What Therapists Don't Talk About and Why

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What Therapists Don't Talk About and Why:

Understanding Taboos That Hurt Us and Our Clients

by Kenneth S. Pope, Ph.D., ABPP,

& Beverly Greene, Ph.D., ABPP

Publisher: American Psychological Association, 2006

Below are endorsements, ordering information, & about the authors

"This book is a must read for any psychotherapist. It explores the real world and often secret problems encountered in clinical practice in a creative, personal and very useful fashion. In this world of increasing professional accountability and liability, clinicians can be assured that their practices will be much better off for having implemented the common sense suggestions made by the authors."
Jeffrey N. Younggren, Ph.D., ABPP
Risk Management Consultant
American Psychological Association Insurance Trust

"The most practical book on boundaries and ethics I have read in any language. Used as a text one could avoid doing syllabus for an advanced course in professional practice issues. Nothing available in the professional literature can match this contribution by three leaders in the field who have provide a virtual cornucopia of useful guidance about so many vital things which are rarely discussed."
Gary R. Schoener, Licensed Psychologist
Executive Director Walk-In Counseling Center

"It is essentially a superb text about the practice of psychotherapy, with all its unexpected twists, turns, and difficulties for therapists and patients. From its excellent short courses on logical and ethical fallacies, to its astonishing variety of intensely provocative case examples with self-assessment questions, to its steamy discussions of therapists' sexual feelings, the book illuminates, in a non-threatening, conversational tone, the previously-avoided dimensions of the therapeutic endeavor. It belongs on the shelf of any therapist willing to learn or think critically about psychotherapy; it may also save one from a lot of frustration and heartbreak in the work."
Thomas G. Gutheil, MD
Professor of Psychiatry
Harvard Medical School

"What Therapists Don't Talk About and Why is an engagingly written compendium of really fascinating questions and issues that have been avoided by directors of training programs. Pope, Sonne, and Greene manage to tackle thorny issues with good humor and modesty, and without the usual solemnity that stifles honest discussion."
Stephen J. Ceci
The Helen L. Carr Professor of Developmental Psychology, Cornell University
Recipient of APA Lifetime Award for Contribution to Application of Scientific Psychology

"A gift to all of us who teach the ethics of psychological practice."
Celia B. Fisher, Ph.D.
Director, Center for Ethics Education; Mary Wood Doty Professor of Psychology; Fordham University

" This is a very brave book. Provocative without being proscriptive, it is a must-read for all practicing clinicians and would make a superb supplemental text for graduate courses in ethics. The cases alone are well worth the price of the book!"
Ruth E. Fassinger, Ph.D., Professor, Counseling Psychology, University of Maryland, College Park

" Reading this book is like having a conversation with an old, wise friend. Finally, a talk about taboo topics in therapy with answers to unasked questions."
Bonnie R. Strickland, Ph.D., ABPP, Professor Emeritus of Psychology, University of Massachusetts;
former President of the American Psychological Association

"The silent topics in therapy roar like thunder throughout this book. Commitment to providing quality therapy includes addressing such issues. It is a challenging and yet refreshingly honest book -- a must read."
Jessica Henderson Daniel, PhD, ABPP; Children's Hospital, Boston

"Bravi!! This second edition is an indispensable survival guide to help us to recognize and respond to our unacknowledged taboos, secrets, and uncomfortable feelings as therapists. Written by leading scholars in the field, this book simultaneously raised my anxiety and provided me viable methods to relieve it.... This is an essential book for every clinician--from trainees to seasoned practitioners. It will be valuable to instructors, supervisors and study groups as well as therapists in practice."
Linda Garnets, Ph.D.
UCLA, Psychology Department

" Engaging, accessible, and gentle in tone, this book boldly addresses a number of topics that are often ignored in the training and professional development of psychologists. Its provocative observations and questions, sensitive analysis of ethical and professional problems, and practical recommendations for trainees and supervisors dealing with a range of 'taboo topics' makes it a unique resource."
Virginia Gutman, Ph.D.
Professor and Chair, Department of Psychology
Gallaudet University

"A superb contribution, *What Therapists Dont Talk About And Why* masterfully addresses uncomfortable topics among psychotherapists. This comprehensive second edition takes the reader into a much-needed journey of exploration, discovery and learning. A powerful book, I strongly recommend it to all psychotherapists, both seasoned as well as trainees."
Lillian Comas-Diaz, Ph.D., Clinical Professor
Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine

