Reconstructive Therapy - Wolberg
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FREUDIAN PSYCHOANALYSIS
THERAPY: FREUDIAN/ CLASSICAL PSYCHOANALYSIS
1. free association
“ A sequential theme that gave clues t the natu!e " the !e#!esse$ mate!ial%&
'e!(ali)ing *hateve! cmes t min$+ h*eve! "leeting+ !e#ulsive+ ! seemingl,
incnsequential it ma, seem&
2. Dream interpretation and analysis
a technique " a!!iving at the meaning " the uncnscius mate!ial th!ugh
the t!anslatin " s,m(ls& It ena(le t sh* h* $!eams *e!e e-#!essins "
uncnscius *ishes an$ "ea!s that eva$e$ the (a!!ie!s " !e#!essin th!ugh the
assum#tin " s,m(lic $isguises&
3. Transference analysis
.his *as $ne *hen the #atients attitu$es 0$ee# lve+ "ea!+ hate+ ve!valuatin+
e-#ectanc,+ $isa##intment+ an$ the! st!ivings1 that *e!e nt 2usti"ie$ (, the !ealit,
situatin t*a!$s signi"icant #e!snages in thei! #ast 0e&g& #atients #a!ents1 *e!e
(eing ve!(ali)e$ an$ t!ans"e! ve! t the the!a#ist&
PROPONENT:
SI34UND FREUD
PROCEDURES AND TECHNIQUES:
Procedures:
5ecause F!eu$ian #s,chanal,sis is t!ans"e!ence anal,sis+ all means "
"acilitating t!ans"e!ence a!e em#l,e$6
• Assum#tin " #assive !le n the #a!t " the anal,st a!e #u!#sel, $esigne$ t
encu!age #assive $e#en$ence an$ !eg!essin&
• Pe!mit the #atient t lie n the cuch+ !ela- an$ t tal7 "!eel, a(ut an, i$eas !
"antas, that ente!e$ his ! he! min$+ n matte! h* t!ivial ! a(su!$&
• Passivit, n the #a!t " the the!a#ist is 2u$iciusl, maintaine$ even th!ugh lng
#e!i$s " silence&
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• .he the!a#ist als !e"!ains "!m !eacting emtinall, ! !es#n$ing
#sitivel, ! negativel, t an, ve!(ali)e$ ! nn8ve!(ali)e$ attitu$e ! "eeling
e-#!esse$ (, the #atient&
• St!ict ann,mit, is (se!ve$+ an$ n #e!snal in"!matin is su##lie$ t the
#atient i!!es#ective " h* im#!tunate he ! she ma, (ecme&
• A nn2u$gmental+ nn8#unitive+ nn8cn$ning attitu$e (, the the!a#ist is
a$he!e$ t+ $gmatic utte!ances " an, 7in$ (eing "!(i$$en&
• .he chie" 9!ule% the #atient is as7e$ t (e, is the 9(asic !ule% ! 9"un$amental
!ule% " ve!(ali)ing *hateve! cmes t min$+ h*eve! "leeting+ !e#ulsive+ !
seemingl, incnsequential it ma, seem 0"!ee assciatin1& .his un$i!ecte$ 7in$
" thin7ing is a mst im#!tant means " ta##ing the uncnscius an$ " !eviving
uncnscius cn"licts an$ the mem!ies that a!e !elate$ t thei! !igin&
4st im#!tant+ "!ee assciatin+ li7e #assivit,+ enhances the evlutin "
t!ans"e!ence& As lng as the #atient cntinues t assciate "!eel,&
•
.he the!a#ist 7ee#s silent+ even thugh much time ma, #ass *ithut acmment& .he the!a#ist "ights "" all tem#tatins t*a!$ 9small tal7% ! im#ulses
t e-#un$ n the!,& .he the!a#ist inte!"e!es nl, *hen !esistances t "!ee
assciatin $evel# an$ until the #atient #!cee$s *ith un$i!ecte$ ve!(ali)atins&
• .he the!a#ist must als cnstantl, gua!$ against mani"estatins " $est!uctive
cunte!t!ans"e!ence+ *hich+ $isguise$ an$ va!ie$+ a!e m(ili)e$ (,
un!eslve$ #!(lems an$ #!essing nee$s *ithin the the!a#ist& Cmmn "!ms
" cunte!t!ans"e!ence a!e su(tle sa$istic attac7s n the #atient+ im#ulses t (e
#m#us an$ mni#tent+ ! $esi!es t !e2ect the #atient ! t $etach
nesel" "!m the !elatinshi#& 5ecause " cunte!t!ans"e!ence+ a #e!snal
anal,sis is cnsi$e!e$ essential "! anal,sts s that the, can $eal *ith thei! *nuncnscius ten$encies an$ !esistances #!eci#itate$ (, cntact *ith thei!
#atients&
• As the eg " the #atient is st!engthene$ (, an alliance *ith the the!a#ist+ it
(ecmes m!e an$ m!e ca#a(le " tle!ating less an$ less $ist!te$
$e!ivatives " uncnscius cn"lict& .he cntinue$ inte!#!etatin (, the
the!a#ist " the #atients uncnscius "eelings an$ attitu$es+ as *ell as the
$e"ensive $evices that the #atient em#l,s against them+ ena(les the #atient t
*!7 th!ugh #!(lems (, seeing h* the, cn$itin eve!, as#ect " his !
he! li"e& In the me$ium " the the!a#eutic !elatinshi# the in$ivi$ual is hel#e$
t cme t g!i#s *ith ea!l, "ea!s an$ miscnce#tins+ !eslving these (, living
them th!ugh in the t!ans"e!ence&
Techniques:
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• D!eam anal,sis is use$ cnstantl, as anthe! means " #enet!ating the
uncnscius& 5, activating !e#!esse$ mate!ial an$ *!7ing n $e"enses as the,
a!e !eveale$ in $!eam st!uctu!e+ the the!a#ist ai$s the $evel#ment "
t!ans"e!ence&
• .he "!equenc, " visits in F!eu$ian #s,chanal,sis is im#!tant+ t encu!age
t!ans"e!ence+ n "e*e! than "u! ! "ive visits *ee7l, a!e !equi!e$& Fe*e!
