Episode 28: Making the Case for Psychotherapy with Dr. Jonathan Shedler

Hotly debated in mental health care, psychoanalytic therapy has been criticized for lacking evidence in comparison to other approaches. Now, many clinicians attest to the benefits of this evidence-based treatment and see great need in their patients for relationship-centered therapeutic approaches from their doctor and an emphasis on knowing oneself in order to heal. 

Dr. Jonathan Shedler, psychologist and author of, “The Efficacy of Psychodynamic Psychotherapy,” is staunchly advocating for clinicians to keep an open mind about what suits their patients best on this episode of Menninger Clinic’s Mind Dive podcast. This internationally acclaimed article is known for his work in establishing psychotherapy as an evidence-based treatment.  

Alongside hosts Dr. Kerry Horrell and Dr. Bob Boland, Dr. Shedler explores the dilemmas and nuances of psychotherapy throughout its history and how clinicians can use it to their benefit under a modern lens. 

Jonathan Shedler, PhD, is a consultant, master clinician, clinical professor of psychiatry at the University of California (UCSF) and faculty member at the San Francisco Center for Psychoanalysis. He also leads workshops for professional audiences, consults to U.S. and international government agencies and provides expert clinical consultation to mental health professionals worldwide. 

“I think it’s perfectly fine to say we don’t fully know our own hearts and minds. The things that we don’t know cause suffering and can cause symptoms and limitations. Because of this, there’s a tremendous value in coming to know ourselves more fully,” said Dr. Shedler. “That’s what can happen in the context of psychoanalytic therapy and what can allow our patients to ultimately feel more free and more whole.” 

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Visit www.menningerclinic.org to learn more about The Menninger Clinic’s research and leadership role in mental health. 

Listen to Episode 27: OCD, An Expert’s Insider Perspective with Dr. Elizabeth McIngvale

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Visit The Menninger Clinic website to learn more about The Menninger Clinic’s research and leadership role in mental health.

Transcript

00:02

Welcome to the Mind Dive Podcast brought to you by the Menninger Clinic, a national leader in mental health care. We're your hosts, Dr. Bob Boland,

00:11

and Dr. Kerry Horrell. Twice monthly, we dive into mental health topics that fascinate us as clinical professionals, and we explore those unexpected dilemmas that arise while treating patients. Join us for all of this, plus the latest research and perspectives from the minds of distinguished colleagues near and far. Let's dive in. 

00:35

I think I'd say that a lot of times, but I am. So I'm going to say it every time. But there's an extra bit of excitement in today's intro, that we're going to be joined by Dr. Jonathan Shedler. Dr. Shedler is known internationally as an author, consultant, master clinician and teacher, his article, "The Efficacy of Psychodynamic Psychotherapy," won worldwide acclaim for establishing psychoanalytic therapy as an evidence based treatment. And I was saying this right before we hopped on, but I know that deeply because I cited this paper gazillions of times in grad school, and I'm hoping some of my grad school friends are listening. So they'll feel jealous that I'm talking to the Jonathan Shedler,

00:40

every resident had to read it at that point, Dr. Shedler,

01:22

I was just floored at the--I wasn't going to write it at all, actually, I had, I had sworn off writing academic papers, I thought it was I thought it was a thankless job, I wasn't going to do it again. And I assumed that, you know, it would be read by the usual, you know, eight people, you know, who've, you know, two of whom are your good friends, and the other six are professional rivals looking at it to, you know, tear it apart. So I was really just, you know, blown away by, you know, the reception it got. And by the widespread distribution,

01:57

Clearly a great need. And the work you've done since also has continued to be well utilized by the field within, you know, the general broad psychodynamic field, but specifically the psychoanalytic field. So, our kind of our first question for you, or thought we wanted to ask was, you know, you've been such a champion in the mental health field for highlighting, demonstrating that psychodynamic psychotherapy is evidence based, it's effective, and particularly that it offers long standing long term results. And I wonder how you became interested and sort of taken on this discourse, because it sure has been a long standing discourse.

