Thank you Dr Shedler for a very articulate description of Psychotherapeutic treatment and trials. You brought the discussion back to point every time, before it got too complicated. Getting to the source with a patient is life changing for them. But takes time.
Brilliant piece! I’ve said, for ages, that the clinical studies of therapy outcomes rarely take into account differences in outcomes for specific diagnostic groups, as well as effectiveness of therapy over the long term. Rarely are functional outcomes measured in these studies, needless to say long term functional changes. Also, I’m not sure if other factors affecting outcomes (health factors, medication, socio-economic factors) are included in the meta-analyses being studied.
I very much enjoyed the interview too. I respect both of your work and very much appreciate the contributions you have made to our field. Over the last 10 years, I have been studying a form of shorter term psychodynamic psychotherapy (intensive short term, dynamic psychotherapy) I think this model has significant advantages to the traditional psychodynamic approach that I was taught, and that Dr. Schedler discussed, including doing away with the technique of free association which often feeds into intellectual defenses and prolongs treatment. ISTDP is very good at identifying, unconscious anxiety, as well as syntonic defense mechanisms, and repressed affect. Like psychoanalysis it does seek to promote character change. I am curious if either of you are familiar with it and it’s research literature?
Excellent interview really value Jonathan Shedlers view as a psychodynamic Psychotherapist but also used Bruce Wampold great writings in my Assignments.
When the facts and the truth are considered controversial, you know we as a society have a *big* problem. Also, why invite someone to an interview if you're just going to get defensive whenever they say something that makes you uncomfortable or challenges you? (I'm referring to Bruce here). Bruce is missing the point entirely by claiming these short term treatments are essentially "effective enough" because the current mental health system doesn't support longer term treatments. The *reason* the mental health system doesn't support longer term treatments is because they are using these flawed studies as their gold standard when they shouldn't be. The system is 100% profit driven when it shouldn't be. Also, those short term treatments are quite literally _not_ effective enough and those that are subjected to them are often worse off in the long run because they believe they have received adequate treatment but still aren't better so they must be a hopeless case. But the reality is they _never_ received adequate treatment and instead were given a facsimile of what real psyschotherapy is. Whenever Shedler tries to bring the conversation back to the facts, Wampold says "let's not talk about that" and instead wants to talk about some made up scenario that doesn't actually exist. Wampold is literally pulling made up statistics out of his ass to try and poke holes in Shedler's argument and failing miserably. Saying things like "we all know that" is extremely patronising and insulting.
Talking about change, but is there an objective measure regarding the degree of change. Most individuals with personality disorders require a breakthrough in perspective that would require a level of de novo reconsolidation/integration that would require months if not years of trusting reliance on a competent therapist. Dr. Feelgood Wampold does not recognize the degree that the superficial phenomena "flight into health" or placebo arises when individuals have entered into therapy after a period of profound hopelessness. Just allowing themselves to be vulnerable in therapy briefly provides a tremendous sense of relief while allowing them to avoid anything significantly confrontational to their egos which would be so difficult for them to tolerate. So many "escape" with their transitory experience of relief from their isolation and experiencing a hope when they were previously hopeless, yet not having actually learned what is necessary for meaningful change.
Jonathan keeps receipts and instead of being praised for it he is shunned by the accepted consensus (i.e. something is better than nothing, in the short term, but we will tell you its the best). Tells you all you need to know about the current system of mental health care.
I was extremely interested in what Jonathan had to say- but to me this became unwatchable before the end of the hour with him constantly cutting off Wampold, not letting him finish a single question, comment, or response. Please, Jonathan, could you please give the man a chance to finish speaking - as others have pointed out here, a certain amount of nuance can be lost, if you cut a person off *every time* before they're finished, just assuming/anticipating you understand the question. The interview is 97% one person talking (which is fine, since it's an interview), but please, show some courtesy and restraint and let the interviewer finish! I would have enjoyed this a great deal more if not for that aspect. ALSO- would be very fascinated by a deeper discussion (even debate, as they referred to at one point), between Jonathan and (either Wampold, or, perhaps more interestingly, a CBT advocate of some kind). Would love to see someone put that together- could be fascinating. (Please have a moderator present though!;)
Cutting off Walpold the entire hour. Appreciate Shedler’s passion but there should be more give and take in a discussion to actually call it a discussion. Also, too much vocal fry (likely some tension in vocal cords) can be irritating to listeners.
Agree. This is my one criticism of Shedler in many interviews - although I agree with many if not all of his points, he is usually chomping at the bit and cuts people off. Take a breath, Jonathan!
