Sunday, September 6, 2009

A therapist's attachment**






I ran a short workshop last week on attachment and attachment in the psychotherapeutic process. Some interesting comments came out of it as participants gave feedback and asked questions.


At one point we spoke about the longer term attachments that can happen in therapy. One of the participants had been reading this blog prior to the workshop and asked a question about pre-verbal issues and their treatment.


I was going to suggest we did a demonstration rebirth but decided against the idea! With pre-verbal issues one is usually dealing with the more psychotically damaged person quite often with characterological problems or what is sometimes known as personality disorders or a third degree impasse in Transactional Analysis terms.


Doing co-therapy with Mary Goulding


The question was asked about how one treats the pre-verbal client and my answer was with attachment in the transference relationship. And amongst other things it is through this the client learns how to self soothe. The only problem is that it takes time. I am not aware of an expedient way to treat such characterological problems.


The question was then asked, how long is that? Usually 1, 2 or 3 years but in my answer I noted that my longest client ever was about 11 years. A very paranoid man who saw me once a week for about 11 years. There were a few breaks in that time but not many and none of them were long breaks. This brought a flurry of comment and questions.


After I stopped seeing him finally, he left and that was that. Months later on christmas day there was a knock on my front door. I went to see who it was and it was him! He said hello and handed me a Christmas present. We had a discussion for about 10 - 15 minutes and he left.


The paranoid personality type


This left me a bit perturbed as he had come to my home uninvited. This man could be very paranoid and could have created all sorts of paranoid beliefs system about me in his head. However I just let it go, did not hear from him again and forgot about the whole thing. Then next christmas day there was a knock at my door and when I opened it there he was again! I got another gift, we talked for 15 minutes and he left. This has continued every christmas since.


This has been good for me because after 11 years I got to know him very well and of course I developed an attachment to him. Of course as a therapist I need to be very careful with this and so forth. But after 11 years I had developed an attachment and this once a year continuity I like because it is a continuity of our relationship.


Sometimes clients complain that the therapy relationship is a one sided attachment wise which I agree with and then they complain that the only reason I see them is because they pay me and that if they died I wouldn’t even go to their funeral. Well if the man under discussion died I would go to his funeral.


The complaining clients are correct however and I would not go to the funerals of most of my clients should they ever have one. However I can recall two that I have gone to. At one I was even asked by the husband to give a short eulogy, which I did. That was of a woman who I saw for five years most of it at three times per week. So it was an intense therapy relationship and yes I did develop an attachment to her and I was moved by her death and emotionally moved at her funeral.



Let me tell you, that is not an easy thing to do, to see a client three times a week! What the heck are you going to talk about! If I see her Monday and then again on Wednesday there is not a lot of time for something significant to happen. However we managed.


At the workshop I also mentioned that over the years a few clients had legally changed their surname to mine. This brought consternation from some of the workshop participants asking if that was professional and ethical. My response was what is wrong with it? I can’t stop them anyway but of course they wanted me to agree with it which I did.


This has not happened for a long time and was in the early 90s if I recall correctly. These people had read about the Schiffian school of Transactional Analysis where Jacqui Schiff’s clients would change their name and so it was a follow on from that.

I must say that regarding the attachment or therapeutic relationship from my point of view this did have an impact. To me it meant something special and I was indeed very glad for them. I have not seen or heard from them for a long time now which is a bit sad. So clearly I did have an attachment of some kind with them.


Graffiti


24 comments:

  1. Yes Tony,
    I can imagine the modeling and transference superimposing itself onto the clients and trainees alike. I have seen such relational based transference look a kin to a DNA type thing where lots of things are absorbed by individuals strivint to model themselves on their instructor (parent figure).

    The group (tribe, cult like) dynamic. Its so fun to watch and even more fun to be a part of. As you know though, they grow up, leave the nest and become their own individual selves (perhaps still with a couple of little quirks here and there).

    Difficult yet beautiful transitions none the less. Gosh i like that picture!

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  2. Geez! All i meant to say was... i really liked this post. And i really love that picture. Cheers...

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  3. Roses!!

    You certainly have learnt a lot and that is a very erudite statement. Well said. And I would agree with the sentitments you express.

    Go Grrrrllll!!

    Tony

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  4. I love this stuff Tony and i can't help feel a need to want it more and more. Thank you so much for the lovely strokes. I'm in a bit of a fix right now with my Psych assignment. I don't know where to start and it's due in on Wednesday! *Gulp*

    That probaly explains the critical examination found in my first comment. But truely what i meant to say (and probably under less academic pressure would have said) was the second comment. I will 'chill out' after this assessment is done and not be so sharp with my comments soon.

    Thank you again for the lovely strokes and - gosh i hope you had a lovely day!

    Ps... I'm so enjoying the pressure or studying! Its driving me crazy!! Cheers

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  5. Good to hear Roses,

    It does certainly sound like you are learning a lot of stuff and learning how to use it as well. Not just parrot like learning.

