpsweden.se. Förutom medlemsskap krävs även att du genomgått den tre dagar långa introduktionsutbildningen precore, samt att du har legitimation eller är student i slutet av din utbildning på legitimationsgrundande utbildning.

Observera att dessa presentationer kommer att visa ISTDP på avancerad nivå, utan att redogöra för grunddragen i metoden. Bakom interventioner som kan se enkla ut finns alltid komplexa bedömningar som avgör hur det är lämpligt att agera i stunden. ISTDP är en omfattande metod som tar tid att lära sig. Därför är denna seminarieserie endast öppen för dem som redan har gått en introduktionskurs (så kallad precore). Därutöver behöver du ha legitimation eller vara i slutet av din legitimationsgrundande utbildning. Är du nyfiken på ISTDP och vill lära dig mer om grunderna i metoden så kan vi varmt rekommendera att läsa mer om utbildning på vår hemsida.

Här köper du biljett till vårens föreläsningar: Klicka här

VÅRENS FÖRELÄSNINGAR

1. februari: Patricia Coughlin: “handling resistance without contributing to it”

About Patricia: Patricia Coughlin, Ph.D., is a Clinical Psychologist with over 40 years of experience.  Having trained with Habib Davanloo, she developed a specialty in ISTDP and has been a prominent teacher and supervisor in the field since the 1990s.  In addition, she has written many articles, and four books, on theory and practice of ISTDP.

About Patricia’s presentation: In this webinar we will focus on the topic of “handling resistance without contributing to it”.  ISTDP is a method of psychotherapy based on the theory of unconscious conflicts.  All too often, therapists focus exclusively on defense and resistance and, in so doing, contribute to it. Davanloo taught us to identify and then intensify the patient’s conflict in such a way that they turn on and abandon their defenses in order to face their true feelings. This procedure is designed to create an intrapsychic crisis, which, when successful, unlocks the unconscious. Engaging in an interpersonal conflict with patients can lead to misalliances and drop outs. Learning to manage the twin forces of alliance and resistance, in order to facilitate an internal crisis and opening of the unconscious, is an essential skill to master.


1:a mars: Brian Kok Ravn: “The Stuck Electrician – Working with Syntonic Character Defenses”

About Brian: I have been in the field as a clinical psychologist since 2006 and got my initial training working with outpatient psychiatry specifically focusing on personality disorders. I finished my Core Training with Ph.d. Patricia Coughlin in 2012 and went on to participate in Jon Fredericksons “Training for Trainers”. I started out teaching my first core group in 2015 and has since then started a new core group each year. I’ve been in supervision with Dr. Allan Abbass since 2015 and has twice presented cases with both fragile and high resistant patients at the Copenhagen Immersion seminar taught by Dr. Allan Abbass. Currently I work solely as a private practitioner in Psykolog Kok Ravn ApS with a broad range of topics doing both Individual ISTDP Psychotherapy, ISTDP Informed Couples Therapy, Supervision, Training and Individual and Group Dynamic Coaching for Businesspeople.

About Brian’s presentation: Highly syntonic character defenses are quite a challenge for the therapist to work with. We will look into session fourteen in the fase of treatment where the patient through previous repeated clarification slowly begins to turn on his defenses and let feelings rise in the transference. It will be demonstrated how turning the patient against his own defenses with this kind of high resistance requires both pressure, clarification, challenge and head on collision in combination.

5:e april: Jody Clarke: ” Opening the Family Tomb: A Study of the Intergenerational Transmission of Psychopathology”

About Jody: Jody Clarke is certified as a Psychospiritual Therapist with the Canadian Association of Spiritual Care (CASC), he is also a Professor of Pastoral Theology, at Atlantic School of Theology in Halifax. Through a series of wonderful incidents he was invited to his first symposium in Intensive Short Term Dynamic Psychotherapy two decades ago. From there he was invited to join Dr. Davanloo’s Supervision Group. Then from 2007 – 2020 Jody became a member of Dr. Davanloo’s Montreal Closed-Circuit Video Workshop. He has written and co-authored several papers integrating ISTDP with literature and events in history.

About Jody’s presentation: Exploring the nature of the intergenerational transmission of psychopathology is fascinating on numerous fronts. The pathogenetic figure or figures contribute directly to the to the character of the resistance. Essentially, the family tomb does not want to be open. In this presentation we will watch the application of Davanloo’s ISTDP and the subsequent breakthrough into the family crypt. Davanloo’s theories are designed to free patients from the destructive forces in their lives, but his technique also offers liberation for ancestor’s long since buried.


3:e maj: Tami Chelew: “ISTDP Informed Couples Therapy”

About Tami: I am a licensed marriage and family therapist in private practice in San Diego, CA. I originally trained as a couple’s therapist. I am a certified Emotionally Focused Couple (EFT), Supervisor and Therapist, Dually Certified in Accelerated Experiential Dynamic Psychotherapy (AEDP) for Individuals and Couples, and IEDTA Certified in Intensive Short Term Dynamic Psychotherapy (ISTDP). My background in EFT for Couples, AEDP, and ISTDP have all served me well in shaping and expanding my clinical skills and developing my efficiency and art as a psychotherapist. I am passionate about teaching and training motivated therapists in helping them become more effective at what they do. I offer both individual supervision and an ISTDP Informed Couples Monthly Training. My colleague Matt Jarvinen and I co-created the ISTDP San Diego Community offering online training with master EDT trainers to therapists globally to help spread the love and efficacy of ISTDP. I am the president of the IEDTA and have served on the IEDTA Board for the past 4 years My husband and I have been married for 33 years. We have two grown, strong daughters and two precious grandsons. To learn more, visit me at www.tamichelew.com

