Survey Response: Jon Frederickson, MSW

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This survey was last updated in July 2011.

Degrees/Licenses Held: MSW

Contact Information:
3000 Conn. Ave. N.W. #400
Washington, D.C. 20008

Number of years in practice: 28

Number of years in practice with patients who have chronic pain symptoms: 10

Number of patients you have seen who have had TMS/chronic pain: 10

What is your association to the TMS community? none

What is your association to the ISTDP community? Presenter, supervisor, teacher, and practitioner of ISTDP. Faculty in numerous ISTDP training programs.

Have you ever suffered from TMS/PPD/somatization? no

Are you able to conduct therapy sessions over the phone? No, because it is necessary to see the patient's physical responses to interventions in order to correctly assess when and how somatization occurs in the session.

What insurance plans do you currently accept? none

Do you have a sliding scale of payment for people who are not covered by insurance? no

Are you familiar with the PPD/TMS approach? If so, what have you done to educate yourself about it, and what plans do you have for further education about TMS? I have read several books by Sarno.

What have you done to educate yourself about chronic pain and somatization, and what plans do you have for further education?
I have read a number of books and articles on somatization, the autonomic nervous system, biophysiology, somatic treatments, and neuroscience. I have also seen and given presentations on the treatment of somatization.

What is your general approach to treating patients in chronic pain, and how would you compare it to the TMS approach?
I use ISTDP. Like TMS, ISTDP focuses on the relationship between unconscious rage and symptoms. Whereas TMS focuses primarily on symptoms resulting from tension (the somatic nervous system), ISTDP focuses on symptoms that result from the somatic, sympathetic, and parasympathetic nervous systems. Whereas TMS relies primarily on cognitive psychoeducation, ISTDP relies on a more experiential process. We help patients experience their rage as deeply as possible in sessions. We do this in a graded process, helping patients face their rage until a somatic symptom occurs. Then we point out the process, help them see the link between the rise of rage and the emergence of the symptom. Once the symptom is gone, we help the patient experience higher levels of feeling until no symptoms occur. In our understanding, somatic symptoms occur due to two pathways: 1) due to a rise of anxiety discharged into the somatic, parasympathetic, or sympathetic nervous systems; or 2) due to the use of the defense of somatization whereby the patient identifies with the person with whom he is angry. For instance, a patient imagined one day chopping his father in the head. A moment later he had a “splitting headache.” He turned the rage back onto himself by identifying with the body of his father.

As we are going to post your answers on the TMS Wiki, feel free to write some text to introduce yourself:
I am co-chair of the ISTDP Training Program at the Washington School of Psychiatry, chair of the ISTDP Training Program at the Norwegian Society for ISTDP, and faculty at the ISTDP Core Training Programs at the Italian ISTDP Society in Treviso and the Laboratorium Psychoeducaji in Warsaw, Poland. I have published several cases showing how to treat cases of somatization in the Ad Hoc Bulletin of Short Term Dynamic Psychotherapy. A chapter on the treatment of this condition will appear in my forthcoming book, Co-Creating Change.

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