DR. WARSHOW HAS EXPERTISE IN THE FOLLOWING APPROACHES:

Dynamic Emotion-Focused Therapy (DEFT)

Intensive Short-Term Dynamic Psychotherapy (ISTDP)

EMDR

Somatic Experiencing

Mindfulness Techniques

Gestalt Therapy

Behavior Modification for ADHD

Dynamic Emotion-Focused Therapy (DEFT):

As Developed by Susan Warren Warshow, LCSW

DEFT activates compassion for self as the springboard to freedom from restrictive defenses and symptoms, which then leads to an expanded capacity for emotional vitality and closeness. The client and therapist work together to identify and reduce anxiety; toxic forms of shame and guilt that are fused with self-attack; and self-defeating defenses in order to make way for rising feelings. To increase receptivity to this process, Ms. Warshow has painstakingly crafted targeted interventions that are informed not only by advanced study but also by her own trial and error experiences over many years. The DEFT therapist also seeks to employ empathically attuned non-verbal signals, body language, tone of voice, eye gaze, choice of words, rhetoric and metaphor that promote a felt connection to all parts of the self and to the therapist.  

DEFT is an accelerated, affect and somatic-focused, experiential and psychodynamic therapy. It relies on an egalitarian relationship, a partnership between client and therapist that is mutually authentic and self-reflective. Self-disclosure in the interest of the client, spontaneous humor, true affection, creativity, constancy and respectful regard are explicitly valued in this approach.

DEFT is evidence-based in that it is grounded in theoretical principles validated by STDP, psychodynamic, hope and self-compassion research. Demonstrable success is shown in recorded session material in the treatment of highly defeating personality patterns, depression, severe anxiety and relationship difficulties. DEFT tracks and reinforces the presence of hope and a sense of mastery throughout the therapeutic process as the client enters new ways of being and relating. This generates growth-related positive affects between client and therapist, often mixed with anxiety, which is a natural response to change. These feelings, like all feelings, will be carefully explored.

DEFT also subscribes to attachment theory and nurtures a genuinely caring and engaged relationship between therapist and client that provides a “secure base,” one that can hold and welcome all that the client feels; and also has the ability to transform the relationship to self and others.

Mobilization of the client's will to give careful, moment-to moment attention to his/her internal world, a form of mindfulness, is central to the DEFT process, i.e. both client and therapist precisely track all manifestations of anxiety symptoms, toxic forms of shame and guilt, distancing behaviors and rising feelings. Keeping these phenomena outside of awareness creates barriers to the ultimate goal… freedom of emotional experience and shared expression. As the unconscious becomes conscious through an experiential process, it becomes possible for the client to integrate past experience in new ways, leading to changes in behavior and the development of more secure, loving attachment relationships.

DEFT is informed by but not wedded to a particular theory, as it encourages therapists to be attentive to intuition and creative flow and to be observers/researchers into those interventions that create change moments within the client. Any therapist at any time might happen upon a new inroad that will bring about an unexpected result. A runner is trained for years by his coaches, but when he is alone on the field and the gun cracks, he must also pull from something within himself that only he is privileged to access. The same creative force resides within our clients. Therapists need to stay open to their own instincts and to those of their clients to be the best they can be.  Each of us has inexpressible qualities that we bring to the “I-Thou” relationship, as described by Martin Buber.

Susan Warren Warshow has said: “I embrace cutting edge research but I shall always view psychotherapy as an art as much as a science. I never want to lose the sense of wonder, beauty and spirit in deep human connection. There will always be within me a sense of awe and humility for that which can never be entirely known. Teasing out the variables involved in successful outcomes will keep us busy for lifetimes, but it will always be my client's feedback that most profoundly shapes my course.”

Intensive Short-Term Dynamic Psychotherapy (ISTDP):  

ISTDP (From Wikipedia, the free encyclopedia) “Intensive Short-Term Dynamic Psychotherapy (ISTDP) is a form of short-term psychotherapy developed through empirical, video-recorded research by Habib Davanloo, MD.  Patients come to therapy because of either symptoms or interpersonal difficulties. Symptoms include traditional psychological problems like anxiety and depression, but they also include medically unexplained symptoms such as headache, shortness of breath, diarrhea, or sudden weakness. "Medically unexplained" in this instance means symptoms occur without any medically identifiable cause. These are theorized, within the ISTDP model, to occur in distressing situations where painful or forbidden emotions are triggered outside of awareness. Within psychiatry, these phenomena are classified as "Somatoform Disorders" in DSM-IV-TR.