About Tami’s presentation: Many ISTDP and EDT therapists who work with both individuals and couples are naturally interested in learning how to effectively apply their work to couples from an ISTDP framework. Most current couples’ models do not work from a theory of unconscious anxiety, nor explicitly identify defense patterns and their costs as explicitly as ISTDP. Dr. Davanloo’s contribution to defense work and understanding the pathways of unconscious anxiety is incredibly relevant in working with couples; especially when the stimulus (often their partner) is sitting next to them in the room. Equally important is increasing a couple’s capacity towards experiencing and expressing their mixed feelings openly and honestly with one another. This builds capacity on many levels in both partners toward less defensiveness, greater anxiety regulation and affect tolerance toward emotional closeness in being less guarded and distant, and more open-hearted and connected, which is often their shared longings for couples’ treatment. The focus of this presentation is based both on theory and technique; ISTDP metapsychology and the application of ISTDP clinical skills by closely monitoring the response to intervention in each couple member. This will include monitoring each partner’s triangle of conflict and triangle of persons to better understand how each of their intrapsychic conflicts and/or low ego capacity is unconsciously contributing to their interpersonal conflicts causing their current symptoms and suffering. When each partner can better understand both their own and their partner’s dynamics, it helps build empathy between them and is a motivator for healthy change. We will view case material demonstrating how to effectively work with a couple when both partners have different ego capacities. Many couples are highly motivated and yet feel stuck in relational defeating patterns and high anxiety during times of conflict. We will look at how to work with the complexities of detachment, projective processes, repression, and cognitive-perceptual disruption in the room and we will witness the change processes as they unfold. We will be underscoring the 5 parameters in Dr. Allan Abbass’s work that comes from Dr. Davanloo’s Central Dynamic Sequence which serves as a road map for working with both individuals and couples. These include assessing the ego capacity of each partner by restructuring defense patterns of relating, moving from syntonic to dystonic defense patterns, restructuring anxiety pathways as needed, detecting any anxiety thresholds that are too high, and inviting the de-repression of feelings, to bring breakthroughs into the unconscious. Working actively on the “front of the system” activates both partner’s resistance systems, Complex Transference Feelings, along with the Conscious Therapeutic Alliance (CTA) and the Unconscious Therapeutic Alliance (UTA), which is the healing force in each couple member and therapist. This way of working offers a comprehensive psychotherapeutic couples treatment course that is effective and short-term. This presentation will show that working in this focused way, in the here-and-now, by monitoring anxiety dysregulation and building affect tolerance helps both partners to have more capacity to deal, feel and relate to one another in good times and in hard times. Also, honoring the urge of expressing loving impulses to reach out and hold hands or offer a much-needed comforting hug is welcomed. These tender, loving moments are meaningful to the couple and lead to further gains of deeper, honest communication and character change that offer corrective emotional experiences together. Learning Objectives include: 1. How to assess and psycho-diagnose the ego capacity of each couple member. 2. When and how to use Graded ISTDP interventions when detecting anxiety thresholds so that each partner can feel safe in their body and in the room with us and with each other to build more ego and relational capacity. 3. Witnessing the restructuring efforts so that resistances drop, and Alliance can grow and overcome resistance for both partners to feel more in contact with their mixed feelings and with each other. 4. How to explicitly privilege the felt emotion of love and other positive feelings to increase and deepen their emotional intimacy and attachment bond. You will witness and feel their love in the room. Reaching the couple stuck underneath their resistances by understanding and healing their unconscious wounds transforms their love through healthier ways of relating which positively impacts their children, their grandchildren, and the generations to come. To me, this is sacred legacy work. Working effectively with couples from an ISTDP framework can be a significant factor in contributing to the greater collective conscious healing in the couple and family system, society, and the world at large.


7:e juni: Niklas Rasmussen: “Undervalued functions of the head-on collision in ISTDP”

About Niklas: Niklas Rasmussen is a licensed psychologist, a certified ISTDP therapist, trainer and supervisor. He has 15 years experience of clinical work, mainly in outpatient psychiatric health care. Since 2019 he has a private practice in Stockholm offering ISTDP therapy, ISTDP-training and supervision. He also teaches ISTDP at Uppsala University and at Marie Cederschiölds högskola i Stockholm

About Niklas’ presentation: Head-on collision (HOC) is usually described as an effective intervention when the patient’s resistance is crystallized. It is defined by a therapeutic position of radical honesty about the prize of the resistance. In ISTDP-literature, the main goal with HOC is described as helping highly resistant patients towards emotional break-throughs. But the therapeutic stance associated with HOC can have multiple functions in the therapeutic process, such as: 1) assessing the patient’s suitability for ISTDP in trial therapy: 2) initiating termination of therapy when necessary. 3) establishing and reestablishing therapeutic borders in therapy. 4) a path to essential self-care for the therapist. 

In his presentation, Niklas will discuss these extended, and so far undervalued, functions of HOC based on his own experience as an ISTDP therapist, supervisor and supervisee. He will also talk about how HOC can be used at different stages of a therapist´s development and common countertransference reactions associated with the use of HOC.

What’s love got to do with it?

On December 6 and 13, 2021, Patricia Coughlin offers an online two-day seminar on the topic of therapeutic love.

In a letter to Jung, Freud wrote, “Psychoanalysis is a cure through love”. What did he mean? What does love have to do with the practice of ISTDP?

Patricia Coughlin presentation
Patricia Coughlin

In this two day webinar we discuss the central importance of love in the healing process. Human beings are wired for love and connection. However, loss, disappointment and even abuse in close relationships creates intensely mixed feelings which prove difficult, if not impossible, to bear. Defenses against these painful and guilt laden feelings often become a resistance to closeness which prevents the giving and receiving of love. Unless removed, these defenses and resistances will undermine treatment efforts and perpetuate suffering, resulting in frustrated therapists and patients destined to live lonely, isolated lives.

ISTDP is a method of therapy designed to dismantle these defenses and resistances in order to reach the patient and free him to love and be loved. Rilke wrote, “For one human being to love another. That is the most difficult of all our tasks, the last test and proof, the work for which all other work is but preparation.” This is just as true for us, as for our patients. Are we open, available, engaged and responsive or hiding behind our theories and techniques. It is my contention that we must BE the change we seek to facilitate in others. We will discuss and share our experience of love in the therapeutic process.

We will follow a number of cases from beginning to end in order to observe the process of healing wounds that impair our ability to give and receive love.

When Davanloo started to innovate, he recorded sessions and reviewed them with patients, once their therapy had concluded. It was during one of these feedback sessions that a patient alerted Davanloo to interpersonal defenses, designed to keep the therapist and others, at an emotional distance. He came to refer to these strategies as “tactical defenses” which operate as a resistance to emotional closeness. Unless such defenses and resistances are recognized and removed, treatment will remain superficial and largely ineffective.

