Tuesday, August 24, 2010

Resistance to regular scheduling

1986: Dr. Spotnitz was a very dynamic and confident man who conveyed a specific analytic attitude along with the verbal intervention.  Relating his actual recommended interventions can only give a hint of the attitude and definiteness accompanying it.  Part and parcel of the supervision was incorporating the correct analytic attitude toward the patient.
Responding to a case of a stubborn man who is damaging to his relationships and resists treatment:  "Come to my office and do what I tell you so I can help you.  Your thoughts, feelings and judgment is no good.  Come in so that I can take care of you. I'll structure you - come in  {the 'structure' refers to asking questions].  Come in, lie down and talk.  Answer my questions.  Force the patient to get well. Be persistent! Don't let up!

An inconsistent younger patient:
You're not getting any place, you need regular appointments and to talk about the five subject areas every session. [Dr. Spotnitz's variation on "say everything" and "tell the story of your life" is to tell the patient to cover five areas each session: current life, past life, dream life, sex life and therapy-thoughts,feelings and ideas about the therapist and the treatment]. Work on getting cured. Tell me everything - don't be a faker and a liar. Take regular sessions and cut out all drugs.  Be a regular guy.  You're behind schedule, you're wasting your life, you're too old to be fooling around.

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