Got Therapy?

There's a rule in psychoanalytic thought that comes before technique: you have to survive the patient. It doesn't mean enduring the hour. It means staying able to think while the person in front of you genuinely lands on you — because in most clinical traditions, being affected isn't the interference. It's the information.

Michael Baltimore and Dan Rose work through the euthymic window and why we're built to leave it, Fonagy's marking, Bion's oscillation between Ps and D, and the analytic third. Along the way: what a person's taste in movies tells you about how they fall apart, the two failure modes of a therapist who doesn't survive, and whether any of this can be taught to someone who didn't arrive with it.

Then they turn it around — because the patient has to survive the therapist too, and nobody hands them a manual on the way in.

Got Therapy? makes complex psychological concepts accessible and practically applicable. New episodes weekly.

00:00  Cold open (4th of July)

02:00  Self-esteem as accepting your complexity

03:30  Not-me states — Sullivan, Bromberg, and George Costanza

07:00  Self-compassion and giving yourself a break

09:00  Rigidity vs. flexibility — the stick that bends

10:00  Normative narcissism, Kohut, and the Porsche 911

15:00  Microtrauma and social comparison

18:00  Ethical codes and holding your neighbor

24:00  Ideology, the real, and conflict "all the way down"

27:00  Narcissism on a spectrum; the "phallic" type

30:00  Mirroring and validation in therapy

41:00  Countertransference and owning what's in you

45:00  Self-esteem, validation, and the classroom

49:00  Internalizing the therapeutic moment

51:00  Having vs. being — Fromm, and "cultivate life"

When does therapy actually begin? Not at the first intervention — maybe not even at the first session. In this conversation we work through the opening pages of Good Therapy: The Process and the Journey and land on the things that rarely make it into a treatment manual: the nonspecific factors, the waiting-room greeting, the projection a client brings before they've met you.

At the center is what one of us calls the music of therapy — the idea that the same words carry entirely different meaning depending on how they're played. "I love you" through gritted teeth isn't the same sentence. A confrontation delivered well opens something; delivered badly it wounds.

We also get into unconditional positive regard as a verb rather than a posture, the co-created nature of every therapeutic moment, and why every model — ours included — is a cookie cutter that leaves something out. As one of us puts it: to explain everything is to explain nothing.

Plus a teaching assignment that stumped graduate students for years: watch your own tapes and tell me when therapy happened.

Got Therapy? makes complex psychological concepts accessible and practically applicable. New episodes weekly.

00:00  Cold open (4th of July)

02:00  Self-esteem as accepting your complexity

03:30  Not-me states — Sullivan, Bromberg, and George Costanza

07:00  Self-compassion and giving yourself a break

09:00  Rigidity vs. flexibility — the stick that bends

10:00  Normative narcissism, Kohut, and the Porsche 911

15:00  Microtrauma and social comparison

18:00  Ethical codes and holding your neighbor

24:00  Ideology, the real, and conflict "all the way down"

27:00  Narcissism on a spectrum; the "phallic" type

30:00  Mirroring and validation in therapy

41:00  Countertransference and owning what's in you

45:00  Self-esteem, validation, and the classroom

49:00  Internalizing the therapeutic moment

51:00  Having vs. being — Fromm, and "cultivate life"

What makes therapy work — before any technique? In Episode 82, Dr. Michael Baltimore and Dr. Dan Rose start drafting the opening chapter of a book on good therapy and land on a bigger question: what does a good therapist actually do beneath the manual?

Dan calls it the "music of therapy" — the nonspecific, relational factors that carry any intervention's real effect. Together they trace how therapy begins before the first word (proto-transference), how the same sentence can open a person up or shut them down, how confrontation becomes an invitation rather than an attack, and why "unconditional positive regard" may work better as a verb than a noun.

A conversation for clinicians, students, and anyone curious about how change really happens in the room.

Chapters: 00:00 Cold open 02:29 The cookie-cutter problem 05:00 What manualized treatment leaves out 08:00 The music of therapy — common factors 11:11 When does therapy begin? Proto-transference 14:08 The unconscious & the "unthought known" 17:00 Co-creation and the free-jazz model 19:26 The corrective emotional experience 20:56 The music behind the words 30:11 Relationship as the oxygen 36:09 From Pokémon to the real problem 39:08 Binocular vision & powerlessness 42:36 Setting the stage — a cure through love 44:36 Unconditional positive regard: noun to verb 48:37 Closing & sign-off

Got Therapy? — a conversation about the mind, the relationship, and the work of change, with Dr. Michael Baltimore and Dr. Dan Rose. New episodes regularly; subscribe to follow along.

Got Therapy? makes complex psychological concepts accessible and practically applicable. New episodes weekly.

00:00  Cold open (4th of July)

02:00  Self-esteem as accepting your complexity

03:30  Not-me states — Sullivan, Bromberg, and George Costanza

07:00  Self-compassion and giving yourself a break

09:00  Rigidity vs. flexibility — the stick that bends

10:00  Normative narcissism, Kohut, and the Porsche 911

15:00  Microtrauma and social comparison

18:00  Ethical codes and holding your neighbor

24:00  Ideology, the real, and conflict "all the way down"

27:00  Narcissism on a spectrum; the "phallic" type

30:00  Mirroring and validation in therapy

41:00  Countertransference and owning what's in you

45:00  Self-esteem, validation, and the classroom

49:00  Internalizing the therapeutic moment

51:00  Having vs. being — Fromm, and "cultivate life"

What happens to the people who come home from the worst experiences of their lives — and never truly arrive?