We will observe a number of cases in which defenses against emotional closeness figure prominently. We will follow the process from defense to feeling to insight and change in several cases. We will use the case of “Broken Bird” and “The Man with Pain and Depression” and “The Man who couldn’t get divorced” to illustrate the process through which the unresolved conflicts from the past block the patient’s inability to give and receive love.

For more information and tickets: click here.

The event is organized by ISTDP Israel.

The limitations of ISTDP. Part 2: Patricia Coughlin

What are the limitations of ISTDP? What would a balanced view of ISTDP be like? Just as any approach to psychotherapy, ISTDP is subject to both idealization and devaluation. Over the past few years, we at ISTDPsweden.se have published quite a lot of positive stories and news about ISTDP. Now it’s time to do some balancing. We sat down with some prominent ISTDP clinicians to discuss the shortcomings and downsides of ISTDP. Here’s the second part, an interview with Patricia Coughlin. You can find the first part here.

ON LEARNING ISTDP

Just how difficult is ISTDP to learn? Should learning ISTDP be easier? 

Patricia Coughlin presentation
Patricia Coughlin

Patricia Coughlin: I don’t think it’s possible or even desirable to make the complex and challenging task of helping someone change easy. As Rilke said,”...many things must happen, many things must go right, a whole constellation of events must be fulfilled, for one human being to successfully advise or help another.”  

Our desire for life and therapy to be easy can really backfire, giving us false expectations and setting us up for a sense of inadequacy. Life is hard and complicated – so is therapy.  The danger here is to oversimplify and get reductionistic in our approach.  I believe that is already happening in ISTDP and does us all a disservice.  The masters in most fields have a great ability to tolerate complexity and uncertainty.  We would do well to expand this capacity within ourselves.

ON JARGON and research

Unlocking the unconscious is sometimes described as a unique aspect of ISTDP. But other models also facilitate emotional breakthroughs and spontaneous reporting of previously repressed material. Could the jargon mystify the therapy process and put ISTDP at risk of distancing from other models?

Patricia: From what I can see, the masters in our field readily admit overlap between models and don’t claim an exclusive corner on the market of transformation.  Many approaches find a way to access the unconscious forces responsible for the patient’s symptoms and suffering and, in so doing, help the patient resolve previously unconscious conflicts. 

That said, the development of a systematic, yet flexible, method for reliably getting there – something the central dynamic sequence of ISTDP provides – seems to be a real contribution to the field.  The research seems to suggest that ISTDP is highly effective with cases that often fail in other treatments – character disorders, treatment resistant depression, functional disorders and conversion, for example.

ON RESEARCH GAPS

Even though there’s more and more research showing the efficacy of ISTDP as a whole, there’s still not so much high-quality research on the different ingredients of the therapy. What are some of the challenges with the specific ingredients of ISTDP?

Patricia: While we have not done much research in ISTDP on the specific elements, I have gathered data from other sources to support each step of the central dynamic sequence. This material has been outlined in both Lives Transformed and Maximizing Effectiveness in Dynamic Psychotherapy. It’s my contention that it is the combination of the six factors associated with positive outcomes that are responsible for the effectiveness of ISTDP. 

While often associated with a dramatic breakthrough of feelings, this is only one of six factors involved in the application of ISTDP. Understanding all the steps and being able to implement them effectively is essential to mastery. Too many are skipping over crucial steps, such as a dynamic inquiry in which patient and therapist develop an agreement on the problems to be addressed, goals to be achieved and tasks involved in the treatment or turning patients on defenses before pressing for the experience of feelings. This often undermines the alliance and derails the process.

ON IDEALIZATION AND DEVALUATION

Historically, the ISTDP community has unfortunately been subject to sect-like behavior such as a strong idealization of charismatic figures (such as Davanloo) along with exclusion and devaluation of critical voices. Is there something in particular that makes ISTDP vulnerable to this? What can we do to safeguard against this in the present and future?

Patricia: Sadly, this seems to be a tendency in human beings, not just practitioners of ISTDP. Look at our political situation here in the US.  Idealization, demonization, and splitting are rampant.  We need to take a stand against this.

I will never forget an interaction with a young trainee who came to a seminar, having read my books. He expressed disappointment when I acknowledged being confused by what was happening in a particular session. Of interest, the group has asked to see a case in which everything did not go smoothly, but rather one in which we had to ride some rough patches to get to a positive outcome. 

Despite this conscious desire, when I presented just such a case (which ended with a good outcome, by the way), the trainee said, “I am really upset. I need to idealize you- you are supposed to know everything.” I replied with something like, “I would suggest that idealizing anyone is ill advised. We all struggle. The point is not to be perfect but to be open to feedback and constantly learning. If you trust the UTA, it will guide you.”

He continued to protest. I found this baffling, yet this desire to have someone to idealize seems pervasive. We must do what we can to combat this.

OTHER LIMITATIONS AND WEAKNESSES

Do you see other major limitations or weaknesses in ISTDP? 

Patricia: The biggest one to my mind is the exclusive focus on feelings toward and in reaction to others – what one might refer to as “attachment affects“. As Blatt pointed out so eloquently in his classic book, The Polarities of Experience, human beings have two primary drives that motivate their behavior throughout life: 1) the need to attach securely to others and 2) the need to be autonomous, self defined and self directed. 

Many of our patients sacrifice one of these needs for the other. In most cases, they sacrifice self in a desperate attempt to maintain an attachment to the other. If we join them in this preoccupation with feelings toward others and neglect their own feelings, wishes, desires and goals, we could exacerbate their problems rather than ameliorate them.  We want to help patients feel all of their feelings – about themselves, as well as others – so they can be a solid self, capable of closeness with others.

Some limitations are not inherent in the model but involve the way it is sometimes taught.  We know from all the research that focusing on specific interventions, without a clear case conceptualization of the patient to help the clinician know what to do when, the treatment is likely to be ineffective.  A heavy focus on learning a method, if not combined with an equal focus on the person of the therapist – the very vehicle of transmission of the treatment itself – will be ineffective.

Do you find there are aspects of ISTDP that we have to address and change in order for the method to thrive? 

Patricia: Healthy expression of feelings. The exclusive focus on the experience of feelings and impulses, with a relative neglect on the issue of how these feelings can be expressed in a constructive manner. It seems as if there is an assumption that if we help patients abandon defenses and experience their feelings freely, they will automatically find healthy and constructive ways to communicate these feelings to others.  That’s a pretty big assumption. After the mixed feelings have been experienced and integrated, I ask how they plan to communicate these feelings to the others involved to assess whether they can do so constructively or need some help in that area.

