BiteSize Therapy
@bitesizetherapy.bsky.social
Psychologist. Personal thoughts, not professional advice. An account for therapists.
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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.
🧵
“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-...
Humility is often mentioned as 𝘢𝘯 important quality in a therapist, but given its impact on the other virtues, it might be 𝘵𝘩𝘦 most important quality in a therapist.
From Here to Humility
Guest post by @bitesizetherapy.bsky.social on the foundational importance of humility in psychotherapy
At every stage, a clinician must be willing to acknowledge that they do not have all the answers
www.psychiatrymargins.com/p/from-here-...
Guest post by @bitesizetherapy.bsky.social on the foundational importance of humility in psychotherapy
At every stage, a clinician must be willing to acknowledge that they do not have all the answers
www.psychiatrymargins.com/p/from-here-...
From Here to Humility
At every stage, a clinician must be willing to acknowledge that they do not have all the answers
www.psychiatrymargins.com
November 6, 2025 at 5:46 AM
Humility is often mentioned as 𝘢𝘯 important quality in a therapist, but given its impact on the other virtues, it might be 𝘵𝘩𝘦 most important quality in a therapist.
Reposted by BiteSize Therapy
![“… the work of therapy is so difficult, and its strains on our normal self-esteem and exhibitionism so great, that [therapists] need narcissistic stabilization more than other people do and therefore seek out-of-the-office opportunities to be bigshots (McWilliams & Lependorf, 1990, p. 438).”](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:o3vabq2mcbzg54o364id2pf4/bafkreigylcnr6pu5jr4xue2t4uxahmoruf3rgnf6kwz4y2vjur4xdwvcum@jpeg)
There is a difference between sharing knowledge and being a know-it-all; the first is a bid for connection, the second is a barrier to it.
From Here to Humility
Guest post by @bitesizetherapy.bsky.social on the foundational importance of humility in psychotherapy
At every stage, a clinician must be willing to acknowledge that they do not have all the answers
www.psychiatrymargins.com/p/from-here-...
Guest post by @bitesizetherapy.bsky.social on the foundational importance of humility in psychotherapy
At every stage, a clinician must be willing to acknowledge that they do not have all the answers
www.psychiatrymargins.com/p/from-here-...
From Here to Humility
At every stage, a clinician must be willing to acknowledge that they do not have all the answers
www.psychiatrymargins.com
November 5, 2025 at 3:33 PM
There is a difference between sharing knowledge and being a know-it-all; the first is a bid for connection, the second is a barrier to it.
Psychotherapy is an ongoing education in humility.
-Nancy McWilliams
-Nancy McWilliams
November 5, 2025 at 4:09 AM
Psychotherapy is an ongoing education in humility.
-Nancy McWilliams
-Nancy McWilliams
I knew I had been reading too much psychoanalytic literature when I said the clocks regressed by one hour.
November 2, 2025 at 9:38 PM
I knew I had been reading too much psychoanalytic literature when I said the clocks regressed by one hour.
Truly humble people, I suspect, never describe themselves as such; rather, they worry about their own pride, arrogance, and hubris.
- Donna Orange
- Donna Orange
November 1, 2025 at 8:58 PM
Truly humble people, I suspect, never describe themselves as such; rather, they worry about their own pride, arrogance, and hubris.
- Donna Orange
- Donna Orange