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Archives for April, 2012

Psychotherapy

ADHD Symptoms and the Dynamics of Distraction

Both of my clients who had received a diagnosis of ADD prior to starting therapy and are now taking meds continue to help me understand the psychological origins of this difficulty.

Later in a session, when talking with one patient about how distracted he gets and the ways he procrastinates, I made the parallel: his urge to "move on" from guilt or remorse, putting those feelings out of his mind, resembles the way...
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Psychotherapy

The Hopeless Inner Mess

Alan talked in session about his disappointment over the job interview, odds that he won't get an offer, and feeling "depressed" about it. We've discussed depression before but something about what he was saying felt different this time.

He mentioned attempts to rouse himself into action, then sinking back into lethargy. At one point, he was lying on the couch, then got up to clear off his desk. Alan had been neglecting that...
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Psychotherapy

Lethal Ideals

As he left the office last night, Naomi's boss gave her some instructions that struck her as ridiculous, betraying a lack of understanding for the flow of work during the evening shift. As she talked about him, she sounded scornful. Because she felt so angry, she wound up doing virtually nothing, which in the end made her feel "guilty" because she'd wasted time that she might have used to develop other projects.

She...
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Psychotherapy

The Client as Colleague

Just before our session, David had his monthly consultation with the psychiatrist in charge of his medication. Prior to that meeting, David had spent hours researching his various meds, their indications and side-effects, new drugs on the market, etc.

He presented a written report with all this information to the psychiatrist during their consultation. "He basically did what I told him to do," David said to me, at the beginning of our session...
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Psychotherapy

Empathy vs Sympathy

Things I heard myself say during sessions yesterday:

I think you feel so screwed up that there's no hope you could ever do anything to get better ... that you might as well throw yourself onto the trash heap.

Sounds like you're saying none of these apartments will make things any better -- one's as good as another -- because wherever you go, you'll take yourself and all your pain along with you.

I...
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Psychotherapy

The Mouth-Breast Rupture

Janice continues to struggle with this new awareness of having a mouth. It isn't only symbolic or metaphorical -- a way to describe coming alive to her needs; she feels it on a quite physical level, too. When I returned from my vacation break, she talked about feeling as if her mouth had been cut away from her face. Now, she feels as if her mouth is like an ugly...
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Psychotherapy

Of Fees and Cancellation Policies

During our first session, I began by telling Deanna that the lead-up to the appointment had felt like chaos -- the "forgotten" session, her difficulties in getting the forms to me in a timely way, taking days to reply to emails, the incomplete information on the new client questionnaire, etc. She agreed right away and I suggested it was a good place for us to start our discussion.

Deanna went on to tell...
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