Peter Malinoski, Ph.D

 Overview of the Practice of Psychology

Every psychologist’s practice is based, explicitly or implicitly, on certain assumptions about what is good, true and beautiful. These assumptions guide the psychologist’s actions in both direct and subtle ways. Part of the reason so much controversy and fragmentation exists in the field of psychology is because there is such disagreement about foundational principles. Psychology has to take its premises and assumptions from the conclusions of other disciplines, including epistemology, metaphysics, and most especially philosophy and theology. I start from a foundation that what the Church has taught on faith and morals through the ages is true. Thus, my practice is solidly based on a traditional Catholic foundation in these disciplines. As a depth psychologist, I work with patients to understand and resolve the underlying problems that cause their symptoms. In the way that I conceptualize cases, most “psychological disorders” (i.e. depression, anxiety, panic attacks, etc.), are essentially symptom constellations that point to underlying issues that need to be addressed.

By way of analogy, if a person presented at an emergency room with intense abdominal pain and fever, it would be inappropriate to limit treatment to painkillers and fever-reducing medications to ease the discomfort of the symptoms. The underlying appendicitis must be cured in order to prevent further harm to the body and to resolve the symptoms of fever and pain. I argue that overreliance on symptom-focused approaches in psychotherapy reduces the likelihood of resolving core psychological problems. In depth psychotherapy, we focus on the core issues. In my theoretical model, all psychological disorders can be ultimately traced back to original sin, the sins of others, and one’s own personal sins, and the effects of these sins. In essence, sins are failures to love, and sins damage our relationships with God and other persons. Thus, the first focus in treatment is to assess and increase the person’s capacity to receive love from God and others. Authentic love is always given freely, but there is a high cost to receiving it in this life. Most people resist being deeply loved because if we accept real love, it changes us in painful ways, by purifying the sinful, disordered, and dysfunctional parts of ourselves. We are also called to give up familiar and comforting lesser goods in order to receive greater goods that we have not yet experienced and cannot even imagine with our limited vision. Thus, the second focus in treatment is on overcoming the person’s psychological impediments to loving.

There are three major components to love: benevolence, competence, and constancy. Impediments can compromise any of these components. Often, patients have worked diligently on spiritual and moral impediments to loving, but have inadvertently neglected psychological obstacles, limiting their success.

Assessment and Case Conceptualization

Appropriate treatment is based on a solid and accurate case conceptualization.  In most cases, I start with about five hours of psychological testing at the beginning of short- or long-term individual, marital or family therapy. When appropriately used, psychological testing allows for a much more rapid and deeper understanding of the underlying personality organization of the personand the unconscious conflicts and issues in the individual’s psychology. It is like a radiologist using a CAT-Scan or MRI to observe underlying structures in the body that cannot be detected from the surface. Psychological assessment increases the efficiency and effectiveness of treatment, saving time, effort, and money by identifying the root causes of the symptoms, allowing for treatment to be specifically tailored to the individual’s needs.

Individual Psychotherapy

My individual psychotherapy practice is divided into two major sections. In my short-term or brief treatments, the client starts with a 90-minute intake interview and then about five hours of psychological testing. Afterward, we spend a total of six to eight hours reviewing the results of the assessment, focusing on core underlying issues, personality organization, situational stresses, emotional regulation (including defenses and coping mechanisms),cognitive processes, self-structure and self-image, interpersonal style and relational issues, sexual issues, psychological conflicts, psychological factors impacting the spiritual life, and diagnoses. We then discuss any need for ongoing treatment with an emphasis on what individuals can do without the help of a therapist. The focus of a brief intervention is on increasing understanding and insight into the ultimate causes of the symptoms. The enlightening of the intellect can then help the person use their will more effectively to choose better courses of action. The emphasis in brief treatmentis on the intellect, on understanding the self and others better, thereby increasing the person’s competence to accept love and to love. In long-term therapy, patients engage in the process of working through their underlying issues in the ongoing therapeutic relationship. They test out their assumptions about relationships and work on new ways of relating with me and with others in their lives. The experience of relating differently allows for enduring underlying change in their personality organization, completing developmental work. The emphasis in long-term therapy is on working through insights, training the will, integrating emotions, and learning to better accept and givelove in relationships. I work with persons aged 14 and older in individual psychotherapy.

Suffering is inevitable in this life, and it is required in the arduous task of loving. Rather than searching for ways to eliminate suffering, I focus on working with patients to transition from suffering as a rebel or a stoic to redemptive suffering, that is, suffering with meaning and purpose, and from a position of underlying peace. One therapeutic goal is to be able to increase the capacity for suffering, to better be able to bear the cross well and die to self. Gentleness and an understanding of the magnitude of human brokenness are necessary for empathetic work at the most profound levels. “A bruised reed He will not break, a smoldering wick He will not quench (Isaiah 42).” I admire the courage, perseverance, humility, openness, and vulnerability of those who invite me to know them deeply. I am honored to be asked to join them on their journeys.

