The benefits of psychodynamic therapy

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Hmm... clearly the issue of whether someone makes money out of a set of ideas is only tangential to evaluating the merits of the set of ideas. (If throwing money into a pit for years on end is the criterion for judgment, anecdotal experience suggests psychoanalysis has rather more to answer for than GTD...)

However, IMHO, the bottom-up nature of GTD, like the solution-focussed nature of CBT, *does* imply a set of values, because in choosing to implement either you are opting not to radically overhaul your life but to reduce the tensions, conflicts and disturbances that arise in the course of your current lifestyle, thus making it easier to maintain that lifestyle and disincentivising you to make any radical changes to it. (Both GTD and CBT can reach beyond this to the broader, deeper level, but David Allen's approach inevitably puts the emphasis on the smaller daily level, I think.)

Where I disagree with shtriemel is in the idea that there is necessarily something wrong with that.

There is a doctrinal belief within much of psychotherapy (a belief that is, among other things, in tune with therapists' own profit motives) that everyone comes to the therapeutic encounter burdened by deep unsolved issues borne of inherent psychological conflict. But what if I'm broadly happy with the life I've chosen and just want to improve aspects of it with CBT and GTD?
 
ludlow said:
(If throwing money into a pit for years on end is the criterion for judgment, anecdotal experience suggests psychoanalysis has rather more to answer for than GTD...)

Wrong. The number one group of psychotherapists getting training in psychodynamic psychotherapy is psychiatrists and family doctors (at least within the last 5-10 years...and at least on the East Coast). Hence it's the state/province footing the bill not the client. And the $$$ stays the same for the therapist regardless if they see the same client 6 times a week or once. And how do I know this? My girlfriend is a psychiatry resident.

BTW...Freud spent time raising money for clients who couldn't afford his services. Anna Freud provided free analysis for children/adolescents.

There are crooks in every profession. One has to be careful which rabbi/priest, lawyer, accountant and therapist they choose.

ludlow said:
There is a doctrinal belief within much of psychotherapy (a belief that is, among other things, in tune with therapists' own profit motives) that everyone comes to the therapeutic encounter burdened by deep unsolved issues borne of inherent psychological conflict. But what if I'm broadly happy with the life I've chosen and just want to improve aspects of it with CBT and GTD?

Congrats. But you're not describing my clients. Nor a majority of the clients who are trying to resolve a repeatition of problems in their lives that are not easily dismissed with breathing exercises and "correct" thinking. There is an intelligent post, a few up from this one, that describes the process quite well. Until then, I suggest you read Healing the Soul in the Age of the Brain for a wonderful description of why psychodynamic therapy works and why it is more effective than CBT for persistent emotional problems.
 
Open my eyes, please!

shtriemel said:
You must be joking. GTD is "value-neutral"? You're kidding right?
Jeff K said:
In what specific ways do you see GTD as value-laden? Could you illustrate only with direct references to source material (as in writings by David Allen and company)?
shtriemel,

Please, give us the examples that will prove your statements just as Jeff asked. If there is something wrong with GTD that I cannot see your arguments may open my eyes.
 
TesTeq said:
shtriemel,

Please, give us the examples that will prove your statements just as Jeff asked. If there is something wrong with GTD that I cannot see your arguments may open my eyes.

It values unhealthy living. Some may consider "having it all with a cherry on top" to be healthy. I don't, nor do my friends or clients. But we buy the myth, swallow an SSRI and get on with it. Things have to get worse to get better...I have faith in that.

Allen states this (GTD CD's) by telling his listerns that they "can have it all". I think this is dangerous thinking, and it's so pervasive in North America that you'd have to be blind not to see/feel its effects.

Again, I think there are some interesting ideas in GTD. But the problems I have with the system (which I've detailed in many of my posts) outweight the benefits so far. But i'm giving it another shot, so we'll see..
 
shtriemel said:
It values unhealthy living. Some may consider "having it all with a cherry on top" to be healthy.

It doesn't value unhealthy living. It gives one a way to process all the stuff they need to get done. It isn't GTDs fault that we live in a world that according to you values unhealthy living. I like making a living at my chosen profession and I don't need to pop a pill to cope. I do need to make sure that I have all my information in a trusted system so that I can make my customers happy. I don't need to hire a therapist to help me cope when manilla folders & 3x5 index cards do the trick.

