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Earlier this year, blog commenter TK wrote: “Isn’t this the greatest countertransference, in this age of fee-for-service psychotherapy as opposed to psychotherapist-on-salary: How do I work around my own economic motivation in deciding whether to continue with a patient or terminate? “In other words, how does one reconcile the consistent economic incentive to keep a client coming [...] I attended a very good lecture this week on contemporary views of countertransference. It inspired me to write a brief overview of the concept here, with more to follow. To understand countertransference, it helps to tackle transference first. As I’ve discussed previously, transference was a word coined by Sigmund Freud to label the way patients “transfer” [...] Two events prompt me to write about therapy endings. In the more abrupt and traumatic of the two, a local psychiatrist died last month in a tragic accident, leaving many patients suddenly without their doctor. The other event, far more commonplace, was the decision of one of my own patients to stop therapy. These events [...] In this age of managed care it may seem surprising, perhaps even suspicious, that traditional psychodynamic therapy is designed to be open-ended, with no fixed number of sessions or duration. This can be anxiety-provoking both to third-party payers, e.g., insurance companies, who prefer to know from the start how much a treatment will cost, and [...] The recent debates over U.S. healthcare reform are long overdue, yet still sadly inadequate. (The discussion is about health insurance, actually, not the care itself. But I titled this post “healthcare reform” since that is what everyone is calling it.) There is no need to rehash the plentiful evidence that the current system is broken: [...] In my last post, I highlighted diagnostic challenges related to borderline personality disorder (BPD): Sometimes dramatic, self-destructive behavior leads to reflexive, inaccurate use of this label, while other times eagerness to diagnose a medication-responsive illness such as bipolar disorder can lead to overlooking BPD. Naturally, this barely scratches the surface. Thousands of books have been [...] When Sigmund Freud originally developed psychoanalysis (the precursor to dynamic psychotherapy), he likened treatment fees to those for music lessons: “As to time, I follow the principle of payment for a fixed hour exclusively. A given hour is assigned to each patient, and that hour is his and he is responsible for it even if he [...] |
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Copyright © 2010 Steven P Reidbord MD - All Rights Reserved |
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