The Expert on Expertise: An Interview with K. Anders Ericsson

June 23, 2020 By scottdm Leave a Comment

I can remember exactly where I was when I first “met” Swedish psychologist, K. Anders Ericsson. Several hours into a long, overseas flight, I discovered someone had left a magazine in the seat pocket. I never would have even given the periodical a second thought had I not seen all the movies onboard — many twice. Its target audience wasn’t really aimed at mental health professionals: Fortune.

Bored, I mindlessly thumbed through the pages. Then, between articles about investing and pictures of luxury watches, was an article that addressed a puzzle my colleagues and I had been struggling to solve for some time: why were some therapists more consistently effective than others?

In 1974, psychologist David F. Ricks published the first study documenting the superior outcomes of a select group of practitioners he termed, “supershrinks.” Strangely, thirty-years would pass before another empirical analysis appeared in the literature.

The size and scope of the study by researchers Okiishi, Lambert, Nielsen, and Ogles (2003), dwarfed Rick’s, examining results from standardized measures administered on an ongoing basis to over 1800 people treated by 91 therapists. The findings not only confirmed the existence of “supershrinks,” but showed exactly just how big the difference was between them and average clinicians. Clients of the most effective experienced a rate of improvement 10 times greater than the average. Meanwhile, those treated by the least effective, ended up feeling the same or worse than when they’d started — even after attending 3 times as many sessions! How did the best work their magic? The researchers were at a loss to explain, ending their article calling it a “mystery” (p. 372).

By this point, several years into the worldwide implementation of the outcome and session rating scales, we’d noticed (and, as indicated, were baffled by) the very same phenomenon. Why were some more effective? We pursued several lines of inquiry. Was it their technique? Didn’t seem to be. What about their training? Was it better or different in some way? Frighteningly, no. Experience level? Didn’t matter. Was it the clients they treated? No, in fact, their outcomes were superior regardless of who walked through their door. Could it be that some were simply born to greatness? On this question, the article in Fortune, was clear, “The evidence … does not support the [notion that] excelling is a consequence of possessing innate gifts.”

So what was it?

Enter K. Anders Ericsson. His life had been spent studying great performers in many fields, including medicine, mathematics, music, computer programming, chess, and sports. The best, he and his team had discovered, spent more time engaged in an activity they termed, “deliberate practice” (DP). Far from mindless repetition, it involved: (1) establishing a reliable and valid assessment of performance; (2) the identification of objectives just beyond an individual’s current level of ability; (3) development and engagement in exercises specifically designed to reach new performance milestones; (4) ongoing corrective feedback; and (5) successive refinement over time via repetition.

I can remember how excited I felt on finishing the article. The ideas made so much intuitive sense. Trapped in a middle seat, my row-mates on either side fast asleep, I resolved to contact Dr. Ericsson as soon as I got home.

Anders replied almost immediately, giving rise to a decade and a half of correspondence, mentoring, co-presenting, and friendship. And now he is gone. To say I am shocked is an understatement. I’d just spoken with him a few days prior to his death. He was in great spirits, forever helpful and supportive, full of insights and critical feedback. I will miss him — his warmth, encouragement, humility, and continuing curiosity. If you never met him, you can get a good sense of who he was from the interview I did with him two weeks ago.

“My Mother Made Me Do It”: An Interview with Don Meichenbaum on the Origins of CBT (Plus: Tips for Surviving COVID-19)

May 26, 2020 By scottdm Leave a Comment

Imagine having the distinction of being voted one of the top 10 most influential psychotherapists of the 20th Century.

Psychologist Don Meichenbaum is that person. In his spare time, together with Arron Beck and Marvin Goldfried, he created the most popular and researched method of psychotherapy in use today: cognitive-behavior therapy (CBT).

I got to know Don years ago as we shared a car ride, traveling to and from a training venue while teaching separate, week-long workshops in New England. We laughed. We talked. We debated. Fiercely.

We’ve been friends and colleagues ever since, recreating our car ride discussions in front of large audiences of therapists at each Evolution of Psychotherapy conference since 2005.

As Don approaches his 80th birthday, we look back on the development of CBT — what he thinks he got right and how his thinking has evolved over time. Most trace the roots of CBT to various theorists in the field — Freud, Wolpe, and others. Don is clear: his mother made him do it. That’s right. According to him, CBT got its start with Mrs. Meichenbaum. I know you’ll be amused, but I also believe you’ll be surprised by why and how she contributed.

That said, my interview with Don isn’t merely a retrospective. Still actively involved in the field, he shares important, evidence-based tips about trauma and resilience, applying the latest findings to the psychological and economic impacts of the coronavirus. You’ll find the interview below

Is the Lack of a Higher Death Toll the Real Tragedy of COVID-19? An Interview with Stephen Jenkinson

May 4, 2020 By scottdm 16 Comments

This blogpost comes with a “trigger warning.” For most, the last 60 days have been witness to the complete disruption of daily life. Many people have died — nearly 250,000 worldwide, 70,000 in the United States — from a virus that the majority of us had never heard of just three, short months ago. Looking forward, humanity seems to be left with only stark and frightening choices between degrees of death and economic devastation. Given these realities, it is perfectly understandable if you would rather ignore this post announcing my interview of Stephen Jenkinson.

If you don’t know him, Stephen is teacher, storyteller, palliative care worker, and author of the award-winning book, Die Wise. I happened to read it back in 2016, right after it was released. Of his work, Stephen observes, “It’s not really a crowd pleaser.” Neither does his subject matter “submit to being clever, coy, or especially ironic — all the high water marks of casual conversation in urban centers.” As the title of his book indicates, he talks about death.

Jenkinson’s thesis? We are death phobic in the extreme, a culture that not only doesn’t believe in, but is actually hostile toward endings. We hide away our elderly, spend our final days separated from family, isolated in hospitals, talk euphemistically about transitions rather than the realities of no longer existing. This fact and this fact alone, he argues, has tremendous consequences for how we live and go about our daily lives.

I reached out a little over a week ago, asking if he would agree to an interview about how our culture’s attitude toward death might be shaping the North American response to the COVID-19 outbreak. From the concentration of deaths in “nursing homes,” breathless reports of “promising treatments” and a vaccine, the championing of healthcare professionals (while many are losing their jobs), and the media’s relentless (and scientifically uninformative) reporting of “hot spots” and “death counts,” it seemed to me we were dancing around the subject.

I’ve done a lot of interviews over the years, but none like this one. Several times, I had goosebumps. I was also concerned. Was Stephen’s direct and unflinching discussion too much? I actually asked several colleagues to watch and offer feedback before agreeing to post:

U.S. based Psychologist Randy Moss said, “Jenkinson’s calm, yet passionate exegesis about the pandemic exposes our collective ignorance about death while inviting us to think deeply about how to go forward.”
Long-time friend and therapist, Michele Weiner-Davis called the interview, “fascinating, poetic, and provocative.”
Swedish colleague Patrik Ulander remarked, “it was a handful, kept me awake at 4:30 this morning. His take is so fundamental and not even really about the corona virus, but instead about us denying the only thing we’re really sure about: we’re all going to die.”

P.S.: In case you didn’t see it, here’s an interview I did two weeks ago with a CCU physician on the frontlines of the COVID-19 outbreak. As you will see, it affirms and extends much of what Stephen Jenkinson advises, while simultaneously putting a face to the challenges we face as a culture in the near future.