I am carefully listening to this. Around 17:20 "I need this fourth step".
gotcha. I just ordered a book from His website direct so hopefully I'll get the updated one.
I expect you will be getting the 4th edition of
Unlearn Your Pain, though it appears a book titled
Hidden from View that Dr. Schubiner coauthored with psychiatrist Dr. Allan Abbass is also available through his website. Abbass’s specialty is Intensive Short-Term Dynamic Psychotherapy (ISTDP). Like Ellen, I only have the 2nd edition of
Unlearn Your Pain, so I don’t know what is new in the fourth edition. I am guessing that like the two Scubiner books I have read, the fourth edition of
Unlearn Your Pain contains zero Freudianism. If so, I hope you will not be put off by that.
Several years ago, I watched an interview of Schubiner where the interviewer tried to bait him into criticizing Sarno’s distraction theory to explain why the brain creates TMS pain. Schubiner declined to take the bait. Instead he just said, without elaborating, that he preferred “a different perspective.” In
Hidden from View, Schubiner expressed his reverence for Sarno because of his pioneering work in mindbody medicine. Schubiner has also said, however, that Sarno “got the big things right” about TMS but not everything. He analogized Sarno to Einstein, genius that he was, who got the big things right about relativity but not everything.
My understanding of Schubiner’s “different perspective" is that it is based on a combination of ISTDP and the new, new thing in brain science called predictive coding, aka predictive processing. Perhaps Schubiner goes into predictive processing in the fourth edition--as he did in
Hidden from View, which was published after the second edition of
Unlearn Your Pain. At any rate, I will focus here on ISTDP.
The founder of ISTDP, Dr. Habib Davanloo, began as a Freudian psychiatrist. However, in 1987 he concluded that Freud’s three-part structural theory of how the mind works (id, ego, and superego) “is not really a self-consistent system.” The only one of the three parts that Davanloo regarded as salvageable was a run-amok version of the superego that he initially called the punitive superego and later renamed the perpetrator of the unconscious.
Turning now to the Schubiner video interview that I linked above, Schubiner used the term “emotional processing” with regard to the fourth step about which you inquired. As Ellen noted, Schubiner has more formally called this Emotional Awareness and Expression Therapy. Schubiner’s personal emotional processing in the video had several steps:
1. Anger – he felt his anger at the hospital that employed him for many years but did not renew his contract. He expressed his anger while alone in his car by cursing the hospital management and by imagining himself blowing up the hospital building(s) with TNT.
2. Sadness – he felt his sadness about being let go by the hospital.
3. Compassion – he felt compassion for himself and for the hospital because it was losing money and needed to solve that problem.
4. Forgiveness – he forgave himself for his anger at the hospital and forgave the hospital because it needed to replace him with a physician who would generate more revenue.
As I see it, the four steps above are an adaptation of the ISTDP formula for processing anger and related emotions. That formula has four emotion elements: rage, sadness (or grief), guilt, and love—usually to be experienced in that order though sadness and guilt are sometimes reversed. ISTDP therapists are instructed not to stop with merely helping a patient to feel his anger and “portray” it, i.e. imagine carrying out his aggressive angry impulse. The reason is that if a therapist fails in “helping the patient to experience the entire range of complex feelings (that is grief, guilt, and love in addition to rage), the results can include dropout, symptom exacerbation, and potentially serious acting out.” Nat Kuhn MD,
Intensive Short-Term Dynamic Psychotherapy: A Reference 199 (2014).
Returning to Schubiner ‘s personal emotional processing in the video, the first element in the ISTDP formula is to process one’s anger. Schubiner did this by feeling his anger at his employer and then (while in his car alone) cursing the employer and imagining he blew up the hospital with TNT. The second element in the ISTDP formula is to process one’s grief. Schubiner felt his sadness over loss of his long relationship with the hospital. The third element in the ISTDP formula is to feel one’s guilt about getting angry. This is missing from what Schubiner did. The reason is that the ISTDP formula pertains to anger at a loved one (hence the fourth element, love). We instinctively feel guilty when we get angry at a person we love (it’s an evolutionarily conserved reaction). Schubiner apparently did not love the hospital administration—so no feeling guilty for him in this situation. The fourth and final element in the ISTDP formula is, of course, to feels one’s love for the person he got angry at. This element might appear to be missing from what Schubiner did, but consider the context of his anger. If you are angry at a loved one, then as part of experiencing your love for the person you will likely have compassionate understanding for his or her conduct that angered you, and you will likely forgive the person. But Schubiner was not angry in the context of a personal relationship. He was angry in the context of an employment relationship. In that relationship, compassion and forgiveness for the employer who got rid of you are about as close to love as you can get. I believe Schubiner was just using a contextually appropriate adaptation of the ISTDP formula when he felt compassion and forgiveness for not just for himself but also for the hospital. Finally, note that Schubiner said his pain ended once he did all that emotional processing.