02:36

Yeah, because unlike most, you know, most people who are publishing, publishing psychological research, I actually treat patients regularly. And at the time, I was an attending doctor, in an outpatient psychiatry clinic. And literally every day I was there, there was a procession of patients coming through, you know, who were just, you know, miserable, who were suffering greatly. And just about all of them, had had some kind of quote unquote, evidence based therapy, and they had nothing to show for it. Like literally nothing years of treatment, nothing. You know, the more I believe in science, I believe in, I believe in evidence, you know, the research literature seems to show or at least the buzz about what the literature research literature shows, is that these, you know, so called Evidence based therapies, which is really a codeword, as you know, for brief manualized therapies, you know, the literature seems to show that they're effective, they're called the gold standard. And every single day, there was the evidence of my eyes and ears of this procession of patients who had gotten nothing out of it. And I'm like, How can there be such? You know, do I have a bizarrely aberrant patient sample? I don't think so. How can there be such a discrepancy between what I'm seeing clinically with my own eyes, and what everybody is saying, you know, quote, unquote, science shows, which prompted me to look into the research literature more closely. And there was really a lot of troubling things going on, in how research is conducted and how it's reported. Yeah, I

04:15

mean, we probably should use the definitions, you're, you're actually already started it off, because I asked you to find evidence based therapy, and particularly the one that's in quotes. Since you're right, it is kind of used as a code word is sometimes it seems to just mean not not psychodynamics there.

04:30

Well, well, that's exactly the issue of let me just before you say anything more, that's exactly the issue. It's a code word. It means the code word de facto means anything but psychodynamic or psychoanalytic, and then it I mean, it's really a sleight of hand. Because in fact, you know, all of these so called evidence based, ie not psychoanalytic therapies, over time are incorporating more and more and more sigh Do analytic methods and you know the sleight of hand is the things that make those therapies effective to the extent they are effective, really come out of the psychodynamic tradition, while the people who are promoting these therapies, I think as a matter of marketing or PR, you know, are devoted to trashing everything, psychodynamic, so, you know, the level of insincerity and disingenuousness, about how we talk about therapies is, to me, it has been, you know, shocking.

05:33

Now, it's probably a tension in the field that a lot of people outside the field would have no idea about,

05:39

no, not not not a clue. And we do a terrible disservice to the public. Because, you know, here we are, you know, having our internal turf battles. And, you know, ultimately, it's our clients and our patients who pay.

05:52

I know, you probably have another definition, but I wanted to throw in here, okay. Go ahead. There was a wonderful article that came out relatively recently, and I'm sad, I don't remember the author's names. But they studied the public, and they studied the public's perception of therapy. And one of the things they found was that a lot of the public had a reaction to psychoanalytic therapy as if it's like just terminology, I don't want to be analyzed, that sounds too much. But when they got down to the nitty gritty of what people were looking for in therapy, they were much more likely to be looking for the core tenets that you would find in a psychodynamic kind of therapy. manualized therapy?

06:29

Well, you know, psychoanalysts have been their own worst enemies. I mean, they are deaf, dumb and blind, to our public perceptions. You know, I don't know who to be more angry with, you know, should I be angry at the people? Well, there's, there's a lot of stakeholders, right? health insurers, health insurance companies are in it for profit, they have an incentive to trash what I would call meaningful psychotherapy, pharmaceutical companies, I don't think they're, I don't, I think they're indifferent about whether people get psychotherapy, but they have a powerful incentive to steer people to medication. Right, then there's all the, you know, proponents of other forms of brief manualized therapy, you know, who love to trash psychodynamic approaches. And so everybody, you know, everybody is disparaging, belittling, misrepresenting distorting it. But honestly, I don't know whether I'm angry with people who are doing that, or with the people inside of psychoanalysis, who are just so oblivious to how they communicate in public, that, you know, people don't have a clue what it is, you know, what it is that happens in these therapies? You know, that's meaningful, because I think it is what people want. And if we talk about it, and jargon and theoretical terminology, we're not communicating what we're offering,

