Episode 005: A Journey Learning Psychotherapy
This week I (David Puder), had a discussion with Randy Stinnett, Psy.D, regarding his journey to become an excellent therapist. Randy shares aspects of his journey and insights. His enthusiasm is contagious. He discusses formative influences including Habib Davanloo, Donald Kalsched, and Todd Burley.
By listening to this episode, you can earn 0.5 Psychiatry CME Credits.
Other Places to listen: iTunes, Spotify
Article Authors: David Puder, MD, Randy Stinnett, PsyD
There are no conflicts of interest for this episode.
I asked Randy to give a summary of his 5 recommendations for someone aspiring to be an excellent therapist, which compliments the dialogue on this podcast:
Find teachers and mentors early on in your training as a psychotherapist who have demonstrated mastery and effectiveness as therapists and learn as much as you can from them. The most valuable impact on your training as a therapist will not come principally from textbooks and research on psychotherapy (though you should be an avid consumer of these), as much as it will come through a relationship with a teacher or mentor who skillfully embodies the knowledge and craft of a psychotherapist. Don't try to copy that person but rather be yourself, and be open to learning from many teachers.
In addition to the content of the patient's speech and thought processes, focus on the interpersonal process level of the therapeutic interaction. Periodically ask yourself when working with a patient "What is happening right now between the two of us that may be re-enacting an important relationship or relational pattern pertinent to their presenting problem?" In addition to the patient's verbal and thought content, focusing on the non-verbal/bodily/behavioral/relational level of experience in the moment will often provide a doorway into the conflicts and struggles the patient is really there to address.
Read literature and research on psychotherapy theory and technique related to reprocessing emotional memory as a potent change-factor in psychotherapy. The "common-factors" of the psychotherapist are necessary but not sufficient to bring about lasting change. You have to understand how to facilitate a reprocessing effect of the emotionally-based relational trauma memory in the context of an empathically attuned therapeutic relationship. Never stop learning about how to creatively do this.
Position yourself to receive quality feedback on your work as a therapist. This includes having skilled supervisors/mentors view your actual therapy work and provide you with useful critiques to improve your craft. Feedback can come through a traditional supervisory relationship but can often come through belonging to a formal psychotherapy institute such as a regional psychoanalytic training institute, and others. My own experience training for several years with the Gestalt Associates Training of Los Angeles (GATLA) was priceless for the quality feedback I received while doing real life work in front of a group of fellow therapists as well as a master level trainer.
Pursue your own psychotherapy. Your own unaddressed conflicts, traumas, and personality features will undoubtedly influence what you focus on in therapy. Your own internal reactions while working with the patient (i.e., "countertransference") can be of great help while working with a patient. However, your internal reactions can also hinder your effectiveness as a therapist if you end up avoiding what should be focused on during the session. Personal psychotherapy will be invaluable in identifying and reprocessing these vulnerable areas in our own selves, as fellow human travelers on the same road as our patients, so as to be as effective as possible for our patients.
Download: PHQ-9
Download: GAD-7