@@LisaFladager Probably because people invite him to an interview but end up getting defensive and argumentative whenever they feel challenged by him. Right at the start Walpold wrote him off as controversial in attempt to invalidate anything he had to say.
Very interesting, but it's unfortunate that Dr. Shedler repeatedly interrupts Dr. Wampold, not giving him time to finish asking his question. Maybe nuances in the questions are being missed.
@@williamjames3995 Bruce also interrupts and cuts Jonathan off by saying "let's not talk about that" every time he feels challenged. Don't invite someone to an interview if you're not open to what they have to say.
This was kind of funny. Shedler saying he's upset by researchers conducting studies and telling clinicians how they should adopt their latest treatment, yet doesn't give equal weight to people with lived experience also having an equal voice. It was scary how much Wampold dismissed Shedler -- OUCH!! I saw a video of an alleged debate between Wampold and Fonagy, where Fonagy said there are 2,400 treatments. Today, Shedler said that all treatments are equally effective. Hmmm. In the same debate video, Wampold stated that he wants research to find out what it is with some therapists that makes them effective. Hmmmm. No mention of that today. Just a presumption that therapies (and presumably, therapists) "work". Hmmm.
This was kind of funny. Shedler saying he's upset by researchers conducting studies and telling clinicians how they should adopt their latest treatment, yet doesn't give equal weight to people with lived experience also having an equal voice. It was scary how much Wampold dismissed Shedler -- OUCH!! I saw a video of an alleged debate between Wampold and Fonagy, where Fonagy said there are 2,400 treatments. Today, Shedler said that all treatments are equally effective. Hmmm. In the same debate video, Wampold stated that he wants research to find out what it is with some therapists that makes them effective. Hmmmm. No mention of that today. Just a presumption that therapies (and presumably, therapists) "work". Hmmm.
Thank you Dr Shedler for a very articulate description of Psychotherapeutic treatment and trials. You brought the discussion back to point every time, before it got too complicated. Getting to the source with a patient is life changing for them. But takes time.
Excellent interview. Thank you dr Shedler
100% agree with Shedler on this.
Brilliant piece! I’ve said, for ages, that the clinical studies of therapy outcomes rarely take into account differences in outcomes for specific diagnostic groups, as well as effectiveness of therapy over the long term. Rarely are functional outcomes measured in these studies, needless to say long term functional changes. Also, I’m not sure if other factors affecting outcomes (health factors, medication, socio-economic factors) are included in the meta-analyses being studied.
I very much enjoyed the interview too. I respect both of your work and very much appreciate the contributions you have made to our field.
Over the last 10 years, I have been studying a form of shorter term psychodynamic psychotherapy (intensive short term, dynamic psychotherapy) I think this model has significant advantages to the traditional psychodynamic approach that I was taught, and that Dr. Schedler discussed, including doing away with the technique of free association which often feeds into intellectual defenses and prolongs treatment. ISTDP is very good at identifying, unconscious anxiety, as well as syntonic defense mechanisms, and repressed affect. Like psychoanalysis it does seek to promote character change. I am curious if either of you are familiar with it and it’s research literature?
The conversation we needed! Part 2 anyone?
yes please
Yes! Part 2 and with fewer interruptions from Shedler. I love his passion but we gotta set some ground rules for the next chat 😅
excellent interview. ty both.
Very good discussion/argument surrounding different perspectives in particular clinical modalities.
Excellent interview really value Jonathan Shedlers view as a psychodynamic Psychotherapist but also used Bruce Wampold great writings in my Assignments.
As a clinician, thank you for this
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shedler boss baller shot caller. maximum respect
When the facts and the truth are considered controversial, you know we as a society have a *big* problem. Also, why invite someone to an interview if you're just going to get defensive whenever they say something that makes you uncomfortable or challenges you? (I'm referring to Bruce here). Bruce is missing the point entirely by claiming these short term treatments are essentially "effective enough" because the current mental health system doesn't support longer term treatments. The *reason* the mental health system doesn't support longer term treatments is because they are using these flawed studies as their gold standard when they shouldn't be. The system is 100% profit driven when it shouldn't be. Also, those short term treatments are quite literally _not_ effective enough and those that are subjected to them are often worse off in the long run because they believe they have received adequate treatment but still aren't better so they must be a hopeless case. But the reality is they _never_ received adequate treatment and instead were given a facsimile of what real psyschotherapy is.
Whenever Shedler tries to bring the conversation back to the facts, Wampold says "let's not talk about that" and instead wants to talk about some made up scenario that doesn't actually exist. Wampold is literally pulling made up statistics out of his ass to try and poke holes in Shedler's argument and failing miserably. Saying things like "we all know that" is extremely patronising and insulting.
I'm having trouble finding the industry's empurical evidence of disorders. Any suggestions?