Also, re the zealotry snip, you are at a GTD BB. Wouldn't you expect a certain amount of zealotry?

I can look up the specific reference if deemed absolutely necessary, but I remember DA writing something to the effect that "you CAN'T do it all... you need to decide of all things you could be doing what is most important & do that." (paraphrasing of course).
 
I do not think it is dangerous thinking.

shtriemel said:
Allen states this (GTD CD's) by telling his listerns that they "can have it all". I think this is dangerous thinking, and it's so pervasive in North America that you'd have to be blind not to see/feel its effects.
I haven't noticed that David said "you can have it all"!

I think that he rather says "you can do anything but not everything".

In "Ready for Anything" he also says that:
David said:
Not be the best - do your best. Attempting to be the best can easily have struggle, ego and self-recrimination as baggage, with win/lose as a format. But doing your best is a dynamic, ever-changing experience that is possible anytime, by anyone
I do not think it is dangerous thinking.
 
TesTeq said:
I haven't noticed that David said "you can have it all"!

I think that he rather says "you can do anything but not everything".

In "Ready for Anything" he also says that:

I do not think it is dangerous thinking.

Tes,
Breathe. We can disagree.
 
Whipped cream on mine.

shtriemel said:
It values unhealthy living. Some may consider "having it all with a cherry on top" to be healthy. I don't, nor do my friends or clients. But we buy the myth, swallow an SSRI and get on with it. Things have to get worse to get better...I have faith in that.

Joylessness, punishment and pain seem to be emerging as a theme here. And profit. If people are happy, if they order their lives by their own hands and take possession of their own happiness, then they may not feel the need to spend $200 an hour recalling childhood memories to a tiki in a den. And to anticipate the inevitable response, the satisfaction people have with their lives by employing GTD is just as genuine and valid as a similar outcome authorized and authenticated by the tiki. GTD just takes a heckuva lot less time and money.

Having it all with a cherry on top is one of limitless objectives a person can plug into the GTD system. There are people on this board who really are in the helping professions, like pastoring and teaching, and they're using the increased ability to Get Things Done to do more for others. It's rather culture-deviant to encounter someone here who feels compelled to condemn fellow board members for their positive views of a system to which this entire board is dedicated. It's not constructive, and among lesser mortals, you'd already have been called a troll. But gosh darn it, we're unhealthy have-it-allers, and I guess you're the cherry du jour.

If another reading of GTD can crack this nut, DA deserves a complimentary license from the APA.
 
Arduinna said:
then they may not feel the need to spend $200 an hour recalling childhood memories to a tiki in a den. GTD just takes a heckuva lot less time and money.

Something I'd expect from the quick-fix generation. But I'm sure GTD will fit it all. Ahem.

Arduinna said:
It's rather culture-deviant to encounter someone here who feels compelled to condemn fellow board members for their positive views of a system to which this entire board is dedicated.

Actually, if what I saying was so out of this world, no one would care would they? For example, if I stated that staring at the moon was more effective than using GTD, than people would most likely ignore me. But since I'm a therapist, working in the helping profession, I guess my observations are taken a little more seriously...actually forget my credentials, the fact that other's are so quick to defend GTD against any criticism speaks volumes, no?

Again, I've just moved, have time on my hands, and thought I'd get some stuff off my chest visavis the whole GTD thang. Like tin-foil on a cavity...ouch.

Healthy ideas and systems are able to absorb critique.
 
shtriemel said:
It values unhealthy living.

Just wishing to clarify: Do you think that any way of living in which:

1) there are one or more outcomes you wish to bring about,

2) at any given time and place there may be more than one action you can choose to take to move toward those outcomes, and

3) you cannot necessarily take every potential action at the moment it comes to your attention

...is inherently unhealthy? As far as I can tell, these points represent the threshold at which Allen's GTD model become applicable.

I'd agree that many of the people who are drawn to GTD are living in an unhealthy way, trying to do too much with too little and possibly for the wrong reasons, but it does not follow that the system itself values such a way of life.

As others have pointed out, none of Allen's writings seem to suggest that "can have it all" -- indeed, the system and its proponents seem to encourage the realization that you can't have it all, and therefore tools to help make good choices may be useful. I'd be very interested to hear about contrary examples from any of the GTD materials.

-T.
 
