Thanks for this. Do you have any recommended resources that discuss the tension between when validation is appropriate and when a challenging statement is effective? I've found a lot of wisdom on this topic in Ed Teyber's "Interpersonal Process in Therapy," and find his dichotomy of "Internal focus for change, vs external focus" quite parallel. I know this is a perrenial tension, so i'm just looking to hear more theorists' conceptualizations on this topic.
This is too vague a question for me to answer. I need to know about a specific instance, with a specific patient, to make any meaningful comment about whether "validation" or challenge is called for. By the way, many of our patients are far too reliant on external validation and since psychotherapy - therapy of the psyche or internal world - is our task, focusing on how the patient feels or what he thinks is likely to be most helpful.
@@patriciacoughlinphd1852 Thanks. I don't have a particular patient in mind, I just am looking to be pointed in the right direction for further study where these kinds of dynamics are explored. I appreciate your detailed comment, and the emphasis on being in tune with the clt's feeling as a priority❤
Thank you for this Patricia. I know I sometimes find it hard not to get too much on the patients victim side and I definitely can fall into the trap and take their perspective rather than helping them face their mixed feelings towards the ones that did them wrong. I also know that when I do this I end up confused and therapy gets stuck. So I agree from my own experience that the only way to get any movement and resolution I must put focus on helping the patient face their mixed feelings towards the ones that did them wrong and this process actually frees them from the victim role. It also makes it possible for them to connect to their own values and live life free and in alignment with their genuine self.
Thank you for your insight on this topic Dr. Coughlin. I am in a social work undergraduate program and I am studying to do this work. I have suspected what you’re saying to be the case. The victim consciousness seems to be embraced among many people, therapists, and professors in my region. The events that happen to people are important to acknowledge as you say but the patterns associated with victim consciousness and work seem to play into, or undercut the types of problems we seek to mend. I’m excited to continue to learn and practice ISTDP in the future.
Great comment; I enjoyed hearing you on this. It's also a common pitfall in Coherence Therapy; there's sometimes a fine line between coherence empathy towards a symptom/schema and inadvertently encouraging a client's victim mindset.
Wonderful integration of Lynne Forrest's model; I often use it in a psychoeducational workshop to help students/clients see where they, or others fall on the victim triangle.
@@patriciacoughlinphd1852 Oh interesting, I'm just going by the book "Beyond Victim Consciousness," in which she discusses the Victim Triangle of perpetrator/Rescuer/Victim (pg34); however I see that on that page she credits a Dr. Karpman for defining the 3 roles of the triangle.
Psychic trauma in the past is the cause of Neurosis, the mental illness that affects everyone to a greater or lesser extent. Few have been exposed to war (as a combatant or civilian), live in a dangerous neighborhood or had a near-drowning experience,but everyone has been affected by their parents. Faulty parenting is omnipresent. Suboptimal parenting is not intentional, but rather the result of the lack of proper education or experience. The fact is then that the patient is a victim and the parent a perpetrator of the causation. The result is Post-traumatic Stress Disorder, a term not generally referred to in this situation. My impression of your presentation is to have the therapist downplay the past and encourage the patient to assume full responsibility as an adult and "just get over it" Dr. Davanloo was heavily committed to stripping the patient's protective shield (the cause of the pain and suffering) and exposing the TROOTH (the painful truth) regarding the parents misbehavior (unintentional, in most cases). In this way, the patient can get in touch with their true feelings and in many cases kill (in the subconscious) the offending parent. Having dispensed with the offending parent they are left with the parent (same parent) they love. This amounts to a "cure", a word rarely applied in psychiatry.
Not at all. I am not suggesting one "just get over it" - but face squarely what happened and how one truly feels about it. It's not our feelings about the upsetting things that have happened to us that causes problems but the things we do to avoid our true feelings that ultimately wreaks havoc.
While patients may well have been victimized in the past, adopting the role of the helpless victim is something that Davanloo taught us to challenge assiduously. Research suggests that those viewing themselves as victims suffer physically, as well as emotionally, and literally die earlier than their empowered cohorts. I am not suggesting we tell patients to "get over it" but to deal openly and honestly with their feelings about what has transpired in their lives.
to be clear, i'm not advocating for endorsing and maintaining the clients victim narratives/status quo, rather, I have found there is great therapeutic value in acknowledging that the client is not really responsible for anything, from a distal perspective. This aligns with the idea that people are just trying their best in every moment, with their current capacities (again, which no one chooses). The problems with a "pull your bootstraps up" approach that stresses agency too much is 1. you can get "reactance" from the client. 2. it denies real-life causes and effects and 3. it makes you appear insensitive to the clients experience and feelings (whether or not you actually are).
