The Emergence of a Unique Clinical Perspective
Several things have contributed to shaping the view that informs my clinical work over the past three decades. First, throughout my training I had the good fortune of having great mentors, who taught me more about character than simply clinical methods. Second, my role as a clinical teacher has been primarily in continuing education, serving as a faculty member in the Dept. of Psychiatry at Harvard Medical School for 37 years and also directing a private continuing education organization, which has necessitated constantly updating my clinical knowledge-base. For three decades I have dedicated a half or full day nearly every week to reading the professional journals and new books to keep up with the newest developments, and for the past two decades I have developed and updated continuing education courses in nearly every area of mental health assessment and treatment. Thirdly, I spend 5-10 hours/week consulting with other clinicians about problems and impasses they encounter in the treatment they offer, and from this, I have developed some understanding of what does and does not work in psychotherapy. Fourth, 38 years practicing clinical hypnosis and writing 4 textbooks on hypnosis have shaped an interest in combining psycho-dynamic/exploratory treatment with very focused cognitive-behavioral, skill-based approaches that contribute to comprehensive treatment. Fifth, my 47 years studying the eastern meditative traditions, and more recently the positive psychology movement in modern Western psychology, have shaped a more positive view of mind and development.
The Clinical View of Integrative Treatment
Historically, a prospective psychotherapy client was offered a treatment modality that more reflected the training and/or interests of the therapist, not necessarily what was the best match to the client’s presenting problem(s). Three decades of increasingly sophisticated psychotherapy outcomes research has substantially changed, in the best sense, how psychotherapists now offer or should offer treatment. Currently, the evolving standard of integrative psychotherapy means that the best clinicians have knowledge/expertise in a wide variety of approaches and the flexibility to select the method, or combination of methods, that research has shown to be the most efficacious and clinically effective for that type of problem, and that specific treatments are carefully matched to the given client’s needs and problems, and not simply limited by the therapist’s interests/training. However, we live in a age of scientific rhetoric and suggestive influence in advertising so that it is not uncommon to hear distorted claims that a given clinical method is ‘clinically proven.’ Such claims area poor substitute for the years of hard work updating clinical knowledge-base and skills that allows for a deep appreciation of the evolving clinical tradition, summarized by the best of what we have to offer as the current state-of-the-art, as well as an appreciation for of the most promising new developments and innovations in treatment. The Center for Integrative Psychotherapy offers genuinely integrative treatment based on the integration of psycho-dynamic, developmentally-informed, cognitive-behavioral, hypnotherapeutic, and systemic approaches to psychotherapy, along with the developments in positive psychology.
Over the years, I worked to develop range of new treatment protocols. For example, in the 1980s and 1990s my associates and I developed step-by-step treatment protocols for a range of behavioral medicine problems and for the treatment of simple and complex posttraumatic stress disorders. In the 1980s we developed structured self-psychologically-oriented hypnotherapy protocols for individuals with chronic self development and self esteem problems. These protocols emphasize not simply the absence of feeling bad about, but sustaining a strong positive feeling about the self. In the same time frame we developed structured protocols for treating attachment problems in personality disordered and dissociative disordered individuals that emphasize working on secure attachment as not simply the absence of relational disturbance but on developing and holding a deeply positive internal map for healthy secure intimacy that gives the individual a sense of being secure in the relationship and able to grow, development and flourish within the security of the relationship. The Center’s view is that treating psychiatric disorders not only focuses on the negative, i.e. on treating psycho-pathology, but equally on the positive, namely on developing and exploring: the best coping skills, a strong sense of mastery over problems, the range of healthy inner resources and character strengths, on moving beyond coping to thriving, with vital engagement in everyday life, satisfaction with life, everyday happiness, and concern with the greater social good as legitimate goals of treatment.
The Center’s Specialty Areas of Treatment*
Clinical Hypnosis for a wide range of problems
Difficulties with relationships, dismissing, anxious/preoccupied and disorganized attachment styles mainly in personality and dissociative individuals
Difficulties within relationships--repetition of the same dysfunctional patterns across many relationships, sometimes referred to as core conflict relational themes
Couples treatment–an experiential, skilled-based approach
Short-term, skilled-based cognitive-behavioral and hypnotherapeutic treatments for:
Anxiety disorders (generalized anxiety, panic, specific phobic, agoraphobia, obsessive-compulsive disorder)
Depression and bipolar disorder
Problems of sexual desire, arousal, and climax
A variety of health/behavioral medicine problems, like pain, headache, asthma, hypertension, functional gastrointestinal conditions, and skin conditions
Functional somatization and conversion disorders, like non-epileptic seizures
Step-by-step phase-oriented treatment for:
Addictions–alcohol and drug abuse or dependency; eating disorders
Complex habits like hair pulling, skin picking, and self mutilation
Simple posttraumatic stress disorder
**Developmentally-informed treatment for:
Major dissociative disorders
Complex trauma and abuse disorders
**Our treatments for these more complex clinical areas include an updated integration of the affect-, self-, and attachment-development protocols developed by our Center with other most successful treatments according to current psychotherapy outcomes research for these conditions, such as schema therapy in New York, mentalization-based psychotherapy in the United Kingdom, and metacognitive psychotherapy in Italy.
Positive Psychotherapy for:
Peak performance and excellence in sports, the arts, and the work-site
* Treatments at the Center strive to be culturally and diversity sensitive.