What Therapists Don't Talk About and Why: Understanding Taboos That Hurt Us and Our Clients

Pages: 199
Item #: 4317105
ISBN: 978-1-59147-401-2
List Price: $29.95
Member/Affiliate Price: $24.95
Copyright: 2006
Format: Softcover
Availability: In Stock
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For individuals in the U.S. & U.S. territories

Available electronically for Kindle
Overview
This second edition is an indispensable survival guide…an essential book for every clinician—from trainees to seasoned practitioners.

This book was created to help therapists and therapists-in-training explore the myths and taboo topics that weaken their practice and cause anxiety, discomfort, and confusion. Some of these topics include feeling incompetent; making mistakes; getting caught off guard by fee entanglements; becoming enraged at patients; managing illness; understanding sexual arousal and impulses; praying with patients as part of therapy; feeling ashamed; being fired; and not knowing what to do.

The title of the 1993 first edition of this book was Sexual Feelings in Psychotherapy: Explorations for Therapists and Therapists-in-Training. The new title for the second edition reflects a greatly expanded scope that focuses on a variety of other topics in addition to sexual feelings.

The book discusses the damaging myths that therapists seem to hold about themselves that sustain the taboo topics. By offering questions for self-assessment and a series of "explorations" that can be used to examine taboo topics individually or in groups, the book provides resources for recognizing the myths, challenging the taboos, and speaking honestly and directly with patients and others about topics that have been off-limits.

Table of Contents

About the Second Edition

Foreword to the Second Edition: Things My Teachers Never Mentioned
—Gerald P. Koocher

Foreword to the 1993 Edition
—Melba J. T. Vasquez

  1. Questioning Myths, Taboos, Secrets, and Uncomfortable Topics
  2. Therapists' Sexual Arousals, Attractions, and Fantasies: An Example of a Topic That Isn't There
  3. Creating Conditions for Learning
  4. Questions We'd Rather Avoid: A Self-Assessment
  5. Possible Clues to Taboo Topics and Uncomfortable Feelings
  6. Passages and Scenarios for Exploration
  7. Confronting an Impasse: What Do We Do When We Don't Know What to Do?

Appendix: "Therapists' Anger, Hate, Fear, and Sexual Feelings: National Survey of Therapist Responses, Client Characteristics, Critical Events, Formal Complaints, and Training"

Index

About the Authors

Reviews & Awards

—Linda Garnets, PhD, Department of Psychology, University of California, Los Angeles

The silent topics in therapy roar like thunder throughout this book…a challenging and yet refreshingly honest book—a must-read.
—Jessica Henderson Daniel, PhD, ABPP, Children's Hospital, Boston, MA

Essential for those both learning and teaching psychotherapy, this book contains helpful insights and illuminating empirical data. Beautifully written…likely to become required reading for mental health professionals [and to] find a welcome home on any educated patient's bookshelf.

—Harold Bursztajn, MD, Codirector, Harvard Medical School Program in Psychiatry and Law, Cambridge, MA

Reading this book is like having a conversation with an old, wise friend. Finally, a talk about taboo topics in therapy with answers to unasked questions.
—Bonnie R. Strickland, PhD, ABPP, Professor Emeritus of Psychology, University of Massachusetts, Amherst; former President, American Psychological Association

Whatever the original or subsequent title of this book, it is essentially a superb text about the practice of psychotherapy, with all its unexpected twists, turns, and difficulties, for therapists and patients. From its excellent short courses on logical and ethical fallacies, to its astonishing variety of intensely provocative case examples with self-assessment questions, to its steamy discussions of therapists' sexual feelings, the book illuminates, in a nonthreatening, conversational tone, the previously avoided dimensions of the therapeutic endeavor. It belongs on the shelf of any therapist willing to learn or think critically about psychotherapy; it may also save one from a lot of frustration and heartbreak in the work.
—Thomas G. Gutheil, MD, Professor of Psychiatry, Harvard Medical School, Boston, MA

This book is a must-read for any psychotherapist. It explores the real world and often secret problems encountered in clinical practice in a creative, personal, and very useful fashion. In this world of increasing professional accountability and liability, clinicians can be assured that their practices will be much better off for having implemented the commonsense suggestions made by the authors.
—Jeffrey N. Younggren, PhD, ABPP, Risk Management Consultant, American Psychological Association Insurance Trust

This book is very readable, enjoyable, and a breath of fresh air in a field with many secrets. A glimpse into the secret, private, and unspoken world of the therapist. There is no other book like it! A delight to read.
—John D. Robinson, EdD, MPH, ABPP, Professor of Psychiatry and Surgery, Howard University College of Medicine, Howard University Hospital, Washington, DC

