Clinical psychologist, EMDR consultant and yoga teacher in Boulder, Colorado. Author of The Complex PTSD Workbook and EMDR Therapy and Somatic Psychology; writes on trauma, attachment and the nervous system.

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  Innovations in Psychotherapy Conference

  Their words

  Honored to be speaking at the 2026 Innovations in Psychotherapy Conference (Nov 10–13 in Anaheim & Online)! Join us for evidence-based education & practical strategies to enhance your practice. Use code SPEAK26 to save $50:

  x.com

Clinical psychologist, EMDR consultant and yoga teacher in Boulder, Colorado. Author of The Complex PTSD Workbook and EMDR Therapy and Somatic Psychology; writes on trauma, attachment and the nervous system.

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  Therapeutic Yoga for Trauma Recovery: A Clinical Summit for Mind-Body Healing

  Their words

  There’s still time to join me for Therapeutic Yoga for Trauma Recovery: A Clinical Summit for Mind-Body Healing!

  x.com

Clinical psychologist, EMDR consultant and yoga teacher in Boulder, Colorado. Author of The Complex PTSD Workbook and EMDR Therapy and Somatic Psychology; writes on trauma, attachment and the nervous system.

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  The Complex PTSD Treatment Manual

  Their words

  Have you grabbed the free worksheets from my Complex PTSD Treatment Manual yet?

  x.com

Clinical psychologist, EMDR consultant and yoga teacher in Boulder, Colorado. Author of The Complex PTSD Workbook and EMDR Therapy and Somatic Psychology; writes on trauma, attachment and the nervous system.

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  Vagus Nerve and Polyvagal Practices retreat, Cancun

  Their words

  Join me in Cancun Jan 30–Feb 6, 2027 with Leading Edge Seminars!

  x.com

Clinical psychologist, EMDR consultant and yoga teacher in Boulder, Colorado. Author of The Complex PTSD Workbook and EMDR Therapy and Somatic Psychology; writes on trauma, attachment and the nervous system.

From one piece If the Body Doesn't Keep the Score, What Does? 2 beliefs · drarielleschwartz.com

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  "The body keeps the score" is only half the story, and the missing half matters: a body described only as a harbinger of the past is a body people learn to avoid.

  Their words

  the issue that I take with some of the language around "the body keeps the score" is that it maybe doesn't also recognize that the body also carries so much wisdom and so much intelligence and kind of helps guide us towards healing

  If the Body Doesn't Keep the Score, What Does?drarielleschwartz.com

• Our readingkorrents.com

  The body is not an archive of trauma: what feels like a memory stored in the hips or the jaw is a mind-body feedback loop, and the loop is what therapy interrupts.

  PsychotherapyTrauma

  Their words

  It may not be stored there, but what you're tapping into, it's not a repository of the memory, but it's part of this mind-body feedback loop where there's a sensation that your brain has an association to that might have a familiarity to a time in which you felt sad or scared.

  If the Body Doesn't Keep the Score, What Does?drarielleschwartz.com

Clinical psychologist and clinical professor of psychiatry at UCSF. His 2010 meta-analysis established psychodynamic therapy as an evidence-based treatment; he has argued ever since that "evidence-based therapy" is used as a marketing term.

• Our readingkorrents.com

  When institutions can only offer compromised care they end up calling it best practice, and the patients who do not get better conclude that they themselves are beyond help.

  Their words

  When patients don't get the help they need, they don't come away thinking, I didn't get good treatment. They come away thinking, I am too broken to be helped. They leave more hopeless and demoralized than when they came. That is harm.

  When Compromised Care Becomes "Best Practice"jonathanshedler.substack.com

Psychiatrist and clinical assistant professor at Case Western Reserve University. Writes Psychiatry at the Margins on the philosophical and scientific arguments inside psychiatry and the psy-sciences.

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  The Rumpelstiltskin effect claims only that the act of being diagnosed can itself help, not that a diagnosis is a net good for the patient.