It’s not enough to feel one’s feelings. We also have to help patients understand what the feelings mean. Patients often develop pathological beliefs about the self that perpetuate their suffering.  I’m thinking of a case of a man who was suffering from anxiety and depression, related to pathological mourning, following the death of his first born. As I helped him abandon defenses and face the rage and grief he had been suppressing, he felt better, but still did not share these feelings with his wife. It was only as we started to explore this, that his pathological beliefs that 1) grief will drive a woman crazy (as it had his mother); and 2) real men don’t cry, were exposed and re-examined.  

So helping patients to express feelings would be another step in the development of ISTDP?

Human beings are meaning-making machines. We are most often upset – not about what happened – but what we made it mean. In my own life, I interpreted my father’s tendency to keep an emotional distance from me as a personal rejection. I thought he just didn’t like me very much.  When I was 30 years old, my mother told me that he was born during the 1918 flu epidemic, on the very day his 18 month old brother died of the virus. Subsequently, two of his younger brothers died in childhood. His father died when he was only 42. In an instant, I understood that my father’s distance was not a sign of lack of love for me, but a defensive posture.

I was very sick as a child and often hospitalized. It was because he did love me and was afraid to lose me that he couldn’t bear to come visit me. My whole view of him, myself and our relationship changed in an instant. Just feeling my feelings about what I interpreted as rejection wouldn’t get me there. Of course I could still be sad and angry that he didn’t deal with this differently, but what I felt was enormous compassion for him and we got much closer as a result. Sometimes we need to help patients ask their family about life events in order for them to get more emotional clarity.

Here’s the first part of our series of articles on the limitations of ISTDP. Below you’ll find a list of our latest interviews:

Online presentation with Patricia Coughlin

Patricia Coughlin presentation
Patricia Coughlin

Mastering the trial therapy in ISTDP – AN online presentation with Patricia Coughlin

At the end of November this year, Patricia Coughlin will give an online presentation on the topic of the ISTDP “trial therapy”. ISTDP often begins with a longer therapy session, usually 2-3 hours, where we assess the patient and the suitability of the treatment model to the patient – the trial therapy. Research has shown that this first session in itself can have long-lasting benefits on mood symptoms and interpersonal problems.

In this video based webinar you will learn how to work effectively with a highly resistant patient with both a character disorder and anxiety and depression. You will observe the process of a trial therapy, in which a specific set of interventions is employed as a vehicle for determining the nature of the unconscious conflicts responsible for the patients symptoms and suffering. We will also discuss suitability for treatment with Intensive Short-Term Dynamic Psychotherapy (ISTDP).  The webinar is organized by a group of ISTDP therapists in Oslo, Norway: Psykologvirke

Date: November 23rd

Time: CET 12.00 – 20.00

Price: 1800 NOK

Registration and more information: click here

PATRICIA COUGHLIN

Patricia Coughlin Della Selva, Ph.D., is a licensed Clinical Psychologist with over 35 years of clinical experience. Currently she is Clinical Faculty at the University of New Mexico School of Medicine. Over the past 20 years she has written professionally, given presentations at professional conferences and conducted workshops for mental health professionals internationally. Currently, she is conducting training groups in New York, Australia, Denmark, and Poland. Patricia last presented in Sweden in the fall of 2016.

Patricia has authored three books which are all considered essential readings for anyone interested in ISTDP: Intensive Short-term Dynamic Psychotherapy: Theory and Technique (1996), Lives Transformed (2006; in collaboration with Dr. David Malan) and Maximizing Therapeutic Effectiveness in Dynamic Psychotherapy (2016).

A while back we did an interview with Patricia Coughlin, which you can find here.

Here are some of our other recent interviews:

You can find other articles and materials in english by following this link.

Patricia Coughlin: “ISTDP is a psychoanalytic method”

Here’s an interview with Patricia Coughlin. In September this year, the Swedish society for ISTDP will have the great pleasure to welcome Patricia to Malmö – if all goes according to plan. We sat down with her to talk about learning ISTDP, about sexual conflict, about psychoanalysis and more.

Patricia Coughlin Malmö
Patricia Coughlin

How do you feel about coming back to Sweden to present? 
I am delighted to return to Sweden and welcome the opportunity!

How did you end up becoming a therapist and later on specializing in ISTDP?
I knew from an early age that I was meant to be a psychologist. I pursued this goal with great focus and determination, obtaining my PhD at the age of 25. I was always interested in depth – in understanding the patient (and myself) in a profound way. I was most interested in what was happening beneath the surface, in the unconscious. All of my early education and training was in psychoanalytic/psychodynamic theory and practice. Like Davanloo, I became frustrated and guilty about erratic results with interpretive methods. Many patients came to understand their difficulties, but only some transferred that learning into change. Meeting Davanloo in 1988 and watching tapes of the Machine Gun Woman, the German Architect, and others, was a life altering experience. I saw the unconscious crack open in the most unmistakable way, when the therapist actively intervened to identify and intensify the patient’s core conflicts. I needed to learn that! 

How did you experience training with Davanloo? 
I had good experiences with Dr. Davanloo. He was always respectful and very helpful. I learned more from him than anyone about how to intervene rapidly and effectively. I was in a core group in Montreal for three years. Most of the time, I was the only woman in the group. Many in the group had been training with Davanloo for decades, yet very few seemed to be able to master the technique. Why was that?

In my own estimation, supervision, without teaching, gets limited results. There was little reference to the theory upon which ISTDP was built. He just assumed we already knew analytic theory. Luckily, I did, so I could employ the techniques in order to gain rapid access to the unconscious. Then, all my former knowledge, skill and training, aided me in helping the patient resolve the unconscious conflicts responsible for his symptoms and suffering.

Davanloo was very impersonal in his interaction with trainees. The lack of focus on the person of the therapist was the other factor that I thought contributed to problems in learning and growing. I have tried to include a good deal of teaching, as well as a focus on dynamic case formulation and personal development of each trainee in my groups, in order to enhance the learning experience. My trainees learn the method and the theory it is based upon, and develop as people, as well as clinicians.

