Wow. My first therapist brought up such HEAVY transference that I had to discontinue with her. Your simple explanation helped me see what the issues were. Thank you for your work. ❤
@@patriciacoughlinphd1852wow fabulous!! A woman of many talents I see (which does not surprise me). They are very Rorschach. I look at them and wonder/try to interpret what you were trying to depict when painting them..
Another excellent video Patricia. Makes me think about how we are similar to some of our colleagues in the CBT camp put this video illustrates how we for those that use EDT/ istdp interventions take it a couple of steps further and deeper. Our CBT colleagues look at cognitive distortions for thinking traps in the form of things such as all or nothing thinking or overgeneralizing. In a way they're looking at the CTA without using the TOC & TOP. In essence we use them, along with other interventions (eg Defense work within the triangles; HOC) to go from surface to depth getting to the UTA. Like you pointed out with the fella who had using been using what appeared to be projection/externalizing on to women "All you women" (ie, women n general, his mother, his wife). It appeared in your description that you use the transference then portrayal to get to the UTA then it brought out the other figures. Thus leading to expressions, passing, & resolving of CTF. As you said, it allowed him to distinguish and differentiate between all of the women figures thus leading to further consolidation. So like with our CBT colleagues, they try to use the CBT model to point out distortions though keeping it on the surface via cognitive work. This unfortunately, from what I understand, reinforces the defenses (eg cognizing, intellectualizing, rationalizing) thus keeping the patient stuck at the surface. This is not meant to devalue or CBT colleagues but more so to see how we are similar and where we detour from one another in our respective interventions. As I'm saying this I'm also keeping in mind and being cognizant that this would be contraindicated, that is reinforcing defenses in standard istdp approach. From my understanding if we were doing a graded approach we would restructure defenses via repressive/mature defenses to reduce regressive defenses. Thank you again for the video it helped me consolidate these thoughts. If you see anything inaccurate feel free to comment or offer constructive feedback. Thanks again Patricia.
Thanks for your message. I would suggest it's the other way around. Psychodybnamics well preceded CBT. Aaron Beck was an analyst who simply added an exploration of distorted thinking and beliefs to his other dynamic interventions. Over the years, CBT practitioners have borrowed and renamed dynamic concepts, replacing defense with avoidant strategies, for example. Yet, as you say, they talk ABOUT feelings but don't encourage the experience of these feelings in the body, along with their attendant impulses. Davanloo found it was the actual visceral experience of these forbidden feelings and impulses that triggers an unlocking of the unconscious, allowing us to get to the source of the problem. Perhaps this is one of the reasons that relapse is so high in CBT and relatively low in ISTDP. In fact, ISTDP is the only method that can demonstrate that patients get better and better over time with no additional treatment. So , some elements may seem similar, but the model as a whole has different aims and results.
Was using my phone to write this earlier and multitasking while traveling. Didn't mean to imply that CBT came before psychodynamic theory and therapy. I was aware that Beck was analytically trained however I learned something else from you in this response. As I now recall reading some of his earlier stuff he did use more analytically driven language as he was transitioning into a more cognitive framework. I can see what you mean about beck's predecessors altering the language and Concepts further. Right, the CBT folks talk about feelings as if they are logical constructs rather than an experience. They don't use the neurobiological concept such as the striated and smooth muscles in anxiety. Nor the visceral motor and sensory experience like in anger where one feels the Heat rising up through the body and through the head and neck wanting to release the impulse through the Fists. CBT is skills driven with its interventions whereas I know you have offered some alternate thinking on this with regard to istdp and how some tried to use istdp in a skill-wise fashion which unfortunately can at times lead to a distilled like version of istdp if one is not mindful to avoid that. Like when you mentioned interventions such as psychodiagnosis and response to intervention in other videos and books. As you said these need to be case specific rather than overly standardized skills that are placed onto or done to a PT. Right, that was what I was trying to convey earlier when I talked about how we work through depth in istdp. Like you said when Davanloo was demonstrating how to unlock the unconscious he was trying to get to the UTA to create structural change. The concept in his writings, if I was following correctly, with multidimensional structural change/MDUSC. We are using depth to to create lasting change for the PT. Helping them to move along the psychoneurotic side of the spectrum. Enhancing the ego adaptive capacity so the PT no longer has to either repress or act out but rather adaptive capacities through that change/healing. Getting better and better over time as you said in your response in which istdp is used versus CBT or TAU. The change is structural (depth) vs cognitive alone (surface). Like when you've quoted Freda From-Richman ( probably spelled wrong on my part 😊) the patient is in need of an experience (depth/structural) not an explanation (surface/cognitive). Thanks again for these videos and sharing your wisdom.
Great video, thanks! I always wonder to what extent conflicts are resolved (especially with figures from the past), and when we could say that it is resolved... I have the impression that more than resolving them, we learn to recognize them, accept them and understand the impact they generate in our present and our present bonds, with the purpose of stopping "idotism" or compulsion to repeat... What would you say about it? Manu thanks!
It's my experience that, when patients experience deep love for the parents who also caused them pain and generated anger , there is a profound inner shift that creates healing. ISTDP is very ambitious. Our intention is to resolve conflicts and actually achieve cure, rather than simply increase awareness so people can "manage" better. I just finished two treatments with people in their 60s, who had had decades of other therapy, meditation retreats, etc. Now they say, "How did this happen? I am happier than I've ever been. I feel free and spontaneous. I no longer have to think about what to do or how to manage, it just flows". This is actually possible, though not all patients receive this level of healing.