Good Morning, Monster: A Therapist Shares Five Heroic Stories of Emotional Recovery

Dr. Gildiner’s therapeutic techniques and philosophies draw on several theories and ways of thinking that are common in Western therapy. She often engages the patient in Cognitive Behavioral Therapy (CBT); here, the patient learns to identify their own problematic thought patterns and behaviors. The American Psychological Association (APA) explains that CBT is highly effective and can be used in a variety of circumstances, such as the treatment of anxiety, depression, post-traumatic stress disorder, eating disorders, stress management, mental illness, or in family or marital counseling. It can be used in combination with other therapies. The APA and other medical bodies, such as the Mayo Clinic and the National Institute of Health (NIH), promote the use of CBT and point to clinical research that supports its effectiveness. It operates on three basic principles:

Psychological problems are based, in part, on faulty or unhelpful ways of thinking; Psychological problems are based, in part, on learned patterns of unhelpful behavior; and People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives (“What Is Cognitive Behavioral Therapy?” American Psychological Association, 2017).

In sessions, the therapist works with the patient to identify faulty or skewed ways of thinking or perceptions. Understanding the reason or causes of one’s own behaviors and those of the people in the lives of the patient can also be an important component. In some cases, the therapist may lead the patient in role-playing exercises or assign the patient “homework.”

The versatility and applicability of CBT means that it is used regularly by clinicians, as demonstrated by Gildiner’s five case studies. One of the benefits of CBT is that it provides the patient with the tools to conduct self-examination outside of the therapy session and once therapy is concluded. CBT enables the patient to do their own work and this approach is key to Gildiner’s empowering message that patients are “heroes,” i.e., that they can overcome trauma and other psychological obstacles through their own strength and courage.

Much of Gildiner’s approach is also rooted in psychoanalysis. Psychoanalysis was developed by Dr. Sigmund Freud in the 1890s. Freud utilized a combination of hypnosis and free association (talking without a planned intent and allowing the mind to bring up any images, symbols, dreams, ideas, or thoughts as they occur, then discerning connections between them) (Burton, Eleanor Sawbridge. “Sigmund Freud.” Institute of Psychoanalysis, 2015). Gildiner’s PhD focused on Freud and her clinical and academic publications are rooted in psychoanalysis and this form of therapy can be clearly traced through the approaches and methods she uses with her five patients. Psychoanalysis focuses on delving into the unconscious mind through thoughts, memories, associations, and dreams. It is built on the idea that the conscious mind is not aware of the full causes of certain thoughts, patterns, or behaviors. Examining the past, such as childhood and other developmental stages, can uncover these fuller reasons and help the patient to better understand their feelings and behaviors. Excavating past feelings and experiences is key to psychoanalysis sessions, and Gildiner goes through this process with each of her patients. Psychoanalysis is considered to be best suited for those with long-term issues that are ongoing or rooted in past traumas and can be an intensive and long-term form of therapy, again, characteristics that Gildiner’s five case studies have in common. In some cases, it is usual for the therapist to be “replaced” in the session by an important figure from the patient’s past, as if the patient is speaking with that person instead of the therapist (Kunst, Jennifer. “What Is Psychoanalysis?” Psychology Today, 15 Jan. 2014). This is a process of transference (see Index of Terms), which reveals essential information to the therapist and enables the patient to bring their repressed feelings and experiences into the present, where they can be processed. All of these aspects of psychoanalysis are contained in Good Morning, Monster.

The APA notes that both therapies can be used alone, in combination, or in combination with other therapies.