My experiences with Davanloo were good while I was training with him, but he cut me off, as he has everyone who goes off on their own. I haven’t heard from him since I left training, but have heard that he denies knowing me. He has done this with everyone he has ever trained, so I don’t take it personally. At the same time, this way of treating people gives ISTDP a bad name and has undermined the method expanding more widely and rapidly.

What’s your perspective on the relationship between psychoanalysis and ISTDP? 
ISTDP is a psychoanalytic method. In many ways, this technique is similar to Freud’s early work, in which he was quite active and confrontational. Over time he got more passive and pessimistic, not in the least part due to being a Jew who was driven out of his country. For many reasons, he became increasingly pessimistic about human nature all together.

Davanloo felt Freud took a wrong turn when he decided to “bow to the superego’s resistance, which sees our efforts come to nothing”. Instead, he took up resistance as soon as it was apparent, inviting the patient to face and experience the feelings he has been avoiding, in order to heal. He also put pressure on the patient to decide whether to continue hiding and avoiding painful realities and feelings or to face them courageously in order to heal. By identifying and intensifying inner conflict and ambivalence, he was able to unlock the unconscious. 

His methods are all used pre-interpretively. It’s for those patients who are locked in by defenses and unavailable for a therapeutic alliance. Once the defenses break down, and the feelings break through into consciousness, dynamic therapy ensues. Many confuse the part with the whole, and the means for the end, but his method is used to open the unconscious. Once the unconscious is open and fluid, working through previously unconscious conflicts, to a new and healthy end is the order of the day. I think this whole mid phase of therapy has been neglected in ISTDP. My colleague Jonathan Entis and I are writing a book about this presently.

Sexuality used to be a central theme in psychotherapy education and writing. This seems to have changed and psychotherapy training nowadays hardly deals with the topic at all. Or that’s at least my impression. Maybe that’s different if you’re trying to become an analyst. Are we past the time when sexuality was a central aspect of psychotherapy? 
In my experience, many patients struggle with conflicts regarding sexual feelings and impulses, as well as those regarding rivalry and competition. The idea that we only have one kind of conflict – guilt over rage toward loved ones – is dangerously narrow. When we develop a set idea about the origin of the patient’s difficulties before meeting and assessing him, we will be prone to confirmation bias. It is essential to keep an open and curious mind and to evaluate the nature, intensity and history of the patient’s problems, in order to ascertain the nature of conflicts responsible for them The neglect of these other conflicts and our narrow focus contributes to poor outcomes. I have seen many patients who suffer from jealousy and rivalry conflicts get no help from other clinicians. It is important that we take all the data into consideration.

So does ISTDP offer unique insights about sexuality and sexual conflict?
The insight about the origins of conflicts regarding sexuality, rivalry and competition are not unique to ISTDP, but confirm psychoanalytic notions of the Oedipal conflict and sibling rivalry. The rage toward the competitor, along with forbidden sexual desires for family members, generates anxiety and defenses that undermine sexual pleasure and performance and can also contribute to a pattern of staying in the position of the loser. Inhibitions about “winning” and “beating” rivals are common and can be traced to Oedipal and sibling rivalry. Understanding these conflicts and the analytic ideas associated with them are important in helping clinicians identify and resolve them, both within themselves, and in their patients.

What are some of the aspects of ISTDP that still are in need of development? 
ISTDP, like many therapeutic models developed over the last 50 years, focuses almost exclusively on conflicts around attachment. The need to attach in a secure fashion to others is only one of two primary drives in operation from birth to death. The other is the innate tendency to be a separate, unique individual. The need for autonomy, self definition, and self determination is just as important as the need for attachment. If we focus exclusively on attachment, we can support the patient’s problem, which is often an excessive reliance on support and validation from others. 

Attending to the patient’s sense of self, so that he can feel solid and secure within himself, is capable of self regulation, self definition, self mastery, and intimacy with self, as well as other, is often neglected. Getting these two drives in balance, such that the more solid one’s self of self and the better able to stand on one’s own two feet, the better able we are to attach in a secure manner. 

The more secure our attachments, the freer we are to separate. Attending to what Blatt called “The Polarities of Experience” are needed to facilitate health and optimal functioning. In contrast, relying excessively on other validation, while being unable to self validate, sets patients up for enhanced anxiety and sub optimal functioning. If we only focus on reactive feelings toward others, and neglect how the patient feels about himself (proud and capable, for example), we keep them at effect, rather than cause. When we take over the process and dictate what the patient should do (face feelings) and must stop doing (rationalizing, avoiding, etc) we reinforce passivity and a tendency to sacrifice self for other. Supporting and encouraging differentiation, as well as attachment, is often required.

In what ways have your way of doing therapy changed over the past five or ten years, and why?
My work is smoother and more integrated. And I am more myself in the process.

What are you struggling to learn as a teacher and therapist right now? 
I am always learning, and hopefully, improving in my ability to teach, supervise and support the development of the person of the therapists. The fact that so many of my current and former trainees have gone on to become real contributors in the field – writing, teaching and presenting at conferences – is a great source of satisfaction and optimism for the future.

Where do you see ISTDP going in the coming five or ten years? 
I have no idea where ISTDP will go from here and look forward to seeing how it all evolves. My greatest concern is that the method is being taught in a highly technical fashion, with little, if any reference to theory or case conceptualization. There are no short cuts and this complex method can’t be learned and practicing by rote. Of course we are all eager to pass on our knowledge, but training and expertise take time. It is a life long journey. It’s important to remember that the best therapists have superior meta-cognitive skills. They have superior working memory, are able to spot patterns as they happen, and tolerate complexity and uncertainty. Containing these polarities – being systematic but flexible, courageous and enthusiastic but humble and open to feedback – is a challenge for us all.

Would you like to say something directly to the Swedish audience ahead of the event? 
I want to wish my Swedish colleagues all the best. These are scary times. Remember to focus on what you can do rather than worrying about things we can’t control. Just three 10 minute periods of meditations on gratitude each day will significantly boost your immune system. I have just returned home from Norway and am incredibly grateful to have arrived safely and in a healthy state. I am extremely grateful that we have the internet and secure sites so we can see our patient’s remotely. I am also grateful for some down time to rest and reflect. We all tend to work a great deal. Slowing down is a good thing. I hope the virus will die down and our plans to get together in late summer will materialize.

