Very interesting and helpful video. I especially appreciated your point about the full and unchecked bloom of feelings leading to the therapist becoming the focus and motivation to do therapy, while the rest fades into the background. I seem to recall reading that studies have found the relationship/alliance with the therapist to be the key to successful outcomes. So I guess it may be a fine line between deepening this relationship in order to address the problems that brought the client into therapy in the first place, or alternatively locking into a desperate clinging to therapist as a kind of “reason to live”.
The therapeutic alliance is essential and needs to be distinguished from a transference neurosis. Having trust in your therapist and viewing them as an ally in your healing is vital. Having them become the center of your life is not.
@@patriciacoughlinphd1852 is it reasonable to want your therapist to care about you? I mean that she appreciates me and likes to see me and doesn't forget about me if I don't have a session for a couple months. Is that full-blown transference neuroses? I have attachment trauma and have lived an isolated life. I do know that I have a "wish" deep down that she could love me, but I know that is not rational/realistic, and I don't expect it. (This "love wish" must be transference, but I'm not focused/stuck on that, so I don't think it's much of a factor.) But what about the expectation of care? I didn't even notice that I wanted her to care about me until the rupture happened. We've been dealing with ruptures since then for over a year now and I am still stuck trying to figure out if she cares about me. Is that transference or is that "normal"? I seem to have an inability to go to the trauma in front of her in this state of rupture (we were trying to start emdr.). If she doesn't care about me, then the work will be to somehow process the hurt from that, and why I was tricked in the first place, and then get to a point where I can say bye without feeling like a complete loser/failure/piece of sh*t. I don't know if that's even possible, is this full-blown transference neuroses? Am I supposed to be able to process trauma with her, not knowing if she cares about me? I can't access those feelings in front of her, my inner cynic/critic just makes me feel so incredibly stupid/weak/pathetic about the giving of attention to the trauma, having someone else pay attention to it, shameful. I don't think she gets it.
@@daniellec2172 Therapy should be structured with an agreement about the schedule. Why was therapy interrupted for months? If your therapist did not reach out, that would be are flag. Ask yourself if you care about you and are treating yourself with care and respect by clinging to someone who has not demonstrated a consistent commitment to your care.
Hi Patricia, thanks for this clarification! I've been watching your videos and I'm reading two of your books! I have other styles psychodynamic training and what I liked the most about your style and the ISTDP model is the emphasis on technique vs only theory. Also the idea of trial therapy in which the story is explored after working with the defenses has also caught my attention (and not as a journalistic interview)... I think that's how we began to intervene from the very beginning moment and increases the motivation to treatment. Unlike the traditional style of having 3 or 4 interviews and then giving a ”devolution”, which in my opinion greatly intellectualizes the process.
We need three areas of competence - a solid grounding in theory, with techniques that flow from and are internally consistent with that theory AND are supported by research evidence.
Yes. I met someone once well call her Mary. She did say she had "fallen in love" with her therapist. I myself had some counselling and did make a friend for a short time of my counselor. I even had her home phone number and address. I never took advantage of the last. Eventually I married and left therapy. And, last I heard she to had married and raised a family. I can't say that I was first she gave personal information to about herself (Val) or how that went but as for me I respected her disclosures.
A therapist has no business giving patients her home address and phone number. There are ethical standards which make clear distinctions between personal and professional behavior. It is not up to the patient to take responsibility for professional boundaries, but that of the therapist.
@@patriciacoughlinphd1852 yes. Later that therapist I heard had a stalker. I was long removed from therapy by then but we both went to the same university as graduate student.
@@patriciacoughlinphd1852 what if they see their clients at home and they give phone number to contact outside of sessions? Do you realize how bad the attachment pain gets?I think you have no idea...if you are having panic attacks middle of the night because you know they will abandon you? Just being able to write to my therapist anytime gives me so much comfort! ...and I dont write him (!) unless things get very bad! I really dont obsess about this particular person because he IS available and he is caring. are the boundaries about YOU or your client?
I had a psychologist ask me if i would go to a pub with him .The same dr had an erection when i was telling him about a child's sex assault,he also lied about being divorced. This man broke me than after he ended treatment he had the friends he told me about during therapy meet me online. Canceled by mental health and addiction
How would a transference neurosis be resolved? Does this mean a patient should withdraw from therapy completely? Perhaps not a candidate for psychotherapy?
It is up to the patient to honestly communicate their feelings and fantasies and up to the therapist to use them therapeutically - seeing the pattern in them - and getting to the source of it.
I might be one of those people. My therapist could never help me on the attachment stuff. He told me he is not my husband or my friend (I never ever implied anything sexual or anything outside of scope of therapy, I just wanted more sessions) . then he kicked me out.
It seems you’re defining transference neurosis as falling in love with the therapist. However I understand the transference neurosis as being any transferential manifestation of neurosis (which may be love but equally may be a range of other emotions)
Very interesting and helpful video. I especially appreciated your point about the full and unchecked bloom of feelings leading to the therapist becoming the focus and motivation to do therapy, while the rest fades into the background. I seem to recall reading that studies have found the relationship/alliance with the therapist to be the key to successful outcomes. So I guess it may be a fine line between deepening this relationship in order to address the problems that brought the client into therapy in the first place, or alternatively locking into a desperate clinging to therapist as a kind of “reason to live”.