Tetsujin said:
Just wishing to clarify: Do you think that any way of living in which:

1) there are one or more outcomes you wish to bring about,

2) at any given time and place there may be more than one action you can choose to take to move toward those outcomes, and

3) you cannot necessarily take every potential action at the moment it comes to your attention

...is inherently unhealthy? As far as I can tell, these points represent the threshold at which Allen's GTD model become applicable.

I'd agree that many of the people who are drawn to GTD are living in an unhealthy way, trying to do too much with too little and possibly for the wrong reasons, but it does not follow that the system itself values such a way of life.

As others have pointed out, none of Allen's writings seem to suggest that "can have it all" -- indeed, the system and its proponents seem to encourage the realization that you can't have it all, and therefore tools to help make good choices may be useful. I'd be very interested to hear about contrary examples from any of the GTD materials.

-T.

I've already discussed his introduction to GTD on CD. Anyway, I'm running out of steam debating the faithful. If it works for you great, hell even I'm trying to implement some of the ideas. But my practice as a therapist tells me that people can do much, much more with a scaled down lifestyle, than more efficiency experts telling how you can live the dream and do it stress-free. It's a lie they're selling, and it's one we lap up every chance we get.
 
Actually, if what I saying was so out of this world, no one would care would they? For example, if I stated that staring at the moon was more effective than using GTD, than people would most likely ignore me. But since I'm a therapist, working in the helping profession, I guess my observations are taken a little more seriously...actually forget my credentials, the fact that other's are so quick to defend GTD against any criticism speaks volumes, no?

First, the fact that people respond doesn't necessarily demonstrate "caring" or respect. You may not have been here at the time, but there was a lively discussion that was initiated by a post from a lady in the Eastern Bloc who was looking for friendship or trying to sell flowers or something. In terms of you being a "therapist" and your observations being taken "a little more seriously" as a result, I assure you: I can see no evidence in anything you've said that you're a therapist of any stripe. I am responding to what you're saying on its own merits. "Forget my credentials..." no problem, they weren't there to remember. You are a name making claims and assertions and accusations on a board. That's it. You could be a 15 year-old kid who has yet to learn to use the spell/grammar checker. You've been given the benefit of a steadily eroding doubt. That's all.

I'll agree with you on one thing, though. "Healthy ideas and systems are able to absorb critique." Indeed, and healthy systems process the valuable nutritive materials and discard the rest. I think we've gotten some insights from one person who has issues with the entire idea that people can help themselves, and is highly irritated that a whole community of individuals is exploring the use of GTD for just that purpose. However, given the germ-to-chaff ratio, I'd consider further processing a waste of time I could be using in the lofty pursuit of the cherry of life, aka
GETTING THINGS DONE.​
 
Arduin[CENTER said:
na]First, the fact that people respond doesn't necessarily demonstrate "caring" or respect.

Actually I disagree. I have seen odd postings on this BB - clearly selling one thing or another - that were entirely ignored. And though cognitive dissonance proves to be a heady barrier for most folks to admit their problems with this system - or you've done such a good job running the critics out of town - their responses to my posts indicate that they fear something. Could that be that GTD, CBT and other tweaks aren't enough? Perhaps even causing more problems than they're worth? Could it be that the underpinnings are faulty? I believe so.
 
shtriemel said:
It values unhealthy living.

I did not get anything at all like this from the book. I speculate, shtriemel, think that you are being triggered in this way because of things that related to your set of beliefs, life experiences, and values about what constitues healthy living.

FWIW, having met David, Kathryn, and staff--I can say that I think you would be pretty surprised if you were to meet them. Very down-to-earth, normal folks--and they were genuine, it wasn't BS. Not what I think you would expect from them given your previous posts.

shtriemel said:
Some may consider "having it all with a cherry on top" to be healthy. I don't, nor do my friends or clients.

And a lot of people agree with you. This is fine. So don't aspire to have that kind of life. No one here is requiring you to do so. Not even GTD or David Allen. One thing that occurs to me is that, because of your line of work, where you hear about people's problems for a living, you may be getting stressed out a lot, and may need to de-compress. Both of my parents as well as some friends of mine are MDs, and I know that at different times they have all needed to take a find ways to "decompress" from the stresses of their work, as diagnosing someone with cancer, telling them that they are losing their eye sight and nothing can be done, or having a patient die on the operating table are all very upsetting things that happen to them, respectively, on a regular basis.