Patricia is coming to present in Malmö, Sweden, on the 10th of September, 2020. Make sure to make a reservation now, as seating is limited. Depending on the CoVid-19 situation, the date might be subject to change.

If you liked this Patricia Coughlin interview, you might find our other interviews interesting. For example, we have done interviews with several of Patricia’s former students, such as Kristy Lamb and Jon Frederickson. Here’s a list of our recent interviews:

[POSTPONED] Patricia Coughlin on sexuality in Malmö

On September 10, the Swedish association for ISTDP welcomes you to a one-day conference with Patricia Coughlin in Malmö, southern Sweden. EDIT: Due to CoVid-19, this event has been postponed until 2021.

Understanding and resolving sexual conflicts with Intensive Short-Term Dynamic Psychotherapy (ISTDP)

We’re very happy to welcome Patricia Coughlin back to Malmö for this one-day conference. The focus of the talk will be on understanding conflicts around sexuality. Patricia Coughlin, a renowned expert in ISTDP, will discuss how to detect the presence of these conflicts in your patients, and present methods designed to resolve them. Authentic videotaped examples of work with patients who struggle with conflicts around sex, jealousy and rivalry will be shown.

Patricia Coughlin portrait

Patricia Coughlin

Patricia Coughlin Della Selva, Ph.D., is a licensed Clinical Psychologist with over 35 years of clinical experience. Currently she is Clinical Faculty at the University of New Mexico School of Medicine. Over the past 20 years she has written professionally, given presentations at professional conferences and conducted workshops for mental health professionals internationally. Currently, she is conducting training groups in New York, Australia, Denmark, and Poland. Patricia last presented in Sweden in the fall of 2016.

Patricia has authored three books which are all considered essential readings for anyone interested in ISTDP: Intensive Short-term Dynamic Psychotherapy: Theory and Technique (1996), Lives Transformed (2006; in collaboration with Dr. David Malan) and Maximizing Therapeutic Effectiveness in Dynamic Psychotherapy (2016).

Registration and info

Location: Nobel house, Act room, Per Weiiersgatan 6, 211 34 Malmö, Sweden

Date: Thursday, September 10th, 2020 At some point during 2021

Time: Registration starts at 8.30, workshop 09.00–17.00 (lunch approx. 12.00-13.00), book signing 17.00-18.30

Price: 2000 SEK for non-members, 1500 SEK for members of the Swedish society for ISTDP, 750 SEK for full-time students (regardless of membership). Lunch and coffee is included in the price. 15% discount for “early bird” registrations before April 15th! Register now – seating is limited!

Registration: E-mail your full name, work title, any food allergies or preferences and full invoice information to Victoria Paglert (vpaglert@gmail.com) for registration.

Contact: Victoria Paglert (vpaglert@gmail.com), Peter Lilliengren (peter.lilliengren@affekta.se)

This information is also available in this flyer.

Welcome! We’re looking forward to seeing you in Malmö next year.

For information about our other events (in Swedish and English), make sure to check out our events page.

Jon Frederickson: “Training with Davanloo was startling”

We did an interview with Jon Frederickson ahead of his first ISTDP workshop on Finnish soil at the end of March. In the interview he discusses the relationship between psychoanalysis and ISTDP, as well as his own discovery of ISTDP and other themes.

Jon Frederickson portrait
Jon Frederickson

How do you feel about going to Finland to present for the first time? 
I’m very excited of course to teach a new group of therapists. But, honestly, what has me really excited is to be in the homeland of Sibelius. Such a giant in classical music! If only I had a little more time, I would visit his home in the woods and absorb the mood of the forest of which his music spoke.

For people who don’t know you, how did you end up becoming a therapist and later on specializing in ISTDP? 
I was initially inspired to become a therapist through the writings of Erich Fromm. Such an inspirational writer, a psychoanalyst, a sociologist, an atheistic mystic. How could I not be fascinated by such a brilliant and heartful role model! I became psychoanalytically trained and some years later had a chance to see videotape of ISTDP. It was like seeing psychoanalysis live and active in a way I had never dared to imagine.

In the nineties you had quite a lot of training with Patricia Coughlin, and later on you met Davanloo and trained with him. How did you find training with Patricia and Davanloo? 
Supervision with Patricia revolutionized my work as a therapist, making my therapy far more focused and effective. With Davanloo, it was a bit startling. I was chair of a psychoanalytic psychotherapy training program and yet with Davanloo I was for the first time understanding many concepts on far deeper levels than I ever had before. Sadly, he dismissed psychoanalysis at that point in his career. Yet his training only deepened my appreciation and understanding of its depths.

Speaking of psychoanalysis, what’s your perspective on the relationship between psychoanalysis and ISTDP? 
Freud said that any therapy is psychoanalysis if it operates with a concept of the unconscious and the transference. ISTDP meets those criteria. ISTDP is obviously more active an approach than a classical analysis done on the couch. However, its work is entirely based on the exploration of unconscious feelings, addressing unconscious anxiety, and the careful work with unconscious defenses and resistance in the transference relationship. And in line with Bion’s statement about psychoanalysis, our work is based on faith that the patient will become healed by becoming at one with the emotional truth of this moment. 

In Helsinki you’re doing a workshop on trauma. Does ISTDP offer a unique take on trauma, or is this a standard psychoanalytic perspective?
I don’t know how to answer that because psychoanalysis is such a pluralistic community now that it would be reductionistic to claim that there is “one” way psychoanalysts work with trauma. Unlike some other communities, ISTDP therapists and analysts understand that the effects of trauma depend on multiple factors such as the child’s age when the trauma occurred, nature of the trauma, genetics, temperament, and the parental response to trauma.

We also recognize that dealing with the trauma involves not just the mind but the body. And we also recognize that issues of symbolization and mentalization must be carefully attended to. And we also note whether it was a one-time trauma or a case of cumulative trauma. All these factors lead to a complexity in treatment which any psychoanalytically informed clinician must take into account.

ISTDP is in many ways still a “new form of therapy”, given that so few people have been trained in it. What are some of the aspects of ISTDP that still are in need of development? 
ISTDP, while quite effective in research studies, has yet to develop research specifically into the treatment of narcissistic personality disorder and perversions. Our recent research with drug addicts is showing a surprising amount of effectiveness with patients suffering from psychotic symptoms. So I think we need to do more research into what differentiates the near-psychotic group of patients who respond to work on splitting and projection, and the psychotic level of character structure that does not respond. Given the successes we are having, I am hoping we can build on Marcus’ work on near-psychosis in our future work.