  Their words

  The Rumpelstiltskin effect is not a claim that receiving a diagnosis is a net benefit or a net positive. It is a claim that the mere act of receiving a diagnosis can be beneficial.

  psychiatrymargins.com

Clinical psychologist, EMDR consultant and yoga teacher in Boulder, Colorado. Author of The Complex PTSD Workbook and EMDR Therapy and Somatic Psychology; writes on trauma, attachment and the nervous system.

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  Unlocking the Past: A Yogic Perspective on Healing Intergenerational Trauma

  Their words

  Join my on-demand course with @YogaUOnline—Unlocking the Past: A Yogic Perspective on Healing Intergenerational Trauma, exploring how yogic approaches can resolve inherited trauma.

  x.com

Psychiatrist and clinical assistant professor at Case Western Reserve University. Writes Psychiatry at the Margins on the philosophical and scientific arguments inside psychiatry and the psy-sciences.

• Our readingkorrents.com

  A prescriber cannot outsource containment to the therapy hour: the emotional and relational dynamics are part of prescribing, not an intrusion on it.

  Psychotherapy

  Their words

  The emotional and relational dynamics are not an intrusion upon the work of prescribing. They are a part of the work itself.

  psychiatrymargins.com

Clinical psychologist and clinical professor of psychiatry at UCSF. His 2010 meta-analysis established psychodynamic therapy as an evidence-based treatment; he has argued ever since that "evidence-based therapy" is used as a marketing term.

• Our readingkorrents.com

  Telling a patient "your feelings are valid" is not therapy: it is the mirror image of "get a grip", and it makes the therapist a judge of feelings instead of a companion in them.

  Psychotherapy

  Their words

  The phrase "your feelings are valid" does not invite curiosity or deeper self-understanding, which is the point of psychotherapy. It is the mirror image of "stop whining and get a grip." One sounds warm and one sounds harsh, but neither deepens self-awareness.

  jonathanshedler.substack.com

Marriage and family therapist working from attachment theory and emotionally focused therapy. Author of Secure Love and the person behind The Secure Relationship.

From one piece How Anger Shows Up in Anxious Attachment, and What the Work Is 2 beliefs · juliemenanno.substack.com

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  Underneath the anger of anxious attachment is unresolved grief about not having been responded to.

  Attachment theory

  Their words

  Underneath anger is sadness over all your cumulative experiences in life of not being responded to, past and present. The sadness around powerlessness. Unresolved grief.

  juliemenanno.substack.com

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  Getting angry quickly in an anxiously attached person is a threat-detection habit their nervous system learned, not a character flaw.

  Their words

  When you get angry fast, it usually is not because you are "too much." It is often because your nervous system learned to live on alert.

  juliemenanno.substack.com

Clinical psychologist, EMDR consultant and yoga teacher in Boulder, Colorado. Author of The Complex PTSD Workbook and EMDR Therapy and Somatic Psychology; writes on trauma, attachment and the nervous system.

From one piece Clinical Reflections on the Critique on Polyvagal Theory proposed by Grossman et al., (2026) 2 beliefs · drarielleschwartz.com

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  Regulation must precede reflection: cognitive insight fails while a nervous system is in defensive dominance.

  Polyvagal theory

  Their words

  Polyvagal theory provided me with a coherent framework for understanding why cognitive insight alone often fails when a nervous system is in defensive dominance. In such states, higher-order cortical processes are functionally constrained.

  drarielleschwartz.com

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  Polyvagal theory survives the 2026 "untenable" critique: what the critics contested was mechanism and evolutionary framing, not the clinical proposition.

  Polyvagal theory

  Their words

  The central clinical proposition of polyvagal theory-that autonomic state functions as an organizing platform shaping perception, emotion, and relational behavior-was not empirically disproven in the critique.

  drarielleschwartz.com

Founder of the International Center for Clinical Excellence and originator of Feedback-Informed Treatment. Writes about what actually makes a therapist effective, usually against the field's own assumptions about training and experience.

