Why do some patients not get better in psychotherapy? Irwin Hirsch reminds us of the dangers of "coasting in the countertransference." It is a simple, useful, and powerful book about a problem that prevents patients from improving.
booksinpsychotherapy.blogspo…
Sure, being a psychotherapist is challenging...But agreeing to order 16 customized caffeine beverages from an artisan coffee shop for a group of graduate trainees was one of the most stressful experiences of my life. (Did we know these beverages come in green and purple?)
This kind of listening expands what it means to embody attuned responsiveness with each patient. Thinking of what Balint refers to as being the “unobtrusive analyst.”
A focus on the here and now transference does not mean you have to explicitly make it about “us.” You listen for how it might be, letting the possibility inform your listening and response, even if just implicitly, with the aim of inviting the patient to expand their exploration.
The kinder and the more thoughtful a person is, the more kindness he can find in other people.
Kindness enriches our life; with kindness mysterious things become clear, difficult things become easy, and dull things become cheerful.
- Leo Tolstoy
Saying that psychotherapists shouldn't offer advice and that advice is not therapy is an overly simplistic formulation.
It comes from a psychoanalytic and psychodynamic tradition which I highly value, perhaps above others in some respects...
When it is formulated as a one-sided rule, it is more an article of dogma akin to a theological prohibition then reflecting the spirit of critical thinking which is the strength of the psychodynamic model.
It seems like a glaring blind spot to me to both assert the primacy of reflective function and also to assert singular prescriptions for practice.
Next step might be to do a little bit of a literature search to see how this has been addressed previously because I strongly suspect there are formulations which are not black and white.
The signal on social media has devolved into a binary one.
“In our contemporary psychoanalytic climate, "omniscience" and "omnipotence" can come in many other forms, including an unexamined tendency to proceed as if discussing the ongoing interaction in the moment is always a good idea…
- that is, proceeding without considering how working in this way may affect the patient whose facility in this area is not as well developed as the analyst's.” - Robert Grossmark, The Unobtrusive Relational Analyst
“In psychoanalysis, the fact of an ending is known but its location is not. Neither analyst nor patient can envision how far away it is, or what it might look like when it arrives. Both have to be willing to enter deeply into an engagement about which the only certainty is —…”
Desire is evil and illusory, yet without desire we should not seek for that which is truly absolute, truly boundless. We have not experienced it.
Simone Weil
Gravity and Grace
"...our childhoods leave in us stories... stories we never found a way to voice...When we cannot find a way of telling our story, our story tells us-we dream these stories, we develop symptoms, or we find outselves acting in ways we don't undersand" p10 Grosz (2013)
"I suppose I saw my job as coaxing them into the pleasure of talking...It wouldn’t be simply, you’ve come here to have a terrible conversation so you can get better, but instead what might be the pleasure or use of actually talking to somebody."
interviewmagazine.com/litera…