visits than this encu!age 9acting 8ut% an$ the! !esistances t t!ans"e!ence&
• .he use " the !ecum(ent cuch #sitin ena(les the #atient t
cncent!ate n the tas7 " "!ee assciatin *ith as "e* encum(!ances "
!ealit, as #ssi(le& It hel#s the the!a#ist+ als+ t "cus n the uncnscius
cntent un$e!l,ing the #atients ve!(ali)atins *ithut having t a$2ust t the
$eman$s such as *ul$ e-ist in a "ace8t8"ace #sitin& Cncent!ating n the
#atients inne! li"e+ !athe! than n e-te!nal !ealit,+ hel#s t (!ing n the
#henmenn " t!ans"e!ence&
•
Du!ing the ea!l, stages " anal,sis the main tas7 is t (se!ve:"!m "!eeassciatins an$ $!eams:mani"estatins " cn"licts an$ the t,#es " $e"enses
em#l,e$+ *hich "!m a 7in$ " (lue#!int " the uncnscius #!(lems " the
#atient& .his (lue#!int is use$ late! at the stage " t!ans"e!ence& Since !e#!essin
is th!eatene$ (, the #e!atin " e-#l!ing the uncnscius+ an-iet, is a#t
t a##ea!+ stimulating $e"ensive mechanisms& .hese "unctin as !esistances
t #!$uctivit,+ an$ even t ve!(ali)atin& F!ee assciatin ma, cnsequentl,
cease+ an$ the #atient ma, e-hi(it the! mani"estatins that ##se c#e!atin
*ith the t!eatment en$eav!& Such !esistances a!e $ealt *ith (, inte!#!etatin&
.h!ugh inte!#!etatin the #atient is (!ught t an a*a!eness " h* an$ *h, he
! she is !esisting an$ the cn"licts that ma7e !esistance necessa!,&• Sne! ! late! the #atient *ill 9t!ans"e!% #ast attitu$es an$ "eelings int the
#!esent !elatinshi# *ith the anal,st& O(se!vance " the 9(asic !ule+% the
attac7 n !esistances th!ugh inte!#!etatin+ an$ the cnsi$e!atin "
uncnscius mate!ial in $!eams an$ "!ee assciatins !emve ha(itual #!tective
$evices an$ "a;a$es that #e!mit the #atient t maintain a cnventinal
!elatinshi#& .he #atient is mst a#t t e-#!ess st!ivings t*a!$ the the!a#ist
!te$ in #ast e-#e!iences+ #e!ha#s even !e#!$ucing the #ast in the #!esent&
.hus+ a !evival " #athgenic #ast cn"licts is institute$& Unli7e su##!tive
an$ !ee$ucative the!a#,+ in *hich t!ans"e!ence ma, (e use$ as a the!a#eutic
vehicle+ the t!ans"e!ence is inte!#!ete$ t the #atient in !$e! t e-#se its
natu!e& .his is the chie" means " !eslving !esistance+ " (!inging the
in$ivi$ual t an a*a!eness " the *a!$e$8"" cntent+ an$ " !eali)ing the
hist!ical !igin " cn"licts&
• .he $evel#ment " t!ans"e!ence ma, ccu! insi$iusl, an$ mani"est itsel"
in$i!ectl,+ ! it ma, su$$enl, (!ea7 ut in sta!7 "!m& It "ten sh*s itsel" in
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changes in the cntent " "!ee assciatins+ "!m inne! "eelings an$ #ast
!elatinshi#s *ith #a!ents t m!e inncuus t#ics+ li7e cu!!ent events
an$ situatins& .his shi"t is evi$ence " !esistance t $ee#e! mate!ial activate$ (,
the e!u#ting t!ans"e!ence "eelings& Smetimes "!ee assciatin ma, cease
enti!el,+ *ith lng stu((!n silences #!evailing that a!e engen$e!e$ (, an ina(ilit,
t tal7 a(ut "eelings in !elatin t the the!a#ist& .he #u!#se " su#e!"icial tal7 !
silence is t 7ee# "!m a*a!eness !e#!esse$ emtins an$ "!gtten mem!ies
assciate$ *ith ea!l, chil$h$+ #a!ticula!l, the Oe$i#us cm#le-& Until these
can (e (!ught ut int the #en+ the emtins !elating t them $ischa!ge$+ an$
the assciate$ mem!ies !eclaime$+ the cn"lictual (ase " neu!sis *ill su!vive&
.he t!ans"e!ence neu!sis ""e!s an ##!tunit, "! this !evivi"icatin since+ in the
!elatinshi# *ith the the!a#ist+ the #atient *ill e-#se lves+ "ea!s+ an$ hates that
*e!e cha!acte!istic " his ! he! *n e-#e!iences $u!ing the Oe$i#al #e!i$&
.!ans"e!ence+ h*eve!+ acts as a su!ce " #*e!"ul !esistances that
im#e$e the!a#eutic #!g!ess& Once the #atient is in the g!i# " such !esistances+he ! she is usuall, $ete!mine$ t cling t them at the e-#ense " an, the!
mtivatin+ inclu$ing that " getting *ell& On the #sitive si$e+ t!ans"e!ence
is im#!tant $iagnsticall, since it !eveals a mst accu!ate #ictu!e " the
#atients inne! cn"licts&
• Smetimes t!ans"e!ence mani"estatins (ecame s intense that the, a!e
reproduced and reenacted with the therapist + im#!tant cn"lictual
situatins an$ t!aumatic e-#e!iences 0t!ans"e!ence neu!sis1 that ha$ (een
su(2ect t in"antile amnesia& 5, !ecve!ing an$ !ecgni)ing these !e#!esse$
e-#e!iences an$ cn"lictual situatins that ha$ neve! (een !eslve$ an$ (,
living th!ugh them *ith a ne*+ less neu!tic+ an$ nn8#unitive #a!entalagenc,+ the su#e!eg *as (elieve$ t un$e!g m$i"icatin&
STRENGTHS AND WEAKNESSES:
Strengths
.hse #atients *h a!e ca#a(le " esta(lishing a the!a#eutic alliance have an
##!tunit, t (e hel#e$ th!ugh the ne-t #hase " !eg!essin+ in *hich in"antile
cn"licts a!e !evive$ an$ a t!ans"e!ence neu!sis $evel#s that ena(les the#atient t *!7 th!ugh an$ !eslve the cn"licts&
.he techniques " "!ee assciatin+ l,ing n the cuch+ #assivit, n the #a!t "
the anal,st+ a!e #u!#sel, $esigne$ t encu!age #assive $e#en$ence an$
!eg!essin& .he inevita(le !esistance " the #atient is manage$ (, time$
inte!#!etatins&
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Un!eslve$ cn"licts eme!ge in the t!ans"e!ence+ an$ thei! un$e!stan$ing is
hel#e$ (, #!#e! inte!#!etatin& Sl*l, the !iginal in"antile cn"lict eme!ges an$
is $e"initivel, !eslve$&
Weaknesses:
Nt all #e!sns a!e ca#a(le " esta(lishing an initial the!a#eutic alliance+ *hich
is the #!elimina!, !equisite "! #s,chanal,sis&
De"ensive mist!ust an$ "!ust!atin at the lac7 " imme$iate g!ati"icatin " nee$s
an$ $eman$s ma, (lc7 #!g!ess&
• .he the!a#ists seemingl, c!uel an$ un"eeling (ehavi! ma, (e l7e$ u#n as
a sign " a ha!sh #e!ve!sit,+ an$ the #atient ma, (e un*illing t give u#
his ! he! $etachment an$ nee$ "! cnt!l& .he anal,tic situatin ma, the!e"!e
neve! get "" the g!un$&
NEO-FREUDIAN AND NON-FREUDIAN PSYCHOANALYSIS
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THERAPY: NEO8FREUDIAN PSYCHOANALYSIS
Amng the #!#sitins " the ne8F!eu$ians a!e the "ll*ing6
& .he m,!ia$ elements:scial+ inte!#e!snal+ int!a#s,chic:ente!ing int cha!acte!