The therapy itself was developed during the 1960s to 1990s by Dr. Habib Davanloo, a psychiatrist and psychoanalyst from Montreal who grew frustrated with the length and limited efficacy of psychoanalysis. He video recorded patient sessions and watched the recordings in minute detail to determine as precisely as possible what sorts of interventions were most effective in overcoming resistance, which acts to keep painful or frightening feelings out of awareness and prevent interpersonal closeness.”

ISTDP's primary goal is to help the patient overcome internal resistance to experiencing true feelings about the present and past which have been warded off because they are either too frightening or too painful. The technique is intensive in that it aims to help the patient experience these warded-off feelings to the maximum degree possible; it is short-term in that it tries to achieve this experience as quickly as possible; it is dynamic because it involves working with unconscious forces and transference feelings.

Eye Movement Desensitization and Reprocessing (EMDR):

EMDR was created by Francine Shapiro.  Dr. Warshow uses EMDR with children, adolescents and adults who suffer from post-traumatic stress disorder or severe anxiety and stress. Through this technique, his clients become free to move through their traumas, letting go of disturbing rumination and imagery so they might re-engage with the next phases of their lives.

The EMDR Institute, Inc., website describes EMDR as follows:

“EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.  Repeated studies show that by using EMDR people can experience the benefits of psychotherapy that once took years to make a difference.

EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma. The brain's information processing system naturally moves toward mental health.  If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can causes intense suffering.  Once the block is removed, healing resumes.

Using the detailed protocols and procedures learned in EMDR training sessions, clinicians help clients activate their natural healing process. “Twenty positive controlled outcome studies have been done on EMDR.  Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions.  Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions.

There has been so much research on EMDR that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the American Psychological Association and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 70,000 clinicians throughout the world use the therapy.  Millions of people have been treated successfully over the past 20 years.”

“EMDR therapy is an eight-phase treatment.  Eye movements (or other bilateral stimulation) are used during one part of the session.  After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist's hand as it moves back and forth across the client's field of vision.  As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings.

In successful EMDR therapy, the meaning of painful events is transformed on an emotional level.  For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, "I survived it and I am strong."  Unlike talk therapy, the insights clients gain in EMDR result not so much from clinician interpretation, but from the client's own accelerated intellectual and emotional processes.  The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them.  Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients' thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies.”

Somatic Experiencing (SE):

SE (From SomaticExperiencing.com) “Somatic Experiencing® (SE) is a naturalistic approach to the understanding and healing of trauma developed by Peter A Levine over the past 40 years and taught throughout the world. SE®is a clinical methodology based upon an appreciation of why animals in the wild are not traumatized by routine threats to their lives while humans, on the other hand, are readily overwhelmed and traumatized. Fortunately, the very same instincts (and related survival based brain systems) that are involved in the formation of trauma symptoms can be enlisted in the transformation and healing of trauma. Therapeutically, this “instinct to heal” and self-regulate is engaged through the awareness of body sensations that contradict those of paralysis and helplessness, and which restore resilience, equilibrium and wholeness.

Because human responses to potential threat vary so greatly, it is difficult to identify or classify sources of trauma. Most people associate trauma with events like war, violence, extremes of physical, emotional or sexual abuse, crippling accidents, or natural disasters. However, many ''ordinary'' or seemingly benign events can also be traumatic. For example, so-called minor automobile “whiplash'' accidents frequently lead to bewildering and debilitating physical, emotional, and psychological symptoms. Common invasive medical procedures and surgeries (particularly those performed on frightened children who are restrained while being anesthetized), can be profoundly traumatizing. Somatic Experiencing® utilizes basic tools (and “building blocks”) but also works differentially with various sources of trauma. These diverse categories include:

Medical: hospitalizations, surgeries, invasive medical procedures, anesthesia, burns, poisoning, fetal distress and traumatic birth.

Accidents: falls, high impact accidents (including auto accidents), head injury, electrocution.

Suffocation: drowning, strangulation.

Attack: rape, war, bombings, physical abuse, mugging, molestation, physical injury, stabbing, gunshot wounds, animal attacks.