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  Outcome Rating Scale (ORS)

  Their words

  The ORS is a brief, 4-item measure designed to assess areas of life functioning known to change as a result of therapeutic intervention. It takes less than one minute to complete and score.

  scottdmiller.com

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  Session Rating Scale (SRS)

  Their words

  The SRS is a brief, 4-item measure designed to assess the therapeutic alliance. It provides immediate feedback on the quality of the relationship and allows for course correction in real time.

  scottdmiller.com

Psychiatrist and clinical assistant professor at Case Western Reserve University. Writes Psychiatry at the Margins on the philosophical and scientific arguments inside psychiatry and the psy-sciences.

From one piece The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors) 3 beliefs, in the piece's order there

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  Self-diagnosis is an attempt to secure the therapeutic effect of a medical intervention patients cannot officially access.

  Psychotherapy

  Their words

  Likewise, self-diagnosis should be understood as an attempt to secure the therapeutic effect of a medical intervention to which patients do not have official access.

  doi.org

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  Diagnoses that have therapeutic effects are medical interventions and should be treated and researched as such.

  Psychotherapy

  Their words

  If a clinical diagnosis can have a therapeutic effect, then, at least in some instances, diagnoses are medical interventions in themselves and ought to be treated and researched as such, with an eye to both positive effects and potential iatrogenic harms.

  doi.org

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  Clinical diagnosis can have a therapeutic effect independent of any other intervention.

  Psychotherapy

  Their words

  Their experiences highlight a striking, neglected and unchristened medical phenomenon: The therapeutic effect of a clinical diagnosis, independent of any other intervention, where clinical diagnosis refers to situating the person's experiences into a clinical category by a clinician or the patient.

  doi.org

Psychiatrist and clinical assistant professor at Case Western Reserve University. Writes Psychiatry at the Margins on the philosophical and scientific arguments inside psychiatry and the psy-sciences.

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  How Does the Psychiatrist Know?: On the Epistemology of Psychiatric Diagnostic Reasoning

  Their words

  Recently I reviewed Adrian Kind’s 2025 book, “How Does the Psychiatrist Know?: On the Epistemology of Psychiatric Diagnostic Reasoning,” on this substack. I had mentioned that Kind’s book is the first systematic, in-depth, book-length philosophical investigation into how psychiatrists arrive at their diagnostic conclusions.

  psychiatrymargins.com

Psychiatrist and clinical assistant professor at Case Western Reserve University. Writes Psychiatry at the Margins on the philosophical and scientific arguments inside psychiatry and the psy-sciences.

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  Unshrunk: A Story of Psychiatric Treatment Resistance

  Their words

  (publication date March 18, 2025, Viking) by Laura Delano is a compelling and troubling memoir of psychiatric patienthood, iatrogenic harm, and finding a meaningful and flourishing life outside of the mental healthcare system.

  psychiatrymargins.com

Psychiatrist and clinical assistant professor at Case Western Reserve University. Writes Psychiatry at the Margins on the philosophical and scientific arguments inside psychiatry and the psy-sciences.

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  Roll Back the World: A Sister’s Memoir

  Their words

  Deborah Kasdan’s Roll Back the World: A Sister’s Memoir (2023) is an honest and vulnerable account of her sister Rachel’s life with schizophrenia and the challenges this presented for the family.

  psychiatrymargins.com

Founder of the International Center for Clinical Excellence and originator of Feedback-Informed Treatment. Writes about what actually makes a therapist effective, usually against the field's own assumptions about training and experience.

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  A therapy is only shown to be more effective if it is compared against another treatment intended to help, not against a control nobody expected to work.

  EMDRPsychotherapyCBT

  Their words

  If one really wanted to know whether a treatment (e.g., CBT, IPT, ACT, EMDR) was more effective, it had to be directly compared to an approach intended to help - what Wampold and colleagues termed, a "bona fide" treatment. Doing otherwise, they argued, conflated artifacts of research design with actual research results.

  writings.scottdmiller.com

Founder of the International Center for Clinical Excellence and originator of Feedback-Informed Treatment. Writes about what actually makes a therapist effective, usually against the field's own assumptions about training and experience.

