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The Trauma of Psychological Treatment r 103 using none toencode none on web,windows applicationqr code c# reciprocal. Rather, th none for none ey remain out of balance by design, and are intentionally skewed to shed the maximum light on patients interior and relational worlds. As is discussed later in this chapter, even when therapists elect to share their personal thoughts and feelings with patients in order to deepen the work, or to help them arrive at new insights, they maintain an emotional reserve.

The clinical distance that results is believed to benefit patients, in that it provides the necessary space for psychological analysis and intervention. Without it, therapists would be less capable of viewing patients concerns from different angles, asking them questions that expand their understanding, lending them their egos, and extending them their hope. However, the events of 9/11 suggest that this distance is advantageous for both members of the clinical dyad.

It defends therapists against being so permeable to patients affective states that they fully take them on, and it buffers them against the frightening material and elevated emotions that they face in long days of back-to-back sessions, or during lengthy clinical careers. Additional factors reinforce mental health professionals protection against the onslaught of emotions. Some therapists restrict their practices to the kinds of patients with whom they feel safest and most effective, with whom they feel the greatest kinship, or whom they find most interesting.

To avoid becoming overwhelmed, and to guard against vicarious trauma, they may cultivate a stance of detachment or neutrality, and may limit the number of patients they see who are severely traumatized, disturbed, or depressed (Zimering, Munroe, & Gulliver 2005). Moreover, therapists strictly regulate the amount of time they spend in each session, and design their clinical spaces with their personal comfort in mind. These factors help therapists manage the feelings their patients induce in them, which are known as countertransferences, while enhancing their sense of control.

One therapist acknowledged these benefits, saying,. Birt Reports Issues It s my place, my tim e, it s forty- ve minutes. I know what the boundaries are. If I feel a countertransferential buildup I can distance myself from it.

. After 9/11, however, h none none e felt that he lost control over sessions. In contrast with the predictable, measured pace of his usual clinical work, this thing was going at 90 miles per hour. In addition,.

The intensity was up a hundredfold, and it was all there in the room. You could not hide behind any neutrality, or curiosity about what does that mean . Many other therapists none for none similarly experienced a diminished sense of protection and control. At the same time, their receptivity to patients subjective states. r Therapy after Terror and affects grew. One none for none therapist explained that doing psychotherapy requires therapists to enter each patient s subjective world:. I was taught that you can t really understand what your patient is feeling unless you allow yourself to be drawn into that subjectivity. And then the work of the therapy is really to pull yourself back and come out, and look at it in a much more objective way. .

Yet many therapists di none for none scovered a peculiar inability to pull themselves out of patients subjectivities after 9/11. Therapists heightened vulnerabilities to the sentiments of their patients also were linked to their strong identifications with those who were injured or bereaved by the attack. It has been suggested that therapists are drawn to stories about the extremes of human experience because hearing these tragic accounts allows them to take their own psychic measure, reflect on their personal conflicts, and revisit their early histories.

In the view of a psychoanalyst,. Every analytic career is always a lengthy self-analysis. So I m always discovering parts of myself. By listening to other people I can nd something I ve missed, something that I ve shut out .

. . There s something I m going to hear that will help me if I listen well enough.

. Moreover, as therapist none for none s listen to their patients, they imagine themselves being subjected to the specific catastrophes that are described before disavowing such identifications and recovering their sense of self (Thomas 2002). But in listening to patients after 9/11, therapists encountered a range of identifications, both with their patients and with the victims they discussed, that were much too close for comfort. Some were unable to fully shake these identifications due to eerie similarities between themselves and fellow New Yorkers who perished in the attack.

To them, the photographs of the deceased that were on missing persons flyers all over town, and in the New York Times every day, all looked vaguely familiar. One therapist had the upsetting realization that it could be me :. I remember seeing a yer of a woman who was missing, and she was exactly my age, born on my birthday, same year, and I knew of course she must be dead. And I thought, why her Why not me . Some therapists found none none it so difficult to differentiate themselves from their patients that when they tell me these things, I m living it. When patients.
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