Talking about change, but is there an objective measure regarding the degree of change. Most individuals with personality disorders require a breakthrough in perspective that would require a level of de novo reconsolidation/integration that would require months if not years of trusting reliance on a competent therapist. Dr. Feelgood Wampold does not recognize the degree that the superficial phenomena "flight into health" or placebo arises when individuals have entered into therapy after a period of profound hopelessness. Just allowing themselves to be vulnerable in therapy briefly provides a tremendous sense of relief while allowing them to avoid anything significantly confrontational to their egos which would be so difficult for them to tolerate. So many "escape" with their transitory experience of relief from their isolation and experiencing a hope when they were previously hopeless, yet not having actually learned what is necessary for meaningful change.
Jonathan keeps receipts and instead of being praised for it he is shunned by the accepted consensus (i.e. something is better than nothing, in the short term, but we will tell you its the best). Tells you all you need to know about the current system of mental health care.
well said
I was extremely interested in what Jonathan had to say- but to me this became unwatchable before the end of the hour with him constantly cutting off Wampold, not letting him finish a single question, comment, or response. Please, Jonathan, could you please give the man a chance to finish speaking - as others have pointed out here, a certain amount of nuance can be lost, if you cut a person off *every time* before they're finished, just assuming/anticipating you understand the question. The interview is 97% one person talking (which is fine, since it's an interview), but please, show some courtesy and restraint and let the interviewer finish! I would have enjoyed this a great deal more if not for that aspect.
ALSO- would be very fascinated by a deeper discussion (even debate, as they referred to at one point), between Jonathan and (either Wampold, or, perhaps more interestingly, a CBT advocate of some kind). Would love to see someone put that together- could be fascinating. (Please have a moderator present though!;)
36:56
35:18
41:18 I was wrong about narcissists. They do suffer.
Of course they do, they're human.
Cutting off Walpold the entire hour. Appreciate Shedler’s passion but there should be more give and take in a discussion to actually call it a discussion. Also, too much vocal fry (likely some tension in vocal cords) can be irritating to listeners.
Agree. This is my one criticism of Shedler in many interviews - although I agree with many if not all of his points, he is usually chomping at the bit and cuts people off. Take a breath, Jonathan!
@@LisaFladager Probably because people invite him to an interview but end up getting defensive and argumentative whenever they feel challenged by him. Right at the start Walpold wrote him off as controversial in attempt to invalidate anything he had to say.
Very interesting, but it's unfortunate that Dr. Shedler repeatedly interrupts Dr. Wampold, not giving him time to finish asking his question. Maybe nuances in the questions are being missed.
Psychoanalysis/psychodynamic is great but it’s not assessable to therapists 3 years of school and tens of thousands of dollars (after grad school).
1😊
Viewing this like a session, Bruce seems to avoid something that makes him uncomfortable.
Viewing this like a session, Shedler is going full „Overcontroller“ by interrupting Bruce a lot.
@@williamjames3995 indeed! My one criticism of Jonathan is that I wish he didn't interrupt so much. Let the man finish his sentences!
@@williamjames3995 Bruce also interrupts and cuts Jonathan off by saying "let's not talk about that" every time he feels challenged. Don't invite someone to an interview if you're not open to what they have to say.
I hope you two get out of your ivory towers sometime.
This was kind of funny. Shedler saying he's upset by researchers conducting studies and telling clinicians how they should adopt their latest treatment, yet doesn't give equal weight to people with lived experience also having an equal voice. It was scary how much Wampold dismissed Shedler -- OUCH!!
I saw a video of an alleged debate between Wampold and Fonagy, where Fonagy said there are 2,400 treatments. Today, Shedler said that all treatments are equally effective. Hmmm.
In the same debate video, Wampold stated that he wants research to find out what it is with some therapists that makes them effective. Hmmmm. No mention of that today. Just a presumption that therapies (and presumably, therapists) "work". Hmmm.
This was kind of funny. Shedler saying he's upset by researchers conducting studies and telling clinicians how they should adopt their latest treatment, yet doesn't give equal weight to people with lived experience also having an equal voice. It was scary how much Wampold dismissed Shedler -- OUCH!!
I saw a video of an alleged debate between Wampold and Fonagy, where Fonagy said there are 2,400 treatments. Today, Shedler said that all treatments are equally effective. Hmmm.
In the same debate video, Wampold stated that he wants research to find out what it is with some therapists that makes them effective. Hmmmm. No mention of that today. Just a presumption that therapies (and presumably, therapists) "work". Hmmm.
What? Shedler never said all treatments are equally effective... He also gave countless example of people's lived experience supporting his claims.