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A Therapist's Handbook to Dissolve Shame and Defense: Master the Moment

The effort to surmount shame and formidable defenses in psychotherapy can trigger shame and self-doubt in therapists. Susan Warren Warshow offers a user-friendly-guide to help therapists move past common treatment barriers. This unique book avoids jargon and breaks down complex concepts into digestible elements for practical application. The core principles of Dynamic Emotional Focused Therapy (DEFT), a comprehensive treatment approach for demonstrable change, are illustrated with rich and abundant clinical vignettes. 

This engaging, often lyrical handbook emphasizes "shame-sensitivity" to create the safety necessary to achieve profound interpersonal connection. Often overlooked in treatment, shame can undermine the entire process. The author explains the "therapeutic transfer of compassion for self," a relational phenomenon that purposefully generates affective expression. She introduces a three-step, robust framework, The Healing Triad, to orient therapists to intervene effectively when the winds of resistance arise. Chapters clarify:

- Why we focus on feelings

- How to identify and move beyond shame and anxiety

- How to transform toxic guilt into reparative actions

- How to disarm defenses while avoiding ruptures

This book is essential reading for both advanced and newly practicing mental health practitioners striving to access the profound emotions in their clients for transformative change.


"The Dynamic Emotion Focused therapy of Susan Warshow spotlights advances in psychotherapy that bring new luster to the clinical work of both doyens and tyros. Clear, concise writing and illuminating transcripts sharpen the realization of practical principles. The author is an expert who will enliven the development of your expertise."

--Jeffrey K. Zeig, Ph.D., The Milton H. Erickson Foundation

"Doing psychotherapy is a paradox. All day, every day, you are with people. And yet, when it comes to helping your client in the moment, you are utterly alone. A Therapist’s Handbook to Dissolve Shame and Defense fills the void. Like a wise mentor, Susan Warren Warshow senses the challenges you will face and steps in with sage advice."

--Scott D. Miller, Ph.D., Director, International Center for Clinical Excellence

"If you are a therapist struggling personally and professionally in client sessions, read Susan Warren Warshow. She offers a practical guide with ample vignettes for clinicians who feel stuck yet have the courage to slow down and start making subtle, significant shifts to strengthen their skills." 

--Dr. Stan Tatkin, Psy.D., MFT, author of Wired for Love and We Do

"Every therapist faces the challenge of how to empathize with the wholeness of the patient: her longings, her anxiety, and the behaviors that prevent her from fulfilling her longings. In A Therapist’s Handbook to Dissolve Shame and Defense, Susan Warshow beautifully illustrates through numerous vignettes how to help patients face avoided feelings and move beyond anxiety and defenses that prevent them from pursuing their passions. For any therapist who wants to deepen their capacity for empathy, compassion, and deeper healing, this book is a must read."

--Jon Frederickson, MSW, faculty, Washington School of Psychiatry; Author of Co-Creating Change, The Lies We Tell Ourselves, and Co-Creating Safety: Healing the Fragile Client

"With wisdom and clarity, Susan Warshow provides key concepts to enable clinicians to work effectively with shame—both our own and that of our patients. Referring to shame as "the gatekeeper in therapy", she provides moving clinical vignettes to illustrate its powerful role in development, its relationship to anxiety, its protective signal function for survival. Rather than attacking shame, she teaches us how to guide patients in recognizing shame and to make use of the transformative power of compassion."

--Pamela J. McCrory, Ph.D., Licensed Psychologist PSY 12094; Assistant Clinical Professor, Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Co-Chair, Arts, Creativity and Culture Committee, Los Angeles County Psychological Association 

"Susan Warshow's book offers an essential contribution to psychotherapists and students in clinical settings, focusing on the centrality of shame in emotional suffering. She highlights psychotherapy elements that facilitate greater self-acceptance and social intimacy. Well-chosen client examples bring her conceptualizations to life and demonstrate the nuances of an attuned approach to working with shame and defense in psychotherapy. 

Her honest personal sharing accents the book in a thought-provoking way, and her astute insights are free of unnecessary jargon. A Therapist’s Handbook to Dissolve Shame and Defense amplifies that shame is a gateway to emotional integration. Many authors theorize about the meaning of compassion. However, this book demonstrates what this profoundly important phenomenon looks like in actual therapeutic encounters. A Therapist’s Handbook to Dissolve Shame and Defense speaks more to being present, gently challenging, and leaning into the shame experiences that emerge not only in the client but also in the therapist. How the therapist meets that difficult emotion is key, and the overall premise is that one cannot be present to the shame in another if one cannot face those experiences within oneself. Her gift to therapists is to encourage authenticity, and she has generously offered her own processes as the conduit for showing the way."