A common reaction to reading about ISTDP or watching a presentation is that the method is confrontational and even violent. Should ISTDP be less confrontational?
ISTDP isn’t violent, defenses are. That’s we try to block and identify defenses which do violence to the patient. Let us not forget that defenses cause the patient’s problems and presenting problems. They are a form of internalized violence. And the most compassionate thing we can do is block unconscious forms of violence that hurt the patient, and to help them see these previously invisible mechanisms so that he they have a chance to do something different.

Likewise, we don’t interrupt the patient. We interrupt the defenses that interrupt the patient. We never interrupt the heart speaking from its depths, we interrupt the defenses that keep the patient from speaking from her heart. Also, the idea of confrontation makes no sense about 99% of the time. After all, if the poor patient can’t see a defense, is not using it intentionally, and is unaware of it, he just needs some compassionate help to see his defenses. Otherwise, how could he do anything different in the moment?

Think of self-attack. It’s a form of violent communication to oneself. A child who grew up with a critic becomes a critic to himself. The nicest thing we can do is interrupt this form of self-cruelty and help the patient look under that defense to see what the feelings are being warded off.

Coming back to you, in what ways have your way of doing therapy changed over the past five or ten years, and why?
Hahaha! Throughout my career, as I look back, I can see that I have increasingly surrendered my resistance to being here, now, with the patient I have. I am increasingly able to accept the patient unconditionally, without needing him to change in any way. This may sound easy or trivial to readers who believe you already do this. And, if you do, good for you! But I find that this is a universal journey we take as therapists as we give up even the tiniest resistances to reality: meaning the patient as he is. My work has become very attuned to the tiniest cues of the unconscious will-to-health. And that shift may be the most important technical shift in my work recently.

What are you struggling to learn as a teacher and therapist right now? 
I’m in the midst of several projects with the aim of developing new forms of training and supervision. The research shows that graduate training does not improve therapist effectiveness. And after graduation, research shows that therapists do not improve. Research also shows that 93% of psychotherapy supervision is ineffective and 35% actually harmful. So in this part of my career I am most interested in researching what helps therapists become more effective. That is why I am focusing on skill building exercises and DVDs. I have a skill building book coming out next year. And I’ve begun a three-year study where we will study learning processes in a training group. That research will be the basis of a book I will write on the teaching and learning of experiential therapy.

You have two new books in the making. Can you tell us something about them?
My next book, Co-Creating Safety: treating the fragile patient, is designed for therapists who want to learn how to treat the most disturbed patients in their caseloads, ranging from patients who just had a psychotic break to patients in the borderline spectrum of character structure. After that, my next book will be, Healing Through Relating, a skill building book with skill building exercises training therapists in the fifty most important skills in developing a therapeutic alliance. I was trained as a professional musician. So I’m trying to develop some “étude” books now for therapists.

Would you like to say something directly to the Finnish audience about the event? 
I look forward very much to showing you a three-hour session which will allow us to learn concepts, see them put into action, and see how a patient begins to recognize the unconscious enactments that have driven her suffering. There is something about seeing a real therapy that is helping the patient moment by moment that is unlike any other kind of learning experience. I look forward to seeing you there!

If you liked this Jon Frederickson interview, you might be interested in our other interviews. Among them, there’s another Jon Frederickson interview from last year. There’s also a recent interview with Kristy Lamb on ISTDP for addictions that might be of interest. Here are the five most recent interviews:

You can find all of our content in english by following this link.

Kristy Lamb: “I want ISTDP to become the standard of care for addiction treatment”

This is an interview with Kristy Lamb, who’s a psychiatrist and ISTDP clinician in California. For the past few years, she’s been running an outpatient clinic – BOLD Health – which treats addictions using an intensive format of ISTDP.

Kristy Lamb portrait
Kristy Lamb

It’s been two years now with the BOLD clinic if I’m not mistaken. How does it feel? What have you learned? 
We started BOLD Health in March of 2017, so we are coming up on our 3 year anniversary already. It’s all really exciting – so much has happened over the past 3 years.

Trained as a physician in Family Medicine and Psychiatry I had no background at all in business before this. So it has been a wild ride of learning as I go, trying to balance all the different aspects of the project. Learning about running a business and being an entrepreneur with regular supervision and deliberate practice for the clinical development of my staff and myself. 

For better or worse, much of the learning about the business has been trial and error.  So much of what I didn’t know, I didn’t realize until some issue or crisis and it was in working through the crisis that I learned.  I think it is much this way in therapy that you know what to do and how to do it until you come across something new, and then, the working through, the attunement and attention to the response to intervention, helps build your working model.  

What’s the background of the clinic? How are things developing? 
When I first graduated from residency (after five years of training in family medicine and psychiatry after medical school), I was working in a number of different environments practicing both general medicine and psychiatry from a concierge clinic to a homeless shelter and even in the jails. I had a passion for serving underserved and marginalized populations, but wanted to expose myself to all different clinical environments to see how things worked. It was clear that the system in the US creates a great chasm between the haves and the have nots. 

In the county clinics I had 15 minutes to see a patient and taking extra time to do any type of therapy was frowned upon because the system was so impacted. However, in the concierge, pay-for-service model I could spend as much time as I needed with people and as you’d expect those patients got better. So I set out to start a private practice in order to have the time and space to hone my skills in ISTDP but eventually to build space to do research so we can show the long-term cost-effectiveness of ISTDP and bring the model back to the community setting. And that’s where things are now. 

Why is ISTDP a suitable treatment for addictions? Aren’t there other psychological models with more scientific backing? 
This is such an important question. With the number of people dying from substance use each year growing exponentially, it’s imperative that we are figuring out what treatments work and what treatments don’t work.  Unfortunately, in the US over 90% of treatment programs are based in the 12-step model which has only about an 8% success rate. It has no scientific backing and was started as community support, not treatment. We are certainly not against the 12-step program and encourage our patients to engage in the community of 12-step. But we also recognize that substance dependence requires psychological treatment and often medications in the early stages if patients are to have sustained sobriety and more so, sustained success in their lives. 

