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Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBecoming MyselfBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExercise-Based Interventions for Mental IllnessExistential PsychotherapyExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHandbook of Evidence-Based Therapies for Children and AdolescentsHealing the Heart and Mind with MindfulnessHeinz KohutHelping Children Cope With Disasters and TerrorismHigh RiskHistory of PsychotherapyHow and Why Are Some Therapists Better Than Others?How Clients Make Therapy WorkHow People ChangeHow Psychotherapists DevelopHow to Fail As a TherapistHow to Go to TherapyHypnosis for Inner Conflict ResolutionHypnosis for Smoking CessationI Never Promised You a Rose GardenIf Only I Had KnownIn Others' EyesIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyInside the SessionInside TherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt's Not as Bad as It SeemsItís Your HourLearning ACTLearning from Our MistakesLearning Supportive PsychotherapyLetters to a Young TherapistLife CoachingLogotherapy and Existential AnalysisLove's ExecutionerMadness and DemocracyMaking the Big LeapMan's Search for MeaningMaybe You Should Talk to SomeoneMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulnessMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeNietzsche and PsychotherapyOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and 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LivesReclaiming Our ChildrenRecovery OptionsRelationalityRent Two Films and Let's Talk in the MorningSaving the Modern SoulScience and Pseudoscience in Clinical PsychologySecond-order Change in PsychotherapySelf-Compassion in PsychotherapySelf-Determination Theory in the ClinicSelf-Disclosure in Psychotherapy and RecoverySerious ShoppingSex, Therapy, and KidsSexual Orientation and Psychodynamic PsychotherapySigns of SafetySoul Murder RevisitedStaring at the SunStraight to JesusStrangers to OurselvesSubjective Experience and the Logic of the OtherTaking America Off DrugsTales of PsychotherapyTales of UnknowingTalk is Not EnoughTalking Cures and Placebo EffectsTelling SecretsThe Behavioral Medicine Treatment PlannerThe Body in PsychotherapyThe Brief Couples Therapy Homework Planner with DiskThe Case Formulation Approach to Cognitive-Behavior TherapyThe Challenge for Psychoanalysis and PsychotherapyThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Couch and the TreeThe Couples Psychotherapy Treatment PlannerThe Crucible of ExperienceThe Cure of SoulsThe Death of PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of PsychoanalysisThe Gay and Lesbian Psychotherapy Treatment PlannerThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Healing JourneyThe Heart & Soul of ChangeThe Heroic ClientThe Husbands and Wives ClubThe Incurable RomanticThe Love CureThe Making of a TherapistThe Mindful TherapistThe Mirror Crack'dThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New Rational TherapyThe Older Adult Psychotherapy Treatment PlannerThe Other Side of DesireThe Pastoral Counseling Treatment PlannerThe Philosopher's Autobiography The Pornographer's GriefThe Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem of EvilThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Psychotherapy Documentation PrimerThe Psychotherapy of HopeThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Sex Lives of TeenagersThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe Trauma of Everyday LifeThe Trouble with IllnessThe UnsayableThe Way of the JournalTheory and Practice of Brief TherapyTherapy with ChildrenTherapy's DelusionsTheraScribe 3.0 for WindowsTheraScribe 4.0Thinking about ThinkingThinking for CliniciansThinking for CliniciansThoughts Without a ThinkerThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTrauma, Truth and ReconciliationTreating 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Jon Frederickson, the author of this eminently useful new work for clinicians interested in learning about the theory and practice of intensive short term dynamic psychotherapy, is a co-founder of the ISTDP Institute and co-chair of the ISTDP Training Program at the Washington School of Psychiatry, where he has taught for the past 25 years. His stated goal is to explicitly teach clinicians how to provide therapy, just as he was explicitly taught how to play music when he was training to become and worked as a professional musician. All of those years of teaching pay off for the reader, because this book is a master class in theory and practice. Although there are seemingly countless books written about psychodynamic psychotherapy, most do a poor job of describing how clinicians might actually effectively practice psychodynamically under the constraints most of us currently face: one (or at most two) sessions per week, and in therapies that are time-limited. (Short-term in this instance refers to therapies generally lasting less than a year). This book, in contrast, is both theoretically rich while providing concrete suggestions and ideas about how to incorporate ISTDP principles into one's own practice.
Following in the tradition of Habib Davanloo, a Harvard University psychiatriest and trained analyst who pioneered ISTDP from the 1960s to the 1990s, Frederickson makes accessible to the new clinician both the theory and practice of ISTDP in a way that previous books written on the topic have not managed to do. His manual emphasizes the importance of taking an active stance in order to allow patients to experience avoided and unconscious emotion. In order to do this, he convincingly argues for the importance of helping pateints to correctly label their feelings and experience those feelings in his or her body. (A third step in Davanloo’s process, experiencing the bodily impulse, receives noticeably less thorough attention in Frederickson’s book). Although these steps are theoretically simple, in practice most patients are highly defended. Frederickson’s tome is an exhaustive treatise explaining, in moment-to-moment vignettes, how to help the patient along in this process. In contrast to other case write-ups in ISTDP, where transcripts of entire sessions are often provided, he provides numerous shorter snippets of dialogue and analyzes the provided dialogue line by line.
One of the absolute strengths of this book is Frederickson’s ability to explicitly describe how bodily experiences of anxiety are manifested. In so doing, he provides information regarding easily observable bodily responses that can help the therapist help the patient regulate his or her anxiety. Anxiety regulation is of course important because we want the patient’s anxiety to remain at a level that is productive but tolerable. If a patient’s anxiety is too low, no significant work will happen. If it’s too high, the client will become flooded and overwhelmed. This is one example of the way Frederickson provides information that fully accessible and immediately applicable. I would say that this chapter alone is worth the price of the book.
At 532 pages, this book is fairly long, and there appear to be parts that are redundant. Re-reading the book gave me the sense that Frederickson has a clear plan in mind, and is playing variations on a theme in the later chapters. I am willing to believe that what seems like repetition, repetition, repetition is more than the rhetorical device of a teacher intent on repeating information until a (somewhat dull) student retains the information. However, even with two passes, the overall plan remained somewhat opaque.
Frederickson makes frequent reference in his book to videos he has created, both on YouTube, which are free, and on his website, most of which are not. Although this constant self-promotion was initially off-putting, the videos he’s produced did indeed help to deepen my understanding of the material. After reading his book several times, I purchased some of his training materials on-line and am considering enrolling in a three-year training program through the ISTDP. It has literally been years since I have been as excited by a book that I’ve read about therapy as this one. This book is likely intended for early career therapists, but it is rich enough to be enjoyed by more seasoned practitioners as well. For clinicians interested in exploring the practice of intensive short-term dynamic psychotherapy, this book is a must-read.
© 2014 Kyra Grosman
Kyra Grosman, Psy.D. has a clinical psychotherapy practice in Manhattan. She may be reached by emailing firstname.lastname@example.org or calling (646)418-6095.