    Tony

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  6. er·u·dite (ěr'yə-dīt', ěr'ə-)
    adj. Characterized by erudition; learned. See Synonyms at learned.

    [Middle English erudit, from Latin ērudītus, past participle of ērudīre, to instruct : ē-, ex-, ex- + rudis, rough, untaught; see rude.]
    er'u·dite'ly adv., er'u·dite'ness n.

    Word History: One might like to be erudite but hesitate to be rude. This preference is supported by the etymological relationship between erudite and rude. Erudite comes from the Latin adjective ērudītus, "well-instructed, learned," from the past participle of the verb ērudīre, "to educate, train." The verb is in turn formed from the prefix ex-, "out, out of," and the adjective rudis, "untaught, untrained," the source of our word rude. The English word erudite is first recorded in a work possibly written before 1425 with the senses "instructed, learned." Erudite meaning "learned" is supposed to have become rare except in sarcastic use during the latter part of the 19th century, but the word now seems to have been restored to favor.
    (Dictionary.com)

    Still learning it would seem *Giggles*

    Thank you Tony. Not very good at the 'parrot' type learning i'm afraid. I think it would make things much more easier.

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  7. Interesting again, Tony. I don't have much else to say, but it was good.

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  8. Well there we have it Roses, our mobile online dictionary. Yes you are learned.

    Cheers

    Tony

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  9. Hi Sara,
    thanks for your comments

    Take care

    Tony

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  10. I dont have much to say either, except that this post left me with a warm fuzzy feeling!

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  11. That is a good thing Kahless

    Graffiti

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  12. Yes it is Graffiti.
    I think it is because I liked the thought that it was possible for you to have attachments with your clients. I was glad for them.

    How about clients that grate on you? Have you had any of these that seeme to stick around and not pick up the transference?

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  13. Well I have had a few in my time Kahless, who grate on me. Maybe I should write a post about them.

    But it is always nicer to write about the good ones than the bad ones
    R u on facebook at this time

    Graffiti

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  14. "Well I have had a few in my time Kahless, who grate on me."

    I so giggled at this statement. Talk about 'relational'! Yes, perhaps you could write a post about them. What a great idea Kahless! I think most of us (well I or me anyway) "studious psychotherapist hopefuls" would like to taste (even cyberly) what to expect when we enter the big world of psych, out there.

    Yeah - chugging along in my little red procrastination mobile. She's a beaut!

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  15. Umm, sorry about that last comment. Just a tad stressed at the moment.

    Our dining room light is behaving weird and i don't know why. That's not the stessful bit - i was just wondering why it was mis-behaving. Its the other stressful stuff that's stressing me out.

    Our magnetic underlay just arrived this morning and i popped the mattress one onto our mattress, and the pillow case ones onto our pillows. I'm just assuming that's what they were for because they're kind of pillow case size and not mattress size at all - if you know what i mean?

    That's not the stressful thing either. I was just thinking of how badly new things can smell sometimes - you know what i mean?

    Yeah - i'm going to bed now after i turn off the weird self willed dinning room light and tuck myself into our strangely smelling bed - makes me wonder how the north and south poles smell. I don't know why!

    Hmm, my little red procrastination mobile is quite the entertainment system. Well, i like it and it goes faster than any of the other procrastination mobiles i've seen about.

    Umm...

    I'm all procrastinated out for today. Have to plug it in to the wall and charge it up for tomorrow. I wonder how far i can get with one nights worth of charge. I guess i'll find that one out tomorrow sometime.

    Perhaps i should take with me a power point just in case i run out of electricity, like, a long way away from home. Probably wouldn't work though - I don't think powerpoints fix flat tires.

    I'd better hit the strange smelling sack. It's getting late. G'night. Sweet dreams and all that stuff...

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  16. {{{{{{{{Tony}}}}}}}}
    xoxoxoxoxoxoxoxoxoxo
    :-)

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  17. The word verification reads like an online drunk test. Just an observation.
    :-)
    (And I'm so impressed that I passed!)

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  18. Tony,
    I just finished and submitted my Psych assignment. Phew! It was one of the most exciting and enjoyable assignments that I've ever been involved in.

    I was thinking about TA as an intergrative approach. It was mentioned at the conference the other week and I blurted out something before I realised i'd said anything at all. A lovely person kept explaining what she meant but i was reeling from my sudden and unexpected outburst. It felt as though i was yelling but i don't think i was. *Blush*

    I think TA is very much an intergrative concept but not in the thought that other approaches and their can be utilized with it, but that it IS intergrative.

