What Creates Change in Psychotherapy? | Dr. Mary Jo Peebles
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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General Info: www.ericspiegelphd.com Group Practice: www.therapistsinphiladelphia.com