This book shows clinicians how to use Interpersonal Reconstructive Therapy (IRT) to change maladaptive patterns regarding safety and threat in treatment-resistant patients.

According to IRT theory, patients who suffer from maladaptive anger, anxiety, or depression are reenacting dysfunctional lessons in affect management modeled by parents and other early attachment figures. For example, a depressed woman who is afraid to assert herself can be described as reliving a childhood during which speaking up was dangerous, leading to rejection, even abandonment. IRT gives sufferers the tools to revise or replace internalized versions of attachment figures (the "family in the head") to create a more secure internal base.

IRT is integrative, drawing on any intervention relevant to the case formulation, and it is compatible with medications as needed for stress management. Evidence of effectiveness is provided for a treatment-resistant population. In this warm and engaging book, author Lorna Smith Benjamin shows how patients can more effectively cope with threat and find safety in their everyday lives.

About the Author: Lorna Smith Benjamin, PhD, is a psychotherapist; creator of Structural Analysis of Social Behavior (SASB), a model for describing interactions with self and others; and creator of Interpersonal Reconstructive Therapy (IRT), which was developed for "treatment-resistant" psychiatric patients on the basis of what she learned after decades of using SASB in research and clinical practice.
Dr. Benjamin got her undergraduate degree at Oberlin College and her graduate degree at the University of Wisconsin. During her graduate studies, she got firsthand experience with the continuity between infrahuman primates and humans as a graduate student of Harry Harlow in his laboratory at the University of Wisconsin. Her specializations there also included learning theory, neurophysiology, and mathematical psychology. That was followed in the department of psychiatry at the University of Wisconsin, Madison, by internship, more clinical training, and then academic appointments that progressed from research associate to full professor.
A skiing addict, Dr. Benjamin moved to Utah in 1987, where she sponsored a dozen graduate students in the University of Utah department of psychology and concurrently held an appointment as adjunct professor in the department of psychiatry. Her assignment there was to consult for personality disordered cases at the University of Utah Neuropsychiatric Institute (UNI). Her psychopathology practicum at UNI eventually became the IRT clinic in 2002. Since then, she has collaborated extensively with Dr. Ken Critchfield, who joined Benjamin in the clinic first as a postdoctoral fellow, then as director of research, and later as director of the clinic until Benjamin retired in 2012. Critchfield moved to James Madison University, where, as associate professor, he continues to harvest information from the IRT database and teach clinical skills related to IRT. Benjamin resumed work at UNI on a part-time contract and presently is active offering consultations and in-house mini-workshops about psychothearpy, analyzing data, and writing. She also provides day-long or multiday workshops for professionals on IRT and SASB, usually emphasizing personality disorders