A Therapist's Handbook to Dissolve Shame and Defense: Master the Moment
The effort to surmount shame and formidable defenses in psychotherapy can trigger shame and self-doubt in therapists. Susan Warren Warshow offers a user-friendly-guide to help therapists move past common treatment barriers. This unique book avoids jargon and breaks down complex concepts into digestible elements for practical application. The core principles of Dynamic Emotional Focused Therapy (DEFT), a comprehensive treatment approach for demonstrable change, are illustrated with rich and abundant clinical vignettes.
This engaging, often lyrical handbook emphasizes "shame-sensitivity" to create the safety necessary to achieve profound interpersonal connection. Often overlooked in treatment, shame can undermine the entire process. The author explains the "therapeutic transfer of compassion for self," a relational phenomenon that purposefully generates affective expression. She introduces a three-step, robust framework, The Healing Triad, to orient therapists to intervene effectively when the winds of resistance arise. Chapters clarify:
- Why we focus on feelings
- How to identify and move beyond shame and anxiety
- How to transform toxic guilt into reparative actions
- How to disarm defenses while avoiding ruptures
This book is essential reading for both advanced and newly practicing mental health practitioners striving to access the profound emotions in their clients for transformative change.
REVIEWS
"The Dynamic Emotion Focused therapy of Susan Warshow spotlights advances in psychotherapy that bring new luster to the clinical work of both doyens and tyros. Clear, concise writing and illuminating transcripts sharpen the realization of practical principles. The author is an expert who will enliven the development of your expertise."
--Jeffrey K. Zeig, Ph.D., The Milton H. Erickson Foundation
"Doing psychotherapy is a paradox. All day, every day, you are with people. And yet, when it comes to helping your client in the moment, you are utterly alone. A Therapist’s Handbook to Dissolve Shame and Defense fills the void. Like a wise mentor, Susan Warren Warshow senses the challenges you will face and steps in with sage advice."
--Scott D. Miller, Ph.D., Director, International Center for Clinical Excellence
"If you are a therapist struggling personally and professionally in client sessions, read Susan Warren Warshow. She offers a practical guide with ample vignettes for clinicians who feel stuck yet have the courage to slow down and start making subtle, significant shifts to strengthen their skills."
--Dr. Stan Tatkin, Psy.D., MFT, author of Wired for Love and We Do
"Every therapist faces the challenge of how to empathize with the wholeness of the patient: her longings, her anxiety, and the behaviors that prevent her from fulfilling her longings. In A Therapist’s Handbook to Dissolve Shame and Defense, Susan Warshow beautifully illustrates through numerous vignettes how to help patients face avoided feelings and move beyond anxiety and defenses that prevent them from pursuing their passions. For any therapist who wants to deepen their capacity for empathy, compassion, and deeper healing, this book is a must read."
--Jon Frederickson, MSW, faculty, Washington School of Psychiatry; Author of Co-Creating Change, The Lies We Tell Ourselves, and Co-Creating Safety: Healing the Fragile Client
"With wisdom and clarity, Susan Warshow provides key concepts to enable clinicians to work effectively with shame—both our own and that of our patients. Referring to shame as "the gatekeeper in therapy", she provides moving clinical vignettes to illustrate its powerful role in development, its relationship to anxiety, its protective signal function for survival. Rather than attacking shame, she teaches us how to guide patients in recognizing shame and to make use of the transformative power of compassion."
--Pamela J. McCrory, Ph.D., Licensed Psychologist PSY 12094; Assistant Clinical Professor, Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Co-Chair, Arts, Creativity and Culture Committee, Los Angeles County Psychological Association
"Susan Warshow's book offers an essential contribution to psychotherapists and students in clinical settings, focusing on the centrality of shame in emotional suffering. She highlights psychotherapy elements that facilitate greater self-acceptance and social intimacy. Well-chosen client examples bring her conceptualizations to life and demonstrate the nuances of an attuned approach to working with shame and defense in psychotherapy.
Her honest personal sharing accents the book in a thought-provoking way, and her astute insights are free of unnecessary jargon. A Therapist’s Handbook to Dissolve Shame and Defense amplifies that shame is a gateway to emotional integration. Many authors theorize about the meaning of compassion. However, this book demonstrates what this profoundly important phenomenon looks like in actual therapeutic encounters. A Therapist’s Handbook to Dissolve Shame and Defense speaks more to being present, gently challenging, and leaning into the shame experiences that emerge not only in the client but also in the therapist. How the therapist meets that difficult emotion is key, and the overall premise is that one cannot be present to the shame in another if one cannot face those experiences within oneself. Her gift to therapists is to encourage authenticity, and she has generously offered her own processes as the conduit for showing the way."