07:53

I can see you're really averse to ruffling feathers but you know, but why don't we just I mean, why don't we take that for a while? Why don't you define what you mean by psychodynamic psychotherapy? Because it is a term mean, I think we all think we know what it means by I'm not sure we're always

08:12

well, yeah, let me let me do it very simply. Sure. The fundamental premise is that by virtue of being human, we don't fully know our own hearts and minds, we don't fully know ourselves, if you want to, you know, attach theoretical terms. You know, we could speak of unconscious mental processes, but I think it's perfectly fine to say, you know, we don't fully know our own hearts and minds, the things that we don't know, can harm us can cause suffering, can cause symptoms can cause limitations, and that there's tremendous value in coming to know ourselves more fully. And that happens in the context of a meaningful relationship. You can't separate interventions and techniques from the relational context in which it occurs. So what is psychoanalytic therapy, it's a kind of therapy, where we come to know ourselves more deeply and fully and become freer and more whole, in the context of a meaningful therapy relationship. In that respect, it's exactly the opposite of the kinds of therapies that are being promoted now, where we have, you know, techniques, interventions, you know, worksheets, apps, et cetera, et cetera, where you know, we're all these interventions are simply stripped out. So out of any relational context, right, which means stripping away the part of it that makes it psychotherapy, and selling this snake oil to the public, because there are stakeholders that benefit from it and profit from it.

09:47

I'm thinking about how you someone we had on the podcast early on is one of my mentors, Dr. Jon Allen. And he came on the podcast to talk about something he coined plain old therapy, right. I've read about that. Yeah, and like that, you You know that there's there's just 1000s of different flavors of therapy with manuals and specificities and interventions. And ultimately, even amongst those with the thing that causes, maybe that's not the right word, the thing that is most related to I guess, if you will, the change that happens, this is still the relationship, the experience of empathy, the experience of being attuned to has seen and known that this, again, across all the different flavors of therapy continues to be the driver.

10:31

I think you were getting at that early on, when you said that, like there's certain parts of all therapies that people want, even if they call them something else.

10:39

I think people want to be seen and heard and understood as individuals, and they want to be helped to better understand themselves. So they don't need to keep doing things in the same self defeating ways. And what they get instead is, you know, is tips and skills and practice exercises, and, you know, and basically, their personhood disappears in the therapy. And in that respect, I would say that the therapy is, the therapy isn't the cure, the therapy is part of the disease that purports to cure, that that kind of stripping away of our sense of personhood. And, of course, if we're not responded to as a whole person, as a whole human being by by somebody else in a relationship, it's very hard to experience ourselves as a whole human being.

11:30

And this is where again, I think that there are plenty of therapists who are doing, you know, saying this is what I do, I do DBT, or CBT, or whatever. And ultimately, they are still utilizing a lot of these relational components alongside of it, and oftentimes, like this is, when looking at it. This is what the patients are wanting the most, much more than a worksheet much more than students don't

11:52

want worksheets. And homework is I mean, speaking in absolutes? Sure, some patients do. But generally speaking, it's not what patients are looking for. We have data that tell us that that's not what patients are looking for. And yet, that's what so many stakeholders in the so called mental health and wellness space are trying to sell them something other than what they want.

12:14

And you're sort of already starting to make the point. But the usual complaint, even by some experienced therapists I've heard is that Whoa, psychodynamic therapy is just either too unscientific depending on if you're a critic, or too personal to lend itself to like, traditional investigation, but Well, that's