This is a very brave book. Provocative without being proscriptive, it is a must-read for all practicing clinicians and would make a superb supplemental text for graduate courses in ethics. The cases alone are well worth the price of the book!
—Ruth E. Fassinger, PhD, Professor, Counseling Psychology, University of Maryland, College Park; Fellow, American Psychological Association

Engaging, accessible, and gentle in tone, this book boldly addresses a number of topics that are often ignored in the training and professional development of psychologists. Its provocative observations and questions, sensitive analyses of ethical and professional problems, and practical recommendations for trainees and supervisors dealing with a range of "taboo topics" make it a unique resource.
—Virginia Gutman, PhD, Professor and Chair, Department of Psychology, Gallaudet University, Washington, DC

A remarkably useful work with extraordinary depth, invaluable to everyone from trainees to experienced professionals who want to prepare for pitfalls in practice as well as to do their best work. Nothing available in the professional literature can match this contribution by three leaders in the field who have provided a virtual cornucopia of useful guidance about so many vital things that are rarely discussed. An essential work for those teaching ethics or seeking to practice ethically in any mental health field, this volume has the sanguine and in-depth examination needed to truly master these issues. The most practical book on boundaries and ethics I have read in any language…essential for students, teachers, supervisors, and practicing clinicians. Used as a text, the book would allow one to avoid doing a syllabus for an advanced course in professional practice issues.
—Gary R. Schoener, MEq, Licensed Psychologist, Executive Director, Walk- In Counseling Center, Minneapolis, MN

Pope, Sonne, and Greene have written a practical, thought-provoking, and comprehensive guide to exploring the sensitive issues embedded in mental health practice. They approach this content with fearlessness, humor, and wisdom, challenging professionals to explore the real impact of our values, assumptions, and personal interests on our clients. This book is a uniquely valuable resource for faculty and clinicians committed to responsible practice.
—Elizabeth Reynolds Welfel, PhD, Professor, Cleveland State University, Cleveland, OH

Pope, Sonne, and Greene's new book provides an excellent resource for all mental health professionals and their trainees to examine issues that are rarely discussed in graduate programs. This clearly written book not only asks perplexing questions about various dilemmas encountered in professional practice but also provides thoughtful answers leading to ethical action. This book should be required reading in any ethics or professional issues seminar.
—Emil Rodolfa, PhD, Director, Davis Counseling and Psychological Services, University of California, Davis; Former Chair, Association of Psychology Postdoctoral and Internship Centers; former President, State of California Board of Psychology

This book is about those difficult, or even impossible, dilemmas and quandaries of psychotherapy—the double-binds and provocations with which our patients unexpectedly confront us. The authors gather anecdotes and scenarios from the widest spectrum of theoretical orientations and professional (or unprofessional) settings. It is an invaluable book that presents psychotherapy practice and ethics as a set of remarkably interesting questions with no easy answers.
—Martin H. Williams, PhD, Clinical and Forensic Psychologist, San Jose, CA

What Therapists Don't Talk About and Why is simply excellent: helpful, thoughtful, brave, entertaining, and so very "experience-near." This book addresses seemingly taboo issues (e.g., therapists' attraction to clients) in ways that can help all of us negotiate difficult, but all-too human dilemmas in an ethical and clinically sensitive manner. Pope, Sonne, and Greene are, of course, thoroughly serious and comprehensive in their treatment of this topic; nevertheless, they are also quite humorous and cynical at appropriate times, and these qualities, in combination with multiple case examples, make this important book quite accessible. Highly recommended.
—Barry A. Farber, PhD, Professor, Director of Clinical Training, Clinical Psychology Program, Teachers College, Columbia University, New York, NY

Convincingly and readably, the authors show therapists how to confront their own demons of fear, anger, guilt, shame, embarrassment, prejudice, sexual arousal, immobilization, and helplessness that can arise in the therapeutic encounter and threaten to derail the process. A how-to book of extraordinary utility.
—Elaine B. Pinderhughes, Emerita Professor, Graduate School of Social Work, Boston College, Boston, MA

The authors roll back the carpet and help us look at what we've swept under it. They make us uncomfortable, asking personally tough questions about our feelings in clinical situations. The book is a significant advance because it goes beyond the "just don'ts" and helps us to understand what is personally challenging and learn what to do about it. This volume will be helpful for students and practitioners alike and would be extremely valuable in peer supervision groups. Ethics educators rack their brains for ways to help improve our ethical behavior; this one goes in the toolbox.
—Michael C. Gottlieb, PhD, ABPP, Independent Practice, Dallas, TX

