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Therapist and Patient Mental Representations: the Early Therapy Relationship in Long-Term Psychodynamic Psychotherapy

Cheri Marmarosh, Rachel Whipple, Melanie Schettler, Sandra Pinhas, Jami Wolf and Sinan Sayit

Several hypotheses regarding attachment needs and early therapy relationship are posited by the authors of this study.  The hypotheses regarding early therapy relationship are based in part upon the attachment experiences that occur previously in life with primary caregivers.

1. Describe what the article refers to as an selfobject-hungry and selfobject-rejecting styles of attachment in the therapy relationship.
2. The article puts forth hypotheses that counselors may question their value, internalize feelings of helplessness, and experience anger with clients who are introjective (selfobject-rejecting).  Do you agree with this assessment?  Why or why not?
3. What type of attachment style would lead a psychodynamic therapist to focus on relational issues and support a need for closeness?   What type of attachment style would lead a psychodynamic therapist to focus interpretation within the relationship?

How Can We Know What We Need To Know? Reflections On Clinical Judgment Formation

Cordelia Schmidt-Hellerau and Fred Busch

Psychodynamic theory provides a level of objectivity from which therapists can view themselves and their interactions with clients, removing narcissistic impressions and judgments.  The basis for this distancing can be explored through considering how judgments about therapist-patient interactions are formed.  This article examines those judgments, and how they are formed, and encourages reflection for therapists regarding how subjective impressions can be compared and contrasted with objective standards available through psychoanalytic theory.

1. The article notes that psychoanalysts can differ in how they help a client from other caring people in a client’s life through an investigation of defense mechanisms, anxieties, and unconscious needs.  What is your description of how a psychoanalyst differs from other caring people in a client’s life?
2. Describe what the author refers to as the orientation based approach to science-practitioner integration.  What are the strengths and limitations of this approach?
3. Present two examples from the case of Eleanor where the therapist reacts objectively to what Eleanor is sharing, examining details through psychoanalysis rather than reacting defensively to the statements or judgments that Eleanor shares.