In Episode 81, Dr. Michael Baltimore and Dr. Dan Rose use Christopher Nolan's take on Homer's Odyssey as a lens on trauma, PTSD, shame, and the long road back home. It becomes an hour on containment, on why what we can't put into words we're doomed to put into action, on the risk of pushing healing too fast, and on what post-traumatic growth actually looks like when you refuse to romanticize the wound.

Two clinicians thinking out loud about integrating the hardest things we carry.

Chapters:
00:00 — Being heard vs. being fixed (containment)
04:30 — Nolan's Odyssey and the reveal that rewrites the story
08:18 — Coming home from war, but not arriving
14:11 — Calypso as the therapist on the island
25:33 — If you can't say it, you'll act it out
32:31 — PTSD: the event, the processing, the trigger
36:27 — Do no harm: the risk of moving too fast
37:58 — Post-traumatic growth
46:52 — Reaction vs. response
57:17 — What good therapy begins with

Got Therapy? is a production of Midland Studios. Nothing in this episode is a substitute for individual therapy — if any of these themes land close to home, please reach out to a licensed clinician.

Hosts: Dr. Michael Baltimore & Dr. Dan Rose

Got Therapy? makes complex psychological concepts accessible and practically applicable. New episodes weekly.

00:00  Cold open (4th of July)

02:00  Self-esteem as accepting your complexity

03:30  Not-me states — Sullivan, Bromberg, and George Costanza

07:00  Self-compassion and giving yourself a break

09:00  Rigidity vs. flexibility — the stick that bends

10:00  Normative narcissism, Kohut, and the Porsche 911

15:00  Microtrauma and social comparison

18:00  Ethical codes and holding your neighbor

24:00  Ideology, the real, and conflict "all the way down"

27:00  Narcissism on a spectrum; the "phallic" type

30:00  Mirroring and validation in therapy

41:00  Countertransference and owning what's in you

45:00  Self-esteem, validation, and the classroom

49:00  Internalizing the therapeutic moment

51:00  Having vs. being — Fromm, and "cultivate life"

What happens to the people who come home from the worst experiences of their lives — and never truly arrive?

In Episode 81, Dr. Michael Baltimore and Dr. Dan Rose use Christopher Nolan's take on Homer's Odyssey as a lens on trauma, PTSD, shame, and the long road back home. It becomes an hour on containment, on why what we can't put into words we're doomed to put into action, on the risk of pushing healing too fast, and on what post-traumatic growth actually looks like when you refuse to romanticize the wound.

Two clinicians thinking out loud about integrating the hardest things we carry.

Chapters:
00:00 — Being heard vs. being fixed (containment)
04:30 — Nolan's Odyssey and the reveal that rewrites the story
08:18 — Coming home from war, but not arriving
14:11 — Calypso as the therapist on the island
25:33 — If you can't say it, you'll act it out
32:31 — PTSD: the event, the processing, the trigger
36:27 — Do no harm: the risk of moving too fast
37:58 — Post-traumatic growth
46:52 — Reaction vs. response
57:17 — What good therapy begins with

Got Therapy? is a production of Midland Studios. Nothing in this episode is a substitute for individual therapy — if any of these themes land close to home, please reach out to a licensed clinician.

Hosts: Dr. Michael Baltimore & Dr. Dan Rose

Got Therapy? makes complex psychological concepts accessible and practically applicable. New episodes weekly.

00:00  Cold open (4th of July)

02:00  Self-esteem as accepting your complexity

03:30  Not-me states — Sullivan, Bromberg, and George Costanza

07:00  Self-compassion and giving yourself a break

09:00  Rigidity vs. flexibility — the stick that bends

10:00  Normative narcissism, Kohut, and the Porsche 911

15:00  Microtrauma and social comparison

18:00  Ethical codes and holding your neighbor

24:00  Ideology, the real, and conflict "all the way down"

27:00  Narcissism on a spectrum; the "phallic" type

30:00  Mirroring and validation in therapy

41:00  Countertransference and owning what's in you

45:00  Self-esteem, validation, and the classroom

49:00  Internalizing the therapeutic moment

51:00  Having vs. being — Fromm, and "cultivate life"

What is self-esteem, really? In this episode of Got Therapy?, Dr. Michael Baltimore and Dr. Dan Rose reconsider self-esteem through a psychodynamic lens — not as a high score you defend, but as the acceptance of a complex, often conflicted self.

The conversation moves through not-me states (the parts of ourselves we'd rather not own, from Sullivan and Bromberg), self-compassion, and why a rigid, always-positive self becomes brittle. Dan walks through normative narcissism after Kohut — why everyone feels a flash of "I don't measure up" driving past the neighbor's new car — the spectrum from healthy-level to disordered narcissism, and how mirroring and validation open the door to real change. Along the way: microtrauma and social comparison, holding a relationship with someone whose views you can't stand, and Fromm's question of having vs. being — the thread they carry into next week's "Cultivate Life."

Got Therapy? makes complex psychological concepts accessible and practically applicable. New episodes weekly.

00:00  Cold open (4th of July)

02:00  Self-esteem as accepting your complexity

03:30  Not-me states — Sullivan, Bromberg, and George Costanza

07:00  Self-compassion and giving yourself a break

09:00  Rigidity vs. flexibility — the stick that bends

10:00  Normative narcissism, Kohut, and the Porsche 911

15:00  Microtrauma and social comparison

18:00  Ethical codes and holding your neighbor

24:00  Ideology, the real, and conflict "all the way down"

27:00  Narcissism on a spectrum; the "phallic" type

30:00  Mirroring and validation in therapy

41:00  Countertransference and owning what's in you

45:00  Self-esteem, validation, and the classroom

49:00  Internalizing the therapeutic moment

51:00  Having vs. being — Fromm, and "cultivate life"