It's always a good day whenever I see a new video from you released! :) Regarding "coherence" in the unconscious, Dr. Danielle Knafo makes the apt point that when dealing with psychotic patients on the more disturbed/severe end of the spectrum, one might often see (especially if working in a psychiatric hospital like I did for many years) the phrase in their patient file "patient exhibited incoherent speech content", alluding to delusions + symptoms they may be talking about. But she notes that the "incoherent speech" is *not* *incoherent* *to* *the* *patient* , but often only to the psychiatrist. The delusions carry meaning and significance to the patient, and often represent a playing out of autobiographical myths about the self, in an attempt at restoration/restitution of the self. She (and others like Dr. Nancy McWilliam's husband, Dr. Michael Garret) make a similar point that the term "anosognosia", which is a psychiatric term that refers to a patient's lack of insight into their mental disorder, could often just as easily be described as a lack of insight _on_ _the_ _part_ _of_ _the_ _psychiatrist_ in understanding the patients point of view, and that something has superseded/taken a greater prominence in their mental life. Finally, on a side note, I know your one of the most well known proponents of ISTDP. However I'm wondering how you reconcile/makes sense of the enormous "Common Factors" research literature by Bruce Wampold etc, suggesting that in fact no 1 approach/modality seems to be very much more effective than another, and that it seems to be the _therapist_ (and all of their characteristics like being warm, empathetic, open, etc) which seems to be the variables that influence successful patient outcomes....?
Read "Common Factors are not so common" by Weinberger. Most therapies focus on one or two of the 6 crucial factors associated with positive outcome. The thesis of my third book, Maximizing Effectiveness, is that ISTDP is so powerful because it incorporates all 6 factors into the model.
@patriciacoughlinphd1852 lf l could go to school, l would for psychoanalysis. I adore Frued, Jung, and Cadmus, Dr. Coughlin how you break things down so gently; l look forward to, "Psychology Today" featuring you in thier "continuing education" section!
Doctor Coughlin, you tell very detailed stories of patients' lifes. Do patients agree you use the information or how is it not a confidentiality breach?
Since there is no identifying information whatsoever, there is no issue around confidentiality. That said, my patients sign a release to discuss their case for teaching and research purposes.
Yes, no identifying information, unless someone has shared that they were your patient. Then it would be easy to identify them by some details. But in such case the patient would play their role in the disclosure. Thank you for explaining!
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A beautiful, and beautifully explicated, example of the coherence of the unconscious. Thank you.
Glad you found it helpful.
It's always a good day whenever I see a new video from you released! :)
Regarding "coherence" in the unconscious, Dr. Danielle Knafo makes the apt point that when dealing with psychotic patients on the more disturbed/severe end of the spectrum, one might often see (especially if working in a psychiatric hospital like I did for many years) the phrase in their patient file "patient exhibited incoherent speech content", alluding to delusions + symptoms they may be talking about. But she notes that the "incoherent speech" is *not* *incoherent* *to* *the* *patient* , but often only to the psychiatrist. The delusions carry meaning and significance to the patient, and often represent a playing out of autobiographical myths about the self, in an attempt at restoration/restitution of the self.
She (and others like Dr. Nancy McWilliam's husband, Dr. Michael Garret) make a similar point that the term "anosognosia", which is a psychiatric term that refers to a patient's lack of insight into their mental disorder, could often just as easily be described as a lack of insight _on_ _the_ _part_ _of_ _the_ _psychiatrist_ in understanding the patients point of view, and that something has superseded/taken a greater prominence in their mental life.
Finally, on a side note, I know your one of the most well known proponents of ISTDP. However I'm wondering how you reconcile/makes sense of the enormous "Common Factors" research literature by Bruce Wampold etc, suggesting that in fact no 1 approach/modality seems to be very much more effective than another, and that it seems to be the _therapist_ (and all of their characteristics like being warm, empathetic, open, etc) which seems to be the variables that influence successful patient outcomes....?
Read "Common Factors are not so common" by Weinberger. Most therapies focus on one or two of the 6 crucial factors associated with positive outcome. The thesis of my third book, Maximizing Effectiveness, is that ISTDP is so powerful because it incorporates all 6 factors into the model.
Appreciate you!
Thanks so much.
Than you for your work
You are most welcome
As always, breathtakingly beautiful analysis/dissection!!
Thanks!
@patriciacoughlinphd1852 lf l could go to school, l would for psychoanalysis. I adore Frued, Jung, and Cadmus, Dr. Coughlin how you break things down so gently; l look forward to, "Psychology Today" featuring you in thier "continuing education" section!
Doctor Coughlin, you tell very detailed stories of patients' lifes. Do patients agree you use the information or how is it not a confidentiality breach?
Since there is no identifying information whatsoever, there is no issue around confidentiality. That said, my patients sign a release to discuss their case for teaching and research purposes.
Yes, no identifying information, unless someone has shared that they were your patient. Then it would be easy to identify them by some details. But in such case the patient would play their role in the disclosure. Thank you for explaining!