Psychotherapy Pearls

Critical Insights for Doing Psychotherapy

Psychotherapy Pearls began as a personal project to capture as many of the clinical insights as possible from the careers of its two authors, Fred Levin and Meyer Gunther. Such wisdom accumulates piecemeal only from the continued intensive experience of working each day with patients who are suffering from a vast array of difficulties: narcissistic deficits, depressions, anxiety and phobic disorders, learning disabilities, attention deficit/hyperactivity disorder, bipolar illness (so-called manic depressive disorder), Alzheimer's disease and other dementing illnesses, mourning and melancholia, and so forth. The only way to learn about specific people is to become immersed in their psyche: to care with and about them, over long periods of time, and only then can one learn to respect the dignity and power of individuals as they patiently find enduring solutions to their problems. To be part of this intensity is a great privilege, as well as a responsibility. Out of respect for those we have worked with, both colleagues and patients, and in order to make things a bit easier for those who wish to improve their knowledge of psychotherapy theory and technique, we have worked diligently to state our hard won insights clearly for students of all levels of experience and sophistication.

One unique feature of Psychotherapy Pearls is that we cover both technique and psychopathology in one book. Most textbooks tackle one or the other, but we believe this is wasteful, since it makes most sense to us to consider technique in close proximity to our discussions of the very illnesses and problems for which our technique is designed to address. Moreover, in considering technique we center our thinking about common sense psychology which most readers have been thinking about, whether they realize it or not, from the beginning of their lives, but without ever pulling these bits of insight together into a body of knowledge or theory as such. For example, our book begins with the following subjects: feelings, beginning therapy, listening, empathy, idealization, paying attention, free association, therapeutic relationship, referrals, patient selection, diagnosis, calming down, transference, resistance, defense, working through, and so forth.

It is not possible to cover everything in any book on a single subject. But we try hard not to leave out essentials, or correlated matters. For example, we cover not only suicidal, but homicidal impulses; biological as well as psychological illnesses; theoretical issues and practical matters. In the latter category, we consider such matters as how to decide when and whom to refer patients to and whom and when to accept patients into treatment, how to keep one's patient records, and how best to manage such things as vacation absences, billings, and even how to plan for the possible death of the therapist (i.e. how to help the patient deal with our absence, whether brief or permanent).

We have taken the time to personally create the index for our book, because we believe that only the author's involved can generate the proper subject headings, or know where important ideas appear in the text. This should make our book more user friendly than many other books where the index is generated simply on the basis of some computer program for doing so, without the sensitivity of the authors being involved in the process.

The reader may appreciate that each of the subject chapters have been discussed at length after they were composed by the authors, as we reviewed each word of our text, and debated with each other our conclusions, nuances, and wording. Often these debates lasted into the evening, and intense feelings were aroused on both sides. But our goal in this process was always finding a common denominator which we could better explicate for the reader, without doing any injustice to the complexity and evern beauty of the questions being asked. The mind and brain are complex beyond bel