Nursing Essays - Therapeutic Relationship Patient
therapeutic relationship in psychiatry ..
Note 19. Whatever their specific form or immediate cause, countertransferential enactments must be decoded lest they cause the therapeutic focus to shift unnecessarily from what clients need to achieve to how they are relating to their therapists. If clients’ conflicts with their therapists closely resemble those with non-therapists, all is well. If not, however, clients must use precious time and energy dealing with the disconnectedness that has ruptured their relationship with their therapist instead of exploring their own issues. Therapists who are overly sensitive to slights, for instance, can revert to defending their treatment-related actions and blaming clients for not cooperating with them when clients complain that therapy is not benefiting them. Having to focus on their therapists’ powerful defensive feelings, clients are not able to explore the negative feelings that explain why treatment is not working. ()
The Importance Of Therapeutic Relationships In - Essay UK
In general, therapists should also refrain from using TRIs and CTRIs when clients are dealing with material too primitive for language; when they cannot “give voice” to what they were experiencing. If clients cannot give information, talk slowly enough to be understood, or speak coherently, TRIs exposing those phenomena would deepen clients’ pain. More effective in these cases would be attentive silence or short affective responses that prepare clients for a clearer focus on transferential and countertransferential affect. Clients might then feel comfortable with expressing subjective experience that is just partially known (Bollas, 1987). They might, in time, rely on the attunement of their therapist to bring partial awareness to fuller consciousness. They might then tolerate their therapists’ CTRIs or direct expressions of subjective states that reduce the quality of the therapeutic interaction, given that such expressions would repair some damage in the relationship and thus preserve it in the long run.
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Consequently, clients need to look at how they are unconsciously constructing the therapeutic relationship in accordance with their unconscious principles of knowing. If they do not do so on their own, therapists need to help them by interpreting the transference that betrays the assumptions. “I wonder if you see my asking you to pay your fee at the start of your session as an unreasonable demand similar to those made by your teachers,” a therapist might say.