--Juliet Rohde-Brown, Ph.D.; Chair, Depth Psychology: Integrative Therapy and Healing Practices Specialization, Pacifica Graduate Institute; Licensed Clinical Psychologist
"Master the Moment: A Therapist’s Handbook to Dissolve Shame and Defense is clinical brilliance at its best. Essential components of excellent therapeutic communication skills are expertly described here, and unpacked with useful true-to-life clinical examples. Therapeutic exchanges highlight the use of effective thought empathy and feeling empathy, so essential for the therapeutic process, especially when interfacing with those who are exploring deeply hidden aspects of shame and remorse.
Warshow demonstrates how she shares her own feelings in a caring, honest, supportive, and fruitful way. Her many metaphorical examples underscore how the therapist can effectively nudge the client in assisting the change process while at the same time honoring and respecting the importance of gently and patiently moving forward at the client’s pace.
A treasury of heartfelt approaches and interventions that transcend all theoretical schools of thought, this book is one that can be read over and over by both novice and seasoned professional alike, each time finding more value, and adding to ones ability to effectively master the clinical moment with skill, kindness, and warmth."
--Karin S. Hart, Psy.D. Licensed Psychologist PSY16672, Former Assistant Clinical Professor
Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine
"Susan Warren Warshow’s book is a must read for every clinician! The author’s compassion shines through every page. Elegantly written in simple language, her personal style sinks under theory to reveal embodied exchanges within the nitty gritty of emotional healing. Warshow offers the wisdom and humility of a seasoned practitioner alongside the courage to reveal insecurities and vulnerabilities that inevitably emerge when working with deepest wounds to the self."
--Terry Marks-Tarlow, Ph.D.; Private practice in Santa Monica, California; Conducts workshops and trainings internationally; Author of A Fractal Epistemology for a Scientific Psychology (2020, Cambridge Scholars), Play & Creativity in Psychotherapy (2017), Awakening Clinical Intuition (2014, Norton), and Clinical Intuition in Psychotherapy (2012, Norton)
"Susan Warren Warshow has written a valuable book to guide therapists deeper into the life-changing alliance with their clients that fosters enthusiasm and real growth for both participants. Covering all the important bases of resistance, anxiety, guilt, shame, and especially compassion, Warshow offers detailed process descriptions of her Dynamic Emotion Focused Therapy (DEFT), providing succinct in-session transcripts of meaningful therapeutic exchanges and outcomes. A Therapist’s Handbook to Dissolve Shame and Defense is an inspiring book to read, to reflect on, and to savor the warmth and wisdom emanating from each page."
--Stella Resnick, Ph.D.; Author of Body-to-Body Intimacy: Transformation through Love, Sex, and Neurobiology (2019); Creator of the Embodied Relational Sex Therapy (ERST) training
PESI UK Blog Posts:
Therapist Shame: How to Recognize & Reduce It
10 Ways to Orient Clients Toward Unconscious Feelings
Susan's Journal articles:
The Ad Hoc Bulletin of Short-Term Dynamic therapy: Practice and Theory
1) Treatment of a self-defiling, recovering alcoholic with an avoidant personality. Volume 6, Number 1, September 2002
2) “Even Strangers Loved Me Better.” Treatment of a severely fragile, traumatized patient. Volume 7, Number 1, April 2003, P.5.
3) “The Suicidal Baby: Kangaroo Dreams Reveal a Haunted Childhood .” Using STDP in dream work with a highly anxious patient. Volume 8, Number 2 , July 2004, P. 5.
4) “Slaying the Serpent of Shame.” Treatment of a chronically depressed, anxious patient. Volume 11, Number 3 December 2007, Page 6.
5) “The Impact of Hope in Defeating Resistance.” Treatment of a chronically depressed and defeated man. September, 2010.
