BiteSize Therapy
@bitesizetherapy.bsky.social
Psychologist. Personal thoughts, not professional advice. An account for therapists.
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Although in plain English the word 𝑐𝑜𝑛𝑓𝑟𝑜𝑛𝑡𝑎𝑡𝑖𝑜𝑛 has a connotation of adversarial belligerence, confrontation as a therapeutic technique should be carried out with courtesy and tact and, above all, with genuine curiosity.
- Frank Yeomans
- Frank Yeomans
January 13, 2026 at 9:06 PM
Although in plain English the word 𝑐𝑜𝑛𝑓𝑟𝑜𝑛𝑡𝑎𝑡𝑖𝑜𝑛 has a connotation of adversarial belligerence, confrontation as a therapeutic technique should be carried out with courtesy and tact and, above all, with genuine curiosity.
- Frank Yeomans
- Frank Yeomans
“I’ve sometimes jokingly said that your functioning as a therapist could improve 31.6% if you would just substitute one word for another…’Both, and’ is one way, or ‘also’ vs. ‘really.’” Saying or thinking, ‘What you’re really feeling is…’ implies what you’re thinking is false.
- Paul Wachtel
- Paul Wachtel
January 9, 2026 at 8:56 PM
“I’ve sometimes jokingly said that your functioning as a therapist could improve 31.6% if you would just substitute one word for another…’Both, and’ is one way, or ‘also’ vs. ‘really.’” Saying or thinking, ‘What you’re really feeling is…’ implies what you’re thinking is false.
- Paul Wachtel
- Paul Wachtel
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“Where analysts talk about unconscious processes, nonpsychoanalytic branches of psychological science employ a different label, 𝑖𝑚𝑝𝑙𝑖𝑐𝑖𝑡, in the belief that this term is more value neutral, scientific, and empirical…”
“Where analysts talk about unconscious processes, nonpsychoanalytic branches of psychological science employ a different label, 𝑖𝑚𝑝𝑙𝑖𝑐𝑖𝑡, in the belief that this term is more value neutral, scientific, and empirical…”
January 4, 2026 at 9:22 PM
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“Where analysts talk about unconscious processes, nonpsychoanalytic branches of psychological science employ a different label, 𝑖𝑚𝑝𝑙𝑖𝑐𝑖𝑡, in the belief that this term is more value neutral, scientific, and empirical…”
“Where analysts talk about unconscious processes, nonpsychoanalytic branches of psychological science employ a different label, 𝑖𝑚𝑝𝑙𝑖𝑐𝑖𝑡, in the belief that this term is more value neutral, scientific, and empirical…”
Many intuitively resonant ideas and common cultural notions come from the psychoanalytic tradition (e.g, identity crisis, inferiority complex, defense, projection) but are often not seen as psychoanalytic. There is an idea that if it makes sense, it isn’t psychoanalysis.
- Nancy McWilliams
- Nancy McWilliams
December 30, 2025 at 6:03 PM
Many intuitively resonant ideas and common cultural notions come from the psychoanalytic tradition (e.g, identity crisis, inferiority complex, defense, projection) but are often not seen as psychoanalytic. There is an idea that if it makes sense, it isn’t psychoanalysis.
- Nancy McWilliams
- Nancy McWilliams
Alpha function acts on the data from a person’s total emotional experience…it renders this emotional experience comprehensible and meaningful…By naming it alpha function, Bion hoped to be able to keep the concept open to avoid the premature imposition of meaning.
- Joan & Neville Symington
- Joan & Neville Symington
December 30, 2025 at 4:07 PM
Alpha function acts on the data from a person’s total emotional experience…it renders this emotional experience comprehensible and meaningful…By naming it alpha function, Bion hoped to be able to keep the concept open to avoid the premature imposition of meaning.
- Joan & Neville Symington
- Joan & Neville Symington
“My clinical experience with treatments that seemed to founder…because conflict and psychic pain that should have been verbalized were instead being expressed largely through somatic discharge.”
- Joyce McDougall
- Joyce McDougall
December 30, 2025 at 2:55 AM
“My clinical experience with treatments that seemed to founder…because conflict and psychic pain that should have been verbalized were instead being expressed largely through somatic discharge.”
- Joyce McDougall
- Joyce McDougall
Surprisingly, “One Battle After Another” is not about Therapy Twitter.
December 22, 2025 at 9:16 PM
Surprisingly, “One Battle After Another” is not about Therapy Twitter.
A patient communicates on three channels (verbal, non-verbal, reactions evoked in others). The therapist communicates this way, too. Thus, it’s vital for a therapist to believe in their approach. If the therapist speaks inauthentically, 2 out of 3 channels will be playing something different.
