Aug 17, 2020
Today we feature a brilliant and beloved colleague, Dr. Alex Clarke.
At the start of today’s podcast, Alex describes his unexpected journey from psychoanalysis / psychodynamic therapy to TEAM, but discovered that TEAM can actually be viewed as a type of psychoanalytic therapy. In fact, the two fathers of cognitive therapy, Albert Ellis, PhD, and Aaron Beck, MD, began their careers as psychoanalysts. They were simply looking for specific techniques to help their patients develop rapid and tangible change, and not just understanding that unfolds over a period of years.
David and Alex discuss some of the surprising overlaps between TEAM and psychodynamic therapy, as well as some of the striking differences.
Similarities
Changing the Focus: Often there’s tension in the room, especially during therapy sessions. When you bring it to conscious awareness in a kindly way, it will often lead to therapeutic breakthrough.
The Relationship Journal: This is a rapid way to highlight the recurring patterns that cause conflicts in intimate relationships.
Interpersonal Downward Arrow: This is a high-speed version of psychoanalysis which reveals your “core conflict” in ten minutes, as compared with five years on the analyst’s couch.
Hidden Emotion Technique: This is the idea that anxious individuals are overly “nice” and feel they have to suppress certain kinds of positive or negative feelings, which then emerge, in disguised form as some type of anxiety, such as chronic worrying, a phobia, a panic attack, OCD, and so forth.
Differences
T = Testing techniques: Most analysts are dead set against testing, thinking it will somehow hurt or ruin the “transference.” TEAM therapists are convinced it is difficult, if not impossible, to do good therapy without session by session assessments to track how patients feel, and how they feel about the therapist.
E = Empathy training and methods: TEAM therapists get highly accurate and sensitive empathy ratings after every session from every patient. Many therapists get failing grades from most patients at most sessions. The patient’s criticisms are not taken as evidence for the patient’s distortions of the relationships, but rather as valid indicators of the therapist’s actual errors. This information is used to deepen the therapeutic relationship.
A = Assessment of resistance: Freud devoted his career to understanding and trying to solve the puzzle of resistance—but his free association on the couch was not terribly effective. TEAM therapists bring subconscious resistance to conscious awareness quickly, and melt it away rapidly with a variety of techniques. This opens the door to the possibility of ultra-rapid recovery.
M = Methods: TEAM therapists use more than 100 methods drawn from more than a dozen schools of therapy. The therapist and patient work together collaboratively to solve specific problems, and homework between sessions in mandatory.
Alex’s current passions span a broad range of mental health treatment, and as a result, provide lots of great opportunities for fun and collaboration with David, as well as the rest of the TEAM community.
Clinical work: Alex sees patients three days per week, using TEAM and occasionally medications if needed.
Training / teaching: He teaches with David and several other experienced TEAM therapists at David’s weekly training group at Stanford.
The Feeling Great app: Alex is assisting David and Jeremy Karmel in the process of making TEAM Therapy accessible to everyone as an electronic app. The app will include real-life examples bringing the techniques to life along with step-by-step instructions for how to put techniques into action. Putting these powerful psychotherapy ideas and methods in patients’ hands provides an exciting opportunity to accelerate healing and augment therapy, since the tool can be assigned as homework between therapy sessions. Also, when patients get stuck with topics in the app, they can discuss these with their therapists, deepen their understanding, and bring them to life through role-plays, etc.
Statistical modeling: With David’s mentoring, Alex is working to learn data analytic and statistical modeling methods that can help investigators explore and understand how effective psychotherapy actually works.
Measurement and Search: Alex has joined David’s son, Erik, on the exciting mission of promoting measurement-based and feedback-informed treatment as the standard of care in mental health. They are currently in the final phases of developing and rolling out an electronic system for use by therapists and patients to assess mood before, after, and between therapy sessions in order to assess changes in therapy as well as relapses between sessions. This system will provide unique insights for clinicians as well as patients about what’s helping, what’s not helping. The tool will also have a search-engine celebrating clinicians who commit use measurement consistently in their clinical work and will help patients find clinicians with outstanding skills in the areas where they need help.
Alex was born in Seattle and grew up splitting his time between the east and west coast. Alex went to high school and college in North Carolina and played in a band for several years after finishing college. He also worked in restaurants, real estate, audio engineering, and even owned a vending machine business for several years!
He’s always been a giant outdoors enthusiast, loving to hike, ski, climb, and surf. When Alex went to medical school, he planned to become an emergency room physician because of his love for adventure and wilderness.
During medical school, Alex fell in love with the operating room and almost decided to become a surgery resident. However, during a summer research internship, Alex became increasingly interested in neuroscience and began devouring literature on consciousness and emotion research, as well as the brain-machine interface.
When he discovered psychiatry during his clinical rotations, he was sold. Psychotherapy struck him as particularly awe-inspiring and he decided to dedicate himself to its learning and practice.
In his final year of medical school, Alex traveled around the country doing rotations at medical centers across the US in an effort to learn how mental healthcare is practiced in different settings and regions. He searched broadly for psychotherapy mentors and feels wildly lucky to have found Dr. David Burns during his residency at Stanford.
During residency, Alex trained in several different schools of psychotherapy, including advanced psychodynamic training with the SFCP (San Francisco Center for Psychoanalysis). As he puts it “there are lots of metaphors for human experiences, but all of these schools for some reason feel a need to use their own jargon, which can sometimes be off-putting or confusing.”
I, David, would add that I agree with this 200%. For example, there is a concept called “projective identification.” For years I felt intimidated by this term and couldn’t figure out what it meant! Then someone explained it to me, and for a brief moment, I “got it.”
But now, I again have no idea what it means!
Alex decided that understandable language was important and discovered that Dr. Burns had been developing “common language” for important psychotherapy ideas as well as a framework for understanding how effective treatment works. Alex loved this and decided to join David is his mission of translating essential psychological and philosophical ideas into practical, usable healing techniques. One of things that Alex expresses that he admires most about David is his strength in taking complex ideas and bringing them down to a simple, digestible, human level.
I, David, would add that I love working with Alex, and have learned so much from him, both in terms of the numerous technical discoveries and amazing breakthroughs that have evolved in our research, but I have also learned a little about the incredible value of humility and “selflessness” from this kindly gentle giant!
I, Rhonda, would liked to add that I also love working with Alex. I admire his kind soul, his gentle disposition, and his perceptive mind.
Rhonda and I feel extremely lucky to be working with Dr. Alex!
Rhonda and David