Books For Therapists:
Allostasis, Homeostasis, and the Costs of Physiological Adaptation
by Jay Schulkin
2004, Cambridge University Press
The Archaeology of Mind: Neuroevolutionary Origins of Human Emotions
by Jaak Panksepp and Lucy Biven
2012, Norton Series on Interpersonal Neurobiology
Bodily Changes in Pain, Hunger, Fear and Rage
by Walter Bradford Cannon
1915, D. Appleton and Company
Changing Character: Short-term Anxiety-regulating Psychotherapy For
Restructuring Defenses, Affects, And Attachment
by Leigh McCullough, Ph.D.
1997, Basic Books
Clinical Intuition in Psychotherapy: The Neurobiology of Embodied Response
by Terry Marks-Tarlow
2012, Norton Series on Interpersonal Neurobiology
Co-Creating Change: Effective Dynamic Therapy Techniques
by Jon Frederickson
2013, Seven Leaves Press
The Lies We Tell Ourselves: How to Face the Truth, Accept Yourself, and Create a Better Life
by Jon Frederickson
2017, Seven Leaves Press
Co-Creating Safety: Healing the Fragile Client
by Jon Frederickson
2015, Seven Leaves Press
Evolution, Early Experience and Human Development:
From Research to Practice and Policy
Edited by Darcia Narvaez, Jaak Panksepp, Allan N. Schore, Tracy R. Gleason
2013, Oxford University Press
Healing Trauma: Attachment, Mind, Body and Brain
Edited by Marion Solomon and Daniel J. Siegel
2003, W.W. Norton & Co Inc
I and Thou
by Martin Buber
1958, Charles Scribner's Sons
Intensive Short-Term Dynamic Psychotherapy: Theory and Technique
by Patricia Coughlin Della Selva, Ph.D.
1996 (Reprinted 2004, 2006), Karnac Books Ltd.
Intensive Short-Term Dynamic Psychotherapy,
Selected Papers of Habib Davanloo, MD
2001, Wiley and Sons
Lives Transformed
by David Malan and Patricia Coughlin
2006, Karnac Books Ltd
The Making and Breaking of Affectional Bonds
by John Bowlby
1979, Tavistock Publications Ltd
The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being
by Daniel J. Siegel
2007, W.W. Norton & Co
Opening Up: The Healing Power of Expressing Emotions
by James W. Pennebaker
1997, The Guilford Press
Persuasion and Healing: A Comparative Study of Psychotherapy
by Jerome D. Frank and Julia B. Frank
1960, Johns Hopkins University Press
The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation
By Stephen W. Porges
2011, Norton Series on Interpersonal Neurobiology
The Science of the Art of Psychotherapy
by Allan N. Schore
2012, Norton Series on Interpersonal Neurobiology
Self Comes to Mind: Constructing the Conscious Brain
by Antonio R. Damasio
2012, Vintage Books
Self Compassion: Stop Beating Yourself Up and Leave Insecurity Behind
By Dr. Kristin Neff Ph.D.
2011, HarperCollins
Short Term Therapy for Long Term Change
with Marion Solomon, Ph.D., Robert Neborsky, M.D., Leigh McCullough, Ph.D.,
Michael Alpert, MD, Francine Shapiro, Ph.D., and David Malan, D.M., FRCPsych
2004, W.W. Norton & Co Inc
Theory and Practice of Experiential Dynamic Psychotherapy
Edited by Ferruccio Osimo, Mark J. Stein
2012, Karnac Bookd Ltd
The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment
by Babette Rothschild
2000, W.W. Norton & Co.
Through Paediatrics to Psycho-Analysis: Collected Papers of D. W. Winnicott
1992, Brunner Routledge
Treating Affect Phobia: A Manual for Short-Term Dynamic Psychotherapy
by Leigh McCullough, Nat Kuhn MD Phd, Stuart Andrews and Amelia Kaplan
2003, Guilford Press
The Transforming Power of Affect: A Model for Accelerated Change
by Diana Fosha, Ph.D
2000, Basic Books
Unlocking the Unconscious
by Habib Davanloo, MD
1995, Wiley and Sons
Books For Clients (and therapists too):
Emotional Medicine Rx: Cry When You're Sad, Stop When You're Done, Feel Good Fast
by Penelope Young Andrade, LCSW
2011 Tenacity Press
Living Like You Mean It: Use the Wisdom and Power of Your Emotions to Get the Life You Really Want
by Ronald J Frederick, Ph.D.
2009 Jossey-Bass (A Wiley Imprint)
Emotion Focused Workbook: A Companion To Experiential Dynamic Psychotherapy
by Bridget Quebodeaux