--Juliet Rohde-Brown, Ph.D.; Chair, Depth Psychology: Integrative Therapy and Healing Practices Specialization, Pacifica Graduate Institute; Licensed Clinical Psychologist

"Master the Moment: A Therapist’s Handbook to Dissolve Shame and Defense is clinical brilliance at its best.  Essential components of excellent therapeutic communication skills are expertly described here, and unpacked with useful true-to-life clinical examples.  Therapeutic exchanges highlight the use of effective thought empathy and feeling empathy, so essential for the therapeutic process, especially when interfacing with those who are exploring deeply hidden aspects of shame and remorse.     

Warshow demonstrates how she shares her own feelings in a caring, honest, supportive, and fruitful way.  Her many metaphorical examples underscore how the therapist can effectively nudge the client in assisting the change process while at the same time honoring and respecting the importance of gently and patiently moving forward at the client’s pace.  

A treasury of heartfelt approaches and interventions that transcend all theoretical schools of thought, this book is one that can be read over and over by both novice and seasoned professional alike, each time finding more value, and adding to ones ability to effectively master the clinical moment with skill, kindness, and warmth." 

--Karin S. Hart, Psy.D. Licensed Psychologist PSY16672, Former Assistant Clinical Professor

Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine

"Susan Warren Warshow’s book is a must read for every clinician! The author’s compassion shines through every page. Elegantly written in simple language, her personal style sinks under theory to reveal embodied exchanges within the nitty gritty of emotional healing. Warshow offers the wisdom and humility of a seasoned practitioner alongside the courage to reveal insecurities and vulnerabilities that inevitably emerge when working with deepest wounds to the self." 

--Terry Marks-Tarlow, Ph.D.; Private practice in Santa Monica, California; Conducts workshops and trainings internationally; Author of A Fractal Epistemology for a Scientific Psychology (2020, Cambridge Scholars), Play & Creativity in Psychotherapy (2017), Awakening Clinical Intuition (2014, Norton), and Clinical Intuition in Psychotherapy (2012, Norton)


"Susan Warren Warshow has written a valuable book to guide therapists deeper into the life-changing alliance with their clients that fosters enthusiasm and real growth for both participants. Covering all the important bases of resistance, anxiety, guilt, shame, and especially compassion, Warshow offers detailed process descriptions of her Dynamic Emotion Focused Therapy (DEFT), providing succinct in-session transcripts of meaningful therapeutic exchanges and outcomes. A Therapist’s Handbook to Dissolve Shame and Defense is an inspiring book to read, to reflect on, and to savor the warmth and wisdom emanating from each page."

--Stella Resnick, Ph.D.; Author of Body-to-Body Intimacy: Transformation through Love, Sex, and Neurobiology (2019); Creator of the Embodied Relational Sex Therapy (ERST) training

PESI UK Blog Posts:

Therapist Shame: How to Recognize & Reduce It

10 Ways to Orient Clients Toward Unconscious Feelings

Susan's Journal articles:

The Ad Hoc Bulletin of Short-Term Dynamic therapy: Practice and Theory

1) Treatment of a self-defiling, recovering alcoholic with an avoidant personality. Volume 6, Number 1, September 2002

2) “Even Strangers Loved Me Better.” Treatment of a severely fragile, traumatized patient. Volume 7, Number 1, April 2003, P.5.

3) “The Suicidal Baby: Kangaroo Dreams Reveal a Haunted Childhood .” Using STDP in dream work with a highly anxious patient. Volume 8, Number 2 , July 2004, P. 5.

4) “Slaying the Serpent of Shame.” Treatment of a chronically depressed, anxious patient. Volume 11, Number 3  December 2007, Page 6.

5) “The Impact of Hope in Defeating Resistance.” Treatment of a chronically depressed and defeated man. September, 2010.

