Co-Creating Safety

Book preview


Available in Hebrew, Slovak, and Farsi, and forthcoming in German

Complimentary review copy for professors

Review copy


“This sparkling gem of a book is a riveting, breathtakingly action-packed, and fast-paced tour de force, remarkable for not only its depth and breadth but also its superlative clarity. Bar none, this eminently accessible volume is one of the most deeply satisfying and richly rewarding books on psychotherapy that I have ever read. Deceptively simple, it is actually an extraordinarily profound treatise on working with not just “fragile” patients (whose defenses include denial, splitting, and projection) but actually all patients who have ever mobilized defenses to protect themselves from the pain in their lives—defenses that might once have enabled them to survive but that now interfere with their ability to thrive and to connect with both themselves and others.

            “Seamlessly interweaving theory and practice, Frederickson offers the reader a captivating and aesthetically appealing treasure trove of theoretical and clinical pearls of wisdom garnered from his decades of experience in the field and his finely honed capacity to zero in on—always, of course, with compassion, directness, and nonjudgment—both the individual hidden behind the defenses and what the individual will need to confront to be found. Frederickson is not only a clinician extraordinaire who has mastered his art to near perfection but also a stunningly gifted thinker who, in his writings and teachings, is able to formulate his theoretical framework in a concise and compelling manner.”

Martha Stark, MD, Faculty, Harvard Medical School, and award-winning author of eight books, including Relentless Hope

“A masterwork. Jon Frederickson has elegantly solved the problem of communicating, with crystal clarity, the multiple layers that experienced therapists encounter with the most difficult patients and then presents a new technical perspective on projection that floods the clinical field with sharp-eyed self-knowledge and health-affirming love.”

Thomas Brod, MD, Associate Clinical Professor of Psychiatry, Geffen School of Medicine, UCLA

“Brilliant! Outstanding volume covering in depth understanding, assessment, and treatment strategies for fragile patients. This book is a rich resource for all therapists working with these patients, regardless of their theoretical orientation.”

Allan Abbass, MD, Professor of Medicine, Dalhousie University, and author of Reaching through Resistance

“Jon Frederickson has written a powerful book to help us treat our most challenging and vulnerable patients. His style ranges from poetic descriptions of the suffering of fragile patients to close and sophisticated attention to theory and practice. Jon has a vast store of knowledge in ISTDP and psychoanalysis, and he synthesizes these traditions in a landmark work. Destined to be a classic.”

Everett Siegel, MD, Assistant Professor of Psychiatry, Johns Hopkins University School of Medicine

“A path-breaking and inspiring road map on how to work with severely traumatized and fragile patients where interventions are complicated by the patients’ overwhelming anxiety. Neuroscientific knowledge is very well incorporated in patient narratives, and the book is clearly organized, is theoretically well-based, and covers most clinical situations you will come across. This book is so welcome for manualized psychodynamic practice! Most experienced psychotherapists will recognize the dilemmas of focusing their interventions, and younger therapists will find a gold mine of examples of the challenges they will come across in their careers.”

Bo Vinnars, PhD, Lecturer, Karolinska Institute, Stockholm University

“In Co-Creating Safety: Healing the Fragile Patient, Jon Fredrickson offers the reader a valuable guide for engaging and collaborating with patients who are often the most vulnerable and challenging to treat. Jon is a master clinician and scholar who brings to bear a remarkable ability to synthesize and curate not only his substantial clinical experience but clinical gems and insights offered by many pioneering therapists and researchers. What makes this volume so useful is that Jon is also a skilled supervisor and trainer with a keen ability to describe complex clinical phenomena and treatment in clear prose. There is much here to refresh our understanding of psychotherapeutics, deepen our appreciation for the complexity, and add to our clinical efficacy when working with fragile patients. This is a must-read for all clinicians.”

Jeffrey J. Magnavita, PhD, ABPP, founder and CEO, Strategic Psychotherapeutics, LLC, and former President, Society for the Advancement of Psychotherapy

Co-Creating Safety is a pleasure to read at so many levels. First, we see a wise and experienced therapist working with very challenging patients. He gives the reader such extensive examples of his process that the book could be used as a workbook. Second, Frederickson integrates his approach with perspectives from neuroscience, attachment theory, varied psychoanalytic theories, and more. Third, he describes a therapy process that includes careful monitoring of the therapeutic alliance as it enables the patient to move from building a secure attachment to strengthening the patient and then toward integration. Fourth, he defines anxiety as fundamentally a relational phenomenon, and working with it in the therapy relationship, patients become more fully themselves.”

Michael Stadter, PhD, Faculty, International Psychotherapy Institute, Washington School of Psychiatry, and Center for Existential Studies and Psychotherapy, and author of Presence and the Present

“Jon Frederickson has a marvelous capacity to join with fragile patients to set the stage for a surprisingly fruitful and effective therapy experience. What makes this book so valuable to the practicing clinician are the copious and detailed clinical vignettes that include both the verbatim dialogue and very instructive explanatory comments along the way. The author draws on the best of psychodynamic and experiential traditions to help resistant patients get past their defenses, overcome fears, and become all that they can be. It is a treat to learn from a master clinician and teacher like Jon Frederickson!”

Stanley B. Messer, PhD, Distinguished Professor Emeritus and former Dean, Graduate School of Applied and Professional Psychology, Rutgers University

“Jon Frederickson provides a thoroughly comprehensive and practical method for helping clients who experience severe anxiety symptoms and the psychological defenses that can prevent anxiety regulation. This book is packed with case examples and transcripts that illustrate how to intervene effectively with a wide variety of clinical obstacles. The theory is deep enough to benefit seasoned clinicians, and the examples are accessible and clear enough to benefit new therapists. Very highly recommended!”

Tony Rousmaniere, PsyD, Clinical Faculty, University of Washington, author of Deliberate Practice for Psychotherapists and Mastering the Inner Skills of Psychotherapy, and co-editor of The Cycle of Excellence

“This magnum opus provides a jolt of clarity for clinicians seeking to enter the fragile patient’s terrorized inner world. Masterful session vignettes take the therapist into the consulting room, illuminating a path for the newborn differentiated self to emerge. This delicate process walks a fine line, as Jon demonstrates how to assess the patient’s capacity to take that next step toward liberation. His skillful attunement indeed creates safety for his patients and leads to success.”

Susan Warren Warshow, LCSW, founder of The DEFT Institute and author of Master the Moment