Posted by gardenergirl on January 30, 2004, at 11:03:33
In reply to Re: Wondering About Therapy » gardenergirl, posted by Lonely on January 30, 2004, at 0:35:29
> "Dual relationships", as I understand the term from reading on the 'net, means a situation where a therapist knows someone personally and also works with them in some sort of psychologically theraputic role.
Your definition of dual relationship is correct and it is discouraged, but not impossible. Your situation with your old T seems a bit different, however. T's and clients sometimes can't help but have inadvertent contact in the community. Most T's treat this by not acknowleging the client unless the client acknowleges them first. This way it protects the client's privacy. It seems like your visit to the hospital, although not inadvertent, does not really create an additional relationship. You were a client who was concerned about her T and needed something from her. What an awful situation for both of you!
> There's way too much left unsaid and undone and forever without closure. To me that is a case of the fear of dual relationships gone amuck. I still tear up and feel hurt when I think about it.
I'm so sorry this is still so painful. I hope in time you will be able to process this either with another T or with a good friend. Or even here!
>
> You've made some interesting suggestions that I'd really like to follow up on. Could I ask you what a "client centered approach" is? Would I use that exact phrase if I was interviewing a potential therapist over the phone? Is that a type of therapy that is typically practiced by an LMSW? A psychologist? LMSWs seem to be far more commonly found in our insurance. What is psychodynamic?Client-centered therapy was developed by Carl Rogers. Both LISW's and psychologists may practice. There are aspects of Rogerian therapy that pretty much all T's use, at least in the beginning stages of work and they are warmth, unconditional positive regard, and empathy. Client-centered therapy is one that is "led" more by the client. Whatever issues or needs you bring to the sessions are what the T works on with you. There is not really an agenda or specific approach the T uses, say as in CBT. This is an awkward explanation, but I hope it helps.
Psychodynamic therapy emphasizes the emerging and changing relationship between the T and the client through exploration of the client's past, defenses, wishes, desires, and needs. It is much less structured than CBT, which for some is great and for others feels too vague. In psychodyamic therapy, the goal is for the client to gain insight into what is in their unconscious, what is unknown to them, which then frees them up to behave in a different manner or feel differently about something. There is also a concept called transference, which is key. With transference, the client "transfers" or projects onto the T wishes, desires, needs, etc. which the client may have towards someone else in his or her life. For example, my own parents are highly self-centered. I never got much positive attention and validation from them as a child (or even now). That really hurts, and I still seek that "gleam in my parents' eyes" as my T puts it. I have, in therapy, transferred this need onto my T. I realized this when I wanted to call him to give him some good news about a recent school achievement. I realized I was becoming dependent on him, which felt scary, but also liberating to acknowlege and process with him. I hope this makes sense. My own preference is for psychodynamic therapy, so I feel like I know more about this.
When interviewing new T's or talking with your current, you can ask what their theoretical orientation is. There are many different ones they may say, or they may say "eclectic" which means they use techniques and stuff from many orientations. Or you can ask directly if they are CBT, client-centered, dynamic, etc.
> Yes, I think you've hit the proverbial "nail on the head" when you said that it sounds like the relationship is most important to me. I think that's quite true - I guess I'm a fairly emotional person.
You might also like interpersonal psychotherapy or emotion-focused therapy. These are not as common, but are still out there. But I think any therapist with a dynamic orientation may be good for you. That is if you can deal with the unstructured approach and with the T fostering the transference, which can be scary.
>
> Thank you for your insights - it helps.I hope this helped. Please let me know if you have other questions, and good luck!
gg
poster:gardenergirl
thread:307126
URL: http://www.dr-bob.org/babble/psycho/20040123/msgs/307258.html