Books For Therapists:

Allostasis, Homeostasis, and the Costs of Physiological Adaptation

by Jay Schulkin

2004, Cambridge University Press

The Archaeology of Mind: Neuroevolutionary Origins of Human Emotions

by Jaak Panksepp and Lucy Biven

2012, Norton Series on Interpersonal Neurobiology

Bodily Changes in Pain, Hunger, Fear and Rage

by Walter Bradford Cannon

1915, D. Appleton and Company

Changing Character: Short-term Anxiety-regulating Psychotherapy For

Restructuring Defenses, Affects, And Attachment

by Leigh McCullough, Ph.D.  

1997, Basic Books

Clinical Intuition in Psychotherapy: The Neurobiology of Embodied Response

by Terry Marks-Tarlow

2012, Norton Series on Interpersonal Neurobiology

Co-Creating Change: Effective Dynamic Therapy Techniques

by Jon Frederickson

2013, Seven Leaves Press

The Lies We Tell Ourselves: How to Face the Truth, Accept Yourself, and Create a Better Life

by Jon Frederickson

2017, Seven Leaves Press

Co-Creating Safety: Healing the Fragile Client

by Jon Frederickson

2015, Seven Leaves Press

Evolution, Early Experience and Human Development:

From Research to Practice and Policy  

Edited by Darcia Narvaez, Jaak Panksepp, Allan N. Schore, Tracy R. Gleason

2013, Oxford University Press

Healing Trauma: Attachment, Mind, Body and Brain

Edited by Marion Solomon and Daniel J. Siegel

2003, W.W. Norton & Co Inc

I and Thou

by Martin Buber

1958, Charles Scribner's Sons

Intensive Short-Term Dynamic Psychotherapy: Theory and Technique

by Patricia Coughlin Della Selva, Ph.D.

1996 (Reprinted 2004, 2006), Karnac Books Ltd.

Intensive Short-Term Dynamic Psychotherapy,

Selected Papers of Habib Davanloo, MD

2001, Wiley and Sons

Lives Transformed

by David Malan and Patricia Coughlin

2006, Karnac Books Ltd

The Making and Breaking of Affectional Bonds

by John Bowlby

1979, Tavistock Publications Ltd

The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being

by Daniel J. Siegel

2007, W.W. Norton & Co

Opening Up: The Healing Power of Expressing Emotions

by James W. Pennebaker

1997, The Guilford Press

Persuasion and Healing: A Comparative Study of Psychotherapy

by Jerome D. Frank and Julia B. Frank

1960, Johns Hopkins University Press

The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation  

By Stephen W. Porges

2011, Norton Series on Interpersonal Neurobiology

The Science of the Art of Psychotherapy

by Allan N. Schore

2012, Norton Series on Interpersonal Neurobiology

Self Comes to Mind: Constructing the Conscious Brain

by Antonio R. Damasio

2012, Vintage Books

Self Compassion: Stop Beating Yourself Up and Leave Insecurity Behind

By Dr. Kristin Neff Ph.D.

2011, HarperCollins

Short Term Therapy for Long Term Change

with Marion Solomon, Ph.D., Robert Neborsky, M.D., Leigh McCullough, Ph.D.,

Michael Alpert, MD, Francine Shapiro, Ph.D., and David Malan, D.M., FRCPsych

2004, W.W. Norton & Co Inc

Theory and Practice of Experiential Dynamic Psychotherapy

Edited by Ferruccio Osimo, Mark J. Stein

2012, Karnac Bookd Ltd

The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment

by Babette Rothschild

2000, W.W. Norton & Co.

Through Paediatrics to Psycho-Analysis: Collected Papers of D. W. Winnicott

1992, Brunner Routledge

Treating Affect Phobia: A Manual for Short-Term Dynamic Psychotherapy

by Leigh McCullough, Nat Kuhn MD Phd, Stuart Andrews and Amelia Kaplan

2003, Guilford Press

The Transforming Power of Affect: A Model for Accelerated Change

by Diana Fosha, Ph.D

2000, Basic Books

Unlocking the Unconscious

by Habib Davanloo, MD

1995, Wiley and Sons

Books For Clients (and therapists too):

Emotional Medicine Rx: Cry When You're Sad, Stop When You're Done, Feel Good Fast

by Penelope Young Andrade, LCSW

2011 Tenacity Press

Living Like You Mean It: Use the Wisdom and Power of Your Emotions to Get the Life You Really Want

by Ronald J Frederick, Ph.D.

2009 Jossey-Bass (A Wiley Imprint)

Emotion Focused Workbook: A Companion To Experiential Dynamic Psychotherapy

by Bridget Quebodeaux