!gani)atin necessitate a cm#!ehensive an$ hlistic vie* " #e!snalit, the!,+
tgethe! *ith a cnce!n "! health, as *ell as a(n!mal a$a#tatin&
?& .he li(i$ an$ $eath8instinct the!ies a!e "!mulatins that cannt e-#lain eithe!
n!mal ! a(n!mal (ehavi!= in"antile se-ualit, alne cannt accunt "! an in$ivi$uals
(asic cn"licts ! "! the lines alng *hich cha!acte! st!uctu!e $evel#s&
@& Female se-ualit, is an entit, n a #a!it, *ith+ !athe! than in"e!i! t+ male se-ualit,&
& .he classical t#g!a#h, $es nt e-#lain the st!uctu!e " the #s,chic a##a!atus&
B& .he the!a#eutic encunte! is m!e than a means " !e#eating an$ *!7ing
th!ugh ea!l, t!aumatic e-#e!iences= it is an e-#e!ience in a !elatinshi#+
cntaining #sitive g!*th #tentials that can lea$ t g!eate! sel"8actuali)atin&
& Activit, an$ "le-i(ilit, in the the!a#eutic a##!ach a!e essential= this encu!ages
eclecticismin meth$&
& An #timistic+ !athe! than #essimistic+ vie*#int is 2usti"ie$ !ega!$ing a human
(eings #tentials as a c!eative+ lving+ an$ #eace"ul (eing&
PROPONENT:
AREN HORNEY
HARRY S.AC SULLI'AN
O..O RAN
PROCEDURES AND TECHNIQUES:
.he technical m$i"icatins em#l,e$ (, man, " thse *h have $eviate$ "!m
!th$- F!eu$ian the!, an$ meth$ inclu$e the "ll*ing6
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>& F!ee assciatin is a(an$ne$ as a 9"un$amental !ule+% an$ the inte!vie* is
"cuse$ in natu!e&
?& .he cuch #sitin is !e#lace$ cm#letel, ! #a!tl, (, a sitting8u#+ "ace8t8"ace
#sitin&
@& .he num(e! " visits ma, (e !e$uce$ t as "e* as th!ee sessins *ee7l,+
smetimes t even t* ! ne&
& .he the!a#eutic !elatinshi# is han$le$ in a manne! s as t !eslve
t!ans"e!ence as sn as it (egins t #e!ate as !esistance& An attem#t is
ma$e t minimi)e the $evel#ment " at!ans"e!ence neu!sis& Psitive
elements in the !elatinshi# ma, (e encu!age$ as a catal,st t the!a#,& .he
!elatinshi# is !ega!$e$ nt nl, as a mi!!! that !e"lects uncnscius st!ivings+
(ut als as a vehicle that has values in itsel" as a g!*th e-#e!ience&
B& .he "cus in the!a#, is n (th uncnscius an$ cnscius as#ects "
#e!snalit,& Cu!!ent #!(lems an$ situatins a!e st!esse$ as much as #ast
e-#e!iences&
STRENGHTS AND WEAKNESSES:
Strengths:
• .he!e is a (len$ing " anal,tic techniques *ith meth$s $e!ive$ "!m
su##!tive an$ !ee$ucative a##!aches&• .he the!a#ist *ill int!$uce in$ivi$ual unique i$eas+ man, " *hich ma,
$eviate "!m the classical tenets " the "un$e!s " his ! he! schl& 4!e
signi"icant+ each the!a#ist *ill #!actice *ith his ! he! *n st,le&
Weaknesses:
• .he "ten (len$ing !th$- techniques *ith thse " the! schls "
thught+ smetimes t a #int *he!e an im#a!tial (se!ve! ma, nt (e
a(le t i$enti", the #!"esse$ i$elg,&
THE "INDIVIDUAL PSYCHOLOGY" OF ALFRED ADLER
THERAPY: ADLERIAN .HERAPY
1. roup therapy
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2. !amily therapy ?& Social therapy
PROPONENT:
ALFRED ADLER
PROCEDURES AND TECHNIQUES:
Procedures:
.he (asic tls a!e6
• Inte!#!etatin " ea!l, !ecllectins+ the "amil, cnstellatin+ an$ !ecu!!ent an$
!ecent $!eams 0Deutsch+ D+
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• .he technique " A$le!ian the!a#, is !gani)e$ a!un$ the e-#l!atin an$
$etectin " the 9li"e st,le% " the in$ivi$ual+ inclu$ing the aims+ mtivatins+
an$ cm#ensat!, st!ivings that #e!ate in (th negative an$ #sitive *a,s&
• .he #ast+ *hile cnsi$e!e$ " hist!ical inte!est is !elegate$ t a #sitin less
im#!tant than the #!esent ! the "utu!e+ e-ce#t "! the 9ea!liest !ecllectins+%
*hich a!e use$ t i$enti", the su!ce " the 9li"e st,le&% Once the 9li"e st,le% is
i$enti"ie$+ the #atient is gui$e$ int m!e e""ective *a,s " "unctining in !$e! t