The therapeutic alliance is essential and needs to be distinguished from a transference neurosis. Having trust in your therapist and viewing them as an ally in your healing is vital. Having them become the center of your life is not.
@@patriciacoughlinphd1852 is it reasonable to want your therapist to care about you? I mean that she appreciates me and likes to see me and doesn't forget about me if I don't have a session for a couple months. Is that full-blown transference neuroses? I have attachment trauma and have lived an isolated life. I do know that I have a "wish" deep down that she could love me, but I know that is not rational/realistic, and I don't expect it. (This "love wish" must be transference, but I'm not focused/stuck on that, so I don't think it's much of a factor.) But what about the expectation of care? I didn't even notice that I wanted her to care about me until the rupture happened. We've been dealing with ruptures since then for over a year now and I am still stuck trying to figure out if she cares about me. Is that transference or is that "normal"? I seem to have an inability to go to the trauma in front of her in this state of rupture (we were trying to start emdr.). If she doesn't care about me, then the work will be to somehow process the hurt from that, and why I was tricked in the first place, and then get to a point where I can say bye without feeling like a complete loser/failure/piece of sh*t. I don't know if that's even possible, is this full-blown transference neuroses? Am I supposed to be able to process trauma with her, not knowing if she cares about me? I can't access those feelings in front of her, my inner cynic/critic just makes me feel so incredibly stupid/weak/pathetic about the giving of attention to the trauma, having someone else pay attention to it, shameful. I don't think she gets it.
@@daniellec2172 Therapy should be structured with an agreement about the schedule. Why was therapy interrupted for months? If your therapist did not reach out, that would be are flag. Ask yourself if you care about you and are treating yourself with care and respect by clinging to someone who has not demonstrated a consistent commitment to your care.
Thank you Dr. Coughlin for trying to help and enlighten people like me.
Hi Patricia, thanks for this clarification! I've been watching your videos and I'm reading two of your books!
I have other styles psychodynamic training and what I liked the most about your style and the ISTDP model is the emphasis on technique vs only theory.
Also the idea of trial therapy in which the story is explored after working with the defenses has also caught my attention (and not as a journalistic interview)... I think that's how we began to intervene from the very beginning moment and increases the motivation to treatment. Unlike the traditional style of having 3 or 4 interviews and then giving a ”devolution”, which in my opinion greatly intellectualizes the process.
We need three areas of competence - a solid grounding in theory, with techniques that flow from and are internally consistent with that theory AND are supported by research evidence.
I appreciate your work, in fact I find it helpful.
Glad it was helpful!
Yes. I met someone once well call her Mary. She did say she had "fallen in love" with her therapist.
I myself had some counselling and did make a friend for a short time of my counselor. I even had her home phone number and address. I never took advantage of the last. Eventually I married and left therapy. And, last I heard she to had married and raised a family. I can't say that I was first she gave personal information to about herself (Val) or how that went but as for me I respected her disclosures.
A therapist has no business giving patients her home address and phone number. There are ethical standards which make clear distinctions between personal and professional behavior. It is not up to the patient to take responsibility for professional boundaries, but that of the therapist.
@@patriciacoughlinphd1852 yes. Later that therapist I heard had a stalker. I was long removed from therapy by then but we both went to the same university as graduate student.
@@patriciacoughlinphd1852 what if they see their clients at home and they give phone number to contact outside of sessions? Do you realize how bad the attachment pain gets?I think you have no idea...if you are having panic attacks middle of the night because you know they will abandon you? Just being able to write to my therapist anytime gives me so much comfort! ...and I dont write him (!) unless things get very bad! I really dont obsess about this particular person because he IS available and he is caring. are the boundaries about YOU or your client?
I had a psychologist ask me if i would go to a pub with him .The same dr had an erection when i was telling him about a child's sex assault,he also lied about being divorced.
This man broke me than after he ended treatment he had the friends he told me about during therapy meet me online.
Canceled by mental health and addiction
I hope you ended the therapy with him and will consider reporting him for ethical violations.
Can this occur in other relationships where one person is the authority figure, i.e, teachers?
Absolutely - it happens all the time.
How would a transference neurosis be resolved? Does this mean a patient should withdraw from therapy completely? Perhaps not a candidate for psychotherapy?
It is up to the patient to honestly communicate their feelings and fantasies and up to the therapist to use them therapeutically - seeing the pattern in them - and getting to the source of it.
I might be one of those people. My therapist could never help me on the attachment stuff. He told me he is not my husband or my friend (I never ever implied anything sexual or anything outside of scope of therapy, I just wanted more sessions) . then he kicked me out.
It seems you’re defining transference neurosis as falling in love with the therapist. However I understand the transference neurosis as being any transferential manifestation of neurosis (which may be love but equally may be a range of other emotions)
Indeed it is - it can take many shapes, as you suggest.