    I've been thinking and remembered in Primary school we were given milk for recess. The schools supplied us with a carton of milk (flavoured or not) every day and then after a little while they started putting the milk in plastic bags. I can't spell shashays (sp?). One day i was at a friends place where we were washing the dishes (i was wiping them), when i came to a jug that had a base, back with a handle and a hoop in which the plastic bag went. It was something to put the plastic bag of milk into so that the milk could be stored and poured with much less mess and mishap.

    I imagine Eric (Berne) checking out all these great approaches (nourishing milk) in their floppy messy, difficult to manage constructs. I can see him scratching his chin, chewing on his pipe, considering his kids and the future - thinking; "We've got to get a handle on this stuff". Then I think he dreamed something. I don't know what it was but it was one of those dreams that keeps on coming back every night which, by the morning, had something new built onto it, and had been expanded just that little bit. You know what i mean? Just like how his dream had passed from someone else to him somehow, and is being passed on even today as it expands and grows within us.

    Someone somewhere invented a handle to help us manage and access the milk in the plastic bags, so too is TA the handle that we can pop different perspectives/approaches in to help make them manageable. It's not just intergrative (though it does have its own tools and precepts and allows room for other approachs to be utilized) but IS intergrative in that TA is the handle we now have that makes the ungraspable (or approaches that may be difficult to access and/or apply) much more managable in its clear application of what ever is needed at any given time and/or circumstance.

    Did that make any sense and if not, are you able to help me understand the weirdness of my view on the whole thing?

    Geez! Aren't you glad the assignment is over and my thinking may slow down? I am!

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  19. What are the asterix's for? The 2 of them near the name of this post. Have i missed something - again!

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  20. Hi Lynn,

    Hugs to you as well.
    Not to sure about the 'verification' comment but thanks for dropping by

    Tony

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  21. Hello Roses,

    Transactional Analysis is not an integrative approach per se. Some people use it in an integrative way but if you read the original texts then one would not say that it is an integrative approach.

    So whoever told you that was fibbing in part. But you have raised a thorny issue and a bit of a political hot potatoe. In the past ten years there has been a division in the theory. The TA integraters and the non-TA integraters. In the past there has been considerable acrimony between them but things have settled down a bit of late. Just be aware you are only being told of one side of the coin.

    Welcome to the wonders of politics and theory.

    Tony

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  22. I, at this present time Tony, am able to accept what could possibly be mentioned in your comment about the intergraters and non-intergraters. I've just done a bit of study on the 'crisis' of social psychology - scientific social psychology and critical social psychology - politics, politics, smolitics!! Gosh - its everywhere isn't it? Its interesting to see that i seem to (to my delight) trip and fall onto hot potato issues all over your blog. Really? All a hot potato needs is some butter to melt over it - then with total delight we consume it all up and wipe the drips of melted butter off our chins with the back of our hand. Here *hands you some hot buttered potato* have some!

    I've grown up in the politics of christianity pre/post what ever what ever... whether miracles happen to day or if they were for back then only etc... *rolls eyes* Also, just done an essay on the different perspectives of Hinduism - namely Shankara and Ramanuja (really interesting stuff there Tony!), and at present studying the differences that Aristotle had with his teacher Plato. Gosh... it just goes on and on and on... doesn't it?

    I guess it does tend to be true though... the impasse thingy. If there isn't somekind of an impasse then there may not be any anst (for me anger?) generated to fuel the whole "getting over it and moving on thing". Its a bit like digestion. If there aren't enough bugs in our belly to resist and therefore break down our food then the body doesn't get fed. If the body doesn't get fed, it dies. I don't want TA to die Tony. I'm glad for the impasse - umm, hot potatoes that form from political stand points (or hard headed-ness or I'm right - you're wrong-ness).

    "Just be aware you are only being told of one side of the coin"
    But Tony! What a beautiful coin!

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  23. acrimony = bitterness and anger. That was out of my Collins Australian School Dictionary (2002) harperCollins; Glasgow, Great Britain.

    By the way, while i'm here, you didn't explain the asterix's on the title of this post. Did i miss something somewhere?

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  24. 've been thinking for a little while now Tony. Do you remember when I explained to you how I view hubby and my holidays. It was a few posts back now I think. About waiting for the whole year/s for the couple of days inbetween the 'de-stressing and re-stressing' that he does - just to meet the person I met ( around 33 years ago) and married almost 30 years ago.

    That's a transference too isn't it?

    I take the 17 year old boy's face and plant it onto my 49 year old husbands face and long for the memory (as a 15 year old girl - more masks only this time on my own face) to happen again as it did way back then. I'm ripping us both off aren't I?

    We're not 17 and 15 any more. It's just the way it is. We are now almost 50 and 48 - that's a whole lot of time and effect on both of us. We don't see things the way we used to and therefore can't be the same as we were back then (lots of magical thinking there huh?)

    I don't want to do that anymore. It's yucky and not fair to either of us.

    Also just wondering how you're doing and hoping that you're well. Life is not as it seems is it? But I do, so love it!

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