Relational Flashcards
The self-system
Sullivan believed that personality is the entire functioning of a Person. The self-system developed out of a sense of anxiety.
Self: organization of experience within the personality and is largely composed of internalized experiences with others.
Good me: anxiety-free experiences as an infant with the caretaker
Bad me: anxiety-filled experiences as an infant with the caretakers
Not me: extremely traumatic experiences that can’t be integrated
Instead of sexual and aggressive drives, Sullivan believed people needed to satisfy tendencies toward security, tenderness/intimacy, and lust. When these needs are not met, they can lead to aggression and cruelty.
Process of therapy
• History taking (lot on past)
• Use of silence and free association
– Lessen anxiety by providing structure and consistency
– Create an environment where patient feels ‘held’, replicating the holding environment
• Analysis of Defense and Resistance
– Expect resistance…even if a patient wants change a part of them wants to remain embedded in their old world.
• Analysis of Transference
– Is not the blank screen where client projects onto but instead another subjectivity
– Therapist is to ‘wear the attribute’ – therapist is to join in
• Mutual Enactment
– Therapist is to be both neutral and objective..counter transference
• Analysis of Dreams
– Dream is viewed as an urgent message to oneself to examine something that might lead to trouble if unexamined
• Technical Errors
– Use of basic boundaries, set time and fee, so social contact outside of therapy, and avoid advice giving or imposing values
– Not fully understanding client
– Providing interpretation without the insight
• Encourage Experiences in the Moment…in the past
– ‘Imagine being there right now’
Goals
• “Increase a patient’s skill in living” – Sullivan
• Tolerance for uncertainty and emotions
• Arousal of curiosity
• Greater awareness if one’s impact upon others
• Increase capacity for self-reflection
• Mourn loss and lost possibilities
• Separation from embeddedness in the past
• Find richer meaning in life
Note: the patient prioritizes treatment goals
Beliefs & basic understanding
Every human has a fundamental need for intimate emotional connection with significant others.
• As children, as a result of less than optimal interactions with parents and others, develop deeply engrained mental organizing patterns that guide or misguide relational efforts throughout life.
• These patterns determine, in large part, how one perceive, give meaning to, and emotionally respond to all relationships.
• Thus, in spite of best attempts to make relationships grow and improve over time, it is found that old relationships don’t improve as originally hoped, and that each new relationship becomes, in unfortunate and surprising ways, too much like previous ones.
• People’s minds, like mental computers, are programmed when they were young children.
• That programming can only be changed with outside help.
• Therapist and client together can change destructive patterns through the analytic process the client’s relationships can become truly transformed.
• With a good and sustained therapeutic experience, important relationships can emerge from the heavy imprinting of childhood experiences to become deeply satisfying and relatively free from bitterness and destructive conflict.
How self-disclosure is used in this theory
• Use of self-disclosure is used in moderation if it serves a need for the session/client as it is an important way to let clients know you as a person.
– Professional background— training and practice
– Personal life circumstances
– Feelings about and reactions to the client
– Associations to therapeutic content
– Admission of mistakes made in therapy
• Contemporary analysts are much more open to self-disclosures, especially of their countertransference.
How counter-transference is viewed/used in this theory
- Analysts began conceptualizing unconsciously transmitted relational material (projections, projective identification, etc) as essential to the treatment process.
- The therapist’s internal responses to the patient can be diagnostic
- Projective Identification: therapist has feelings ‘projected’ into him or her by patient because the patient could not tolerate them
Strengths and Limitations
- Applicable to a variety of clients including disturbed clients
- Therapists will make adjustments based on their clients (functionality, age, diagnosis).
- From a cultural stand point, adjustments have been made to work with bilingual and deaf clients as well as those with addictions.
- Therapists are highly skilled
- Can be costly due to amount of therapy needed
