Systems of psychotherapy

Make the unconscious conscious; where id was, there ego shall be.

Keep the insight, drop the couch: the relationship is the laboratory, and time is limited.

Behaviour is not pushed by the past; it is pulled by a goal the person has not admitted to having.

The psyche is self-regulating and purposive. The symptom is the psyche attempting a correction.

We are not driven toward pleasure. We are driven toward people — and we carry them inside.

What looks like grandiosity is usually a self that never got the responses it needed to cohere.

There are two people in the room, and neither of them is objective.

Not insight. The recovery of the capacity to hold minds in mind, in the moment it collapses.

The split internal world arrives in the room. Interpret it there, inside a contract that holds.

Go directly at the defense until the warded-off feeling arrives. And watch the anxiety.

The client knows what hurts and where to go; the therapist provides the conditions in which they can find out.

People are persuaded more by what they hear themselves say than by what they are told.

Lose your mind and come to your senses. What is happening now, in this room, in your body?

You cannot leave a place until you have arrived at it. Emotion is changed by emotion, not by reason.

Anxiety is not always a symptom. Sometimes it is an accurate response to being alive.

Personality is not inside you. It is the pattern of what happens between you and other people, repeatedly.

Depression is a medical illness that happens in an interpersonal context. Change the context.

The group is a social microcosm. Whatever a person does out there, they will eventually do in here.

The only way out is through. Avoidance is what keeps fear alive, so the treatment is to stop avoiding.

Behaviour is selected by its consequences. Change the consequences and you change the behaviour.

It works. The argument is entirely about why — and the eye movements may not be the reason.

It is not events themselves but the meaning we give them that disturbs us.

You are not disturbed by things, but by the rigid demands you place on them.

For the patients cognitive therapy could not reach: go to the childhood origin, and reparent within limits.

It is not what you think. It is how long you think about it, and why you believe you have to.

The problem is not the pain. The problem is the struggle against the pain, and what that struggle costs you.

You are doing the best you can, and you have to do better. Both are true.

For people who know the alternative thought is true and still feel worthless.

Not feeling better, but getting better at being with what is — and noticing the slide before it becomes a fall.

The identified patient is carrying the symptom. The problem belongs to the system.

Nobody is the patient. The relationship is.

The absence of depression is not the presence of a life. Build the positive as well as removing the negative.

You do not have to understand a problem to solve it. Find what already works and do more of it.

The person is not the problem. The problem is the problem.

Every person is a scientist, testing personal theories about the world. Some theories are not being tested.

The personal is political. Some of what arrives as private pathology is a social arrangement, felt from inside.

There is no culture-free therapy. There is only therapy whose culture has been made explicit, and therapy whose has not.

Trauma is held in the body’s incomplete defensive responses, not only in the story about it.

Not a treatment in itself. A state in which other treatments may work better.

The drug does not do the therapy. It opens a window, and what happens in that window is the treatment.

A window in which the trauma can be approached without being overwhelmed by it — or avoided.

The only compound in this family already in routine clinical use — and the one where the psychotherapy is most often left out.

No single system is adequate to every patient. The question is how to combine them without incoherence.

One protocol for all the emotional disorders, because they share a mechanism.

The question is no longer whether it works, but how little human contact it can survive.