"This fine book does not tell the reader what to do, but what to think about. It is one of those rare books that will be equally useful
and valuable to graduate students and practicing professionals."
George Stricker, Ph.D., American School of Professional Psychology, Argosy University/Washington DC

" *What Therapist Don't Talk About and Why* is simply excellent: helpful, thoughtful, brave, entertaining, and so very "experience-near."
Barry A. Farber, Ph.D.
Professor; Director of Clinical Training
Clinical Psychology Program, Teachers College, Columbia University

"An excellent resource for all mental health professionals and their trainees to examine issues that are rarely discussed in graduate programs. This book should be required reading in any ethics or professional issues seminar."
Emil Rodolfa, Ph.D.
Director, University of California, Davis Counseling and Psychological Services
Former Chair, Association of Psychology Postdoctoral and Internship Centers
Former President, State of California Board of Psychology

"This is an enormously essential book addressing often ignored client therapist issues, e.g., a therapists disclosure of his/her sexual orientation, fear of a violent client, a clients culture and hygiene, and needs for a handicapped accessible office. Both the novice and seasoned practitioner will benefit from its matter-of-fact approach as a quasi-ethical guide for enhancing appropriate service delivery and therapeutic practice."
A. Toy Caldwell-Colbert, Ph.D., ABPP
Vice Chair for Psychological Services & Professor of Psychiatry, Department of Psychiatry, Howard University College of Medicine, Howard University Hospital

"This thoughtful and timely book continues in the clinical tradition of 'know thyself' extending from Socrates to Freud. Essential both for those learning and teaching psychotherapy this book contains helpful insights and illuminating empirical data. Beautifully written it is not only likely to become required reading for mental health professionals but also likely to find a welcome home on any educated patient's bookshelf."
Harold J. Bursztajn, M.D.
co-Director
Harvard Medical School Program in Psychiatry and the Law

"This book is about those difficult, or even impossible, dilemmas and quandaries of psychotherapy--the double-binds and provocations with which our patients unexpectedly confront us. The authors gather anecdotes and scenarios from the widest spectrum of theoretical orientations and professional (or unprofessional) settings. It is an invaluable book that presents psychotherapy practice and ethics as a set of remarkably interesting questions with no easy answers."
Martin H. Williams, Ph.D.
Clinical and Forensic Psychologist

"Pope, Sonne, and Greene have written a practical, thought-provoking, and comprehensive guide to exploring the sensitive issues embedded in mental health practice. They approach this content with fearlessness, humor, and wisdom, challenging professionals to explore the real impact of our values, assumptions, and personal interests on our clients. This book is a uniquely valuable resource for faculty and clinicians committed to responsible practice."
Elizabeth Reynolds Welfel, Ph.D.
Professor, Cleveland State University

"More than a thought-provoking resource of useful reminders, valuable insights, and critical questions, this is a book that invites its readers to learn by doing; and guides them through the experience. Those who take up the challenge will find themselves richly rewarded, both professionally and personally. I know that I was."
Dr. Douglas Saunders,
President, Ontario Psychological Association
Assistant Professor, Faculty of Medicine,
Dept of Public Health Sciences, University of Toronto

" From the myths that need to be challenged, the taboos about therapists talking to consultants about the feelings that make them uncomfortable, and the embarrassing moments that are most challenging, Ken Pope and his team of Janet Sonne and Beverly Greene update the 1993 book with new scenarios to use as a guide. Every therapist who practices ethical interventions will want to learn the questions that are suggested to ask themselves about how to handle a whole range of difficult client issues.... This book is MUST reading and should be on every therapists desk."
Lenore E. Walker, Ed.D., ABPP
Diplomate in Clinical & Family Psychology Professor, Nova Southeastern University Center for Psychological Studies

"The authors roll back the carpet and help us look at what we've swept under it.... The book is a significant advance because it goes beyond the 'just don'ts' and helps us to understand what is personally challenging and learn what to do about it. This volume will be helpful for students and practitioners alike and would extremely valuable in peer supervision groups. Ethics educators rack their brains for ways to help improve our ethical behavior; this one goes in the tool box."
Michael C. Gottlieb, Ph.D., ABPP, Independent Practice

"Pope, Sonne, and Greene have nicely outlined a host of issues that can arise in therapy but that trainees may be reluctant to bring up in supervision, and more seasoned therapists may be reluctant to admit to their colleagues or even to themselves. They discuss reasons for our failure to discuss these issues, while noting their importance in rendering care for our patients and in taking care of ourselves; and they provide a framework to begin addressing the issues before they arise in therapy."
David J. Martin, Ph.D.
Chief Psychologist, Director of Training
Director, HIV Mental Health Services
Department of Psychiatry
Harbor-UCLA Medical Center

