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Thursday, September 02, 2010


As you told this story I thought of how in John Bunyan's "Pilgrim's Progress" Christian is wallowing in the Slough of Despond, convinced that he will drown. Help is standing on the side and one imagines Christian wondering why he doesn't dive in to save him. Instead Help directs him to the spots in the swamp where there are stepping stones just beneath the surface, so that Christian is actually able to walk out of the swamp himself without any dramatic rescue.

The point of the episode in the book is that it is just the beginning, and a series of far greater tests and dangers and explorations await Christian. But had he not taken those steps at Help's direction, he would have stayed stuck in the bog, floundering.

Of course, one could say that that Help and the Slough of Despond are pretty good metaphors for the role of the shrink and the plight of the patient in general...

I suspect you did the right thing, but it would have been much more gratifying to have gone into all the stuff you discerned in the beginning and chose not to go into...

Most of us influence others for good and ill in ways we never fully understand. But you know that...

Great case, handled with humility and discretion (and eclecticism: behavioral therapy!). But what news program features 5-minute spots on psychoanalytic recoveries?


Though they addressed the issue that had concerned me, I didn't get the impression that the next therapist was psychoanalytically-oriented. He seemed more of an eclectic type. I think the news program was just giving viewers a chance to ogle the patient's problem for five minutes.

I did find it slightly disconcerting that a therapist appeared with his patient in that forum, though I've seen therapist-researchers I respect do the same thing.

But I wondered how that came about and how any unconscious commentary might represent itself in their subsequent session.

That's that therapist's problem. He can write his own post on the subject 5 years from now.

You were too worried about Tom bailing.

Put the topic out there, that's what he paid for, right?

If he didn't want help he wouldn't have gone there, and if he didn't like your approach he would/could have left.

At a certain point, someone like that needs their arse kicked to push it further to get to the core of their issue, especially if you still had questions, and ideas on what the problem was, to dig deeper.

If it was me on a limited budget (hmm somehow I can relate to being on a limited budget)asking for this, I would want my money's worth to get to the heart of the matter and kick the crap to the curb once and for all.

Oh, and how the patient wrote "you ignored"? That should be "I ignored and did so on purpose, not wanting to face the topic at the time".


Perhaps it was "we ignored."

Well, I'm not sure I like the placement of blame in the wording of "you ignored'.

That, to me sounds like lack of responsibility of the patient.

I suspect, I would be a difficult client, where I can be direct, yet keep things to myself that probably would be useful to address, thus my analysis of that client's note the way it is.

Great topic and love the links also.

Time-limited means goal-limited. The patient sets the goals and the goals were met.

Sometimes I worry that my therapist might not be thinking deeply enough. I find it reassuring that some therapists are so thoughtful, but I still wonder if mine is thinking hard or hardly thinking.

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