Thank you very much for your dedication and for making such great short and specific informative videos. I myself am new to working with ISTDP, so this is very useful and a great inspiration.
Yes, I find this all the time, the generalised exploration doesn’t work. Even when I press the client for feeling they themselves deflect by going to sth else, oh but I don’t always do that… Nope, bring them back. Very good reminder, thank you Patricia.
Always amazing, thank you for sharing your knowledge here, Patricia. So helpful to review how specific you have to be when identifying the cost of the defence on the triangle.
Specificity is central to the effective implementation of ISTDP at every step. Discussing things in general or accepting vague answers is not therapeutic.
Theres a lot of talk in ISTDP litterature about restructuring, but does that imply that they restructure to something else? After a patient is treated, do you usually see them utilizing different defences in everyday life then before treatment? For instance, there's some talk of "channeling anger", but to me it seems that ISTDP is very non-directive when it comes to how patients channel their emotions after breakthroughs. In EFT, we are taught to almost coach patients into expressing emotions adaptevely. I prefer not doing that, but I was really curious to hear your thoughts about the matter. Greetings from Norway
Re-structuring is a method of acquainting patients with their defenses so they can identify them, understand their function and their cost and the, relinquish them in favor of facing and experiencing their true feelings. Defenses are not necessary and can be replaced with healthy functioning. That is the goal, though not always reached. It has nothing to do with coaching or "channeling anger" but facing, experiencing, tolerating and integrating all of one's complex mixed feelings. Hope that helps.
Hi Doc, I'm not a therapist but a client who is trying to figure out why I utilise cognitive bypassing so much during sessions. I've very recently realised that I find it hard to let my emotions out during sessions coz I'm so busy trying to figure out my therapist's blank face (I do understand why the blank face is necessary) that I cannot focus on my own feelings until I've left the session and then of course there is anger etc about something my therapist said which explodes in me some time after the session where I really could've just worked it out with my therapist in the session itself. I come from a home where I was neglected and emotionally, verbally and psychologically abused so I always had to be on guard and try to figure out what my mother's blank face meant so that I would be ready to ward off the next explosion. So I've just realised that, when my therapist has this blank face, it takes me right back to the times when I needed to figure out my mom's blank face and then this hypervigilance makes me not focus on my own feelings at all in the moment. I do plan on bringing this up with my therapist next week but I'm wondering whether it would be unfair of me to expect or request my therapist to show or express her own emotions more openly so that I don't have to try and figure out her blank face and then I cannot even start to feel my own emotions in the moment. Some days she is way more expressive and then I relax more as well and feel more comfortable looking at my own feelings. I get why the blank face and guarding own emotions etc is essential for the therapist’s own wellness. I don't expect her to be my friend, I respect the boundaries etc but I think this is why I find it so hard to stop the cognitive bypassing thing I do in sessions. Then I feel my feelings later and get so mad at my therapist outside of sessions when she's not even around to clarify anything I've misinterpreted. Then I feel terrible for being mad at her for something that is really just happening in my own head. I would be very interested to hear your opinion on whether there have been any studies on what type of client the blank face works for and not. I've googled but really can't find any material on this. If I do this in sessions, I clearly do it in real life as well which really makes it difficult to build relationships when I'm always trying to guess what someone means when they don't express emotion on their face.
It sounds like you've done a lot of good self reflection. Going to your head and trying to figure out what your therapist is thinking and feelings is a defense against the rage that her blank face evokes. I hope she can invite you to experience that rage toward her, and that she becomes more authentic and responsive. The blank face is a charicature and, if anything, is associated with poor outcome. The best therapist are warm, approachable and responsive. There is nothing worse for human being than no response. Have you seen Tronick's famous still face experiment? That says it all.
@patriciacoughlinphd1852 Thank you. My therapist is kind but sometimes quite hot and cold ... don't know if she's actually doing it on purpose. But I'll talk to her about it next week. Oh yes, I have seen that experiment. It hits me right in the feels so hard, as if my chest wants to implode 😪 I appreciate your response and your videos 🙏 thanks again
Nicely said
Your videos rock!
Thanks so much.
This is so helpful, thank you so much!
