Shot. Thanks for that :-)

I recall something or other about how psychoanalytic theory has been critiqued because it was developed around a certain clientele. Namedly: Neurotic white middle class women in vienna. The notion is that it was developed around and for them and it doesn't have applicability to other people. In particular, people with psychoses are unsuited to analysis and people with borderline personality disorder (for example) were also too sick to analyse.

In recent(er) years psychoanalytic theory has developed in order to take on some of those clients. While CBT is developed (mainly) around the 'big three' psychiatric disorders (depression, anxiety, obsessive compulsive) psychoanalysis has attempted to extend itself to disorders that are more severe than white middle class female neurosis.

The couch and free association and dream work (for example) isn't used as much these days...

I guess I'm borderline. Not enough structure and I disintegrate into something resembling a psychotic state. I've seen this happen... Observed it happening to myself. Psychoanalytic theories have taken this on board with providing more structure.

Neutrality... And I disintegrate into something resembling a psychotic state. I've observed this happening to myself too...

The empathy thing is a %#@&#! winner, I tell you.

:-)

There have been theorists (Jaspers, for example) who talk about how one can enter into a patients delusional world and draw them out... Dammit... I can't remember who was renouned for doing this... I used to know, dammit... Part of the phenomenological tradition of psychiatry (before the mass marketing of drugs lol).

The gratification stuff you talked about makes sense. How about this though (okay so I'm drunk at the mo and don't dare quote me on this in the morning)

One of my fantasies / dreams... Is to be held. Like a baby. Rocked in someones arms. Maybe... Like a three year old. Arms around someones neck. Holding on tight. Not a burden on them 'cause I'm too light. To be in someones lap. Being held.

That fantasy can't possibly be fulfilled. I'm too big, you see. Unless there is some giant therapist out there in the world it can never be met.

The therapist doesn't need to attempt to frustrate a patients needs / desires. The very nature of the patients needs / desires means the needs / desires are going to be frustrated. No point in trying to maintain a neutral stance and not meeting the patients needs that can be met - there are going to be so many %#@&#! needs that can't be met.

Can you turn back the clock and undo the abuse?

No.

Can you hold me in your arms like a baby?

No.

Can you be the parent I never had?

No.

Why try and frustrate me when you can't %#@&#! well fix it already? How the %#@&#! is frustrating the needs I %#@&#! well know you CAN meet going to fix it?

(I know there are some that probably shouldn't be met... Touch should be used with caution for example)

But why try?

It will happen soon enough.

I think that attempting for a 'neutral' stance will only be perceived as coldness and uncaring and automatisms. Why? Because we know needs didn't get met (thats why the person is in therapy). Neutrality... Will only be perceived as uncaring...

And really...

Isn't it?

Just a therapists defence... THough when the therapist is in the grip of a theory...

I guess that is why this view is supposed to help some of the patients that couldn't be helped by traditional psychoanalysis...

:-)

Like me

:-)