12:35

completely. So you know, so, you know, let me say a little bit about that. I mean, the the duplicity of I'm talking about people in the field, I mean, the public, the public, they just don't use the messages that they're, that they're very correctly. You know, this this criticism, you know, you know, the first level of criticism is psychodynamic therapy doesn't work? Well, there's no evidence that it works. It's completely bull. We have meta analysis after meta analysis after meta analysis, demonstrating that it works every bit as well, if not better than any of the therapies that are, you know, sold as so-called evidence based therapies. We, we know if it works, right. So if the criterion is, you know, do people improve? That's been answered scientifically, many times over. Right, then the more sophisticated critics, the next line of criticism is? Well, okay, you know, you got these outcomes, it's probably common factors. But there's no scientific evidence for the purported mechanisms of change. Well, first of all, that's flat out untrue. And we have quite a bit of evidence for that. Nobody wants to pay attention to it. But the part that's so disingenuous, you know, it's like criticism for thee but not for me. If you look at the fundamental, you know, theoretical assumptions of the cognitive therapy part of CBT, they are flat out false. Science tells us they're false, we know they're false, right? So the mechanism of change in CBT is far, far from established. And, you know, somehow want people want to point and say, oh, you know, psychodynamic therapy doesn't have evidence for its mechanisms, which it does, and completely ignore the fact that the therapies they're promoting, you know, have no evidence whatsoever. And you know, what I'm talking about specifically, let me not be vague about it, you know, the fundamental assumption of the see, the cognitive part of CBT is that, you know, our emotional state, moods are mediated by thought, by belief, and that if you can change somebody's belief, if you can change the way they think that's going to change their emotional responses, and you know, we know from so many sources, you know, front and center neuroscience, that assumption is just wrong. And you know, Oh, it just sort of boggles my mind that people I mean, it says something about the I don't know what the PR or the something about the culture of psychotherapy research, you know, that just gets glossed over as if it's nothing to think about there. But you know, anything to trash therapies that are, you know, that put relationship and understanding and insight front and center.

15:26

While I'm thinking about, you know, here at the Menninger Clinic, we are regularly seeing, I don't know if I'd go as far as as the majority, but a solid amount of our patients who come in, they failed other treatments. I mean, I can think of most of my current caseload are patients who've been in and out of manualized treatments. And ultimately, there's something that's really getting missed in regard to why they're continuing to struggle. And ultimately, it does seem to relate more to personality functioning. And I wonder if that's kind of an area we can veer into for a little bit. And talk a little bit about personality disorders, one of the things I appreciate greatly from your work is that you differentiate between sort of the DSM personality disorders and the criteria listed within from personality syndromes. And I wonder if you can share a bit about kind of your understanding of character or personality, pathology, and sort of the underlying personality processes that exist,

16:26

I'm going to say some things that I think most people, when they pay attention to it, will think are self evident. So you know, first of all, people don't start to feel unwell, you know, on Monday, and come to see a therapist on Tuesday. Rats! People, you know, people try an enormous range of things, if things are going badly in their life, you know, to try to fix themselves to try to make things better. If it's, you know, a person who's fundamentally doing well in life, right, that is to say, relatively free from internal conflict, who has, you know, good, meaningful, fulfilling relationships with other people who interacts with others in mutual ways, who's not suffering from, you know, significant internal inhibitions or self defeating patterns, you know, we all have difficult, painful periods in life. But if it's somebody who's healthy, functioning very, you know, otherwise functioning in a healthy way, they're gonna get through it, pretty much anything you do, by way of offering psychotherapy is going to be effective. And the overwhelming likelihood is, if without therapy, you know, they're going to come out of it. So by the time somebody gets to see a mental health professional, we're not talking about encapsulated symptoms, you know, I'm doing fine, my relationships are great, my work is fulfilling, I'm happy in my, you know, I'm happy in my marriage, I, you know, live richly and fully I just came down with this case of depression or anxiety, right? That the absurdity of that it just it doesn't work that way. So really, you know, by the time someone gets to see a mental health professional, the things that are causing them difficulties are really woven into the fabric of their lives. It's not about what DSM diagnosis do they have? Right, not what you have. It's something about who you are, and how you live. So that's personality, when you say personality. Personality is a person's sort of characteristic patterns of thinking, feeling, coping, defending against, against distress, attaching to others, relating interpersonally, relating, or failing to create all of these things are what we mean by personality, and everybody has a personality and a personality style. Whether or not it meets criteria for a DSM defined personality disorder. Everybody has a personality style. I think, you know, DSM really did some, starting from starting from DSM-3, and I think it was 1981, I think, some real damage to the field. Because what it did was it it artificially created these, you know, they wanted to shoehorn personality into, you know, into a diagnostic manual of disorders. First of all, how can a personality be a disorder, it's in personalities, personality. So what they did is they took personality styles that were familiar in the clinical literature at the time of the time, ratcheted them up to their most extreme, caricature, pathological form, declared them to be categorical disorders. And the effect that this had on subsequent generations of practitioners is it's led them to treat other mental health or treat things like depression and anxiety. The things that typically bring people to treatment, as if they were sort of encapsulated disorders that had nothing to do with who the person is or how they live their lives, unless they meet criteria for a DSM disorder. So basically, you know, a lot of mental health professionals unless you can, you know, unless something crosses the threshold to get a personality disorder diagnosis, a treat personality is irrelevant. What I would say is that every effective clinician really effective, and we're working toward meaningful and lasting change, we are not treating, you know, the immediate, acute symptom in in a vacuum, what we're doing is examining what it is about who the person is, and how they function and how they live their lives. That is, that is leading to the symptoms, and we address that. So I would say that all genuinely meaningful therapy is really focused on on personality, right, that the goal isn't to change something about the person symptoms to manage this or that symptom. You know, really, the goal is to change something about the person who the person is, so they can live life more fully, and, and freely and, and be more whole. And that's what we're doing. So I believe personality is actually at the center of at the center of what psychotherapy is.