Natural and man made disasters: earthquakes, fires, tornadoes, floods, terrorism, dislocation from the natural world and community.

Horror: Seeing an accident (especially with blood, gore and dismemberment), watching someone else being abused, raped, killed or tortured.

Developmental: neglect, abandonment, loss and ongoing abuse.

Torture, repeated rape and systematic abuse”

Mindfulness Techniques:

Mindfulness techniques have increasingly been incorporated into the field of psychotherapy, and Dr. Warshow has enthusiastically studied and applied these practices in his own work. The Royal College of Psychiatrists offers these definitions of mindfulness:

'…facing the bare facts of experience, seeing each event as though occurring for the first time' (Goleman, 1988: p. 20)

'…keeping one's consciousness alive to the present reality' (Hanh, 1991: p. 11)

'…paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally' (Kabat¬Zinn, 1994: p. 4)

'…awareness of present experience with acceptance' (Germer, 2005: p. 7)

In Dr. Warshow's work, forming a therapeutic alliance to track the client's internal process moment to moment is a path to demonstrably effective therapy. He attempts to mobilize the client's will to sustain careful, compassionate, “here and now” attention to oneself as well as to the therapeutic relationship. Focusing on feelings, longings and cognitions typically cause a rise in some combination of anxiety, shame, guilt and defense. The good news is that these forces can be transcended through a combination of compassion for self and an expanded awareness of their many-faceted manifestations.  Dr. Warshow often recommends mindfulness practice and guided meditation tapes to his clients. He adheres to the idea that slowing down in the session often accelerates the results later down the road.

Gestalt Therapy:

Dr. Warshow sometimes utilizes Gestalt therapy for Post Traumatic Stress Disorder and anxiety. It allows self-exploration by means of enacting various parts of the self as they relate to a particular unresolved experience or relationship. He was introduced to Gestalt therapy for children by Violet Oaklander, who said in an interview with Rafal Mietkiewicz:

“It seemed very organic to me. Fritz Perls talked about the body and senses and all of that. I found that it fit my work with children and child development. And of course, over the years, I started using a lot of creative media, like drawing and clay and puppets and music, because that's the only way it would interest children. But behind that, the basis of my work was Gestalt therapy theory and philosophy. And I developed it more and more as time went by. That's how it got started.”

The following can be accessed at the Gestalt Therapy Page (http://www.gestalt.org/yontef.htm):

Fritz Perls …was influenced directly by Karen Horney and Wilhelm Reich, and indirectly by Otto Rank and others. Perls was especially influenced by Wilhelm Reich, who was Perls' analyst in the early 1930s, and "who first directed my attention to a most important aspect of psychosomatic medicine -- to the function of the motoric system as an armor."  Gestalt psychologists believe that organisms instinctively perceive whole patterns and not bits and pieces. Whole patterns have characteristics that cannot be gleaned by analyzing parts. Perception is an active process and not a result of passively received stimulation of sense organs. All situations are believed to possess inherent organization.

Organisms have the capacity for accurate perception when they use their native ability of immediate experience in the here and now. The task of phenomenological research and therapy is to utilize this capacity to gain insight into the structure of that which is being studied. Because people naturally perceive whole patterns as they occur, actual awareness can be trusted more than interpretation and dogma.

Behavior Modification:

Dr. Warshow uses Behavior Modification techniques to help AHD children and adolescents to become more motivated to change their behaviors and to complete tasks, both at home and at school. Behavioral techniques are one of the foundational principles if successful ADHD treatment.

The Encyclopedia of Mental Disorders states the following: “Behavior modification is used to treat a variety of problems in both adults and children. Behavior modification has been successfully used to treat obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), phobias, enuresis (bed-wetting), generalized anxiety disorder , and separation anxiety disorder, among others.

Behavior modification is based on the principles of operant conditioning, which were developed by American behaviorist B. F. Skinner (1904-1990). Skinner formulated the concept of operant conditioning, through which behavior could be shaped by reinforcement or lack of it. Skinner considered his concept applicable to a wide range of both human and animal behaviors and introduced operant conditioning to the general public in his 1938 book, The Behavior of Organisms.

One behavior modification technique that is widely used is positive reinforcement, which encourages certain behaviors through a system of rewards. In behavior therapy, it is common for the therapist to draw up a contract with the client establishing the terms of the reward system.”