1/ “What the patient does with the therapist in the room always holds a key to what caused her problem, what has kept it going, and what has made it difficult for her to benefit from previous efforts to treat it.”

-Mary Jo Peebles

2/ This is why the answer to the question of how to help cannot be known in advance and cannot be found in the pages of a treatment manual. A meaningful answer can be found only "in the room." But you have to know how to *be* in the room, in a particular way.

3/ The patient doesn't need a cheerleader, an apologist, a hired friend, an ersatz mother, or a fawning sympathizer. She does not need to be treated like a subject in a psychology experiment. She needs someone *in the room* paying attention to what is happening in the room.

4/ Paying attention in a way someone in her distant past did not. If she is like many patients, it's a safe bet to add, paying attention in the way a previous therapist did not. "Providers" are awfully busy these days doing, things other than paying attention in the room.

5/ They're busy prescribing, psychoeducating, completing worksheets, using techniques, "empathizing," assigning homework. Busy busy busy. Always doing. All of these things get in the way of paying attention to what is going on in the room just here, just now.

6/ The most common question beginning therapy students and trainees ask is, what should I do next? If you really want to learn how to pay attention in the room, if you really want to learn how to listen, then you must stop doing. You must first learn how to be still.

7/ "Still" doesn't mean unresponsive or distant. Those who don't know how always confuse it with that so they can dismiss it and thereby reassure themselves they're already doing everything just right. You must learn to be still inside. This takes time.

There are no shortcuts.

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