So glad
Thank you very much for your dedication and for making such great short and specific informative videos. I myself am new to working with ISTDP, so this is very useful and a great inspiration.
I am so glad. Thanks for letting me know.
Yes, I find this all the time, the generalised exploration doesn’t work. Even when I press the client for feeling they themselves deflect by going to sth else, oh but I don’t always do that… Nope, bring them back. Very good reminder, thank you Patricia.
"Give me a recent example so we can really explore this together."
Always amazing, thank you for sharing your knowledge here, Patricia. So helpful to review how specific you have to be when identifying the cost of the defence on the triangle.
Specificity is central to the effective implementation of ISTDP at every step. Discussing things in general or accepting vague answers is not therapeutic.
Theres a lot of talk in ISTDP litterature about restructuring, but does that imply that they restructure to something else? After a patient is treated, do you usually see them utilizing different defences in everyday life then before treatment? For instance, there's some talk of "channeling anger", but to me it seems that ISTDP is very non-directive when it comes to how patients channel their emotions after breakthroughs. In EFT, we are taught to almost coach patients into expressing emotions adaptevely. I prefer not doing that, but I was really curious to hear your thoughts about the matter. Greetings from Norway
Re-structuring is a method of acquainting patients with their defenses so they can identify them, understand their function and their cost and the, relinquish them in favor of facing and experiencing their true feelings. Defenses are not necessary and can be replaced with healthy functioning. That is the goal, though not always reached. It has nothing to do with coaching or "channeling anger" but facing, experiencing, tolerating and integrating all of one's complex mixed feelings. Hope that helps.
Hi Doc, I'm not a therapist but a client who is trying to figure out why I utilise cognitive bypassing so much during sessions. I've very recently realised that I find it hard to let my emotions out during sessions coz I'm so busy trying to figure out my therapist's blank face (I do understand why the blank face is necessary) that I cannot focus on my own feelings until I've left the session and then of course there is anger etc about something my therapist said which explodes in me some time after the session where I really could've just worked it out with my therapist in the session itself. I come from a home where I was neglected and emotionally, verbally and psychologically abused so I always had to be on guard and try to figure out what my mother's blank face meant so that I would be ready to ward off the next explosion. So I've just realised that, when my therapist has this blank face, it takes me right back to the times when I needed to figure out my mom's blank face and then this hypervigilance makes me not focus on my own feelings at all in the moment. I do plan on bringing this up with my therapist next week but I'm wondering whether it would be unfair of me to expect or request my therapist to show or express her own emotions more openly so that I don't have to try and figure out her blank face and then I cannot even start to feel my own emotions in the moment. Some days she is way more expressive and then I relax more as well and feel more comfortable looking at my own feelings. I get why the blank face and guarding own emotions etc is essential for the therapist’s own wellness. I don't expect her to be my friend, I respect the boundaries etc but I think this is why I find it so hard to stop the cognitive bypassing thing I do in sessions. Then I feel my feelings later and get so mad at my therapist outside of sessions when she's not even around to clarify anything I've misinterpreted. Then I feel terrible for being mad at her for something that is really just happening in my own head. I would be very interested to hear your opinion on whether there have been any studies on what type of client the blank face works for and not. I've googled but really can't find any material on this. If I do this in sessions, I clearly do it in real life as well which really makes it difficult to build relationships when I'm always trying to guess what someone means when they don't express emotion on their face.
It sounds like you've done a lot of good self reflection. Going to your head and trying to figure out what your therapist is thinking and feelings is a defense against the rage that her blank face evokes. I hope she can invite you to experience that rage toward her, and that she becomes more authentic and responsive.
The blank face is a charicature and, if anything, is associated with poor outcome. The best therapist are warm, approachable and responsive. There is nothing worse for human being than no response. Have you seen Tronick's famous still face experiment? That says it all.
@patriciacoughlinphd1852 Thank you. My therapist is kind but sometimes quite hot and cold ... don't know if she's actually doing it on purpose. But I'll talk to her about it next week. Oh yes, I have seen that experiment. It hits me right in the feels so hard, as if my chest wants to implode 😪 I appreciate your response and your videos 🙏 thanks again