"This book challenges us to consider those most uncomfortable situations, as its question focused vignettes ask us to deeply self-reflect upon taboo topics. Dostoevsky, who opined that each person has ideas they hide even from themself, would be proud of this tome's efforts to expose us to our own inner secrets and fears. A great thought piece for professionals of all experience levels."
Ed Lundeen, Ph.D. Private Practice
Editor -- Independent Practitioner

" What Therapists Dont Talk About and Why should be required reading for both novice and expert clinicians. Drawing upon the empirical literature and examples from clinical practice, this practical text challenges psychotherapists to consider issues that are often avoided and encourages honest reflection on the personal factors influencing the conduct of psychotherapy."
Edward Shafranske, Ph.D., ABPP, Professor and Director of the Doctoral Program in Clinical Psychology, Pepperdine University

"This is an excellent primer for experienced and novices alike. This book is very readable, enjoyable, and a breath of fresh air in a field with many secrets. There is no other book like it! A delight to read."
John D. Robinson, EdD, MPH, ABPP, Professor of Psychiatry and Surgery, Howard University College of Medicine/Hospital

"This book will be indispensable for supervisors and for practitioners alike. I can hardly wait to use it as a tool in supervision training."
Carol Falender, Ph.D.
Independent Practice;
Clinical Professor, Department of Psychology
University of California, Lost Angeles

"Convincingly and readably, the authors show therapists how to confront their own demons of fear, anger, guilt, shame, embarrassment, prejudice, sexual arousal, immobilization, and helplessness that can arise in the therapeutic encounter and threaten to derail the process. A how-to book of extraordinary utility."
Elaine B. Pinderhughes
Emerita Professor, Boston College, Graduate School, Social Work

"This is one of those 'wish I could have read it my first day in grad school' books. The topics this volume covers are the forbidden ones that every therapist struggles with; reading this book is like having a wise, compassionate, thoughtful teacher and consultant who gets you to think and feel, critically and deeply, about the strange human thing we call psychotherapy. I'll be recommending it to my students and colleagues."
Laura S. Brown, Ph.D. ABPP; Independent Practice

"Psychotherapy is the most human of disciplines, so therapists must deal with their own humanity and its foibles if they are to be optimally helpful. Pope and colleagues successfully utilize the Socratic method to stimulate thought about feelings, and help therapists to feel better about their thoughts. They challenge common myth-understandings about taboo topics and prescribe open self-examination and honest communication. This is a useful guide to often unexplored and dangerous territory."
David Spiegel, M.D.
Willson Professor and Associate Chair of Psychiatry & Behavioral Sciences
Stanford University School of Medicine
President, American College of Psychiatrists

Ordering Information:

Hardcover ISBN: ISBN 1-59147-411-6

Paperback ISBN: ISBN 1-59147-401-9

Publisher: American Psychological Association

Please follow this link to order online from the American Psychological Association book department.

To order by phone: call 1-800-374-2721 (in DC 202-336-5510). TDD/TTY 202-336-6123. Fax 202-336-5502. Please identify yourself as an Internet user.

Orders from the United Kingdom, Europe, Africa, or the Middle East should be sent to American Psychological Association, 3 Henrietta Street, Covent Garden, London, WC2E 8LU, England. Call +44 (0) 207-240-0856 (please identify yourself as an Internet user). Free Phone 0-800-526-830 (U.K. only Fax +44 (0) 207-379-0609).

E-mail for more information: order@apa.org

About the authors:

Ken Pope, Ph.D., ABPP

Janet Sonne, Ph.D. is a licensed psychologist in independent clinical and forensic practice in Redlands, California. She received her BA in psychology from Stanford University and her Ph.D. in clinical psychology from UCLA. She recently retired from her position as professor of Psychology at Loma Linda University where she served as Director of Clinical training for Ph.D. graduate students in psychology. She is former chair and member of the California Psychological Association Ethics Committee. She also served twice as a member of the American Psychological Association Ethics Committee. She is an expert consultant to the California Board of Psychology, Board of Behavioral Science Examiners, and Board of Nursing, as well as to attorneys and religious organizations, regarding professional standard of care and competency issues, and perpetration and sequelae of childhood sexual abuse.

