Relational Interventions By Lawrence E. Hedges

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Psychological Therapy

Introduction: Psychological Therapy

 Before Get Started With Psychological Therapy, As psychotherapists, we strive to be useful to people struggling with life’s many problems. But how exactly do we do this? We begin by studying the many competing theories of the mind and theories of Psychological Therapy now available to us and we choose the ones that make the most sense to us. Only much later are we able to realize that our choice of theories actually expresses what we intend to do in Psychological Therapy that is, how we believe we can best make ourselves useful to our clients. Further complicating things, we are today beset with a vast array of medicalized descriptions of people diagnostic categories devised by psychiatrists to justify to the public and to courts of law their choices of medications and other somatic therapies. To the extent that as psychotherapists we get snagged into medical diagnostic thinking, we have also to contend with the diagnostic system’s assumptions and biases thus adding further complexities to our work.  

Contents Of Psychological Therapy

Part I. Introduction: Relational Listening

Opening Challenge
Psychotherapy as Relationship
Considering “Lower Level” or “Difficult to Treat” Clients
Content vs. Process Treatment Approaches
The History of the Psychotherapeutic Relationship
Developmental-Relational Listening Table 1: Four Developmental Listening Perspectives and Seven Relational Fears
Two Relational Intervention Principles

Part II: Identifying and Engaging the Organizing Transference

Three Brief Case Examples of Fight-Flight-Freeze Predefenses
1. Fight in the Organizing Transference
2. Flight in the Organizing Transference
3. Freezing in the Organizing Transference
Disconnecting Modes: “The Clamor”
Brief Case Illustrations of How Clamor Works in the Organizing Transference
A Thought Experiment for Understanding the Organizing Experience
Considering the Thought Experiment and the Organizing Experience Retreating from Contact and Intimacy: Why Do We Resist Loving Contact?
Summary
The Energy Arc Metaphor
Therapy with The Organizing experience
Optimal Responsiveness with the Organizing experience
Working Through the Organizing Transference and Resistance Varieties of Common Countertransference Relational Experience
Four Kinds of Countertransference to the Organizing experience
Case Studies of the Organizing experience
Case Study: Lawrence Hedges: Paul’s Organizing Transference
Case Study: Audrey Seaton-Bacon: “I Am Going to Die” Summary of the Organizing experience

Part III: Borderline Personality Organization

Introduction: Enactments in Replicated Symbiotic Scenarios
Case Study: Jody Messler Davies: “Love in the Afternoon”
Case Study: Lawrence Hedges: “Eros in the Transference”
Three Common Treatment Errors Case Study: Stephen Mitchell: The Horror of Surrendering
The Symbiotic Replicated Transference-Countertransference
Therapy with Symbiotic Relatedness Scenarios
Passive and Active Transference-Countertransference Enactments
Resistance to Relinquishing Symbiotic Modes
Responding to the Negative Therapeutic Reactions
Case Study: Sarah Turner-Miller: “‘Night, Mother”
Case Study: Donnel Stern: “Perhaps you should have called me.”
Summary: Developmental-Relational Listening to the Symbiosis

Part IV. Summary and Conclusions

The Realization of Relational Interventions
The Listening Perspectives Approach
Distinguishing Between Organizing and Symbiotic Experiences
So What Are Relational Interventions?

Acknowledgements

Appendix A

Informed Consent for Long-Term Psychotherapy Regarding a Case Monitor, Medical Care, and Termination Plans [Also for Use When There is a History of Trauma] Informed Consent Agreement

Appendix B

Informed Consent Regarding Limited Physical Contact during Psychotherapy

Appendix C

A Brief History of Psychiatric Diagnoses

Appendix D

Relational Listening I: Development, Transference, Countertransference Relational Listening II: Resistance, Listening Mode, Therapeutic Intervention

Notes

References

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