Setting. What Is It And Its Function?

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

What is a setting in psychotherapy, why is it needed? Why is this concept so important?

The setting is the time, place, frequency of meetings, payment and some contractual conditions and restrictions that are imposed on the process of conducting a psychotherapy session. The setting fulfills a very important function - it ensures the safety of the client, which is the foundation of our whole life. A parallel can be drawn with Maslow's pyramid of human needs. Safety is a basic need for any person. Agree, it is difficult to realize your plans and dreams, to achieve certain success in development and career, without feeling safe.

Psychotherapy is a very deep, sincere and vulnerable moment. Here it is important to feel the boundaries of security, conditionally - the walls of an imaginary house in which a person will not be disturbed by anyone.

The payment for the psychological consultation gives the client a guarantee that he will not be used by the psychotherapist for personal purposes. What is meant? If the therapist takes a small fee for his services or conducts psychotherapy sessions for free, on a "voluntary basis", it is likely that he is pursuing personal goals in communicating with the person. At best, this is pumping up your skills and experience (a novice psychotherapist), with this approach, the payment for the therapist is really not important, such situations happen and are considered the norm. However, quite often you can face situations when the therapist seeks to satisfy the inner Ego, to receive recognition of his Rescue instinct. This is especially true in cases when the therapist has an unprocessed neurosis in relation to his own family (for example, he tried to save the parents' marriage, to influence the nature of their behavior, but could not do it). In such scenarios, the therapist "trains" on clients, trying to "save" others - for good (which is rare enough) or harm, forcing people to be together, even if it does not benefit them. A very simple example - they are trying to make an artist out of you (because of your own unrealized artistic talents), but at heart you are a lawyer.

Another variant of this attitude of the psychotherapist to the material component is the satisfaction of his narcissistic-neurotic need to be needed. Is it good for the client? Difficult to answer. It is necessary to observe and analyze all situations that occur during therapy sessions.

As for the monetary equivalent for the services of a psychotherapist, the payment should be clear and more or less constant for the client. There are times when it is necessary to revise the cost of the services provided, but it is necessary to report all changes in advance, at least a day in advance, ideally in 2-4 sessions (the client's situations may be different, therefore, this nuance must be taken into account). In psychoanalysis, the revision of payment is much stricter - often the cost of services is revised according to the terms of the contract, and the person is notified six months or a year in advance.

So, it is very important for the client to know the basic principles of psychotherapy - where and when he will come, how much he will pay. Speaking specifically about obtaining effective and deep results, the setting should stipulate the frequency of visits (at least once a week). An important nuance - every time it should be the same time and day of the week! Why? This rhythm creates a certain background of safety for people with heightened anxiety and borderline clients. With this approach, when a person's safety zone is severely violated, the setting of the setting themselves can be healing - thanks to the rhythm and a sense of calmness at the unconscious level, the psychological background is leveled in people.

Most often, the therapist does not change the location of the sessions, and with regard to online communication, Skype also does not change. A useful recommendation in the latter case is that it is advisable to work in the same place, in your secluded corner, in which no one hears or sees.

Situations with cancellation and rescheduling of sessions are also contractual and discussed in advance. The psychotherapist and the client decide on their own whether it is worth concluding a contract or whether it is more convenient for them to build a relationship on trust, having discussed all possible nuances orally. The recommended minimum period for canceling or rescheduling a session is one day. It is not uncommon for clients to cancel or postpone an appointment in less than a day, so many therapists insure their time - in this situation, the session is necessarily paid. This behavior means resistance from the person. All people subconsciously resist changes in their lives, even if they are for the better. Nobody wants to step out of their comfort zone. It is always easier to do something useless and destructive than something really worthwhile.

What is healed by the setting? Attachment disorder, impaired childhood safety, increased anxiety, panic attacks, borderline personality organization, borderline transient states (eg, an emotional outburst), psychological state of addiction, narcissistic and depressive nature are those conditions in which a strict setting is of great importance.

The task of the psychotherapist is to monitor the client's adherence to the setting (whether he arrives on time and pays for it, is there a transfer of sessions and for what reasons, is there a connection with the client between sessions and why). The regularity and consistency of the setting is a huge step for the client on the path to effective psychotherapy, the desired result, growth and development.

It is generally accepted in psychotherapy that there is no relationship or communication between the therapist and the client outside the sessions. However, if such contacts occur, it makes the therapist think about the situation with the client, analyze the last sessions in search of an answer to the question "Why did the client need this now?" The therapist independently decides on the possible communication with the client outside the sessions, depending on the complexity of the case and the position of the person. But all events between sessions, lateness and absence of a client, rescheduling of a meeting are always a subject of discussion at a session. The behavior and actions of a person can testify to quite important things, having understood which you can make a significant breakthrough in the stated problem.

The client's need for a psychotherapist is associated with attachment to the mother. This is a kind of check:

- Mom, are you there? Where are you?

- Yes, I am.

- Ah, well, well, then I'm calm!

A similar need for contact is experienced by people with an increased level of anxiety or attachment disorders, checking whether there is still contact, whether the therapist has left, is he really there, loves and does he still understand?

Why mom? The fact is that the first attachment is formed with any of us with my mother, and then with everyone else. Accordingly, the most common transfer in such cases is mom-child.

Sometimes in the setting there is a rather unusual situation when a client asks to hold a meeting in another place or independently initiates interesting questions-situations that he would like to discuss with the therapist and figure out the true reason for his actions (for example: “I wondered why I didn’t want to come to the session last time? "or" Today came to the meeting, but somehow through force "). Such discussions can take the client to a completely new level of development, at least they mean important and qualitative changes in the psyche, behavior and awareness of therapy.

As an example, consider a personal situation - being late for your session by 59 minutes (the psychotherapist's session duration was 60 minutes). It was at this moment that the awareness of the feeling of fear arose that the therapist could quit, turn away, reject. Thanks to such sensations and unintended events that influenced the delay, the session takes on a completely different meaning, the shade of a new experience, becomes an order of magnitude more significant, and forms full-fledged trust between the client and the therapist. A person begins to perceive himself and others in a different way and ceases to be afraid of new relationships, especially if the companion is very dear to him.