Marital and Family Therapy

When couples with troubled marriages come in to see me, I generally find that they do not know themselves or each other well. They know much about the spouse, but that is different than being able to empathetically attune andenter into their phenomenological world. My model of marital therapy differs from most other clinicians’ ways of working. At the core, I don’t believe marriages have problems, and marriages can’t decide to change. Individual spouses have problems, they bring these problems into their marriages, and individual spouses can decide to change. One’s capacity to understand the spouse is limited by the degree of self-awareness possessed. Spouses who do not understand themselves well are particularly prone to attribute their own unconscious material to the other spouse. The second great commandment is to love your neighbor as yourself. Spouses who don’t or can’t love themselves in an appropriate way are limited in the love they can give to their spouse. In marital therapy, each spouse goes through a brief course of individual therapy first, completing an intake interview and testing, and reviewing the results ofthe testing. The initial focus is on the husband understanding himself and the wife understanding herself more deeply and each assuming responsibility for his or her own contribution to conflicts and problems in the marriage. If both spouses agree to continue, we have eight to ten more hours of marital therapy. In these sessions, we review the results of the each assessment with both spouses present. The focus here is on understanding the spouse more deeply. This greater understanding thus enables the spouses to love each other more deeply. I also work with engaged couples who want to anticipate problems that are likely to emerge in their marriages. Family therapy usually consists of a brief course of individual therapy, followed by marital therapy as described above. Often this is enough to help resolve the issues with a younger child.  With adolescent children, I can do an intake and assessment as well. The teenage son or daughter goes through a brief course of individual therapy to review results and grow in self-awareness, and then we begin a course of family therapy, focused on fostering greater understanding of each other.

The Psychological and the Spiritual

It has long been known that grace builds on nature and the supernatural is based on the natural. Psychological disorder compromises our capacity to grow spiritually. The focus of my practice is to remove the psychological impediments to receiving authentic love from God and others and to loving God and others. Our initial unconscious image of God is formed in the likeness of our earthly fathers before we reach the age of reason, and our image of Mary is heavily influenced by maternal figures. These images are shaped by the experiences of paternity and maternity we absorbed as infants, children and adults. A variety of psychological factors shape our unconscious representations of God and Mary, including transferences and projections. I argue that each of us has two religions. First, the religion that we profess and believe intellectually “in our heads” and that is available to conscious awareness continually. However, we have another, heretical religion that we hold to be true “in our bones,” at an instinctual, unconscious level. One example is the scrupulous person who knows that God loves him in his head, but feels he has to be perfect in order to ward off the wrath of an angry God looking for an opportunity to punish him. Another example is the woman who knows intellectually that God loves her, but believes at an unconscious level that He sees her as valuable only because of her potential to become a wife and mother. Any difficulties a client has relating with men at a natural level will also impact his or her relationship with Jesus as a man. Difficulties with women, especially mother figures, will affect how we relate with Mary in our prayer lives.

Because many individuals’ unconscious God images are so threatening, they are kept out of conscious awareness, and they cause problems because we cannot use the intellect to evaluate them. In my opinion, if psychotherapy is successful, it should improve the person’s capacity to receive the love of God and to follow the great commandments, to love God and neighbor. Psychological deficits caused by problematic relationships with our earthly mothers and fathers can be remedied by experiencing the healing love of God the Father and our Mother Mary in a providential worldview. Thus, psychological treatment can be viewed as an investment to grow in the spiritual life as well, by perfecting and strengthening the natural base upon which it rests. I frequently receive referrals from priests who are providing spiritual direction to persons with psychological issues. People with personality disorders can benefit from solid, orthodox spiritual directors who are sensitive to the impact of such disorders on their directees’ spiritual lives. I have spent considerable time in my career working on models of effective collaboration between spiritual directors and mental health professionals in working jointly to help individuals. I have also worked with religious superiors to help members of religious orders make a better adjustment to religious life. I also specialize in psychological assessments for candidates for the priesthood and religious life.

Regional and National Consultation

I consult regionally and nationally with clients. A part of my national consulting practice is dedicated to working with priests, deacons and religious who are experiencing psychological problems and are seeking psychological help rooted in the Catholic Tradition.

Consultation, Supervision, and Training

Perhaps the area I am best known for in secular circles is my research and work with former members of psychologically abusive groups, colloquially known as “cults.” I frequently receive referrals for Catholics and former Catholics who have been involved with psychologically abusive groups. The majority of my expert witness testimony and psychological consultation for the courts is in this area.

Teaching and scholarship are important to me. I regularly present at professional meetings, and I supervise, train, and consult with several Catholic clinicians. I have provided continuing education seminars and workshops on psychological topics for Catholic priests and seminarians. I also consult with other mental health professionals, particularly psychologists and psychology students to further their ongoing training in psychological assessment and depth psychotherapy, grounded in a Catholic anthropology.