Introduction to Psychotherapy - What the Therapist Actually Does
Whilst some traditional therapists might be described as adopting the stance 'I know; I'll tell you', the stance I advocate is one of 'You know; you tell me'. Bowlby 1988
First and foremost the therapist listens to us, and he listens with his mind in a state of free-floating attention which is completely focused on what we are saying.
Interpretation
Through interpretations the psychotherapist offers us insight and encourages us to develop insight for ourselves by making connections between the conscious and unconscious levels of our mind. The interpretations are likely to be about how we are feeling beneath the surface, how that feeling relates to our relationship with him or her, and how that feeling relates to the relationship we had with someone in our past, usually a parent.
Surviving
Surviving is an important function of the therapist. No matter what we do, whether we attack him, declare love for him, try to throw him off the scent, or completely ignore him, he will stay with us for the whole session, maintain his equanimity, and be there again for the next session.
Countertransference
As well as accompanying us as we explore our feelings the therapist has to be aware of any feelings he experiences in relation to us; these are his countertransference feelings. Two distinct uses of the word 'countertransference' need to be distinguished.
The first refers to a situation where, just as the patient unconsciously brings his repressed feelings and unresolved conflicts to bear on the therapeutic relationship, so does the therapist. The therapist 'contaminates the field with his own problems from elsewhere'. [Brown, D.; Pedder, J. 1991]. This kind of countertransference should not happen.
Provided that the therapist is himself free of neurotic problems he can assume that what he feels is a result of something we are doing to him and use countertransference in the second sense, which is as an important tool by which he can gain understanding of what we are trying to communicate.
The deeper meaning of what the therapist does
The therapist's behaviour towards us has an important meaning at the deepest level of our unconscious, which is that through his attentive listening he is emulating the devoted attention a mother ought to give her baby.
The setting of the treatment
it is the psychoanalytic setting itself that is the foundation upon which everything else rests. [Modell 1990]
The actual setting of the treatment has a deeper meaning too. The setting should be a place where we can leave the everyday world for a while and feel free to explore and express ourselves without inhibition. Because the setting is itself part of the therapeutic relationship the way we relate to it can reveal aspects of our unconscious.
The limits of the therapeutic relationship
An important function of the professional rather than personal nature of the therapeutic relationship is that ultimately we must find it unsatisfying and look to other relationships for satisfaction. To stay with a therapist indefinitely would be equivalent to a child staying with his mother indefinitely.
Related Tags: depression, anxiety, psychotherapy, mental health, therapist, therapy, psychoanalysis
More information about psychotherapy is available at Inside Psychotherapy at http://insidetherapy.blogspot.com/, accompanied by the Psychotherapy Book Store
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