The other thing I would note is that I think you are assuming that those of us who use GTD haven't examined our lives or priorities. I cannot speak for anyone else on this BB, but I assure you, I don't live the a pretentious or shallow life, and my life is anything but unexamined. I have no idea why you have assumed that we are all automatically mindless drones who have bought into a system that you seem to despise, and that each time someone on this list tells you that they are not a CEO type, but a single mom, or whatever, that you sweep such data under the rug.

Please, shtriemel, give us a little more credit than that. We are not dummies! What I am getting from your posts is that you think we are mindless drones, worker ants, and that we are stupid and foolish to follow this system (GTD) because it is dangerous and leads us to some false promised land that is actually very bad for us. And that unless we live our lives the way you think we ought to be living them, then we are WRONG.

Perhaps you might consider what is it about GTD, this BB, your life, or whatever that:

*causes you to be sarcastic and call other people on this board, (who are only trying to help you and don't want to fight with you--with perhaps some exceptions) drones, worker ants, and be so sarcastic as to suggest that we need to determine or NA or decide if, in trying to get a mind like water we should go and flush a toilet?

*has you feeling the need to be RIGHT regarding your continued insistence that that psychodymamic therapy (your way) is far better than CBT when another therapist who practices the same modality as you do freely admits that each therapy camp likes to insist their "Way" is better, and that the reality is that the relationship between therapist and patient seems to be more of a key factor to success than the specific modality used?

*has you keep insisting that CBT is only a short-term modality when others on this board have indicated that they have done it long term with good results?

* has you insisting that GTD is bad because it encourages us to lead an unhealthy lifestyle?

Just some food for thought--I do not suggest that you answer these questions for us here on this BB--rather I suggest that you need to answer them for yourself. The answers are more important for you than they are for us.

shtriemel said:
Again, I think there are some interesting ideas in GTD. But the problems I have with the system (which I've detailed in many of my posts) outweight the benefits so far.

Aside from your philosophical/lifestyle concerns (for lack of a better term) I haven't seen specifically what problems you are having with it? From what I have read, you haven't actually implemented yet, or at least not very much (though I may not have the correct data, I freely admit). From my own experience, I can tell you that reading the book and actually doing what is says are two very different things. I didn't start to "Get" it until I started "doing it". It was only then that I began to see the benefit. I am unsure how far along you are in the book, or with trying to implement, but what I would suggest is that you give it a shot.

I would also suggest that you consider ignoring posts from people who ask questions that you find to be ridiculous or overly simplistic, perhaps from someone whose mind isn't as bright and intelligent as yours? I have no idea if you *really* read a post about someone asking where "brush my teeth" goes on the list, and trying to figure out whether or not it was a project, but if that was true (and wasn't just you being sarcastic), then I would suggest you just show some compassion and empathy (afterall, you are a therapist) for the person's lack of trust in themselves (or insecurity, naivete/mis-reading of the book, or whatever) that they would ask a question that you consider to be too simplistic instead of making fun of them in a public forum.

If you can ignore those posts, and post some of your own PRACTICAL questions, rather than philosophical complaints, I think you would find you would probably get a lot more out of this BB. There are people here that would REALLY like to try and help you, possibly even "befriend" you, but you keep on fighting with us, insulting us. It would have been easier to just write you off as an "angry guy" and move on, but we are trying to help. Granted, you are more open now than you were a few days ago, and I am glad to see that. I hope the trend continues.

shtriemel said:
But i'm giving it another shot, so we'll see..
I am glad to hear that someone in Toronto is going to help you out w/GTD, and that you are giving it another chance, and that your "I dare you to teach me something that could be useful" approach is softening a little bit.

I hope that you know that I sincerely am trying to help, and that you don't take anything in my post as a personal attack, as that is NOT the way in which it is intended.
 
What are you here for?

shtriemel said:
[T]hough cognitive dissonance proves to be a heady barrier for most folks to admit their problems with this system - or you've done such a good job running the critics out of town - their responses to my posts indicate that they fear something. Could that be that GTD, CBT and other tweaks aren't enough? Perhaps even causing more problems than they're worth? Could it be that the underpinnings are faulty? I believe so.