as#i!e t g!eate! #tentialities th!ugh 9n!mal% means&
• In the cu!se " this e$ucatinal #!cess+ st!ivings "! #*e! $iminish an$ a!e
!e#lace$ (, scial "eelings an$ inte!ests that lea$ t healthie! attitu$es t*a!$
the sel" an$ the cmmunit,&
• Scial integ!atin is ne " the mst im#!tant "acets " A$le!ian the!,&
STRENGTHS AND WEAKNESSES:
Strengths:
• A$le!ian cnce#ts can (e a##lie$ t sh!t8te!m ! lng8te!m the!a#,+ $e#en$ing
n the natu!e " the $istu!(ance&
• .he the!a#ist ma, utili)e anal,tic+ active+ #assive+ $i!ective+ an$ nn8$i!ective
meth$s& .he cu!se " the!a#, can e-ten$ "!m cunseling an$ the slving "
acute situatinal #!(lems t a m!e e-tensive !ecnst!uctin " #e!snalit, that
is inten$e$ t lea$ t sel"8actuali)atin&
Weaknesses:
C!iticisms " A$le!s the!, an$ meth$ a!e !gani)e$ a!un$ the "ll*ing
cntentins6
• "i!st+ that nl, ne " mani"l$ human st!ivings is st!esse$:that " "eelings "
in"e!i!it,=
• secn$+ that nt enugh c!e$ence is given t $ee# uncnscius "!ces= an$=
• thi!$+ that gals in the!a#, ten$ t (e !ee$ucative !athe! than !ecnst!uctive in
natu!e&
THE "ANALYTICAL PSYCHOLOGY" OF CARL JUNG
THERAPY: GUN3IAN PSYCHOANALY.IC .HERAPY
1. Dream "nterpretation2. #rt analysis
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PROPONENT: CARL 3US.A' GUN3
PROCEDURES AND TECHNIQUES:Procedures:
• Activit, is the 7e,nte in the!a#,=8 San$ #la, ! t!a,8 C!eative a!t the!a#ies 0Paintings+ $!a*ings+ Scul#tu!e18 Use " 4an$alas
• .he 2ungian #!cess6 Fu! stages in ma7ing anal,sis
8 Catha!sis8 E-#lanatin8 E$ucatin8 .!ans"!matin
• Sme Gungians "ll* the "!mat " classical F!eu$ian anal,sis an$ use thecuch& Othe!s use "ace8t8"ace inte!vie*s&
• .!ans"e!ence neu!sis (eing avi$e$ as much as #ssi(le&
• F!ee assciatin is secn$a!, t a "cusing " the inte!vie* alng s#eci"ic lines&
Techniques:
• .he !elatinshi# is 7e#t n a #sitive level as the the!a#eutic a##!ach va!ies
*ith the #e!snalit, t,#e&
8 .he int!ve!t is #!esume$ t nee$ ela(!ate che!ent inte!#!etatins+ *hile=8 the e-t!ve!t is sai$ t achieve a$2ustment n a much m!e #!agmatic (asis&
• .he $evel#ment " an intellectuall, satis",ing !eligin is "ten cnsi$e!e$ an
essential #a!t " the!a#,+ since !eligin is (elieve$ ca#a(le " !ecnciling e-isting
9a!chet,#es% *ith an ethical s,stem& Neu!sis is !elate$ t the hl$ n the
in$ivi$ual " a!chet,#e #!cesses&
• Cunte!t!ans"e!ence is "ten cnsi$e!e$ a #sitive "!ce that can hel# in the
t!ans"!matin #!cess+ *hich ultimatel, is $i!ecte$ t*a!$ g!eate! in$ivi$uatin&
• .he a(an$ning " the!a#ist auth!ita!ianism an$ the use " the vis88vis
#sitin+ as ##se$ t the cuch+ e-#e$ite !a##!t an$ even !eactivit, n the
#a!t " the anal,st&
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• .he e""ectiveness " the!a#, stems 9"!m the !ealit,8(ase$ inte!#e!snal
e-change (et*een anal,san$ an$ the!a#ist& .his als means that the t* #e#le
in the t!ansactin a!e #a!tne!s+ 2intl, engage$ in a st!uggle t e-#l!e an$ $is#el
the neu!sis that a""ects the #atient+ inclu$ing the !eslutin " the t!ans"e!ence
STRENGHTS AND WEAKNESSES:
Strenghts:
• Em#hasis in t!eatment is nt nl, n the uncnscius (ut als n cu!!ent
$i""iculties& D!eams+ "! instance+ a!e !ega!$e$ as !e"lecting #!esent st!ivings
as *ell as "utu!e #lans " actin&
• Gungian #s,chanal,tic the!a#, #!esu##ses a (asic attitu$e t*a!$ neu!sis
that is !ega!$e$ as an attem#t (, the !ganism t #!mte g!*th as *ell
as illness
Weaknesses:
• .he Gungian #!cess is essentiall, nns,stematic&
• C!iticisms " the Gungian a##!ach !elate t its meta#h,sical cntent+ t the
!eligius8li7e elements *ith *hich the!a#, is im(ue$+ an$ t a ten$enc, "!