December 19, 2025 at 12:25 AM
A patient communicates on three channels (verbal, non-verbal, reactions evoked in others). The therapist communicates this way, too. Thus, it’s vital for a therapist to believe in their approach. If the therapist speaks inauthentically, 2 out of 3 channels will be playing something different.
As this article wonderfully illustrates, the spurning of psychoanalytic thought has led to serious deficiencies in training programs.
Many new clinicians are trained to treat symptoms, but what happens when those symptoms are just the tip of the iceberg? Patients often arrive with longstanding problems that go far beyond what manuals or methodized interventions can address.
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December 10, 2025 at 4:08 PM
As this article wonderfully illustrates, the spurning of psychoanalytic thought has led to serious deficiencies in training programs.
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“In much of contemporary psychotherapy, 𝑒𝑥𝑐𝑒𝑙𝑙𝑒𝑛𝑐𝑒 is a dirty word. In many programs focused on so-called evidence based treatment - which has become a synonym for manualized or at least simplified treatments - excellence is relevant only to writing the manual…”
“In much of contemporary psychotherapy, 𝑒𝑥𝑐𝑒𝑙𝑙𝑒𝑛𝑐𝑒 is a dirty word. In many programs focused on so-called evidence based treatment - which has become a synonym for manualized or at least simplified treatments - excellence is relevant only to writing the manual…”
December 9, 2025 at 9:40 PM
🧵
“In much of contemporary psychotherapy, 𝑒𝑥𝑐𝑒𝑙𝑙𝑒𝑛𝑐𝑒 is a dirty word. In many programs focused on so-called evidence based treatment - which has become a synonym for manualized or at least simplified treatments - excellence is relevant only to writing the manual…”
“In much of contemporary psychotherapy, 𝑒𝑥𝑐𝑒𝑙𝑙𝑒𝑛𝑐𝑒 is a dirty word. In many programs focused on so-called evidence based treatment - which has become a synonym for manualized or at least simplified treatments - excellence is relevant only to writing the manual…”
An AI therapist will know you about as well as Spotify Wrapped.
December 5, 2025 at 8:21 PM
An AI therapist will know you about as well as Spotify Wrapped.
The practice of psychotherapy 𝑙𝑜𝑜𝑘𝑠 much easier than it is. Once trainees get in the chair, illusions of ease fall away.
Becoming a psychotherapist is a popular choice as a second career in mid-life - but do you really know what you’re in for?
www.gq-magazine.co.uk/article/ever...
www.gq-magazine.co.uk/article/ever...
Everyone wants to be a psychotherapist now. But should they?
How many times have you heard someone say 'I'm thinking of retraining as a therapist' this year? As the professional ranks swell with new recruits, Dr. Aaron Balick explains what it really takes
www.gq-magazine.co.uk
December 3, 2025 at 8:33 PM
The practice of psychotherapy 𝑙𝑜𝑜𝑘𝑠 much easier than it is. Once trainees get in the chair, illusions of ease fall away.
𝐸𝑥𝑖𝑠𝑡𝑒𝑛𝑡𝑖𝑎𝑙 𝑛𝑜𝑡𝑎𝑟𝑦 𝑝𝑢𝑏𝑙𝑖𝑐…my fanciful term for perhaps one of the most frequent and fundamental of all transferences: the need to share life experiences with someone else…Our experiences need to be shared, confirmed, ratified…after which we somehow feel different about them.
- James S. Grotstein
- James S. Grotstein
November 25, 2025 at 3:34 PM
𝐸𝑥𝑖𝑠𝑡𝑒𝑛𝑡𝑖𝑎𝑙 𝑛𝑜𝑡𝑎𝑟𝑦 𝑝𝑢𝑏𝑙𝑖𝑐…my fanciful term for perhaps one of the most frequent and fundamental of all transferences: the need to share life experiences with someone else…Our experiences need to be shared, confirmed, ratified…after which we somehow feel different about them.
- James S. Grotstein
- James S. Grotstein
A joke tells of two analysts who meet on the street. One says to the other, “Hello, how are you?” The other wonders darkly to himself, “I wonder what he means by that?”
- Herbert Schlesinger, 𝘌𝘯𝘥𝘪𝘯𝘨𝘴 & 𝘉𝘦𝘨𝘪𝘯𝘯𝘪𝘯𝘨𝘴
- Herbert Schlesinger, 𝘌𝘯𝘥𝘪𝘯𝘨𝘴 & 𝘉𝘦𝘨𝘪𝘯𝘯𝘪𝘯𝘨𝘴
November 21, 2025 at 4:59 PM
A joke tells of two analysts who meet on the street. One says to the other, “Hello, how are you?” The other wonders darkly to himself, “I wonder what he means by that?”