21:29

And thinking about how a common phrase I use in the end of testing reports, or in the end of a therapy summary, where I'm giving recommendation to often say something, and I often think this is gonna land on my patients is vague, but it's so important to me that an ongoing therapy, what would be most useful is to be in a kind of attachment informed, trusting relationship where you can continue to heal and develop a healthier sense of yourself and others, that phrase of like, develop a healthier sense of self and other I'm like, I know that that just sounds really vague. What does that mean? But when I think about for many of my patients, the thing that would help them live a better life, and actually get to the goals that they're wanting to get to is developing a more whole robust, sturdy, kind, compassionate sense of themself for other people.

22:15

Yeah, I mean, even in the most basic level, I've heard people not in the mental health field, just you know, primary care, doctors say I don't treat diseases I treat people. Yeah, right. Yeah. Which kind of is what I think we want.

22:27

But the whole trend in what's going on in mental health now is to try to, you know, fragment people into an encapsulated disorders, and pretend that we can treat a cluster of symptoms, rather than the person who has the symptoms, and the psychological vulnerabilities that that lead to the symptoms.

22:53

Well, I of course, yes, I mean, we often sequester off different disease into different sort of treatment programs and, and often even more sequester out person, you know, personality disorders into their own kind of group. But that's often a lot of people refuse to treat anyways. So

23:10

it's tough, because I mean, working here to psychiatric hospital, we still have to do that. We got to give diagnoses. And we have to meet you know, it's it's this complicated dance, I think of fitting within the model that we have to fit into, for all sorts of reasons and treating the way well,

23:25

So, I think this is all very well said. I mean, we keep talking like about sort of the notion of sort of evidence base and stuff like that, but we really haven't talked, I mean, I know you can't do a review here. But maybe tell us just a bit about some highlights, you know, things you think are important about sort of the evidence for psychodynamic therapy or things that you really wish clinicians knew more about.

23:45

I don't think anybody outside of, you know, the kind of relatively closed psychoanalytic communities. I don't think people even understand what it is. I mean, you know, I mean, there's a kind of a Twitter war about this recently, but you're,

24:03

You're amazing on Twitter. Oh, are you on Twitter, Bob? Yeah, but I guess I'm not a

24:09

Dr. Shelder has a real presence in this way. I think a similar ruffling of feathers would be a good way to say it. 