sme #atients t (ecme #!eccu#ie$ *ith a m,stic #hils#h, t*a!$ li"e an$
*ith s#eculatins " 9a!chet,#es% an$ the! mani"estatins " thei! !acial #ast&
THERAPEUTIC MODIFICATIONS OF SANDOR FERENCZI
THERAPY: .HERAPEU.IC 4ODIFICA.IONS OF SANDOR FERENCI
1. #cti$e therapy
2. !erenc%i&s technical inno$ations
PROPONENT:
SANDOR FERENCI
PROCEDURES AND TECHNIQUES:
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Procedures:
1. #cti$e therapy
• .he #atient *as cnsequentl, en2ine$ t a(stain "!m se-ual satis"actins " all
7in$s+ an$ even t limit tilet activities&
2. !erenc%i&s technical inno$ations
• He u!ge$ that the the!a#ist a$mit his ! he! *n "aults an$ sh!tcmings t the
#atient in !$e! t cnvince the latte! that all auth!it, *as nt ha!sh+ intle!ant+
n! inca#a(le " a$mitting t "ailings&
• . hel# #atients t an a*a!eness " thei! #ast+ Fe!enc)i als encu!age$
them t !elive it (, $!amati)ing chil$h$ situatins+ *hile he !emaine$
tle!ant t the #atients 9acting8ut&% .hus #atients *ul$ !elive thei! chil$h$+
#la, *ith $lls+ an$ engage in (a(, tal7+ *hile Fe!enc)i 2ine$ in the #la,&
• He !ega!$e$ !elatinshi#s as a t*8*a, inte!actin&
• Fe!enc)i a$vise$ setting a time limit t anal,sis as a means " accele!ating the en$ " t!eatment&
Techniques:
1. #cti$e therapy
• & He (elieve$ that this !est!ictin *ul$ (lc7 li(i$ an$ ma7e it availa(le
"! #!2ectin int the t!ans"e!ence&
• .he !elease " !esentment an$ agg!essin $i!ecte$ t*a!$ the the!a#ist*as "elt t (e " the!a#eutic im#!tance&
2. !erenc%i&s technical inno$ations
• & Fe!enc)i !ecgni)e$ that the anal,sts #e!snal "eelings a(ut the #atient
an$ attitu$es t*a!$ the #atient "ten $ete!mine$ the natu!e " the latte!s
!eactins&
• He a$vcate$ that the the!a#ist cnsi$e! the #atients !es#nses as (eing
cn$itine$ (th (, t!ans"e!ence an$ (, !ealit, #!vcatins "! *hich the
the!a#ist shul$ a$mit !es#nsi(ilit,&
STRENGHTS AND WEAKNESSES:
Strengths:
• A mutual anal,sis "ten !esulte$&
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Weaknesses:
• .he te!minatin #hase ! en$ t!eatment *asnt given em#hasis+ as the
t!ans"e!ence " #atient8t8the!a#ist *e!e st!enghten $u!ing the the!a#,&
THE "WILL THERAPY'' OF OTTO RANK
THERAPY: JILL .HERAPY
.he li"e " the #e!sn *as gve!ne$ (, these cnt!a$ict!, st!ivings t unite an$
t se#a!ate&
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PROCEDURES AND TECHNIQUES:
Procedures:
• Ran7 classi"ie$ #e!snalit, int 9n!mal+% 9neu!tic+% an$ 9c!eative a!tist% t,#es+
as 9N!mal% #e#le su(!$inate$ thei! *n *ill t that " the g!u# in cnt!ast t
9neu!tics% *h !e"use$ t ,iel$ thei! *ill t the g!u#&
• A time limit t the!a#, *as usuall, set& .his *as (elieve$ t act as a catal,st t
the unin8se#a!atin cn"lict&
• N e""!t *as ma$e t (!ing ut se-ual mate!ial&
• Resistance *as acce#te$ as an inevita(le e-#!essin " the *ill& It *as
nt met *ith cunte!!esistance ! e-#lanat!, inte!#!etatin& .!ans"e!ence *as
als acce#te$ as an as#ect " the g!*th #!cess in *hich the!e *as a
st!engthening " the 9*ill% t (e nesel"&• Ran7 em#hasi)e$ that the anal,tic hu! ""e!e$ t the #atient+ is a unique
##!tunit, t live th!ugh *ith the the!a#ist the #ast e-#e!iences+ #a!ticula!l,
the (i!th t!auma+ an$ t mve t*a!$ a m!e cm#lete in$ivi$uatin&
• .he!a#ist as a hel#e! m(ili)e$ the #atients 9c!eative *ill im#ulse% "!
#sitive sel" 8!eali)atin& .he !elatinshi# itsel" se!ve$ as a c!!ective
e-#e!ience "! the #atient+ !evelatin " uncnscius mate!ial an$ insight (eing
secn$a!,&
• .he anal,sis *as an e-#e!ience "!m *hich the #atient *ul$ eventuall,
se#a!ate an$ then g n t a ne* e-#e!ience&
• .he !eactins " the #atient t the inevita(le ci!cumstance " se#a!atin*e!e stu$ie$ ca!e"ull,+ *ith the (2ect " *!7ing th!ugh "ea! "+ an$ guilt
t*a!$+ the se#a!atin as *ell as nee$s t cnt!l an$ t (e cnt!lle$&
• Patte!ns " !eactin !athe! than s#eci"ic cntent *e!e t (e stu$ie$& .he
the!a#eutic situatin *as t (e a$a#te$ t the unique an$ in$ivi$ual nee$s "
each #atient&
Techniques:
• Ran7ian anal,sis+ acc!$ing t a!#" 0
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se#a!atin "!m the the!a#ist an$ *ith st!engthene$ *ill achieve$
in$e#en$ence an$ g!*th&
STRENGHTS AND WEAKNESSES:
Strengths:
• .he em#hasis in the!a#,+ thus+ *as n the #!esent !athe! than the #ast& Activit,
in t!eatment *as the 7e,nte+ the #atient (eing encu!age$ t asse!t himsel" !
he!sel" in !$e! t $evel# an$ st!engthen his ! he! *n *ill& An e""!t *as ma$e
t m(ili)e cnst!uctive elements in the #e!snalit, an$ t t!ans"e! the negative
e-#!essin " *ill int #sitive an$ c!eative *ill&
• 3uilt an$ "ea! *e!e g!a$uall, !eslve$ th!ugh this e-#e!ience in the !elatinshi#+
*hich li(e!ate$ the *ill "!m its ne8si$e$ e-#!essin an$ !esulte$ in a 9utili)atin
" its *n cnt!a!iness&%
Weaknesses:
• C!iticisms " Ran7ian anal,sis a!e e-#!esse$ (, thse *h (2ect t the activit,
invlve$ an$ t the "cus n unin an$ se#a!atin t the neglect " the!