- Herbert Schlesinger, 𝘌𝘯𝘥𝘪𝘯𝘨𝘴 & 𝘉𝘦𝘨𝘪𝘯𝘯𝘪𝘯𝘨𝘴
- Herbert Schlesinger, 𝘌𝘯𝘥𝘪𝘯𝘨𝘴 & 𝘉𝘦𝘨𝘪𝘯𝘯𝘪𝘯𝘨𝘴
A therapeutic brand for every human nook and cranny is the profession chasing its own tail. Rather than collecting tools for every situation, we should focus on fundamentals that work in most situations.
www.psychiatrymargins.com/p/the-age-of...
www.psychiatrymargins.com/p/the-age-of...
The Age of Acronyms
"Little by little and letter by letter, acronyms obscure the essence of psychotherapy." Stephanie Foster
www.psychiatrymargins.com
November 17, 2025 at 9:41 PM
A therapeutic brand for every human nook and cranny is the profession chasing its own tail. Rather than collecting tools for every situation, we should focus on fundamentals that work in most situations.
www.psychiatrymargins.com/p/the-age-of...
www.psychiatrymargins.com/p/the-age-of...
“We don’t refer to people based on their theoretical allegiances. We refer to people based on our sense of their character.”
- Lee Grossman (2023)
We are all more human than otherwise and, in the consulting room, we are probably more ourselves than otherwise.
- Lee Grossman (2023)
We are all more human than otherwise and, in the consulting room, we are probably more ourselves than otherwise.
November 14, 2025 at 9:06 PM
“We don’t refer to people based on their theoretical allegiances. We refer to people based on our sense of their character.”
- Lee Grossman (2023)
We are all more human than otherwise and, in the consulting room, we are probably more ourselves than otherwise.
- Lee Grossman (2023)
We are all more human than otherwise and, in the consulting room, we are probably more ourselves than otherwise.
I have referred to the importance of economy in making interpretations…Most things that we think of to say, even quite complicated things, can be pruned.
- Nina Coltart
- Nina Coltart
November 14, 2025 at 4:08 PM
I have referred to the importance of economy in making interpretations…Most things that we think of to say, even quite complicated things, can be pruned.
- Nina Coltart
- Nina Coltart
It is always important that we leave room for a patient to do something with an interpretation beyond just agreeing with it or disagreeing.
- Patrick Casement
- Patrick Casement
November 13, 2025 at 5:07 PM
It is always important that we leave room for a patient to do something with an interpretation beyond just agreeing with it or disagreeing.
- Patrick Casement
- Patrick Casement
Insights occur when a person feels safe to have them.
- Alan Rappoport (1997)
- Alan Rappoport (1997)
November 12, 2025 at 2:19 AM
Insights occur when a person feels safe to have them.
- Alan Rappoport (1997)
- Alan Rappoport (1997)
Defenses, even when they have painful consequences, are comfortable in the sense that they lower anxiety. Forgoing the defenses raises anxiety, so there is discomfort inherent in therapeutic progress.
- Nat Kuhn
- Nat Kuhn
November 11, 2025 at 5:55 PM
Defenses, even when they have painful consequences, are comfortable in the sense that they lower anxiety. Forgoing the defenses raises anxiety, so there is discomfort inherent in therapeutic progress.
- Nat Kuhn
- Nat Kuhn
The supply of interpretations far exceeds the demand.
- Harry Stack Sullivan
- Harry Stack Sullivan
November 8, 2025 at 4:49 PM
The supply of interpretations far exceeds the demand.
- Harry Stack Sullivan
- Harry Stack Sullivan
It is much easier to talk about psychotherapy than it is to do it.
www.psychiatrymargins.com/p/from-here-...
www.psychiatrymargins.com/p/from-here-...
November 7, 2025 at 8:50 PM
It is much easier to talk about psychotherapy than it is to do it.
www.psychiatrymargins.com/p/from-here-...
www.psychiatrymargins.com/p/from-here-...
Salman Akhtar’s definition of humility:
November 7, 2025 at 4:08 PM
Salman Akhtar’s definition of humility:
In the collegial sphere, the majority of eye-rolling events can be traced back to the nearest better-knower. This is the person who travels with a portable lectern so that they can speechify on-the-go.
www.psychiatrymargins.com/p/from-here-...
www.psychiatrymargins.com/p/from-here-...
November 6, 2025 at 8:12 PM
In the collegial sphere, the majority of eye-rolling events can be traced back to the nearest better-knower. This is the person who travels with a portable lectern so that they can speechify on-the-go.
www.psychiatrymargins.com/p/from-here-...
www.psychiatrymargins.com/p/from-here-...