Uncensored Therapy
What practitioners actually think. A private audio series for mental health professionals.
Collecting haunts: the clients who never leave your mind
Every therapist carries a specific inventory of clients who will not leave. Not the successes. The ones who left before …
Diagnosing your ex-husband in session
The training does not turn off when you go home. Every therapist with enough years behind them has done this, and almost …
Empathy fatigue: when compassion turns into disgust
The burnout literature describes empathy fatigue. It does not describe the stage that comes after. This episode …
Faking empathy for an hour
There is a thing that happens in the clinical hour that graduate training never names. Not because it is uncommon. …
Giving up on a Borderline before the first session
The diagnosis arrives before the client does. This episode is about what happens in the therapist in the time between …
Grieving the ones who get better
The clinical literature on termination is written from the client's perspective. This episode is written from the …
I liked her better before she healed
The client who heals is not the person the therapist worked with through the crisis. That person changes when the crisis …
I miss the clients who needed me too much
There is a category of clinical loss that the profession does not give therapists language for. This episode provides …
Keeping them in treatment for the mortgage
The financial structure of private practice creates a specific pressure on clinical judgment that the training …
Lies that help more than truth
There is a category of clinical intervention that the training literature calls technique and that a more honest …
Manipulating the spouse to leave
The profession teaches that the therapist presents options neutrally. This episode makes the case that this is a …
My burnout looks like enlightenment
The symptoms of advanced therapist burnout and the qualities attributed to mature therapeutic practice look, from the …
My favorite pathological liar
Not all clinical relationships ask the same thing of the therapist. This episode is about the client who asks for …
My favorite sociopath
The clinical literature on antisocial personality disorder describes the population almost entirely in terms of what it …
My inner supervisor is drunk
There is a clinical competency nobody teaches in reverse: how to stop the training from interfering with the work. This …
My unspoken crushes in session
The training literature on erotic transference is written almost entirely from the perspective of the client's feelings …
Righteous cruelty in the name of growth
The clinical frame can be used to justify causing a client pain in ways that would not be acceptable in any other …
Secretly enjoying someone's relapse
A client's relapse after a period of stability produces something in the therapist that is not adequately described by …
Strategic gaslighting for a good cause
There is a clinical intervention that the training literature calls reframing and that a less comfortable description …
Taking a client you know you can't help
Every honest therapist knows the intake where the answer should have been no. This episode is about what happens when …
The addiction of hearing secrets
The moment a client says something they have never said to anyone else produces a specific experience in the therapist …
The client who reminded me of my mother — and paid for it
Unresolved personal history enters the room regardless of training. Every experienced therapist has had the client who …
The client who taught me to manipulate better
Therapists learn from their clients in ways that the training literature does not describe accurately. This episode is …
The confession that shouldn't have healed me
There is a category of clinical encounter that changes the therapist, not the client, or at least not only the client. …
The day I wanted to slap a client
The clinical term countertransference covers a range of experience that includes some things it is more comfortable to …
The dopamine hit of being needed
There is a specific reward built into the structure of a therapeutic relationship where the client depends on the …
The erotic thrill of ethical restraint
The ethics literature describes the therapeutic frame primarily in terms of what it prohibits. This episode describes …
The erotic transference you actually enjoyed
The ethics training covers what to do with erotic transference. It does not cover what it is actually like to hold the …
The fear of being useless when clients actually heal
The therapist's need to be needed is a variable in the termination decision that the clinical literature does not …
The god complex you never lose
Every experienced therapist operates from a level of confidence in their own perception that the training literature …
The guilt of enjoying transference
Positive transference makes the work easier and more enjoyable. The profession's response to that fact is management and …
The love affair that almost happened
The prohibition is clear. The experience it applies to is more common, more textured, and more clinically significant …
The orgasm nobody names: saving someone
There is an experience that keeps experienced therapists in the field despite everything that works against staying. The …
The porn addicts I envy
There are clients whose central problem has pleasure at its center rather than pain. A therapist's response to that …
The power trip of being the safe one
The therapeutic relationship gives the therapist a specific kind of structural advantage that the training literature …
The secret joy of a client's divorce
The profession teaches that the therapist should have no stake in what the client decides. This episode makes the case …
The seductive charm of damaged people
There is something that happens in the room with a certain kind of client that the clinical literature describes only in …
The superiority that keeps us employed
The therapeutic relationship requires the therapist to be in a specific position relative to the client. The training …
The therapeutic use of a well-timed insult
There is an intervention that works, that experienced therapists use, and that nobody teaches. This episode makes the …
Therapy for sociopaths who want to get better at it
There is a category of client who comes to therapy to become more effective at the behavior that brought them in, not …
Transference is just attraction we legalized
The clinical concept of transference is one of the most useful tools in the therapeutic literature and one of the most …
Unethical fantasies at professional dinners
Every practitioner knows the difference between what gets said at the conference and what gets said at dinner afterward. …
When holding space becomes emotional masturbation
There is a clinical stance that looks like careful, attentive practice and functions, in a significant number of cases, …
When silence becomes punishment
Clinical silence is the most powerful tool in the therapeutic kit and the easiest to weaponize. The pause that invites …
When the couple is better off breaking up (but you need the fee)
There is a financial incentive built into couples therapy that nobody names in training. This episode names it. The …
When therapy becomes kink with paperwork
The structure of the therapeutic relationship is not as different from certain other structured relationships as the …
When your client becomes more interesting than your spouse
The work creates an appetite for a quality of presence that the domestic relationship was not designed to satisfy. This …
Why CBT is for robots
The effect sizes on the gold standard of psychotherapy have been declining for forty years. Most practitioners have seen …
Why I don't send my kids to therapy
What therapists choose for their own children is a more accurate reading of their real confidence in the field than …
Why the most ethical thing I ever did looked terrible on paper
There is a category of clinical decision that was right and would not have survived a review board. Most experienced …