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Originally Posted by Lrad123
I thought it was interesting that this article had a nice definition of the term “observing ego” which you recently used (can’t remember if it was in this thread or another one):
“The term observing ego refers to an individual's ability to step back, get some distance or perspective, and observe himself as he would a friend or family member.”
This article is interesting, but since my T has repeatedly said he doesn’t do supportive therapy, it may not pertain perfectly to my situation. Although I’m pretty sure he was doing a fair amount of supportive therapy for a while just to establish rapport and make me feel less anxious with him. I still have to read the other articles, but am hoping there is a similar type of article for the type of therapy my T is doing (depth or exploratory?). Anyway, nothing like intellectualizing it all to make me feel more in control!
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Most of the analysts use both supportive and exploratory approaches but some lean heavily to one or the other. What I was trying to say was that your T practices more from the exploratory approach rather than the supportive approach (as you now know). Object relations oriented analysts usually do the more exploratory, while the self psychology and relational analysts lean more towards the supportive type. Your T likely referred you to the latter. But again, most incorporate both to some extent. My T also leaned heavily to one end of the continuum.
With my own T, recently, all he did was adjust his approach to be more supportive at times. Ts should have SOME flexibility, and the literature speaks to that too...My T used to interpret my requests to modify the therapy as transference wishes, but now we have a T-client relationship instead of just the transference relationship. He made a few adjustments and it works well.
I'm curious why your T wouldn't make a few adjustments and wonder if he is like my T in the regard as well. The exploratory type restructures personality/sense of self. In my opinion, that makes it worth it and other therapies do not have that impact.
To answer your question, the Psychiatric Times article talks about the primary components (exploratory and expressive are the same):
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Balance Between Supportive and Expressive Approaches
Supportive approaches do not require adherence to psychodynamic theory (Pinsker, 1994), but they are compatible with it, as they are also compatible with cognitive-behavioral therapy and medical practice in general. Addressing the topic of how to determine the balance between supportive and expressive techniques, Wachtel (1993) advised, "Be as supportive as you can be so that you can be as expressive [or exploratory] as you will need to be."
When psychotherapy is based on the expressive model (i.e., the assumptions, premises and techniques of expressive therapy), the therapist only gives up as much neutrality as necessary. In the supportive therapy model, however, the therapist is no more neutral than necessary. My colleagues and I have proposed that instead of applying the expressive model to all but the most supportive end of the psychotherapy spectrum, the supportive model should be paramount in all but the most expressive treatment (Hellerstein et al., 1994).
The supportive component of expressive-supportive treatment entails being alert for opportunities to offer praise and encouragement, solicit feedback and explicitly define the agenda. Efforts to minimize or prevent anxiety are appropriate with most patients. At the middle of the psychotherapy spectrum, the therapist must determine for each patient whether to utilize transferential aspects of the relationship, or to keep it to himself or herself.
As the patient's condition and goals change, the role of expressive elements may become greater. At all times, however, therapy should be coherent and consistent. One does not make transference interpretations one day and not the next, or alternate between ignoring or challenging defenses. And although discovery of unconscious forces is not an objective when the supportive component is prominent, it is important that the therapist be aware of the ways that the unconscious process and transference can affect the patient, the therapist and the therapeutic relationship. Unconscious forces do not cause all the mental disorders once attributed to them, but they often determine the outcome of treatment.
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In a nutshell more neutrality means no reassurance, comforting, affirmations, that sort of thing. They don't 'bend' to what you need, which causes all sorts of anxieties and heavy transference, which is one reason why you need to go twice a week. My T pushed me for over a year (years?) to go twice a week in order to do expressive therapy. It never happened and he eventually made the adjustments. Your T can too but seems to not want to.
I'm curious if you could ask him if he could be less rigid and incorporate some supportive concepts. That would be a win-win situation for you. If you go with a more supportive therapist, you won't get the benefits of expressive therapy of course.
I think the neutrality is the main difference. For more concrete comparison, basically take the methods of supportive therapy discussed in these articles and think of the opposite-that will tell you what expressive therapy is about. lol Some thing psychoanalysis is mysterious and complicated, but it really is that simple though I reached this conclusion only after years of my own 'research' and experience.