Beginnings in Psychotherapy by Eichler Seth;

Author:Eichler, Seth;
Language: eng
Format: epub
Publisher: Routledge

Intervening

The process of listening and understanding is a natural part of the process that leads to intervention. As a result, it is somewhat artificial to separate these therapeutic functions, because they are interwoven with each other.

As you listen to and understand a patient, new awarenesses form in your mind about the person that you’re sitting with. We try to take these awarenesses or insights and put them into words. Of course we’re making use of empathy—including our concern for dosage, tact, and timing—to guide us. Certain things that may occur to us about someone may be correct, but timing might dictate that your patient is not ready to hear them. Alternatively, certain thoughts might be idiosyncratic, or too revealing about you, to make use of for the purposes of an intervention.

As therapists, we’re trying to expand the insight and understanding of the person with whom we’re working. Listening and intervening are intertwined with one another. Indeed, as a therapist listens, and as thoughts, fantasies, and impulses come to his or her mind, the therapist may begin to shape an insight that can be offered to a patient. Not infrequently, it’s easier for a beginning therapist to offer a tentative question, but with more experience and understanding, more declarative comments can be made that enlarge and enrich the understanding of the person with whom you’re working.

Everything that we’ve been discussing thus far—as well as everything that we have yet to discuss—informs your ability as a therapist to understand your patient and, ultimately, to put that understanding into words. All of the guideposts discussed in this text naturally lead to further understanding of what is taking place in your patient’s psyche. As a result, they become guideposts for intervening as well as for listening.

As I mentioned before, Fenichel said that the most important tool the analyst has is his own unconscious (Fenichel, 1941, as cited in Jacobs, 1991, p. xiii). All human beings have a kind of unconscious radar. We can pick up, discern, and understand things about people we’re with by using a host of different cues. We do our work with ears and eyes, allowing thoughts and feelings to come to our minds. These cues give us a virtually infinite amount of information about our patients. A central part of our work is to put these thoughts into words, which produce interpretations. Our understanding grows in dimension and depth the longer we sit with our patients. The interpretations we provide further the process of regression and lead to new associations.

“Interpretation is the central activity of the analyst during treatment—a process whereby the analyst expresses in words what he or she comes to understand about the patient’s mental life. This understanding includes aspects of psychic life that were formerly unconscious or known to the patient only in an incomplete, inaccurate, or otherwise distorted form. Interpretation is also based upon observation of the way the patient distorts the relationship with the analyst to meet unconscious needs and to relive old experiences.

An interpretation is the statement of new knowledge about the patient.

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