#e!snalit, as#ects&
• .he a(!u#t insistence that the #atient stan$ n his ! he! *n "eet un$e!
an, ci!cumstances is sai$ t have an un"!tunate e""ect n #e!sns *ith
*ea7 eg st!uctu!es *h ma, !equi!e a g!eat $eal " su##!t in ea!l, #hases "
t!eatment&
• THE "ACTIVE PSYCHOANALYSIS" OF WILHELM STEKEL
THERAPY: AC.I'E PSYCHOANALYSIS
Jilhelm Ste7el $ecla!e$ that cu!!ent li"e cn"licts *e!e as im#!tant as #ast
cn"licts an$ that a(slute uncnscius elements *e!e nt the nl, "ci " neu!sis=
!athe!+ as#ects " the cnscius min$ might (e !e#!esse$ an$ t!ans"!me$ (, a *i$e
va!iet, " s,m(ls&
1. 'central idea of the neurosis( 2. "mportance of transference3. )ountertransference
PROPONENT:
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JILHEL4 S.EEL
PROCEDURES AND TECHNIQUES:
Procedures:
.he gene!al the!a#eutic "!mula #!#un$e$ *as this6
• 9Recall *hat !iginate$ ,u! t!u(le+ !ecgni)e ,u! m!(i$ attitu$e+ an$
su!munt it&% Ste7el allege$ that !esistance #!evente$ the #atient "!m
!ecgni)ing m!(i$ attitu$es+ "!m !ecalling thei! !igins+ an$ a(ve all+ "!m
su!munting $i""icult,& Resistance+ h*eve!+ cul$ nt (e !eslve$ (, the
!th$- anal,sts manne! " !emaining a #assive s#ectat! t the
#atients "!ee assciatins an$ $!eams& .his *as the "allac, " #assive
#s,chanal,sis&
• .he the!a#ist must activel, inte!"e!e in (!ea7ing u# !e#!essin& It is
necessa!, t clla(!ate activel, *ith the #atient in the inte!#!etatin "
"!ee assciatins an$ $!eams& .h!ugh 9s,m#ath,% an$ 9imaginative insight%
0qualities Ste7el su(sume$ un$e! the te!m 9intuitin%1 the the!a#ist must (e
ale!te$ t !e#!esse$ cm#le-es an$ must inte!vene activel, t ma7e the
#atient a*a!e " them& .he intuitive "acilit, *ith *hich the s,m(lic
meaning " the neu!sis *as $ete!mine$ an$ the s7ill *ith *hich inte!#!etatin*as ""e!e$ in"luence$ the s#ee$ " the!a#,&
• .he the!a#ists main "unctin+ then+ *as as an intuitive a!tist #!(ing his ! he!
*a, int the #s,che& Ste7el a$mitte$ that active anal,sis #!esu##se$ that
the anal,st *as en$*e$ *ith an intuitive "acult,+ (ut he av*e$ that this
"acult, *as m!e *i$es#!ea$ than ha$ (een #!esume$&
• A(an$nment " the anal,sts #assive !le *as assciate$ *ith activit, an$
$i!ectiveness+ even t the #int " a$vice giving an$ e-h!tatin& Jhile "!ee
assciatin *as utili)e$+ the #atient cul$ nt (e #e!mitte$ t !am(le alng
int (lin$ channels= instea$+ selectin " #e!tinent t#ics "! $iscussin *as in
!$e!&• .he use " the "ace8t8"ace+ sitting8u# #sitin *as als a$vcate$&
Em#hasis *as #ut n the inte!#!etatin " $!eams+ (ut the the!a#ists
intuitin ha$ t (e !elie$ n in!$e! t $ivine *hat elu$e$ "!ee assciatins t
the latent cntent&
Techniques:
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• .he use " a$2uvants in the!a#, *as als in$icate$= Ste7el insiste$ that it *as
essential t a$#t meth$s t the #a!ticula! case !athe! than t "!ce the #atient
t a(i$e (, a #a!ticula! meth$& Jith active meth$s Ste7el (elieve$ that it *as
!a!e "! m!e than B mnths t (e !equi!e$ "! anal,sis& .his sh!t #e!i$ avi$e$
inte!mina(le anal,ses an$ #!evente$ the $evel#ment " unt*a!$+ ill 8"ate$+
unmanagea(le !eactins&
• He $ecla!e$ that cu!!ent li"e cn"licts *e!e as im#!tant as #ast cn"licts an$ that
a(slute uncnscius elements *e!e nt the nl, "ci " neu!sis= !athe!+ as#ects
" the cnscius min$ might (e !e#!esse$ an$ t!ans"!me$ (, a *i$e va!iet, "
s,m(ls&
• .he im#!tance " t!ans"e!ence *as !ecgni)e$ (, Ste7el as an essential #a!t "
eve!, anal,sis& In$ee$+ he "elt that anal,sis *as im#ssi(le *ithut
t!ans"e!ence& .!ans"e!ence+ h*eve!+ cul$ se!ve t* "unctins:that "
e-#e$iting the!a#, an$ that " acting as !esistance t the!a#,& Onl, *hent!ans"e!ence "unctine$ as !esistance *as its han$ling 2usti"ie$&
STRENGHTS AND WEAKNESSES:
Strengths:
• .h!ugh 9s,m#ath,% an$ 9imaginative insight% 0qualities Ste7el su(sume$ un$e!
the te!m 9intuitin%1 the the!a#ist must (e ale!te$ t !e#!esse$ cm#le-es an$
must inte!vene activel, t ma7e the #atient a*a!e " them& .he intuitive
"acilit, *ith *hich the s,m(lic meaning " the neu!sis *as $ete!mine$ an$
the s7ill *ith *hich inte!#!etatin *as ""e!e$ in"luence$ the s#ee$ " the!a#,&
Weaknesses:
• A "!equentl, hea!$ c!iticism " Ste7els s,stem " #s,chthe!a#, is that the
activit, " the the!a#ist ma, s#ns! an e-cessivel, $isci#lina!,+ #!hi(itive+ an$
#unitive attitu$e t*a!$ the #atient& O(2ectins a!e als e-#!esse$ in !ega!$ t
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the ma-imal B8mnth time limit t the!a#, n the (asis that cha!acte!