She is the author of several publications on the topic of therapist-patient relationships, including the book co-authored with Drs. Ken Pope and Jean Holroyd entitled Sexual Feelings in Psychotherapy: Explorations for Therapists and Therapists in Training. In 2007, her article "Nonsexual Multiple Relationships: A Practical Decision-Making Model For Clinicians" received the American Psychological Association Division 42 Award for Best CE article in The Independent Practitioner.

Dr. Sonne's interest in the intricacies of the ethical practice of psychotherapy began at Stanford in her first psychology course. Dr. Phil Zimbardo taught the course and ignited her fascination with how people make decisions to behave in altruistic vs. self-serving ways towards others. While at UCLA, she participated with Dr. Pope and Dr. Jackie Bouhoutsos in the Post Therapy Support Group project, an innovative group therapy program for individuals who experienced sexual intimacies with their therapists. Observing first hand the complex underlying dynamics and powerfully negative effects of such experiences fanned Dr. Sonne's dedication to research and intervention with the patients as well as with the therapist perpetrators. Her experiences on the California Psychological Association and the American Psychological Association Ethics Committees, and various professional licensing boards enhanced her appreciation of the importance of training mental health professionals to conceptualize ethical practice as a process of decision-making rather than a set of rules. As she and Drs. Pope and Holroyd discussed in their book, Sexual Feelings in Psychotherapy, a significant component of that process is the therapist's own reactions to the patient, even though some of those feelings are likely to be experienced as taboo for acknowledgement and exploration. This second edition is designed to expand discussion of the therapist's taboo reactions to patients beyond sexual feelings.

Beverly Greene, PhD, ABPP is a Professor of Psychology at St. John's University in Jamaica, New York and a practicing clinical psychologist in Independent Practice in Brooklyn, New York. In honor of outstanding and significant contributions to psychology she is a Fellow of the American Psychological Association divisions 9,12, 29, 35, 42, 44, & 45, the Academy of Clinical Psychology and the American Orthopsychiatric Association. Dr. Greene holds a Diplomate in Clinical Psychology from the American Board of Professional Psychology and is licensed as a Psychologist in New York and New Jersey.

Dr. Greene received her Bachelors degree in Psychology from New York University where she was a member of NYU's first group of Martin Luther King Scholars. She completed her Masters and Doctor of Philosophy degrees in Clinical Psychology at the Derner Institute of Advanced Psychological Studies of Adelphi University in Garden City, New York. She has served as a School Psychologist with the New York City Board of Education; as a Clinical Assistant Professor of Psychiatry and Director of Inpatient Child & Adolescent Psychology at King's County Hospital's Inpatient Child & Adolescent Psychiatry service in Brooklyn, New York. She has also served as a Supervising Psychologist and Clinical Assistant Professor of Child Psychiatry at the University of Medicine and Dentistry's Community Mental Health Center in Newark, NJ. After a decade of work in public mental health Dr. Greene joined the faculty of St. John's University in 1991 as a Clinical Associate Professor. In 1995 she was granted tenure and promoted to the rank of Full Professor.

Dr. Greene has served in many leadership roles in APA governance including membership on the 2000 Textbook Guidelines Initiatives Workgroup; the 2005 Presidential Task Force on Enhancing Diversity in APA; the 2004 Same Sex Marriage Work Group, responsible for drafting APA policy on same sex marriage & families, and the 2005 Presidential Working Group on Prejudice and Discrimination among others. An Executive Board Member in the Society for the Psychology of Women and the Society for the Psychological Study of Lesbian, Gay & Bisexual Issues, she has also served on committees and task forces within those divisions. She has served as Chair of Div 35's Fellows committee and is current chair of Division 42's Fellows Committee. A member of APA's Committee on Lesbian, Gay and Bisexual Concerns, she was recently elected a Division 42 (Independent Practice) representative to the APA Council of Representatives. She is a member of the Board of Directors of the Center for Lesbian and Gay Interdisciplinary Studies of the City University of New York, and a consultant on Buendia Video Productions 2004 documentary on Psychotherapy with Lesbians and Gay Men.