In regard to why ISTDP is such a great model for addiction treatment, it really comes down to the way we conceptualize addiction – as Jon Frederickson says, “We are all addicted to avoiding reality.” We all use different mechanisms to numb and avoid the reality of our lives and drugs and alcohol are just one way we do this – so some people go to TV, or work, or exercise, or compulsions. 

Any of our defenses can be seen as a mechanism to avoid what we are feeling. Drugs and alcohol are no different and once someone is no longer under the influence by just abstaining from the substance, they can start to look at what was driving the numbing that, in this case, can be lethal.  When the substances are seen as just another defense it is clear that ISTDP is a perfect model to treat the human disease of affect intolerance. 

I think another reason why ISTDP is so important in addiction are the interventions that provides the therapist with a clear and direct way to address the common defenses in this group. Handling projection of will, projection of omnipotence, denial, helplessness and hopelessness, and anxiety regulation. All of which are imperative if treatment is to be successful.

What’s the treatment format, length of treatment, rules etc? And how did it come about? 
Our treatment program averages 10 weeks depending on the patient’s level of acuity.  When a patient signs up for the program they undergo neuro-psychological testing, a commitment interview assessing their will for engagement in treatment and then start the program with groups 3-5 days per week, once per week individual therapy and once per week as needed medication management appointments. 

Each day consists of 30 minutes of biofeedback, an hour of group psychoeducation and then an hour and a half of what we call The BOLD Seat which is structured group therapy. All the group members are given an opportunity to take the BOLD Seat in front of the group to look at a specific problem for the day with the therapist leading the group. The other patients observe and participate, helping that patient see anxiety and defenses. Also, watching your peer gives you the opportunity to see yourself objectively as you may resonate with what the person in the BOLD Seat is saying but be able to see it from a different, more compassionate, distance.  

Our curriculum and the entire structure were developed in collaboration with Jon Frederickson who had piloted this model at a program in Arizona, the data from which was recently published in the Journal of Addictive Diseases.

I had the good fortune of meeting Jon at a week-long training in Whidbey Island, WA, in 2016 and I was just starting to look at group therapy for addiction. We then started working on expanding the previous work that had started in Arizona and now, four years later, here we are. Jon has been an integral part of our development not only for the structure of the program but he provides weekly supervision to our team and has helped establish the ethos of the clinic – compassion, respect and integrity.

What are some of the challenges when doing ISTDP with persons who struggle with addictions? 
Really there is no difference in treating someone with addiction problems than any other patient if the patient is currently sober. Jon Frederickson often talks about the notion that there are specific criteria necessary to actually have a patient in the room.  You can’t do therapy with someone who is actively intoxicated so monitoring for this is critical. 

That being said, as we are an addiction treatment center we have to be sensitive to still welcoming people who are ambivalent about their treatment or struggling to maintain sobriety. We have to greet them with compassion and honesty: they may need a residential program or an inpatient detox or a residential program to begin with. So they can really get some time away from the drugs or alcohol, so that they later can get the most out of our program. 

Accordingly, when we screen for use during the program we work to approach the patient with compassion and understanding to let them know that relapse is common. And we don’t have a right or a need to punish them, but rather use the testing as just information to let us know if their will for engagement in treatment is aligned with their actions. Knowing that that sometimes it’s not, and we just have to pull back and get clear about where they are and what they want for themselves. We work really hard not to own the will of sobriety in any of our patients.

Many patients in recovery haven’t connected to their internal motivation for treatment. They are in program because of their partner, or parents, or job, or the law are setting an ultimatum. We have to work really hard to get clear that unless the patient wants to engage, treatment won’t work. 

What’s it like to do a core training with your fellow colleagues and staff? 
It feels like such a gift to be doing core training with our staff.  When we started, part of the collaboration with Jon Frederickson was to start a new core training cohort with our staff and weekly supervision with him and Esther Rosen. 

My first core training with Patricia Coughlin was personally life changing and the people I met there have become lifelong friends. But it has been a totally different experience to have all of my work colleagues now be a part of the quarterly intensive training. And for us to be able to come back to BOLD and stay motivated between core trainings with weekly skill building and supervision. So many things in place to keep focus.

It really feels like a dream to be working in a clinic based in ISTDP. Even during our lunch breaks we are chatting about defenses, portrayals and psychodynamic understandings of our patients. It creates an environment of support and collaboration like nothing I have ever experienced in any other work environment. I am incredibly grateful to Jon and our whole team for building this space.

In the swedish context there’s quite a lot of talk about deliberate practice nowadays. What are you struggling to learn right now as a therapist? 
I am a big fan of deliberate practice and have seen how deeply it changed my work. In 2016, I took a short course in deliberate practice and then had ongoing supervision with Tony Rousmaniere. I couldn’t agree more with Tony’s notion that the therapist’s own work is the glass ceiling between good providers and great providers. It is only when you can notice and work through your own “stuff” that comes up in sessions that you can really be present with the patient in front of you.

So the deliberate practice related to skill building is wonderful and undoubtedly makes for improved outcomes, but it is the personal work that Tony taught me that I find the most difficult and the most important. What I need to pay attention to so I can know when my anxiety comes up, where I might unconsciously avoid going with my patients, or biases I might have from my own life experiences. It is through this internally focused deliberate practice that I have been able to become more present and more available to my patients, which results in markedly more effective work. This work takes a lot of effort: making time and space for watching my own videos and – as importantly – making time for my own self-care and therapy. 

If you dream a bit, where would you like ISTDP and addiction psychiatry to go within the next 5 or 10 years? 
Thank you for asking! I happen to be someone who sets goals that I think others often think are idealistic or impossible but at BOLD we encourage our staff to dream wildly about what can be. 

I deeply believe in this model and want to see it become the standard of care for addiction treatment. We are looking to start a revolution and would love to see the BOLD Method be known across the world as the most effective treatment of addiction. Dream big! Right?

I would also love to see our clinic running as an incubator where we can continue to hone the model and build a body of research that supports what we are doing, as well as become a training facility so that we can support others to engage in this model of treatment. 

If you liked this Kristy Lamb interview, maybe you’ll appreciate some of our other interviews. Below, you’ll find a list of our five most recent ones.

Also, a while back we reported on the Frederickson et al. 2019 addiction trial. You can find that article here (in swedish). For all of our content in english, please click here.