!ecnst!uctin is lng8te!m& .he "e* "ll*e!s " Ste7el *h !emain have !evise$
his tem#!al limitatin an$ "ten $ lng8te!m the!a#,&
• .he 9intuitive% as#ects " active anal,sis ma, als cme un$e! questining& 4an,
(se!ve!s *ul$ cnten$ that *hat ma7es a the!a#ist intuitive is a high
$eg!ee " sensitivit, that ena(les the the!a#ist !a#i$l, t #e!ceive nuances
in the inte!#e!snal #!cess an$+ n the (asis " e-tensive e-#e!ience+ t
t!anslate these int vali$ $e$uctins& Nt all #e!sns+ h*eve!+ *ul$ (e
ca#a(le " $ing this+ i!!es#ective " the e-tent " t!aining an$ e-#e!ience&
• .he intuitive as#ects " the Ste7elian s,stem+ the!e"!e+ *ul$ (e limite$ t
a !est!icte$ num(e! " 9intuitive% anal,sts+ *h cul$ h,#thesi)e cnst!ucts
*ith a high $eg!ee " #!(a(ilit,&
• A less intuitive anal,st *h t!ie$ this *ul$ in$ulge in guess*!7 that
might (e $isast!us t the the!a#eutic (2ective (ecause it *ul$ "ist
"ault, inte!#!etatins n the #atient&• . use Ste7els s,stem e""ectivel,+ then+ the the!a#ist !equi!e$ an e-t!emel, high
$eg!ee " anal,tic t!aining+ an e-t!a!$ina!, "le-i(ilit, in #e!snalit,+ a $ee#
sensitivit, that *ul$ ena(le the #e!ce#tin " nuances+ an$+ a(ve all+
g$ 2u$gment+ *hich *ul$ #e!mit the 2u$icius em#l,ment " active
#!ce$u!es&
THE "CHARACTER ANALYSIS" AND "ORGONE THERAPY" OF
WILHELM REICH
THERAPY: CHARAC.ER ANALYSIS AND OR3ONE .HERAPY
1.)haracter analysis
2. *rgone therapy
8 9Ph,silgical% !ientatin t the!a#,
PROPONENT:
JILHEL4 REICH
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PROCEDURES AND TECHNIQUES:
Procedures:
1. )haracter analysis
• Du!ing #s,chanal,sis the #atients cha!acte! se!ve$ the inte!ests "
!esistance against the !e#!esse$& 5e"!e ne cul$ ta# the
uncnscius+ the!e"!e+ it *as essential t (!ea7 $*n 9cha!acte!
!esistances% until the in$ivi$ual *as $enu$e$ " $e"enses that (a!!ica$e$
!e#!esse$ mate!ial&
• Cha!acte! !esistance !eveale$ itsel" in attitu$es an$ (ehavi! t*a!$ the
anal,st an$ the anal,tic situatin& Reich $esc!i(e$ the anal,sis "
!esistance+ inclu$ing cha!acte! !esistance+ an$ he insiste$ that this *as
necessa!, (e"!e the #atient cul$ acce#t an$ integ!ate the cntent " theuncnscius&
• ($, tensins *e!e evi$ences " emtinal states an$ !e"lecte$
cha!acte!istic *a,s " !eacting& Pstu!e+ gait+ "acial e-#!essin+ an$
the! muscula! mani"estatins !eveale$ ce!tain !esistances an$ ha$
t (e attac7e$ (, calling attentin t them (e"!e "!mal anal,tic
#!ce$u!es cul$ (e e""ective&
2. *rgone therapy
• He $esc!i(e$ the the!a#eutic #!cess as a cnsecutive lsening " the
cha!acte! a!m!+ a (!ea7th!ugh " !e#!esse$ an$ a""ect8la$en mate!ial!elease$ (, activatin " in"antile se-ual cn"licts+ a *!7ing th!ugh "
in"antile genital an-ieties+ a $ealing *ith !gasm an-iet,+ an$+ "inall,+ a
$evel#ing " "ull !giastic #tenc,& .his *as (ecause anthe! "!m "
a!m! (esi$es cha!acte! a!m! shiel$e$ the uncnscius&
Techniques:
1. )haracter analysis
•Reich als classi"ie$ cha!acte! t,#es acc!$ing t h* the, manage$ t!eslve the #!(lems e-isting $u!ing ea!lie! stages " thei! $evel#ment&
Fu! main t,#es " cha!acte! $e"enses *e!e a##a!ent&
8 Fi!st+ the h,ste!ical cha!acte!+ "ashine$ (, a $e"ense against incest+
*as mani"este$ (, a #assive8"eminine !ientatin *ith su(ve!sive
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e-#!essins " se-ualit, at the same time that an #en av*al " se-ual
inte!est *as avi$e$&
8 Secn$+ the cm#ulsive cha!acte!+ $ete!mine$ (, a $e"ense against
sa$istic an$ agg!essive im#ulses+ $is#la,e$ a #enchant "! !$e!liness+
cleanliness+ an$ th!i"tiness&
8 .hi!$+ the #hallic8na!cissistic cha!acte!+ cn$itine$ (, a $e"ense against
#assive8"eminine ten$encies+ e-hi(ite$ a cl$+ a!!gant+ an$ $e!isivel,
agg!essive manne!= active hmse-ualit, an$ schi)#h!enia cul$
$evel# in such in$ivi$uals&
8 Fu!th+ the maschistic cha!acte!+ *hich *as s#ns!e$ (, a $e"ense
0su(stitutive #unishment1 against "antasie$ !ec!iminatins "!m the
cnscience+ avi$e$ an-iet, (, "!cing the!s t t!eat him ! he! (a$l, s
as t (e a(le t !e#!ach them *hile e-#e!iencing sel"8$amage an$ sel"8$e#!eciatin& .he maschist *ante$ t (e lve$ (ut $isguise$ this in
g!an$ise #!vcatins " the lve (2ect&
2. *rgone therapy
• In !gne the!a#, the muscles " the #atients (ac7+ chest+ 2a*+ a($men+
an$ e-t!emities a!e #!esse$ "i!ml, (, the the!a#ist t elicit emtinal
!eactins an$ t li(e!ate assciatins an$ mem!ies& .he #atients
!eactins a!e then inte!#!ete$& Smetimes the the!a#ist imitates the#atients manne!isms " (ehavi! ! encu!ages 9acting8ut% ten$encies&
• 'e!(ali)atin " "antasies+ mem!ies+ an$ "eelings assciate$ *ith the
9muscula! a!m!% is sai$ t $issi#ate the a!m! an$ t all* the #atient t $eal
*ith $i!ect im#ulses+ " *hich the muscula! mani"estatins a!e $e"enses an$
!esistances&
STRENGHTS AND WEAKNESSES:
Strengths:
Em#hasis is #lace$ n the neu!tic natu!e " cha!acte! t!en$s+ anal,sis "
*hich cnstitutes a chie" (2ective !athe! than a means t $ee#e! !e#!esse$
mate!ial&
.hese ne* i$eas ma$e necessa!, a !e"!mulatin " his h,#thesis&
Cha!acte! *as $evel#e$ "!m a (in$ing " 9(i8ene!g,&% .he!a#,
!em(ili)e$ 9(i8ene!g,% "!m cha!acte! a!m! th!ugh cha!acte! anal,sis+
an$ "!m muscula! a!m! th!ugh 9vegetthe!a#,&% .he !esulting
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li(e!atin " emtins #!$uce$ a m(ili)atin " 9!gne ene!g,+% *hich
vitali)e$ !giastic #tenc,&
Weaknesses:
Cha!acte! anal,sis in itsel"+ h*eve!+ he claime$ *as inca#a(le " achievingthe $esi!e$ gal " !giastic #tenc,&
• Althugh cha!acte! anal,sis has gaine$ *i$e acce#tance amng man,
