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A Psychologist's Thoughts on Clinical Practice, Behavior, and Life

Why Some Youth Can Benefit From Psychotherapy and Others Can't

Critical psychological development is gained early in life. Later, this may not happen even if the patient is provided the most talented of psychotherapist.

Change is difficult and some cannot tolerate the inherent dependency of this type of treatment. A teenager or young adult may need a firmer path in life before they can accept this childhood-like experience that they struggled to escape though there are great differences between the two. Unlike during childhood, a therapist does not make demands, even that of being liked. Their goal is merely that their patient's goals be achieved, so long as they are healthy and some  of which they may be unaware.
Yet for some youth the completion of education through college or graduate school or technical training comes first. They must try to ignore their anxiety and depression until the better day when they feel confident that they can--independently--survive financially in the adult world.

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Reducing the Terror of Psychological Symptoms and Length of Treatment

The treatment of a psychological disorder is often long. Yet to paraphrase Freud's comment of a hundred years ago, it would be nice to have a rapid cure for severe medical problems too. But the problems of living do differ. A traumatic event troubling a previously healthy person may require only one to two months of therapy but not those reflecting a lifetime of distress.


For these sufferers it is important to intermittently relate their current (adult) symptoms to the early developmental experiences which produced them, as can result when one lacked a "good enough" parenting. This enables the patient to understand their life, why they repeat their mistakes. It also reduces their fear from believing that anxiety and depression are magical and may invade their consciousness at any time. All symptoms have a logical reason for existing. Learning their unconscious cause reduces the terror they inspire and gives hope.

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The Unspoken Unavoidable Pain of Psychotherapists

A psychotherapist's work is catalytic, fostering the patient's unconscious mind in its quest for greater emotional health and improved functioning. While this cannot be guaranteed, it usually happens and patients leave therapy satisfied. Likely without achieving as great joy as they wished but that is not a reasonable goal since life gets in the way.

 

But there is also sadness for the doctor who, with rare exception, never learns how their patient's life progresses, like reading a novel with missing chapters. Unlike parents who, after surrendering their grown-up child, do learn of their offspring's continuing life.

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Why Do Patients Lie to Their Therapist?

A prevalent belief is that a patient always tells the truth to their therapist but this isn't true.
1. A woman was referred by her internist to a psychologist for "counseling," the unspoken motive being that she was a continuing, troublesome presence in the doctor's office. That the patient was seriously ill was obvious  Read More 
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The Most Difficult Factor in Treating Children in Psychotherapy

Almost paradoxically, what can be most difficult in treating a child is not the child but their parents' resistance to their treatment which derives from misconceptions: that long-term problems can be eliminated quickly; that the therapist will try to control their lives; or simple jealousy, as when the child values their therapist, or a  Read More 
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Advice for the Beginning Psychotherapist:

(1) Progress in psychotherapy doesn’t directly correlate with the amount of talking. (2) A therapist most usually becomes nervous when there is something that they are not picking up. (3) Patients usually know what they should do but can’t. (4) Know someone well enough before accepting them as a patient. (5) The initially troublesome patient can turn  Read More 
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Failure and Success in the Psychotherapy of Autistic Children

The aloofness noted in autistic children often becomes a self-fulfilling prophecy when their therapist considers it a given, something amenable only to simplistic reward/punishment behavior modification techniques. But the autistic child does have relationships though these are inadequate and require nurturing through play therapy.
No special techniques are required since the basic  Read More 
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Doctors Fear Psychotherapy Too!

I just read an interesting story about a surgeon whose life became so consumed by anxiety that, for a period of time, she stopped working. While not unusual since anxiety and particularly panic attacks can be disabling, what is revealing is the doctor's resistance to seeking mental health treatment. She rejected the thought of  Read More 
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Psychotherapy and Artistic Creativity

While psychotherapy remains the best hope for those who experienced emotionally destructive childhoods it is not the only avenue toward health. Artists often use their creative ability to express their conflicts and relieve their feelings. The writer's block, of which so many writers complain, can indicate the presence of a creative blockage caused by  Read More 
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