final: time limited dynamic psychotherapy – Flashcards

For clients with chronic, pervasive, dysfunctional ways of relating to others Not very interpretative Attachment theory Object relations theory interpersonal experiences directly influence how we mentally construct reality

changing ingrained patterns of interpersonal and intrapersonal relatedness

object representations of self and other derived out of human interactions

people are innately motivated to search for and maintain human relatedness maladaptive relationship patterns are acquired early in life, become schematized, and underlie many presenting complaints Patterns persist because they are maintained to current relationships (circular causality) clients are viewed as "stuck" not sick maladaptive relationship patterns are likely to be reenacted in the therapeutic relationship focus is on one chief problematic relationship pattern The change process will continue after the therapy is terminated - getting positive reactions perpetuate the behavior and changes how they see themselves

a new experience and a new understanding

experience is not an explanation a more functional/adaptive interpersonal style

help client understand their patterns help them look at how they tend to repeat certain patterns across different relationships point out the pattern in the therapy and their life knowing this creates some empathy for ourselves less defensive when see it as the big picture construct a new narrative (help them w how and why they repeat certain patterns

Identifies the interpersonal cycle of maladaptive interactions with others and self Identify problematic patterns involve inflexible self defeating expectations and behaviors, and negative self-appraisals identify the one that is most problematic or most distressing at the time

address one problem at a time

includes thoughts, feelings, bx, motives, and perceptions of the client of an interpersonal nature Interpersonal thoughts: people will think I'm unstable Feelings: I feel inadequate and I feel crazy and out of control Motives: I wish I had a partner to grow old with an dshare the financial burden Perceptions: He seemed like what I was looking for Behaviors: Worrying, withdrawing from social interactions

how patient imagines that others will react in response to their bx Connected to the client's attachment fears fear of rejection often

actual behaviors of others, observed and assumed or interpreted through the patient's eyes Didn't take 2nd class b/c bad teacher; breaking up with because something's wrong with her

how the patient treats him/her self what does the person say to themselves about themselves? how do they treat themselves as a result? harshest critic or withdraw negative introjects are learned based in the way others treat us

therapist's reactions to the patient (countertransference) the therapist's behavior is shaped by the client's evoking pattern ID our reactions and use it to understand their CMP Wanting to take care of, protect defend Very important, their evoking pattern client tells you how others react to them not every reaction is a reaction that means something

Initial phase beginning phase middle phase termination

Let the patient tell their own story in her own words explored the interpersonal context related to symptoms problems used the categories of the CMP to gather, categorize, and probe for info

attending to themes in the patient's speech content and manner of interacting in session be aware of reciprocal reactions be vigilant for reenactments of dysfunction interactions in therapeutic relationship explore patients reaction to the evolving relationship with the therapist

develop a CMP narrative describing the patient's predominant dysfunctional interactive pattern enters into relationships quickly, idealizes it, breakup, confirms fears from this CMP, outline the goals for treatment improve existing relationships (possibly: find intimate relationships) Facilitate a new experience of more adaptive relating within the therapeutic relationship and/or with others in the patients consistent with the CMP Genuine caring, support reaffirming her abilities help the patient identify and understand his or her dynsfunctional pattern as it occurs with the therapist and/or others in her life

review progress and skills learned

client experiences more rewarding interactions with significant others increased emotional fluidity healthier ways of relating to the therapist therapist's countertransferential reaction become more positive client has deeper understanding of his/her interpersonal dynamics

client is experiencing some emotional discomfort basic trust; the willingness to trust the process of therapy a willingness to consider their issues in interpersonal terms: willing to tolerate ability to look at and examine their feelings some are too focused on experience, can't talk about feelings capacity to relate to the therapist in a meaningful way

patients problems can be treated more effectively with something else if client can't attend to the interpersonal content when we believe that the interpersonal focus may do harm

be sensitive for influence of culture consider client's and therapist's worldview and cultural influences culture influences how people express themselves how their interpersonal world is constructed