24:18

Well, you know, people don't know what psychoanalytic therapy is, psychoanalysts have done, not just a terrible job of communicating it. I mean, they've, you know, done everything possible to make a bad situation worse. So you say psychoanalytic, and somebody who's taken, you know, Psych 101, thinks about penis envy and fixations, and maybe they think about id, ego and super ego. And first of all, none of these things are central to what psychoanalytic treatment is. They're very, they're very peripheral. Second of all, this is actually not these are, you know, these are theories dating to the horse and buggy era. They're not how people think about psychoanalysis. They're not how practitioners today, think or practice. So basically people have caricatures of caricatures of stereotypes that date back to 1895. So one thing that came up on Twitter, there was a thread going on where people who are Professor psychology professors teaching Psych 101, were talking about, what should they what should they eliminate from the Psych 101 curriculum. And they started talking about Freud and psychoanalysis. And it made me a little crazy, because the first thing that I that was clear to me was, they didn't speak about psychoanalysis in their textbooks, and they didn't talk to each other and say psychoanalysis or psychodynamic therapy, they kept saying Freud, Freud, Freud, Freud, Freud, Freud. And it was like, they literally did not have a concept that anything has changed in the past, you know, 125 years. And, you know, think about an analogy, we could say, Darwin is really central to, you know, to, it's funny, the evolution of the field of biology. I mean, he really put some core central concepts on the map. But when a student, you know, a college student takes biology 101, they understand that they're studying biology, not Darwin. And, you know, they might, they might learn about some Darwin's concepts they might read about him, they understand that this is a historical figure. And, you know, the field has, you know, been developing for a long time, when people take a course in astronomy, you know, no one says, we're studying Copernicus, you know, let's, let's eliminate Copernicus, from the curriculum, you know, Astronomy and Astrophysics, it is not synonymous with with Copernicus, and yet, you know, almost every psychology, Psych 101 undergraduate textbook I have ever seen, has a chapter on psychoanalysis. It doesn't describe anything about the contemporary field of psychoanalysis, literally nothing. What it does instead is talk about Freud as if it's synonymous as if that's synonymous with psychoanalysis. And not just Freud, that Freud circa 1895. And they get even that wrong, right? So we have a huge PR problem here that people hear the word psychoanalysis. And when I say people, I don't mean just anybody, I mean, university professors, and, you know, educated university students who have studied psychology, and they hear it and what it calls to mind has nothing to do with what we actually do. So that's why I made a point in my, in my 2010 paper, I made the point in the paper and whenever I speak about it, I say, I am not going to talk about the evidence for the benefits of psychodynamic or psychoanalytic therapy, until we're on the same page about what psychoanalytic therapy even is. Right. That's why I started the paper with here are the seven things that go on in psychodynamic therapy. And when I give this talk to people who CBT audiences, and they hear the sex, the seven things, the first thing they all say, pretty much, oh, we all do that. That's what we do. You know, that's not that's not different. Actually, it's not, but they think it is. And then, you know, the ones who are the more partisan ones, they'll say, Well, those seven things aren't psychoanalysis. Oh, really? What is your expertise and immersion? In psychoanalytic psychotherapy, you're going to tell me what is and isn't psychoanalysis because they think it's about penis envy, and, you know, ids and egos and super egos, they have no idea. That's, that's really not how psychoanalyst talk.

29:03

And I think maybe as a, as a point related that it is so common, we have patients coming in. And again, I'm a full time therapist, clinician psychologist, I just do 90% of my day, and I have so many patients coming especially because they're coming in and so much distress, you know, we work in patients, so they're coming in with a lot of distress. And they will say, I know I've read on the internet, what I needed, I need CBT or I need EMDR or I need this or the other and I'm just like, I know it's what we're going to do is develop a relationship and then we're going to try to utilize that relationship to try to help you learn more about yourself. It's also just it is it is a tough sell when there are so many there are so many again out on the internet out for the lay

