2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
A 34-year-old man, B., sought therapy for psychosomatic symptoms that bother him. After undergoing a thorough medical examination for the search for cardiological pathology in the clinic and receiving a negative conclusion, he was at a loss and asked for psychotherapeutic support. Of course, the focus of his therapeutic application was on complaints of physical well-being and related anxiety
However, B.'s rather high intelligence allowed him to assume the existence of a psychogenic connection within the picture of his illness. However, B. did not have the experience and habit of talking about his feelings and desires, as well as being aware of them in general. B. described almost all episodes of his life in an even unemotional tone, while the content of his story caused me anxiety, fear and pity for this person. Having lost his parents early, he married unsuccessfully. In family life, he faced constant rejection, so he spent most of his time at work, where he was very successful and received enough recognition. B. had no close friends, relations with colleagues were rather cool and formal. Most of the emerging personal reactions (they were realized by the client quite rarely) in the form of feelings, desires, etc. B. controlled and preferred to keep to himself. B. also perceived our contact only through the prism of the desired therapeutic effect, I seemed to him only "a specialist who has the opportunity to help him." I often felt like a kind of therapeutic apparatus, despite the fact that I was very emotionally turned on. My attempts to place the phenomena arising in our contact in the form of feelings, desires, observations of B., as a rule, caused two possible reactions. B. either ignored my words completely, or was annoyed, saying that this did not help him move on the path of getting rid of the symptom.
At one of the sessions, we found ourselves in the zone of discussion of the topic of acceptance of B. by other people, as well as the recognition of his need and importance for them. At that moment I was keenly interested in B., which did not go unnoticed for him. After some time, B. asked me if he was really a significant person for me. I replied that during the therapy I managed to become attached to him, and that he occupies a significant place in my life. B. said that he was very moved by the fact that over the years someone was really interested in him, and he burst into tears. And he spoke and cried, in my opinion, to me personally. For the first time during therapy, I felt his presence in contact with me quite clearly. This was a significant advance in therapy, in a way a breakthrough.
In the next session, B. looked alarmed and rather annoyed. He said that he was annoyed that the therapy was proceeding very slowly, in his opinion (at the described moment of therapy, it lasted about 1, 5 months), and also that I was working in a way that was not suitable for him. Since what he said was addressed rather to the air or the space of the cabinet (such a rollback from the achievements of the last session, of course, could be assumed, since the new experience he received in our contact was apparently not easy to assimilate), I suggested to him, despite the obvious risk to aggravate our relations, to say these words, addressing them personally to me. B. spoke them to me, and I again felt the already familiar sensation of B.'s presence in contact, although this time it was not easy for both of us. I asked not to leave contact with me and to remain sensitive to what will happen to him next.
Suddenly, B.'s feelings began to transform - he began to talk about a mixture of fear that I might leave or reject him, and envy that he felt for many aspects of my life. The irritation turned out to be in the background at this stage of the conversation. I supported B. that he was entitled to his feelings, including jealousy, and expressed my gratitude for the fact that he can place his feelings and desires in contact with me, despite the obvious fear and risk of rejection. Interestingly, the self-dynamics of our contact did not stop there - B. said that he experienced significant shame in contact with me, despite the fact that I was obviously building the dialogue in a way that was supportive for him. I asked B. to tell me personally about his shame and carefully observe what would happen to him and how his experience would change. A minute later, B. said that, most likely, his shame intensified precisely because of my caring and supportive position, which he habitually regards as humiliating for him, and added that he felt a desire to disappear. At that moment, I felt acute pain and pity for B. Having told him about them, I added that I believe that he has the right to be cared for, as well as to be recognized by other people of his importance and right to exist. His thesis that a man has no right to pity and care, I met with surprise and even some indignation.
Suddenly, in the field of shame, which looked toxic just a short time ago, insignificant sprouts of other feelings began to appear: thanks to me for the fact that I remain, as before, with him, although, according to his usual calculations, I should have rejected him, and also the pleasure of contact, which he has not experienced in a long time in his life. Shame gradually turned into embarrassment, ceasing to have a toxic effect on contact, although, as before, it remained a figure. I asked B. in this situation to stay in touch and experience this phenomenologically new emotional cocktail. At this point, our session was supposed to stop, and we said goodbye to B. Despite my anxiety about a possible "rollback" as B.'s experience, in the next session he did not avoid contact with me, being present in him quite openly with his feelings and desires. This indicated that the process of assimilation of the experience gained had started.
Of course, the therapy and the difficulties facing it did not end there. B., as before, remains in therapy, receiving much more pleasure and therapeutic experience from it than before this episode. Contact opens up more and more opportunities for us, constantly surprising us with its unexpected diversity.
Recommended:
On The Risk Of Being Imperfect In The Process Of Psychotherapy: A Case From Practice
G., a 47-year-old woman, divorced, was brought to psychotherapy by difficulties in relationships with children who "lead an asocial lifestyle." G. is very intolerant of his "offspring", angrily criticizing them on every occasion.
“You Must Leave Her! There Is Nothing You Can Do To Help Her! " Does The Therapist Have The Right Not To Continue Psychotherapy. Case From Practice
Reflecting on the toxicity of our profession in general and public contact in particular, I recall an instructive incident. He describes a not quite typical professional problem, which corresponds to the same atypical solution. Both the problem described and its solution in this case are not in the field of theory and methodology of psychotherapy, but in the field of professional and personal ethics.
A History Of Veiled Violence And Broken Boundaries In Psychotherapy. Case From Practice
The case that I want to describe demonstrates the situation of correspondence supervision. Therapist - Veronica, a 32-year-old woman who faced a situation of violation of her boundaries in the course of psychotherapy. The client is Robert, her age-old, successful, handsome, well-built man, single, has a high social status.
This Does Not Happen Or A Case From Practice
And again about the injury. At one time, I had the opportunity to work in a children's institution. The most interesting place of service for a psychoanalyst, sitting at the rate of a psychologist, I can tell you. Well, one day the door of my office opened and a girl of fifteen years old appeared on the threshold, famous for being the owner of the most complex pathology of all children.
Where Does Depression Live, Or All The Problems From Childhood?
A case in psychotherapy. The client is a young girl, a designer. Request - bouts of rolling depression after a successful project, unwillingness to develop in this direction. There are no obvious prerequisites for this. Good job, salary, friends, family, parents - everything is fine here.
