Reflective essays on therapeutic relationship in psychiatry

Thus, for the sake of brevity, therapists might have to divide TRIs and CTRIs into two successive TRIs and CTRIs, with the first addressing just the emotional or cognitive-emotional nature of the client-therapist relationship and the second adding the extra-therapeutic or pre-therapeutic aspect (Roth, 2001). For example, after saying, “I wonder if you are turning me off because I have hurt you,” a therapist could add, “It could be that you feel hurt when your wife fails to appreciate your help, as you mentioned earlier.”

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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. ()

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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.

Gabbard, G. O. (Ed.). (1989). Sexual exploitation in professional relationship. Washington, DC: American Psychiatric Press.

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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.

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Reflective Practice and Therapeutic ..

This book is the first to address what really happens behind closed doors during eating disorders treatment, as most writing has onlyaddressed theoretical approaches and behavioral strategies. The field has long needed a book that describes the heart of the matter: thetherapeutic interventions and interactions that comprise life-changing treatment for this life-threatening disorder. In response to this need, the authors have created a book that reflects the individual therapeutic skills and the collective wisdom of senior clinicians, all of whom have years of experience treating anorexia, bulimia, and binge eating disorder. Intended to be a deeply thoughtful and instructive volume,

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which often hinders the development of a therapeutic relationship

Transference and countertransference can contribute to positive therapeutic outcomes in non-analytic therapy as much as in analytic therapy. They can also contribute to negative outcomes and treatment failure. If existential, cognitive-behavioral, or any other non-analytically oriented therapists fail to notice these displaced phenomena at work in their sessions, they are limited in their ability to help their clients move beyond their one-sided, individualistic accounts of problematic relationships and events outside of therapy.

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Therapeutic Psychology - Term Paper

While TRIs and CTRIs may refer to past figures, they become more pertinent if they address material related to those problematic core conflicts presently occurring both outside and within the therapeutic setting. Not focusing on the present, Gill (1982) warns, can make clients feel that therapists are examining past relationships at the expense of their presenting problems. By interpreting the here-and-now, by contrast, therapists imply that clients’ presenting problems are more important than their past difficulties.