Document Detail

Need and responsiveness in the treatment of a severely traumatized patient: a relational perspective.
MedLine Citation:
PMID:  9139551     Owner:  NLM     Status:  MEDLINE    
Severely traumatized patients may exhibit poor functioning and a great deal of dependence upon the therapist. The question is raised as to what such patients truly need from a therapist, and the concept of optimal responsiveness is described. These patients may display complex blends of deficits, resulting from inadequate structuralization, together with pathological internal representations. Their expressed needs in therapy may be true requirements and/or expressions of wishes to be compensated for past suffering and refusal to assume adult functioning. Discerning what might constitute optimal responsiveness to true needs may be further complicated by the propensity some of these patients have for dysfunctional and impulsive behavior. A case is presented that illustrates some of the difficulties in determining how to respond to intense expressions of need, including needs for constant availability of the therapist and for physical contact. It is concluded that although this patient did not need everything from the therapist that she initially thought that she did, her needs were so great that an outpatient treatment situation often seemed insufficient. Despite an overall positive outcome for the patient, the treatment experience was very difficult for the therapist.
M E Connors
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of psychotherapy     Volume:  51     ISSN:  0002-9564     ISO Abbreviation:  Am J Psychother     Publication Date:  1997  
Date Detail:
Created Date:  1997-05-06     Completed Date:  1997-05-06     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0110672     Medline TA:  Am J Psychother     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  86-101     Citation Subset:  IM    
Illinois School of Professional Psychology, Chicago, USA.
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MeSH Terms
Countertransference (Psychology)
Dependency (Psychology)
Depressive Disorder / psychology,  therapy
Object Attachment
Professional-Patient Relations*
Psychotherapy / methods*
Regression (Psychology)
Stress Disorders, Post-Traumatic / psychology,  therapy*
Suicide, Attempted / prevention & control,  psychology

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