anal,sts+ the vali$it, " the the!, an$ technique " !gne the!a#, is
gene!all, cnsi$e!e$ cnt!ve!sial= it is cu!!entl, #!actice$ un$e! the te!m
9vegetthe!a#,% 0nia+
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PROCEDURES AND TECHNIQUES:
Procedures:
Em#athic activit, in t!eatment6
• t!ans"e!ence in eithe! mi!!!ing ! i$eali)ing m$es #!vi$es an ##!tunit, t
!ecti", these $e"icits e-ist in the cnstitutin " the sel"&
• 5, acting em#athicall,+ the the!a#ist gives the #atient a secn$ chance t
inc!#!ate health, st!uctu!es an$ thus ve!cme the !iginal sel"(2ect "ailu!es&
• 3!a$uall,+ the na!cissistic elements a!e !eslve$ as the the!a#ist sl*l, a$#ts
a $ec!easing em#athic !le an$ the #atient nee$s the the!a#ist less an$ less as
a sel"(2ect&
Techniques:
• Instea$ " cnceiving " the $evel#ment " the #s,che in te!ms " the cn"lict(et*een #!ima!, $!ives *ithin the in$ivi$ual an$ the sciali)ing $eman$s "
#a!ental auth!it,+ sel"8#s,chlg, thus "cuses n the vicissitu$es " the sel"
an$ (2ect !e#!esentatins in thei! a!chaic an$ matu!e "!ms&
STRENGHTS AND WEAKNESSES:
Strengths:
• Activit, an$ em#ath, a!e ve!, hel#"ul in the t!eatment " sic7e! #atients+ such as
thse *ith (!$e!line an$ na!cissistic #e!snalit, $is!$e!s&
Weaknesses:
• huts em#hasis n in"antile g!an$isit, an$ i$eali)atin as
$evel#mentall, n!mal cha!acte!istics+ !athe! than !eg!essive an$ $e"ensive
#e!atins+ an$ his 2usti"icatin " #la,ing an active em#athic !le t ma7e u#
$evel#mental $e"icits have (een cnsi$e!e$ (, classical anal,sts as an
a(an$nment " sme (asic #s,chanal,tic tenets&
• .he clinical $ata a!e inte!esting+ (ut sme the!a#ists in$ the language an$
$esc!i#tins " sel"8#s,chlg, cm#le- an$ cn"using& .he, cnten$ that hut
has evlve$ a $,namic t 2usti", his use " activit, in his !elatinshi# *ith his
#atients&
• Since activit, an$ em#ath, a!e ve!, hel#"ul in the t!eatment " sic7e! #atients+
such as thse *ith (!$e!line an$ na!cissistic #e!snalit, $is!$e!s+ m$i",ing
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the cnventinal #assive #s,chanal,tic stance is hel#"ul (ut $es nt !equi!e a
m$i"icatin " the classical $evel#mental the!,& Ding this has nt en$ea!e$
hut t the hea!ts " man, !th$- (elieve!s&
PHASES OF PSYCHOTHERAPY
OBJECTIVES:
+eginning Phase
Phase ".
,sta-lishing a orking relationship ith patient
/iddle phase
Phase "". ,0ploring the causes and consequences of the patient&s disorder
Phase """. Translating understanding into action. "nstituting correcti$e measures
,nd phase
Phase ". Terminating Therapy
THERAPEUTIC TASKS:
+eginning Phase
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Phase ".
1. /oti$ating patient to accept therapy.
2. )larifying misconceptions a-out therapy.
3. )on$incing patient that therapist understands his or her suffering and is capa-le of
helping.
. Tentati$e defining of goals in therapy and of the therapeutic situation
/iddle phase
Phase "".
1. Delineating and e0ploring en$ironmental frustrations and maladapti$e interpersonal
dri$es through inter$ieing.
2. "n cogniti$e therapy searching for false self4statements.3. "n dynamic psychotherapy pro-ing for unconscious conflicts that mo-ili%e an0iety
and $itiate -asic needs through psychoanalytic techniques of free association
dream interpretation analysis of the transference and the e0ploration of genetic
material.. "n -eha$ior therapy appraising factors that need reinforcement and symptoms that
require e0tinction
Phase """.
,nd phase
1. )reating incenti$es for change.2. Dealing ith forces that -lock action.3. 5elping patient to master an0ieties surrounding normal life goals.. )orrection of remedia-le en$ironmental distortions.6. 5elping patient to ad7ust to irremedia-le conditions.8. Symptom remo$al if desira-le hen immediate correction is urgent.9. #d7ustment to those symptoms and a-normal character patterns that for one reason
or another cannot -e remo$ed during present therapeutic effort.
Phase ".
1. #naly%ing the dependency elements of the therapist4patient relationship.
2. edefining the treatment situation ith the aim of encouraging patient to make
independent decisions and to esta-lish indi$idual $alues and goals.
3. 5elping patient to achie$e as much independence and asserti$eness as possi-le.
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RESISTANCES IN PATIENTS:
+eginning Phase
Phase ".
1. ;o moti$ation for therapy or ina-ility to accept the fact that he or she can -ehelped.
2. efusal to accept therapist&s definition of the treatment situation.3. 5ostility aggression detachment intense dependency se0ual demands and
other resistances to a arm orking relationship.
/iddle phase
Phase "".
1. uilt in acknoledging en$ironmental distur-ance or interpersonal difficulties.
2.
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Phase "".
1. #$oidance -y therapist of those pro-lems in patient that inspire an0iety in therapist.
2. Desire to pro-e too deeply and rapidly at the start.
3. "rritation ith resistance of patient toard gaining understanding of the pro-lems
Phase """.
1. !rustration hostility and discouragement in therapist to patient&s refusal to use
insight in the direction of change.
2. Tendency to push patient too hard and too rapidly toard normal o-7ecti$es.
3. !ear of -eing too directi$e ith resultant e0cessi$e passi$ity.
. esentment at patient&s ina-ility or refusal to cooperate ith correcti$e procedures.
,nd phase
Phase ".
1. Tendency to o$erprotect or to domineer patient.
2. "na-ility to assume a nondirecti$e therapeutic role.