Transforming Trauma: Episode 143

Dr. Jonathan Shedler needs no introduction on Transforming Trauma! The renowned psychologist, author, consultant, researcher, and clinical educator is perhaps best known for his article The Efficacy of Psychodynamic Psychotherapy, as creator of the Shedler-Westen Assessment Procedure (SWAP) for personality diagnosis and clinical case formulation, and co-author of the Psychodynamic Diagnostic Manual. He’s also the creator of PsychScan, an AI-guided assessment that frees therapists to treat clients rather than spend their valuable time assessing symptoms.

Dr. Shedler is perhaps slightly less well-known for having previously appeared on this podcast, where he shared his views on the defining characteristics of good psychotherapy. He also provided insight into the widening chasm between research conducted by academic psychologists and “real life” psychotherapy, as well as the common misconceptions around transference and countertransference.

On this episode of Transforming Trauma, host Emily Ruth welcomes Dr. Shedler back to expand on the original conversation, delving deeper into the elements that make up good psychotherapy and the importance of connection between therapist and client. The pair also explore critical flaws in the Diagnostic and Statistical Manual of Mental Disorders (DSM), how modern social subcultures provide a disturbing camouflage for disassociation, and the three pillars of an effective therapeutic working alliance.

“Health insurance companies don’t really like what I would call meaningful psychotherapy,” Dr. Shedler says, acknowledging the extreme pressure that psychotherapists are under on all sides to cure clients or release them in the most cost-effective time frame. Adding to the squeeze are academic psychologists who promote manualized therapy, a tight timeline of 8-12 sessions, as the gold standard of efficacy. Dr. Shedler wants therapists to understand the value of providing truly consequential psychotherapy no matter the time spent and feel confident in their skills despite the  “quick fix” messaging.

Connection is essential to providing and receiving good psychotherapy––and a guiding principle of the NeuroAffective Relational Model (NARM®). “[Therapy] has to take place in a relational context where we don’t feel under threat, where we can experience the therapy relationship as a safe harbor from which it becomes possible to explore the corners of our own minds,” explains Dr. Shedler, “including the dark corners.” Therein lies the first job of an effective psychotherapist: to create a secure relational attachment that makes it possible for the client to do the difficult work of examining all parts of themself.

Dr. Shedler hopes psychotherapists recognize how genuinely significant a step it is for clients to seek therapy in the first place. “When somebody comes to psychotherapy, there’s at least an implicit acknowledgment that there’s some way that [the client is] contributing to their own difficulties or perpetuating [the] difficulties,” he says. “The purpose of psychotherapy is to help people change something about themselves that, number one, is causing difficulties for them. Number two, is something that psychotherapy could realistically help them to change, and number three, is something that they would like to change about themselves; those three conditions must exist in order to do psychotherapy,” Building the container of trust required for those three conditions takes time, something that the DSM and manualized therapy don’t (or won’t) allow for.

“People want real therapy,” Dr. Shedler asserts, even in––or especially in––our fast-paced, relationally challenged society. “Real therapy means really getting to know people as individual humans.” He advises psychotherapists to honor their own humanity, undeterred by the DSM or insurance company rulings. “There’s so much pressure to compromise. Don’t give in.”

Transforming Trauma is extremely grateful to Dr. Shedler for his 25+ years of teaching psychologists, psychiatrists, and psychoanalysts how to provide meaningful therapy. We thank him for his generosity of time and wisdom.

MENTIONED IN THIS EPISODE

PsychScan

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TT114: Championing Relational Therapeutic Solutions In A Quick-Fix World

GUEST CONTACT AND BIO

Website

Jonathan Shedler, PhD, is an American psychologist known internationally as an author, consultant, researcher, and clinical educator. He is best known for his article The Efficacy of Psychodynamic Psychotherapy, which won worldwide acclaim for firmly establishing psychoanalytic therapy as an evidence-based treatment.

 

Dr. Shedler’s research and writing are shaping contemporary views of personality styles and their treatment. He is author of over one hundred scientific and scholarly articles, creator of the Shedler-Westen Assessment Procedure (SWAP) for personality diagnosis and clinical case formulation, and co-author of the Psychodynamic Diagnostic Manual (PDM-2 and forthcoming PDM-3). He has more than 25 years of experience teaching and supervising psychologists, psychiatrists, and psychoanalysts.

Dr. Shedler lectures internationally, leads workshops for professional audiences, consults to U.S. and international government agencies, and provides expert clinical case consultation to mental health professionals worldwide. He is a Clinical Professor in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco (UCSF) and a faculty member at the San Francisco Center for Psychoanalysis.