I believe my informal research, which indicates that 80% of programming problems can be solved by explaining them to a stuffed penguin. This is a testable, i.e., falsifiable, belief. GTD is pretty empirical, and seems to work well for a broad cross section of people. You seem to have a chip on your shoulder, though. Do you want to talk about it? :)
 
shtriemel said:
[snipped] their responses to my posts indicate that they fear something.

The above is only one of many interpretations, and it happens to be one that supports your stance. You state you opinion as if it is fact quite frequently in your posts, the above quote is but one of many examples of this.

Notable is that several times when anyone here post anything that doesn't fit in with your viewpoints, you generally ignore those comments, but sometimes you have taken it one step further and have been sarcastic or rude to the poster. Fortunately, these incidents seem to be decreasing in number and intensity. As a posted above said, [paraphrasing] you will get less and less benefit of the doubt as time goes on.

The same poster was also probably not aware of the therapy credentials you had told us about on another post, but honestly, I don't think that this really matters all that much when talking about GTD and not talking about therapy.

Every therapist is a human first, with human weaknesses just like the rest of us. The fact that you are a therapist, IMO, doesn't really give your particular opinion more weight than that of others.

Actually, I think that you have used your credentials in a way that hurts you, and possibly, also, some people's trust in therapy (regardless of modality), as I speculate that many people would not want to go to a therapist if they thought the experience would resemble anything like the conversation people are having with you on this board. Indeed, sometimes therapy is hard and it is a therapist's job to point out things a client isnt' "seeing", but there are other times when compassion and empathy are necessary.

Going back to your being human, FIRST, just like the rest of us, and not a "Therapy God" with THE answers, the reason that I think that you are getting the types and numbers of replies that you are is because you raise people's defenses by:

* Insulting or arguing with posters who disagree with your viewpoint, or in more lay terms, you hurt other people's feelings and it makes them feel bad. They want the opportunity to let you know "hey, I doesn't feel good when you hurt my feelings, I didn't like that when you said X about me."

* Displaying a "know-it-all" attitude that says "I dare you to teach me anything." Well, you dared people--some are taking you up on your challenge despite your sometimes difficult attitude

* Ignoring posts from others that refute your assertions.

On *any* BB, such posts are likely to get replies. Sorry, I just don't think your "status" as therapist is what is making people reply to you.

And deep down, I think you know you are being intellectually dishonest with yourself by pretending it is the latter when you know that it is the angry, arguementative nature of your posts, some sarcastic, and some not, that are getting your posts this kind of attention.

And, many people, in my opinion, have been very patient with you when you have really begun to wear out your welcome. Not because of your beliefs, but because of the way you condescend to others by the attitude and mood of your posts.

shtriemel said:
[Could it be that the underpinnings are faulty? I believe so.

Yes, you have stated this over and again in a number of different ways. Others have a different view point.

Speaking for myself, I don't fear you, or what you have to say.

Rather, I see you as someone who is, for reasons unknown to me, angry and feels like an outsider, and who wants to get a rise out of people any way he can. In that, you have succeeded.

I suggest that you might give GTD a try with the Toronto fellow you mention, you might learn something that is useful if you are able to give it a fair shot and not be so defensive.
 
Wow...wow...wow. So that's what happens when you poke a stick into a hornet's nest. Anyhoo, I'm not here to increase the number of clients seeking therapy...I'm not here to merely argue (though it's, in a twisted kinda way, enjoyable) with the GTD elite...my posts represent a belief that getting things done isn't the issue, not even close. But we want to believe it is. And so we'll consume, purchase, anything that nourishes the illusion that more is accessible. But of course, and we all know this, the increase in anti-anxiety/depression medication, divorce rate, and all the other social ills that keep us up at night (oh that's right, and all the sleeping medication being consumed), are just a smidgen of what I'm referring to.

Again, I believe many of the responses to my posts/comments reflect the truth of my observations. Not THE TRUTH, but the truth nonetheless.
 
Missing the point

shtriemel said:
Wow...wow...wow. So that's what happens when you poke a stick into a hornet's nest. Anyhoo, I'm not here to increase the number of clients seeking therapy...I'm not here to merely argue (though it's, in a twisted kinda way, enjoyable) with the GTD elite...my posts represent a belief that getting things done isn't the issue, not even close. But we want to believe it is. And so we'll consume, purchase, anything that nourishes the illusion that more is accessible. But of course, and we all know this, the increase in anti-anxiety/depression medication, divorce rate, and all the other social ills that keep us up at night (oh that's right, and all the sleeping medication being consumed), are just a smidgen of what I'm referring to.

