Trusting in Psychotherapy

"Cultivating trusting psychotherapy bonds is complex, challenging, and a critically important topic. In Trusting in Psychotherapy, the author posits that trusting cannot be understood apart from trustworthiness and that therapists should give equal attention to the task of becoming trustworthy to their patients. Blending developmental science and ethical thought, the author elucidates such topics as what it means to trust in the practice of psychotherapy; the many facets of trusting and trustworthiness; attachment relationships; the central role of hope in trust; and the ethical-moral basis of trusting and trustworthiness"-- Provided by publisher Trusting in Psychotherapy is an important book that fills a lamentable void: although virtually everyone—therapists, students, and patients alike—believes that trust is the foundation of psychotherapy, the topic has been neglected in the psychiatric literature, to the detriment of the therapeutic relationship. The author, who brings five decades of study and practice to the enterprise, posits that cultivating trusting psychotherapy bonds—especially for patients who have experienced developmental trauma in close relationships—is complex, challenging, and a critically important topic for examination. Whereas therapists are inclined to focus on patients'problems with trust, the author argues that trusting cannot be understood apart from trustworthiness and that therapists should give equal attention to the task of becoming trustworthy to their patients. Blending developmental science and ethical thought in an interdisciplinary spirit, the author draws on contemporary writings of philosophers to elucidate the concepts of trust and trustworthiness. What it means to trust in the practice of psychotherapy; the many facets of trusting and trustworthiness; attachment relationships, both secure and insecure; the central role of hope in trust; and the ethical-moral basis of trusting and trustworthiness—these and other topics are addressed with competence and care.Intellectually engaging and designed to provoke thought, the book: • Offers a broadly developmental perspective, reflecting the belief that attachment trauma plays a profound role in many severe psychiatric disorders and emphasizing that the resulting and pervasive distrust and social alienation pose significant obstacles to developing therapeutic connections.• Provides an overview of the professional literature on developing expertise in conducting psychotherapy, with discussion of current research.Addresses the proliferation of new therapies in the context of competing schools of thought and what this proliferation means for the therapist caught between science and practice, academics and clinicians. • Is aimed chiefly at psychotherapists, yet its conversational, generally nontechnical style makes it accessible to those who are not mental health professionals, including patients who might wish to listen in on the conversation and families who desire a more complete understanding of the therapeutic process.• Includes key points at the end of each chapter to help the reader stay oriented and focused on the most important concepts. Trusting in Psychotherapy argues persuasively that we should shift the balance of our efforts from developing therapies to developing therapists, a view that deserves to inform mental health research and thought leadership. Cover 1 Half Title 2 Title 4 Copyright 5 Dedicaiton 6 Contents 8 About the Author 10 Foreword 12 Preface 20 Acknowledgments 24 Introduction: The Scope of Trust in Psychotherapy 26 1 From Trusting Therapies to Trusting Therapists 30 Evidence-Based Practice 32 Common Factors and the Therapeutic Relationship 36 Individualizing Psychotherapy 42 What Happened to the Therapist? 47 Psychotherapy Integration 50 Personal Knowledge 52 Knowledge of Ethics 57 Mastering the Craft of Psychotherapy 66 2 Developing Trust and Trustworthiness 80 The Intentional Stance 81 From You and I to We 84 Secure and Insecure Attachment 98 Mentalizing and Epistemic Trust 108 Cultural Diversity: How I Mistook Ethics for Science 117 Basic Trust, Epistemic Trust, and Social Trust 125 3 Trusting 134 The Ethical-Moral Basis of Trusting 134 Trusting in Community 136 Trusting Beyond Reliance 139 Degrees of Trust 143 Trusting in Care and Competence 147 Distrusting Well 151 Trust and Distrust in Couples 154 Trusting and Distrusting Yourself 158 Hoping in Trust 165 4 Becoming Trustworthy 184 The Ethical-Moral Basis of Trustworthiness 186 Therapeutic Neutrality 191 Relational Trustworthiness 198 Writing Personal Formulations 212 Parting Thoughts 224 References 226 Index 242 A 242 B 242 C 243 D 244 E 244 F 245 G 245 H 245 I 245 J 245 K 246 L 246 M 246 N 246 O 247 P 247 Q 248 R 248 S 249 T 249 U 250 V 250 W 250 Back Cover 252 Solidly grounded in contemporary research, yet appealing to therapists who prioritize the patient-therapist relationship, Trusting in Psychotherapy presents psychotherapy as a craft, and embraces the developmental perspective that mastery is the work of a lifetime.