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by Terry Marks-Tarlow
W. W. Norton, 2012
Review by Richard Skaff on Jan 15th 2013

Clinical Intuition in Psychotherapy

Mind-reading or X-ray vision are non-existent in mental health unless you are Clark Kent (Superman) or delusional. If psychiatrists and mental health workers had this ability they obviously wouldn't rely on talk therapy and communication in the psychotherapeutic process. Ironically, the illusion that therapists and psychiatrists have a special talent to read the mind was debunked several years ago in the Rosenhan study in 1973 that provided clear evidence that psychiatrists and mental health workers can't distinguish between the sane and the insane, the normal and the abnormal.

 Admitting that clinical intuition is an intrinsic element in the mental health process would be like admitting that the behavioral health field is made up of psychics and wizards. Psychiatrists and mental health workers often don't admit their deep reliance on their intuition to formulate diagnosis and to provide their alleged treatment, because they may suffer from an identity crisis as scientists or physicians who are supposed to have evidence-based answers. In reality, the entire mental health field is subjective and is based on speculation despite the relentless and futile efforts by the associations, the academics, and the practitioners to promote it as an exact neurobiological science.

 Fostering one's intuitive ability might prove to be useful for psychiatrists and psychotherapists in combination with their bag of tricks that consists of tranquilizers, techniques, and modalities to manipulate clients into changing their behavior. However, solely relying on gut feelings can be no more effective than witchcraft and sorcery, or any person on the street who trusts his or her instinct to deal with any situation.

Where do we draw the line? How can we foster and improve our intuitive ability? How can we learn to pick up on clients' delicate shadings? What happens to the therapeutic process when the confines of therapy are bound within the limits of techniques and tranquilizers? How does intuition improve sensibility in regards to clients?  

The questions are many and the answers can be murky and befuddling. Fortunately, Terry Marks-Tarlow a clinical psychologist in private practice in Santa Monica, California, who also teaches affective neuroscience at Reiss Davis Child Study Center and a research associate at the Institute of Fractal Research, explored this disregarded topic of intuition in her new book titled " Clinical intuition in psychotherapy."

  In her volume, she shares her clinical insights and intuitions that allegedly help metamorphose disordered brains into sound minds. Marks-Tarlow makes the assumption that intuition is a reality for every mammal and builds on this theme to develop her book (e.g. Clinical intuition is continuous with parental instincts as shared by all social mammals, p. 29). However, the author doesn't' address that intuition might be actually contaminated with countertransference and other baggage that the mental health worker might implicitly hold within the dungeons of his or her soul. Instead, she determines that clinical intuition is a right-brain fully integrated system of perceiving, relating, and reacting to the reciprocal process of psychotherapy.

 Marks-Tarlow's book is made up of eight chapters that begin with an introduction and exploration of flashes, hunches, and gut feelings and ends with the pursuit of wisdom. She encourages therapists to incorporate their own sense of humor to clinical practice, and emphasizes the importance of intertwined playfulness with responsive discussion to help mobilize clients toward growth and healing.
She also discusses the interaction between imagination and clinical intuition, and asserts the importance of imagery and metaphor in leading the client to deeper insight and wisdom. In addition, each chapter is laced with exercises to help the reader assimilate the concepts. 

 Marks-Tarlow brings some reality to the process of clinical intuition by emphasizing and validating its importance rather than relying on the usual and ambiguous pseudo-science jargon that plagues the field.  She also attempts to cover every aspect of this innate process that every human possesses as a means to connect to each other through universal consciousness.   

 The book is written in eloquent and lucid style. It smoothly flows from chapter to chapter. However, attributing some neurobiological interpretations to validate the author's thesis of clinical intuition is interesting but nevertheless speculative, and gives the book a pseudo-scientific aura that psychiatry and psychology have been attempting for years to adopt it in order to make themselves look like scientists instead of wizards and sorcerers.

This book will make an interesting reading for mental health workers, and will serve as a guide for clinicians to help them hone their intuitive skills, and comfortably tap into their natural power of intuition, which might induce stronger rapport with their clients as well as change and transfiguration.

© 2013 Richard Skaff,


Richard Skaff, Rancho Palos Verdes, California

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