Again, I believe many of the responses to my posts/comments reflect the truth of my observations. Not THE TRUTH, but the truth nonetheless.

Not too hard to predict what would happen when someone upsets a hornet's nest in this manner. It is uncomfortable, at least for me, to watch others be insulted, called names or have their buttons pushed in a way that seem nothing less than meanspirited, and then to watch those same people say "please stop" in a variety of ways, yet the person keeps doing it nonehtheless?

While this style or arguing may be enjoyable for you, perhaps you could consider others feelings too?

Why is this so hard?
 
Less IS More.

Originally Posted by shtriemel
. . . my posts represent a belief that getting things done isn't the issue, not even close. But we want to believe it is. And so we'll consume, purchase, anything that nourishes the illusion that more is accessible.

Gettting things done really IS the issue for me. The cherry on top was being able to leave work on time, spend the evening with family or friends without thoughts about unfinished work intruding, more time for my favorite pastimes, sleeping soundly at night without waking or dreaming about the work sitting on my desk.

I don't have a six-figure income or a McMansion. I live in a middle-class house, drive a middle-class car, take vacations when I want, and work at a job I like. I am of the age and have enough years of service that I could retire, but the work I do is fulfilling and meaningful to me. I am contented with what I have.

I am a psychologist in a state psychiatric facility. We treat people (most are indigent) who have severe mental illnesses. Hospital stays are short, so there is no time for in-depth therapy - that's for the outpatient therapist. Many of the patients are too ill or impaired to respond well to CBT. The relationship with the treating staff is more important than school of therapy in this setting, and it has been my observation that patients decide who is trustworthy pretty quickly.

I have never experienced David Allen as pushing products on me. Not in the book, not in this forum, not on the CDs. It was my personal choice to buy the GTD Fast CDs, and they have been most helpful in my further streamlining my approach to my tasks.

I do hope you give this process a sufficient trial to determine whether or not it can help you manage your tasks more effectively/efficiently. It took me a little time to get most of the pieces in place, and I still have pieces that need more work. I love that the process is flexible enough to fit my style, my needs, my situation. I, too, had tried other systems, but none really worked for me. This one seems to suit me well. It isn't that this system is the "best," but that it is helping me accomplish what I wanted.

I did want more. More personal time in the evening. I do want less. Less waiting on my desk when I get to work tomorrow, and GTD is helping me achieve just that, and that particular less is giving me the more that I so wanted.

Carolyn
 
OK, I checked out the book recommended on the first page of this thread, Healing the Soul in the Age of the Brain, by Elio Frattaroli. So far I have read part one (the first 78 pages). It’s very interesting--there’s a lot there for those interested in philosophy, religion, and literature, and I think I have a better idea now about where shtriemel is coming from. There’s a lot I could I ramble about, but let me first quote Frattaroli on his basic concept of what it is to be human:

“I believe that humans possess a spiritual as well as a physical dimension, and that there are very real differences between brain, mind, and soul. I think of the soul as the experiencing self, the “I,” an ineffable whole that integrates processes happening at four different levels of experience—body, brain, mind, and spirit.” (6)

Frattaroli answers the question posed by this thread fairly explicitly at the end of part one:

“I am convinced that all psychiatric symptoms originate in the way I have just described—as adaptive mechanisms to relieve the anxiety generated by inner conflict—and that they are appropriately and effectively treated by a psychotherapeutic process (with or without medication) aimed at resolving inner conflict. The symptoms will no longer be necessary (and chemical balance will be restored) once the unconsciously conflicted, anxiety-provoking emotions have been fully accepted into consciousness, that is, once they are no longer provoking unmanageable anxiety.” (78)

Also: “What dynamic psychotherapy offers that all these methods lack is a unique synthesis of private inner experience and interpersonal process: a specific focus on inner conflict as the nexus of change combined with a method that takes advantage of transference as the vehicle for change.” (78)

[I happen to agree with his assertion that materialism is an inadequate philosophy to explain human experience. I don’t know yet to what extent he fleshes out these distinctions, and to what extent effective psychotherapy requires agreement about the exact nature and relationship of the parts of the self.]
 
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