Thanks for this. Do you have any recommended resources that discuss the tension between when validation is appropriate and when a challenging statement is effective? I've found a lot of wisdom on this topic in Ed Teyber's "Interpersonal Process in Therapy," and find his dichotomy of "Internal focus for change, vs external focus" quite parallel. I know this is a perrenial tension, so i'm just looking to hear more theorists' conceptualizations on this topic.
This is too vague a question for me to answer. I need to know about a specific instance, with a specific patient, to make any meaningful comment about whether "validation" or challenge is called for. By the way, many of our patients are far too reliant on external validation and since psychotherapy - therapy of the psyche or internal world - is our task, focusing on how the patient feels or what he thinks is likely to be most helpful.
@@patriciacoughlinphd1852 Thanks. I don't have a particular patient in mind, I just am looking to be pointed in the right direction for further study where these kinds of dynamics are explored. I appreciate your detailed comment, and the emphasis on being in tune with the clt's feeling as a priority❤
@@michaelccrosby Be wary of general rules. Case specificity is essential for effectiveness. Thanks for listening.
Thank you for this Patricia. I know I sometimes find it hard not to get too much on the patients victim side and I definitely can fall into the trap and take their perspective rather than helping them face their mixed feelings towards the ones that did them wrong. I also know that when I do this I end up confused and therapy gets stuck. So I agree from my own experience that the only way to get any movement and resolution I must put focus on helping the patient face their mixed feelings towards the ones that did them wrong and this process actually frees them from the victim role. It also makes it possible for them to connect to their own values and live life free and in alignment with their genuine self.
Thank you for your insight on this topic Dr. Coughlin. I am in a social work undergraduate program and I am studying to do this work. I have suspected what you’re saying to be the case. The victim consciousness seems to be embraced among many people, therapists, and professors in my region. The events that happen to people are important to acknowledge as you say but the patterns associated with victim consciousness and work seem to play into, or undercut the types of problems we seek to mend. I’m excited to continue to learn and practice ISTDP in the future.
Great comment; I enjoyed hearing you on this. It's also a common pitfall in Coherence Therapy; there's sometimes a fine line between coherence empathy towards a symptom/schema and inadvertently encouraging a client's victim mindset.
Wonderful integration of Lynne Forrest's model; I often use it in a psychoeducational workshop to help students/clients see where they, or others fall on the victim triangle.
Who is Lynne Forrest? The Drama triangle was developed by Karman, as far as I know.
@@patriciacoughlinphd1852 Oh interesting, I'm just going by the book "Beyond Victim Consciousness," in which she discusses the Victim Triangle of perpetrator/Rescuer/Victim (pg34); however I see that on that page she credits a Dr. Karpman for defining the 3 roles of the triangle.
Psychic trauma in the past is the cause of Neurosis, the mental illness that affects everyone to a greater or lesser extent. Few have been exposed to war (as a combatant or civilian), live in a dangerous neighborhood or had a near-drowning experience,but everyone has been affected by their parents. Faulty parenting is omnipresent. Suboptimal parenting is not intentional, but rather the result of the lack of proper education or experience. The fact is then that the patient is a victim and the parent a perpetrator of the causation. The result is Post-traumatic Stress Disorder, a term not generally referred to in this situation. My impression of your presentation is to have the therapist downplay the past and encourage the patient to assume full responsibility as an adult and "just get over it" Dr. Davanloo was heavily committed to stripping the patient's protective shield (the cause of the pain and suffering) and exposing the TROOTH (the painful truth) regarding the parents misbehavior (unintentional, in most cases). In this way, the patient can get in touch with their true feelings and in many cases kill (in the subconscious) the offending parent. Having dispensed with the offending parent they are left with the parent (same parent) they love. This amounts to a "cure", a word rarely applied in psychiatry.
Not at all. I am not suggesting one "just get over it" - but face squarely what happened and how one truly feels about it. It's not our feelings about the upsetting things that have happened to us that causes problems but the things we do to avoid our true feelings that ultimately wreaks havoc.
Yes and I think there is a need for drawing line between being rescuer and supporter because it easy to confuse these roles.
While patients may well have been victimized in the past, adopting the role of the helpless victim is something that Davanloo taught us to challenge assiduously. Research suggests that those viewing themselves as victims suffer physically, as well as emotionally, and literally die earlier than their empowered cohorts. I am not suggesting we tell patients to "get over it" but to deal openly and honestly with their feelings about what has transpired in their lives.
to be clear, i'm not advocating for endorsing and maintaining the clients victim narratives/status quo, rather, I have found there is great therapeutic value in acknowledging that the client is not really responsible for anything, from a distal perspective. This aligns with the idea that people are just trying their best in every moment, with their current capacities (again, which no one chooses).
The problems with a "pull your bootstraps up" approach that stresses agency too much is 1. you can get "reactance" from the client. 2. it denies real-life causes and effects and 3. it makes you appear insensitive to the clients experience and feelings (whether or not you actually are).