Pope, Sonne, and Greene's discerning combination of thought provoking questions and topical client scenarios fosters the self examination of personal and taboo topics in the clinical field. This is an enormously essential book addressing often ignored client–therapist issues; for example, a therapist's disclosure of his or her sexual orientation, fear of a violent client, a client's culture and hygiene, and needs for a handicapped-accessible office. Both the novice and seasoned practitioner will benefit from its matter-of-fact approach as a quasi-ethical guide for enhancing appropriate service delivery and therapeutic practice.
—A. Toy Caldwell-Colbert, PhD, ABPP, Vice Chair for Psychological Services and Professor of Psychiatry, Department of Psychiatry, Howard University College of Medicine, Howard University Hospital, Washington, DC

Psychotherapy is the most human of disciplines, so therapists must deal with their own humanity and its foibles if they are to be optimally helpful. Pope and colleagues successfully utilize the Socratic method to stimulate thought about feelings and help therapists feel better about their thoughts. They challenge common "myth-understandings" about taboo topics and prescribe open self-examination and honest communication. This is a useful guide to often unexplored and dangerous territory.
—David Spiegel, MD, Willson Professor and Associate Chair of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA; President, American College of Psychiatrists

This fine book does not tell the reader what to do, but what to think about. It is one of those rare books that will be equally useful and valuable to graduate students and practicing professionals.
—George Stricker, PhD, American School of Professional Psychology, Argosy University, Washington, DC

More than a thought-provoking resource of useful reminders, valuable insights, and critical questions, this is a book that invites its readers to learn by doing and guides them through the experience. Those who take up the challenge will find themselves richly rewarded, both professionally and personally. I know that I was.
—Douglas Saunders, PhD, President, Ontario Psychological Association; Assistant Professor, Faculty of Medicine, Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada

From the myths that need to be challenged, the taboos about therapists talking to consultants about the feelings that make them uncomfortable, and the embarrassing moments that are most challenging, Pope, Sonne, and Greene update the 1993 book with new scenarios to use as a guide. Every therapist who practices ethical interventions will want to learn the questions that are suggested to ask themselves about how to handle a whole range of difficult client issues including, of course, Pope's expert advice on what to do when sexual feelings are aroused in therapy. This book is MUST-reading and should be on every therapist's desk.
—Lenore E. Walker, EdD, ABPP, Diplomate in Clinical and Family Psychology, Professor, Nova Southeastern University Center for Psychological Studies, Ft. Lauderdale, FL

Pope, Sonne, and Greene have nicely outlined a host of issues that can arise in therapy but that trainees may be reluctant to bring up in supervision and more seasoned therapists may be reluctant to admit to their colleagues or even to themselves. They discuss reasons for our failure to discuss these issues, while noting their importance in rendering care for our patients and in taking care of ourselves, and they provide a framework to begin addressing the issues before they arise in therapy. The passages from historic documents and clinical scenarios for exploration and discussion should be of particular use in preparing for troublesome therapeutic situations.
—David J. Martin, PhD, Chief Psychologist, Director of Training, Director, HIV Mental Health Services, Department of Psychiatry, Harbor-UCLA Medical Center, Torrance, CA

This book challenges us to consider those most uncomfortable situations, as its question-focused vignettes ask us to deeply self-reflect on taboo topics. Dostoevsky, who opined that each person has ideas they hide even from him- or herself, would be proud of this tome's efforts to expose us to our own inner secrets and fears. A great thought piece for professionals of all experience levels.—Ed Lundeen, PhD, Private Practice, Allentown, PA; Editor, Independent Practitioner

What Therapists Don't Talk About and Why should be required reading for both novice and expert clinicians. Drawing on the empirical literature and examples from clinical practice, this practical text challenges psychotherapists to consider issues that are often avoided and encourages honest reflection on the personal factors influencing the conduct of psychotherapy. It is a must-read for both novice and expert clinicians.
—Edward Shafranske, PhD, ABPP, Professor and Director of the Doctoral Program in Clinical Psychology, Pepperdine University, Irvine, CA

Pope, Sonne, and Greene are to be congratulated. With this new edition, the authors provide unthinkable conundrums, feelings elicited, and pathways to discuss and think through these previously untouchable areas. Their passages and scenarios—often therapist and trainees' worst fantasies—will provide rich substance for generations of therapists, faculty, and supervisors. This book will be indispensable for supervisors and practitioners alike. I can hardly wait to use it as a tool in supervision training.
—Carol Falender, PhD, Independent Practice, Clinical Professor, Department of Psychology, University of California, Los Angeles

This is one of those "wish I could have read it my first day in grad school" books. The topics this volume covers are the forbidden ones that every therapist struggles with; reading this book is like having a wise, compassionate, thoughtful teacher and consultant who gets you to think and feel, critically and deeply, about the strange human thing we call psychotherapy. I'll be recommending it to my students and colleagues.
—Laura S. Brown, PhD, ABPP, Independent Practice, Seattle, WA