• Our readingkorrents.com

  Therapists overestimate their own effectiveness by about 65%, and it is not a Western cultural artifact.

  Psychotherapy

  Their words

  Since 2012 when the first study appeared in the literature, others have been published documenting the tendency of practitioners to overestimate their effectiveness - on average, by 65% (1, 2).

  Alas, it seems everyone comes from Lake Wobegonwritings.scottdmiller.com

Founder of the International Center for Clinical Excellence and originator of Feedback-Informed Treatment. Writes about what actually makes a therapist effective, usually against the field's own assumptions about training and experience.

From one piece How to (and not to) become a more effective therapist 2 beliefs · writings.scottdmiller.com

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  What does make a therapist more effective is trainable interpersonal skill, not treatment technology.

  Psychotherapy

  Their words

  It turns out that therapists who perform well on the FIS establish stronger relationships and are more effective (2). More to the point, the evidence shows FIS-related skills are trainable and that such training leads to better results (3, 4, 5).

  writings.scottdmiller.com

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  Training a therapist in a treatment model does not make them more effective, however well the model performs in a trial.

  Psychotherapy

  Their words

  Over the last 50 years, treatment methods have proliferated despite a lack of evidence of differential effectiveness between approaches. And even when a randomized controlled trial indicates a particular approach works, none show practitioners become more effective when they are trained in that modality.

  writings.scottdmiller.com

Psychiatrist and clinical assistant professor at Case Western Reserve University. Writes Psychiatry at the Margins on the philosophical and scientific arguments inside psychiatry and the psy-sciences.

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  Psychedelic Alpha

  Their words

  Josh Hardman at Psychedelic Alpha provided a detailed live account of the advisory committee meeting, which I found very helpful in developing a more granular sense of how the meeting unfolded without having to watch it myself.

  psychiatrymargins.com

Founder of the International Center for Clinical Excellence and originator of Feedback-Informed Treatment. Writes about what actually makes a therapist effective, usually against the field's own assumptions about training and experience.

• Our readingkorrents.com

  Therapists do not improve with experience: on average they become less effective, and their clients drop out more the longer they have practised.

  Psychotherapy

  Their words

  Indeed, as I've reported in previous posts, research not only shows therapists do not improve with time and experience in the field, but on average become less effective (1, 2, 3, 4).

  writings.scottdmiller.com

Marriage and family therapist working from attachment theory and emotionally focused therapy. Author of Secure Love and the person behind The Secure Relationship.

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  Secure Love

  Their words

  Secure Love shows you how to understand your attachment style, calm conflict, and build the secure connection every relationship needs.

  thesecurerelationship.com

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  Attachment Style Quiz

  Their words

  Take the free Attachment Style Quiz and get personalised insight into how you connect, where your patterns come from, and your next step toward secure love.

  thesecurerelationship.com

Family therapist and founder of Relational Life Therapy. Author of I Don't Want to Talk About It, How Can I Get Through to You? and Us; argues that Western individualism is what makes couples' work hard.

From one piece The Myth of the Individual 2 beliefs · terryreal.com

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  Opening a fixed relational pattern takes two things: the implicit made explicit, and the person's own recoil from what they see.

  Their words

  Neurobiologists tell us that it takes two things to unlock and open up a neural pathway. The first is that the implicit must be made explicit. Sometimes you need help seeing what you don't see. But you must be open to the feedback. Second, there must be some sort of recoil, a sense of discrepancy, of "Oh no, I'm not sure I really want to keep doing that."

  The Myth of the Individualterryreal.com

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  Character is not fixed: therapy works because habitual neural pathways can re-form, sometimes within minutes.

  Psychotherapy

  Their words

  In my practice, I have seen that opening neural pathways can lead to profound change, to brand-new traits and behavior, sometimes in a matter of minutes.

  The Myth of the Individualterryreal.com