Dr. Greene serves on the editorial and advisory boards of numerous scholarly journals. She was a founding co-editor of the APA Society for the Psychological Study of Lesbian, Gay and Bisexual Issues Series, Psychological Perspectives on Lesbian, Gay and Bisexual Issues, and is the sole editor of series volume 3, Ethnic and cultural diversity among lesbians and gay men. The author of over 75 professional publications, she has received 9 national awards for publications deemed outstanding and significant scholarly contributions to the psychological literature. She is the recipient of the Association for Women in Psychology's 1991, 1995 and 2000 Women of Color Psychologies Award for publications considered significant contributions to the development of greater understandings of the psychologies of women of color. Dr. Greene has also received that associations' Distinguished Publication Award in 1995 (Women of Color: Integrating Ethnic & Gender Identities in Psychotherapy) and 2001(Psychotherapy with African American Women: Innovations in Psychodynamic Perspectives and Practice) for significant and substantial scholarly contributions of research and theory that advances our understanding of the psychology of women. She has also received the APA Society for the Psychology of Women's Psychotherapy with Women Research Award in 1995 and 1996. In 2000 two of her papers tied for this award which is given annually for a paper judged on the basis of scholastic vigor, clinical impact, theoretical creativity and innovation, methodological skill, clarity and style of presentation in addition to the judged importance to psychotherapy with women. The winning paper is recognized as a substantial and outstanding scholarly contribution to the theory, practice and research of psychotherapy with women and as innovative work that advances skills in the psychotherapeutic work with women.

Dr. Greene has been honored by the Georgia State Psychological Association in 2000 for Outstanding Contributions to research on human sexual orientation and by the Feminist Therapy Institute with its 2002 Founding Foremothers award for outstanding contributions to the development of feminist psychology and psychotherapy theory.

In addition to awards for publications she has received the APA Society for Clinical Psychology's 2000 MENTOR award for outstanding contributions and commitment to the teaching and training of clinical psychologists to more effectively deliver services to ethnic minority populations, and its 2000 Psychology of Women mentor award for a psychologist who substantially aids women in clinical psychology to succeed at critical periods in their careers.

Dr. Greene has received numerous awards for distinguished Senior career contributions. In 1996 she received the Outstanding Leadership Citation from APA's Committee on Lesbian, Gay and Bisexual Concerns, citing her "elegant and groundbreaking research on mental health issues of African American lesbians" and longstanding education and training that eases the burdens of stigma, stereotype and ignorance for sexual minorities and people of color. In 2000 she was honored with the APA Society for the Psychology of Women's Heritage award for "impressive and substantial scholarly contributions to the psychological literature highlighting critical issues on the psychology of women, on underrepresented groups of women, and in recognition of creative and innovative publications on the links between gender, ethnicity, and sexual orientation that serve to advance the understanding of the psychology of women. In 2003 she received the APA Committee on Women in Psychology's Distinguished Leadership Award for her longstanding career influence on women's issues and status, recognition as a leader whose contributions and scope of influence advances knowledge, fosters understanding of women's lives and improves the status of women and underrepresented subpopulations of women in psychology and in society. Specifically cited were her "profound and far reaching contributions to psychological theory and practice relating to women, giving voice to the invisible and unheard."
Recent honors include the 2004 Distinguished Senior Career Contributions to Ethnic Minority Research Award sponsored by the APA Society for the Psychological Study of Ethnic Minority Issues(Division 45) in recognition of a senior person who has made significant contributions in writing, publishing and disseminating information on ethnic minority populations and issues and thereby substantively contributing to the current understanding of ethnic minorities. The 2005 recipient of the APA Society for Clinical Psychology's (Division 12) Stanley Sue Award for Distinguished Professional Contributions to Diversity in Clinical Psychology citing remarkable contributions to the understanding of human diversity and whose contributions have significant promise for bettering the human condition, overcoming prejudice and enhancing the quality of life for humankind. She is also the recipient of the Teachers College, Columbia University 2006 Cross Cultural Roundtable's 16th Annual Janet Helms Award for Scholarship and Mentoring and the 2006 recipient of the Florence Halpern Award for Distinguished Contributions to Clinical Psychology. The Halpern award recognizes psychologists who have made distinguished advances in psychology leading to the understanding or amelioration of important practical problems and who have made outstanding contributions to the general profession of clinical psychology and is sponsored by the APA Society for Clinical Psychology(Division 12). Current projects include a collection of narratives, A Minyan of Women: Family dynamics, Jewish identities and psychotherapy practice; a text, Teaching Cultural Competence in Mental Health: A Handbook for Instructors(NYU Press) and Phenomenal Women: Psychological Vulnerability and Resilience Among High Achieving Black Women.

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What Therapists Don't Talk About and Why: Understanding Taboos That Hurt Us and Our Clients