Transforming Relationships

Why do we struggle to change behaviors we consciously want to change? What role does the unconscious play in keeping us stuck? And can artificial intelligence help us grow—or does meaningful psychological change require something uniquely human?

In this episode of Transforming Relationships, Dr. Eric Spiegel and Dr. David Alter welcome clinical psychologist and entrepreneur Dr. Sera Lavelle for an engaging exploration of the unconscious mind, innovative approaches to psychotherapy, and the emerging relationship between humans and artificial intelligence.

Dr. Lavelle is the founder of SOHO Integrative Psychological Services, which includes SOHO Integrative Collective, SOHO Integrative EMDR, and New York Health Hypnosis. Her clinical and entrepreneurial work offers a distinctive perspective on how different therapeutic approaches can be integrated to address the complexities of human behavior.

The conversation begins with a fundamental paradox: people often genuinely want to change, yet find themselves repeatedly engaging in behaviors that undermine their intentions. Dr. Lavelle explores how unconscious processes, competing emotional states, and deeply ingrained coping mechanisms can interfere with our capacity to act on what we know is best for us.

From there, the discussion examines the possibilities offered by clinical hypnosis, EMDR, and ketamine-assisted psychotherapy. Rather than treating these approaches as competing techniques, the conversation considers how different interventions may facilitate change depending on a person's psychological needs, emotional state, and readiness.

A central theme emerges around the relationship between psychological flexibility and the therapeutic relationship itself. How do therapists help people access possibilities that are not immediately available to conscious awareness? And how can moments of confusion, emotional activation, or interpersonal challenge create openings for meaningful transformation?

The discussion then turns to artificial intelligence and its growing role in mental health care. Dr. Lavelle describes the limitations of AI systems trained on conventional therapy conversations, particularly when people seek help during emotionally charged moments outside the therapy room.

Together, the three psychologists consider the potential benefits of AI as a complement to psychotherapy, while questioning whether technology can replicate the relational experiences through which people learn to tolerate conflict, receive difficult feedback, and develop greater psychological agency.

Topics include:

• Conscious and unconscious processes in psychological change

• Why anxiety and other coping mechanisms can become difficult to relinquish

• Emotional activation, self-states, and the capacity for agency

• Clinical hypnosis, EMDR, and integrative psychotherapy

• Ketamine-assisted psychotherapy and therapeutic readiness

• The potential and limitations of AI-assisted mental health support

• The ethical implications of AI in psychotherapy

• Why human relationships remain central to meaningful psychological growth

Ultimately, this conversation asks us to reconsider what creates change—not simply which therapeutic technique is most effective, but how relationships, emotional states, and unconscious processes shape our capacity to become more fully ourselves.

Transforming Relationships is hosted by Dr. Eric Spiegel and Dr. David Alter.

How relationships shape our minds, our lives, and the world.

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"You're not your history. You're more than your history. And the question is, what more are you?"

Dr. Michael Yapko has spent his career studying how people become trapped in patterns—and how psychotherapy and clinical hypnosis can help them discover new possibilities.

In this episode of Transforming Relationships, Michael joins Dr. David Alter and Dr. Eric Spiegel for a provocative and deeply practical conversation about depression, hypnosis, relationships, and the process of therapeutic change.

Michael explains why depression often keeps people oriented toward the past; why feelings, while important, are not always reliable guides for decision-making; and why he thinks psychotherapy is fundamentally about "pattern interruption and pattern building." He also explores why effective hypnosis is relational rather than simply a technique performed on someone, and how therapists can help clients develop concrete sequences for doing things they previously could not imagine themselves doing.

The conversation also turns to artificial intelligence and psychotherapy. Michael discusses both the remarkable potential and current limitations of AI in mental health, particularly when it comes to emotional and relational context.

And then there are the elephants.

Michael shares the extraordinary story of being recruited by the San Diego Wild Animal Park (now the San Diego Zoo Safari Park) to study an expert elephant trainer, identify the largely intuitive patterns underlying his work, and translate them into teachable sequences. The project ultimately helped contribute to changes in how keepers safely work with elephants—while teaching Michael something profound about trust, consistency, relationships, and change.

Dr. Michael D. Yapko is a clinical psychologist, internationally recognized authority on clinical hypnosis and depression, and the author of 16 books, including Breaking the Patterns of Depression, Depression Is Contagious, The Discriminating Therapist, and Trancework.

Transforming Relationships How relationships shape our minds, our lives, and the world.

Hosted by Dr. David Alter and Dr. Eric Spiegel.

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What does effective psychotherapy actually sound like in the room?

In this second conversation with psychologist, psychoanalyst, author, and master clinician Dr. Mary Jo Peebles, we move from talking about psychotherapy to experiencing it in action.