29:52

public like the price we pay for all of these stakeholders with this continual bombarding the public with messaging that's aimed not at promoting good treatment or good care, but is aimed at promoting a brand or an agenda. I mean, don't think of an analogy. I'm a patient, and I have a pain in my side, or I have a fever, and I go to see my internist. And I say, Oh, I read on the internet, I'm here for this drug. Like, people don't go to their doctors and, you know, dictate to them what drug they're looking for, or what intervention, they go to their doctors and say, here's what's wrong, you know, can you make a diagnosis and you know, and treat it. But in therapy, everybody thinks, you know, everybody thinks they're somehow in the know. And that, that, you know, there's somehow there's something elevated about going in and saying, Not, you know, here's what hurts, you know, things suck, My life sucks, I feel terrible, whatever, you know, can you help me? They think there's something, you know, something extra to go in and say I want CBT? Or I want DBT? Or I want EMDR. Right? And what it does is, it makes it very difficult for an actual, competent expert professional, it just makes it harder for them to create and engage in the kind of relationship that's, that's helpful. And, you know, I'm very sympathetic, I've been in the same position, you know, patients come in as I want, you know, do you do this? Anything? You know, well, I do a lot of things. But I don't know, I don't think I don't think it would serve either of us, for us to put the cart before the horse and decide, you know, what's, you know, something is wrong, decide what, what the what the right treatment is for the something before we understand the something. So, you know, I wonder if we could just reverse the order here. Before we jump to a, you know, a brand of treatment, let's figure out what's wrong and why. You know, most patients are actually very receptive to having that kind of discussion, which is, it's an extra hurdle, though, because of the messaging they're getting in the culture, that makes it a little harder to begin meaningful psychotherapy.

32:12

So people listening, whether it be clinicians or patients, really anyone else, I think, would be thinking now that we've really just scratched the surface clearly. Where would you I mean, do you have any recommendations where people should go next, to kind of like to get more information about where we're going? Obviously, your paper would be one and, and other things like that people should be looking into, because it's like, what you're saying is we really, really need to educate ourselves better. I mean, that's a no, no plug away,

32:40

plug myself and actually, for what it's worth I get there's I don't get any royalties, or any benefits whatsoever. But I wrote a manuscript until recently was never published, but was widely distributed. Anyway, it's called, "That Was Then, This Is Now: An Introduction to Contemporary Psychoanalytic Therapy." What I actually wrote it some years ago for my students when I was teaching doctoral level, clinical psychology students, and I was supposed to teach the introductory course on psychoanalytic theory and therapy. And as I started looking at books and articles and things to assign, I realized they couldn't read any of it. And it was also filled with jargon, or so partisan and trying to promote validating, trying to promote one psychoanalytic school of thought over another. You know, you can't make the students into pawns and your internecine battles between, you know, schools, why don't you just teach them the fundamentals of what psychoanalytic what is psychoanalytic approaches and explain it in English. So it's called, "That Was Then, This Is Now," and I believe it's downloadable on your website? Yes. My website is my name, jonathanshedler.com. On the website, there's a writing there's a page that's called writings, that and quite a lot of other papers and articles that I've written are freely available for download a selection of that the sort of most important chapter in that was just published on its own in the journal, contemporary psychoanalysis. So if you have access to that, that journal, you can you can find it there also,

34:18

Dr. Shedler, I am so grateful for the work you've done. Because as you just said, I think taking I'm thinking about all the many, many analytic papers, I've read that I've felt like, Oh, my God, is everybody getting this about me. And so I think the the gap that you have filled in our field, so clearly is taking this type of treatment advocating for it, showing that it's effective and making it is maybe more easily accessible to many clinicians. And so I'm so grateful for your work. And

34:45

we're so grateful. I think you've kind of modeled what you're talking about, like, we wanted all the answers this time. And you said first, we need to understand what we're even talking about. Exactly, which is a good lesson.

34:55

And so just thank you so much for coming on and sharing your wisdom with us on the podcast. That's my plan. Okay.

35:00

Well,

35:01

you've been listening to Dr. Jonathan Shedler. Here on the Mind Dive Podcast. We've been your hosts, I'm Dr. Kerry Horrell, Dr. Bob Boland, and thanks for diving in.

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