Psychiatry & Psychotherapy Podcast Psychodynamic Psychotherapy with Jonathan Shedler, PhD
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Apr 5, 2022 
The podcast delves into the effectiveness of psychodynamic therapy, exploring severe personality problems, encounters with patients claiming to speak with God, mental health disturbances, therapist-patient relationships, envy and empathy in success sharing, and the dynamics of psychotherapy.
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Camouflaged Destructive Impulses
- Toxic individuals often camouflage their destructive impulses within belief systems and social groups that validate them as virtues.
- Through splitting, projection, and projective identification, they externalize their negative qualities onto others, justifying their harmful actions.
Camouflaged Psychosis
- Jonathan Shedler recounts shadowing a psychiatrist early in his career who struggled to determine if a patient's claim of "speaking to God" was a delusion or a cultural norm.
- This experience highlighted how mental health disturbances can find camouflage in communities that normalize dysfunctional behaviors.
Projective Identification in Therapy
- In therapy, projective identification occurs when a patient projects their feelings onto the therapist, and the therapist unconsciously identifies with and acts on those projections.
- Therapists must recognize and process these countertransference reactions to understand the patient's internal world and relational patterns.