When was the last time an excited colleague grabbed you by both shoulders and said, "I just read this wonderful book on ethics and psychotherapy"? Probably around the same time you last won the lottery. Often, reading about psychotherapy ethics is akin to reading the tax code—important, but statutory dry, and perhaps delivered with a hint of catechism-like castigation. What Therapists Don't Talk About and Why is different, in fact, unique. More than simply readable, it is entertaining, witty, and poignant. It is refreshingly accepting, human, and honest about the inner world of the psychotherapist. Rather than lay down a lockstep mode of ethical practice around specific issues, they walk the reader through a series of real-life vignettes, each time asking questions about the reader's reaction that induce discomfort and then help resolve it. The questioning method easily generalizes and, after a few repetitions, begins to form a new layer to one's ethical foundation. By the end of the book we emerge with a tried-and-true technique to apply to any ethical dilemma of psychotherapy; we are newly comfortable with the discomfort of the ethical bind. And we had a fun time getting there. What more can one ask?
—Raymond E. Arsenault, PhD, Independent Practice, Andover, MA

What a resource for teachers of ethics courses!…The book should be useful at all levels of training and experience.
—Lynn P. Rehm, PhD, ABPP, Professor, Department of Psychology, University of Houston, Houston, TX

This second edition is an indispensable survival guide…an essential book for every clinician—from trainees to seasoned practitioners.
—Linda Garnets, PhD, Department of Psychology, University of California, Los Angeles

The silent topics in therapy roar like thunder throughout this book…a challenging and yet refreshingly honest book—a must-read.
—Jessica Henderson Daniel, PhD, ABPP, Children's Hospital, Boston, MA

Essential for those both learning and teaching psychotherapy, this book contains helpful insights and illuminating empirical data. Beautifully written…likely to become required reading for mental health professionals [and to] find a welcome home on any educated patient's bookshelf.
—Harold Bursztajn, MD, Codirector, Harvard Medical School Program in Psychiatry and Law, Cambridge, MA

Reading this book is like having a conversation with an old, wise friend. Finally, a talk about taboo topics in therapy with answers to unasked questions.
—Bonnie R. Strickland, PhD, ABPP, Professor Emeritus of Psychology, University of Massachusetts, Amherst; former President, American Psychological Association

An engagingly written compendium of really fascinating questions and issues that have been avoided by directors of training programs. Pope, Sonne, and Greene manage to tackle thorny issues with good humor and modesty, and without the usual solemnity that stifles honest discussion. I plan to recommend it to my local therapy association.
—Stephen J. Ceci, PhD, Helen L. Carr Professor of Developmental Psychology, Cornell University, Ithaca, NY; recipient of the American Psychological Association's Lifetime Award for Contribution to Application of Scientific Psychology

A superb contribution…a powerful book.
—Lillian Comas-Diaz, PhD, Clinical Professor, Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine, Washington, DC

A gift to all of us who teach the ethics of psychological practice.
—Celia B. Fisher, PhD, Director, Center for Ethics Education, Marie Ward Doty Professor of Psychology, Fordham University, New York, NY

Endorsements for the 1993 Edition

Pope, Sonne, and Holroyd deserve kudos for having the courage to explore the unspoken.…Scholarly, engaging…the field of psychotherapy will never be the same again.
—Donald Meichenbaum, Professor of Psychology, University of Waterloo, Waterloo, Ontario, Canada

Required reading for all clinicians, interns, and other trainees.
—A. T. Morales, DSW, Director of Clinical Social Work and Social Work Training, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles

This superb new volume fills a void in the current literature…With a minimum of jargon and with clarity of prose style, the authors have provided a much-needed manual for psychotherapists of all theoretical orientations and all professional disciplines.
—Glen Gabbard, MD, Vice President of Adult Services, The Menninger Clinic, Topeka, KS; Clinical Professor of Psychiatry, University of Kansas School of Medicine, Wichita; Training and Supervising Analyst, Topeka Institute for Psychoanalysis, Topeka, KS

A landmark contribution.…There could be no more appropriate people to write this valuable resource.
—Melba J. T. Vasquez, PhD, ABPP, Diplomate in Counseling Psychology; former Chair, Board for the Advancement of Psychology in the Public Interest, American Psychological Association

Like a trusted confidant, this reassuring yet challenging book shows how research, theory, and the reader's own feelings can be used to guide clinical practice. It is that rarest of books with which the reader shares an intimate dialogue of personal discovery. Powerful, truthful, and adventurous, it will serve as an essential text to which seasoned therapists will return again and again and should be required reading in all training programs.
—Jesse D. Geller, PhD, Department of Psychology, Yale University; Director, Yale Psychological Services Clinic, New Haven, CT