Through an extended therapy role play—and the conversation that follows —Mary Jo demonstrates the subtle, moment-to-moment work of psychotherapy: noticing what a person may not yet be able to notice themselves, staying with difficult emotions without rushing to make them disappear, working with shame and self-acceptance, and using the therapeutic relationship to create new possibilities for change.

Along the way, we explore why relationship alone isn't enough; the importance of focus, repetition, and awareness; how therapists integrate ideas from different schools of psychotherapy; and the roles of empathy, tension, uncertainty, and the startle response in therapeutic change.

Rather than offering a formula for good therapy, this episode gives listeners a rare opportunity to hear the process unfold in real time—and then step back with Mary Jo to understand what happened and why.

In this episode:

• Why the therapeutic relationship matters—but relationship alone isn't enough • The often-invisible skills of experienced therapists • Role Play: shame, self-acceptance, and the experience of being understood • How therapists synthesize different theoretical approaches • Empathy, tension, uncertainty, and the startle response • Reflections on Mary Jo's upcoming book

Whether you're a therapist, a student of psychology, someone who has been in therapy, or simply curious about what happens between therapist and client, this episode offers an unusually close look at psychotherapy from the inside.

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Psychologist Wendy Lemke joins us for a conversation about ego state therapy, trauma, hypnosis, and the different parts of ourselves that shape how we think, feel, and relate to others.

Through discussion and live role-play demonstrations, Wendy shows how therapists help people work with inner conflict, reconnect with disowned parts of themselves, and develop greater internal balance.

Topics include trauma, dissociation, attachment, hypnosis, internal parts, emotional healing, and the surprising ways therapy can help people feel more connected to themselves and others.

What is it like to live psychologically under the constant threat of war?

In this episode, Ukrainian psychologists Volodymyr Voloshin and Olha Serha share firsthand experiences of living and working in Ukraine during ongoing conflict. We explore trauma, resilience, relationships, uncertainty, and the emotional realities of adapting to life under chronic danger.

The conversation examines how war reshapes identity, daily life, and mental health — while also revealing the power of connection, community, and hope in sustaining resilience.

A moving discussion about survival, healing, and the human experience during war.

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What creates real change in psychotherapy?

In this episode, Dr. Eric Spiegel and Dr. David Alter speak with Dr. Mary Jo Peebles, clinical psychologist and psychoanalyst, about the deeper processes that drive transformation in therapy.

Moving beyond technique-driven and manualized approaches, Dr. Peebles explores psychotherapy as a dynamic, relational process—one shaped by uncertainty, mutual influence, and the evolving interaction between therapist and patient.

The conversation examines how therapeutic change emerges over time through moments of connection, rupture and repair, and shifts in perception and expectation. It also highlights the importance of "scaffolding" in early treatment, the role of relational safety, and the neurobiological foundations of lasting psychological change.

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Topics include:

• The limits of manualized and protocol-driven therapy
• Psychotherapy as a relational, emergent process
• The role of uncertainty and ambiguity in clinical work
• Rupture, repair, and the development of trust
• Scaffolding and early therapeutic structure
• Perception, expectation, and psychological change
• Neurobiological perspectives on transformation

This episode offers a nuanced exploration of psychotherapy for clinicians, students, and anyone interested in how meaningful change unfolds within human relationships.

Timestamps:

00:00 Introduction to Dr. Mary Jo Peebles

02:54 The Complexity of Psychotherapy

05:54 Trans-Theoretical Approaches in Therapy

08:47 Siloed Practices in Psychology

11:55 The Role of Identity in Therapy

15:07 Understanding Patient Experiences

18:07 Role Play: Navigating Panic Attacks

20:54 Exploring Uniqueness vs. Commonality in Therapy

24:11 Role Play: Attachment and Connection

27:06 The Therapeutic Alliance and Patient Engagement

36:05 The Emergence of Change

39:02 Navigating Emotional Spaces

43:51 Understanding the Therapeutic Process

46:17 The Role of Ambiguity in Therapy

48:09 Scaffolding in Early Sessions

52:51 Duality of Experience in Therapy

55:05 Rupture and Repair in Therapeutic Relationships

01:01:52 The Challenge of Change

01:06:57 Structural Changes for Lasting Impact

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Are we truly facing a loneliness epidemic—or are we misunderstanding what connection really requires?

In this episode, Dr. Eric Spiegel and Dr. David Alter explore the growing concern that modern life is eroding meaningful human connection. They examine how changes in technology, work, and social structure have reshaped relationships—and why many people feel increasingly disconnected despite constant contact.

