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Originally Posted by missbella
My response to this article could be just as long as the article itself, but will stop myself. This is yet another piece full of subjective (self-protective?) observations, seeming to put most of the failure of therapy on the client's failures. Freudians were and sometimes still are far more fevered and furious in their patient bashing, so I'm glad this author toned it down.
Half a patient? That's an remote way to see another human being. I see the first omission is failing to view the transaction in everyday human terms and roles: the asymmetrical relationship, a seeker and the sage, the confessor and concealer, the sufferer and the authority. The structure doesn't work for everybody.
I was particularly struck by the ascription of the client's "aversion" to her defenses, assuming the entire transaction intrapsychic (in her head). I can envision other explanations why human beings might pull away from one another, but maybe I have a runaway imagination.
I wish mental health thinkers would ditch the theory momentarily and consider interactions in simple human terms. I experienced therapy as role play, an artificial construct. That pulls in a barge full of complications, potential hazards and impediments.
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I can understand your reaction.
The article seems written in therapy-speak, for therapists.
But the conclusions and implications do seem to me to point to, or at least hint at, problems in the therapists' attitudes, and attitudes common in therapy literature that I have read. Almost tongue-in-cheek in the article, to avoid seeming outlandish?
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To conclude, having half of the patient in therapy can be emotionally trying and evoke strong, contradictory countertransference reactions.
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I found this particularly shocking, like a slap in the face. Imagine what it's like to
BE half-people! But the article is written
for therapists and hence some expression of empathy might be understood or at least excused. The authors then went on to say:
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Throughout the treatment, the therapists experienced themselves as being particularly committed and active, strongly affected by the patient’s predicament. . .At termination, they additionally experienced the therapeutic relationship as marked by fruitless battles and loss of control of the process, feeling despaired, helpless, and frustrated.
. . .
In our study, the therapists’ unprocessed positive regard of the patient seems to have contributed to the therapist underestimating the patient’s problems. . . They do not attribute the limited progress in therapy to their own limited understanding of the patient’s problems, but rather to the patient’s lack of will to open up and try harder. Taken together, this resulted in an inability to adapt their technique and to address their interventions to the patients’ core problems
Several implications for clinical practice and psychotherapy training might be drawn from our findings. . .In such cases, when the patient does not participate with her whole emotional life, this might be the patient’s core problem.
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All-in-all, conclusions that I can agree with as a possibility for some folks, based on my own internal experience of myself and my long experience with ineffective and sometimes harmful therapy. I certainly
tried to participate with my whole emotional life. But maybe when the split is serious it needs some serious understanding -- something the therapists I saw, even supposed experts, seemed unable to do.