lect 7 qualities needed by therapist

7/29/2019 Lect 7 Qualities Needed by Therapist

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Psychodynamic Counselling

Qualities needed by

a therapist &

Therapeutic effect

Lecture 7 Dr. Reem Ibrahim Ahmed

1



Introduction

•

it was not generally recognized that thetemporary separation of young children

from their mothers had any particular

damaging effect.• Everyone could observe that after an

initial stage of distress children became

quiet and well behaved, and it wasnatural to suppose that they had got

over the separation and settled down.2



• Thus the therapist had to possess a very

good theoretical knowledge – that

children do not get over separation so

easily;

• that quietness, and particularly

exaggerated quietness, does not

necessarily mean that all is well, andmight well hide feelings of the utmost

intensity;

3



•

that the consequences of allowing thesituation to develop unchecked would

certainly be distressing and might well be

serious;• and that the way to deal with it was to

bring out the hidden feelings there and

then.

4



• He had also to possess an attitude

to human reactions and emotions like theattitude of a physician to human

physiology –

•that these internal processes are a subjectfit for study,

• that an understanding of them is possible,

• and that rational interventions based on

this understanding can have predicted

effects.5



• What he should not have, of course,

is the plain physician's attitude tohuman emotions:

• for feelings need to be dealt with by

feelings, and not by reversing their

physiological effects –

•

The correct treatment for psychologicalproblems is hardly the immediate

prescription of anti-depressants

6



• The therapist must have deep insight

that should be enhanced by many years

of personal analysis

• and be aware of the consequences for

himself of being in the same situation asthe patient.

• He will thus be able to use his

knowledge of his own feelings in aprocess of identification with the

patient;

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• to know not only theoretically but

intuitively what was needed; and, havingfaced his own feelings in the same

situation, not to be afraid to face those

of someone else.

8



• The therapist's feelings can be shown,

but must only be shown objectively ,

under complete control, entirely in the

service of the patient.

•

It is so easy, in this kind of situation, toproject one's own personal feelings into

what one says to the patient, which very

quickly goes over into seeking sympathyrather than giving it.

9



• Patients are not interested in one's

personal tragedies; certainly not when

they are in the midst of their own.

• Everyone who undertakes psychotherapy

needs to have these qualities.• Not everyone has even the potential to

possess them, though they can be taught;

• and the best way of learning them, of course, is by undergoing psychotherapy

oneself.10



The question of advice

• Now advice is something that it is

absolutely correct to give in its proper

place, particularly when one has expert

knowledge not possessed by the other

person.

• This is so, for instance, when a psychiatrist

is asked to recommend a suitable form of treatment; and even more so when a

solicitor is asked to recommend a course

of action involving complexities of the law.11



But in emotional situations advice is beset

by difficulties, and there are several

reasons why giving it may be a mistake.

• no one can know everything and foresee all

the consequences of a given line of action.• it is far better for a patient to take

responsibility for his own decisions.

• But the two most important reasons aresimply that the advice is likely to be

ineffective, and that clarification of the

feelings may make advice unnecessary. 12



class work

• why does the pt needto ask advice, andfrom a therapist at

that?• This suggests that

there is more to hisrequest than meetsthe eye.

• If so, what is it likelyto be?

13



• the first answer to this question is that

there is some reason why the patientcannot do what he knows to be sensible;

• If the therapist simply tells him to go

ahead, the likely consequence is that thepatient will superficially agree that this is

what he should do,

• He will go away, come up against hisinability to do it, and then be left in

exactly the same situation as before.14



• This now raises another contradiction.

• If the above formulation is correct, then

why has the patient not simply said, yes Iknow this is the sensible thing to do, but I

cannot do it? Instead he has come asking

for advice.• The answer is almost certainly that he has

not quite faced the reason why he cannot

do it, and his request for advice from anexpert in emotional problems - though he

does not know it - is really a request to have

his feelings clarified for him. 15



The question of therapeutic effects

The situation described here representsone almost universally encountered in

psychotherapy, namely that

(1)the patient is brought to seek help by acurrent conflict, but that in addition

(2)this is within the background of

longstanding emotional difficulties, and

(3)both clearly have origins in the distant

past.16



The fundamental questionis now whether it is

sufficient therapeutically

to bring out the currentconflict, or whether it is

necessary also to make

the links with the past.

17



therapeutic effect

• emotional growth independent

of therapy ('spontaneousremission ').

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