The conversation distinguishes between being alone, feeling lonely, and being fundamentally disconnected, offering a more precise framework for understanding emotional isolation.

They also explore why many attempts at connection feel superficial or performative, and what actually creates relationships that are reciprocal, honest, and emotionally sustaining.

The episode concludes with practical, grounded ways to rebuild connection—through consistency, vulnerability, and a willingness to engage beyond surface-level interaction.

• The "loneliness epidemic": reality vs perception
• Real vs superficial relationships
• Technology and social disconnection
• Vulnerability and reciprocity in relationships
• Rebuilding meaningful connection
• The role of environment, nature, and presence

Why is it so difficult to hold multiple perspectives in conflict, especially when identity, history, and trauma are involved?

In this episode, conflict negotiator Naseem Khuri explores the psychology of conflict through the lens of Israel–Palestine and, later in the episode, polarization in the United States. Drawing on his professional work and personal history, he examines how people interpret the same reality in fundamentally different ways, and why conflict is often something to be managed rather than resolved.

The conversation addresses intergenerational trauma, competing narratives of loss and displacement, the danger of certainty, and the role of process in creating conditions for understanding. It also explores the limits of empathy in active conflict and the importance of building structures that allow people to be heard without requiring agreement.

This episode offers a psychological perspective on conflict, identity, and polarization—both in international contexts and in everyday human relationships.

Hosts: Eric Spiegel and David Alter

Guest: Naseem Khuri

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How can hypnosis transform the way we experience pain?

In this episode, psychologists Dr. Eric Spiegel and Dr. David Alter speak with Dr. David Patterson, a leading expert in pain psychology and medical hypnosis, about the science and psychology of pain—and how hypnosis can reshape our relationship with it.

The conversation explores the critical differences between acute and chronic pain, the role of neuroplasticity in maintaining pain patterns, and how hypnosis can help patients shift perception, reduce suffering, and reconnect with activity and meaning.

Dr. Patterson also shares deeply personal reflections on grief, resilience, and healing, illustrating how relational aspects of therapy and human connection play a powerful role in recovery.

This episode offers both clinical insight and human perspective on one of the most challenging experiences people face: living with pain.

Hosts: Eric Spiegel and David Alter

Guest: David Patterson

Pain management Hypnosis Neuroplasticity Chronic pain Medical hypnosis Psychotherapy Pain treatment Mind-body medicine Emotional resilience Healing

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In this episode of Transforming Relationships, Dr. Eric Spiegel and Dr. David Alter sit down with Dr. Susanna Carolusson, a psychologist whose career has spanned five decades of work in trauma treatment, hypnosis, and ego state therapy. Drawing on both clinical wisdom and lived experience, Dr. Carolusson reflects on how her own childhood adversity—including growing up with a deeply troubled parent—shaped her lifelong curiosity about the mind and her commitment to helping others heal.

The conversation explores ego state therapy and parts work, the role of hypnosis in trauma treatment, and the importance of attunement and emotional safety in the therapeutic relationship. Dr. Carolusson describes how understanding the different "parts" of the self can help clients move toward integration, resilience, and a renewed sense of vitality.

Along the way, she offers practical wisdom for therapists and anyone interested in personal growth—from learning to listen to the body's signals to cultivating the kind of curiosity that restores energy, creativity, and connection.

Whether you're a clinician, a student of psychology, or someone interested in the process of healing, this episode offers a rare opportunity to learn from a therapist whose work bridges personal transformation and decades of trauma-informed practice.

Hosts: Eric Spiegel and David Alter

Guest: Susanna Carolusson

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• Ego state therapy and parts work

• Hypnosis in trauma treatment

• Attunement and safety in psychotherapy

• Curiosity as a therapeutic tool

• Therapist–client boundaries

• Resilience and childhood adversity

• Listening to the body in the healing process

psychology, trauma therapy, hypnosis, clinical hypnosis, ego state therapy, parts work, trauma healing, attachment, psychotherapy, mental health, therapy techniques, resilience, personal growth, attunement in therapy, trauma treatment

00:00 Introduction to Transforming Relationships 05:26 The Role of Hypnosis in Trauma Treatment 10:51 Understanding the Parts of the Self 16:11 Curiosity as a Therapeutic Tool 25:39 Navigating Therapist–Patient Boundaries 34:56 The Dandelion Child: Resilience in Adversity 45:19 Listening to the Body: Intuition and Healing

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Follow Dr. David Alter:

General Info: www.drdavidalter.com For Couples: www.partnersatcrossroads.com Follow Dr. Eric Spiegel:

General Info: www.ericspiegelphd.com Group Practice: www.therapistsinphiladelphia.com Instagram: www.instagram.com/drericspiegel