[CantExplain]

DISCUSSION TOPIC:

What role does crisis play in therapy?

Madame T never prevented a crisis or did anything to reduce it. I'm pretty sure that was deliberate. But it got me thinking: do therapists (specifically psychodynamic therapists) actually work to bring on crises and make them more intense?

[Raging Quiet]

I know my T got excited when I was going through a crisis; she said it was when 'real' change happens.

No they don't create a crisis. Sometimes my T is surprised at the sudden onset, but is well able to work with the unconscious material that is finally seeing the light. It's the gold mine in therapy wk.
But, they know it wil come along, working on these issues and mental defences are ingredients of a crisis.
The question is: when is a crisis a crisis?

What are you calling a crisis because a crisis for me is a bipolar episode often so severe I end up hospitalized. I suspect you aren't thinking of something that severe. Because hell no! My therapist works very hard to help me not slide into that severe a crisis.

[feralkittymom]

What you're suggesting sounds very confused. Crises arising from within the therapy may be allowed to "ripen" for a therapeutic purpose; but no T I'm aware of would ever do anything to encourage a crisis to develop outside of the therapy--but nor would they necessarily be right to become directly involved.

If you're referring to the incident I think you're refering to, that sounds like a "crisis" ("" because what I know of it didn't seem objectively to rise to the level of crisis) outside of therapy--so, no, I don't think your T "allowed" it to happen, nor refused to get involved for any manipulative purpose.

[WikidPissah]

I don't think that any of my T's liked it when I was in crisis, nor do I think they attempted to cause the crisis. XT was actually fairly good at detection and prevention.

[mixedup_emotions]

I don't believe my T deliberately tried to cause or intensify ruptures between us. However, he does truly believe that no matter how unpleasant, if we're able to work through it, then there's great learning and growth that comes from looking back on the process of what occurred and how we worked through it.

[stopdog]

I think they are manipulative and wily. So if the therapist thought a crisis would help them in some fashion, I believe they would help fuel it.

I think it does depend on your definition of crisis, as Chris says. I began therapy suicidally depressed and would occasionally relapse into suicidal thoughts for quite a while. I would say that my T would work hard to prevent crises and to help mitigate those when the occurred, including encouraging me to call and calling me back and spending quite a bit of time on the phone with me sometimes.

In terms of our relationship, however, he will wait for me to bring up issues between us and will not broach the subject himself. Well, once, he asked me about a feeling of coolness and distance he was getting from me, to check in to see if the feeling was accurate. He asked if I wanted to discuss it and I did. Other than that one instance, he has waited for me to bring it up. When I ask him why he doesn't bring things up, he mentioned that once he thought what he was sensing was just me trying for some emotional space and wanted to give me that. Once it was to encourage me to develop healthy interpersonal skills. He has admitted that on a couple of occasions he did not bring up the discomfort between us because he had his own personal anxieties about the subject and didn't really want to talk about it. He quickly followed up on that by saying that he DID want to talk about it because I needed to, he was just trying to explain that he was anxious about it also and that why he avoided the subject until I brought it up. He then commented on my "courage" in being able and willing to bring it and address it head-on the way we needed to.

[growlycat]

I think that crises happen on thier own--no need to fan the flames!

[wotchermuggle]

Originally Posted by CantExplain

DISCUSSION TOPIC:

What role does crisis play in therapy?

Madame T never prevented a crisis or did anything to reduce it. I'm pretty sure that was deliberate. But it got me thinking: do therapists (specifically psychodynamic therapists) actually work to bring on crises and make them more intense?

No way do they try to put you in a crisis.

[content30]

Yes, like 1914, I'm wondering what you mean by crisis. When I started seeing my T, I was severely depressed and suicidal. After my first appointment (dragged to her by my family and a friend) I had a very serious and almost fatal attempt that landed me in the ICU. I consider that a crisis. My T did NOT want that at all! My T was very upset and very sorry that I had to deal with such a level of depression and anxiety. Even though I had only seen her once, she called me and my mother several times while I was in the hospital to speak to and encourage both if us--great T (yes, I had signed a consent for my mom)!

Now, my T does encourage discomfort, as some things must get worse before they get better. For instance, she encouraged me to get a different job and change a codependent relationship. I quit my old job and have had a different one for almost a year, which has been one of the best things for me but was hard and scary at first. I changed my living situation and am currently actively not speaking or hanging out with the person on whom I was codependent. We both agreed it was best to do this for a couple of weeks, even though we are no longer roommates. It was hard and is hard, but I would not call it a crisis. Growth often comes out of pain, but my T does not love crisis nor hope for it, she does encourage hard work and allowing levels of discomfort, though. It is all in my best interest.

[sunrise]

Originally Posted by CantExplain

What role does crisis play in therapy?

I tend to think of it more like, what role does therapy play in crisis? I believe therapy at those times would do the opposite of trying to add to a crisis. The therapy would be supportive during a crisis, and also practically-focused, with the T being more directive, giving advice, helping to troubleshoot problems, being more action-oriented, etc. Like when someone's home burns down, they are evicted, they were in a tornado, their spouse suddenly left them, a death of a loved one occurred, they are in danger of being harmed by others (or themselves), etc.

There is also the more existential type of crisis (what meaning does my life have?), and I don't think a T would try to create that, but might encourage discussion and exploration of topics that could lead the client to ask and answer that question, find meaning, etc. I think it could even be possible a T wouldn't know a client was going through one of these more internal crises, but if a client said "crisis" to a T, I would sure hope they would perk up, listen, and swing into action, even if that action was just openness and a willingness to listen and follow the client where he/she needed to go, which might be very, very deep.

There are times that clients get very emotionally dysregulated and can't get out of that. Working on skills in therapy like the classic "learning to sit with one's feelings" can be helpful in this type of crisis of emotions. So again, I think the T would try to help, but in different ways depending on what type of crisis it was.

[scorpiosis37]

Again, i suppose it depends on your definition, but I don't think I have ever been in crisis so I think it's safe to say that my T does not encourage them! My T also does not encourage ruptures, conflicts, or anything else dramatic. She just lets me speak, listens, and is "along for the ride" so to speak. I feel like I'm in control of my sessions and the direction of my therapy; I do not find my T to be manipulative or directive. She takes more of a backseat role.

[BlessedRhiannon]

My T and I actively work to prevent crises, because if I get to that point, I'm completely dissociated or suicidal or having one panic attack right after another. My T's goal is to get me to recognize the signs of impending crisis much earlier on and contact her for help before things get to the crisis point. I'm getting there, but it's hard for me to ask for help early on.

For me - crisis does not produce change. Being in crisis means things have spiraled out of control and I need help getting back to emotionally stable