{"id":894,"date":"2014-03-31T23:49:46","date_gmt":"2014-04-01T06:49:46","guid":{"rendered":"http:\/\/blog.stevenreidbordmd.com\/?p=894"},"modified":"2014-03-31T23:49:46","modified_gmt":"2014-04-01T06:49:46","slug":"my-goal-as-a-therapist-to-make-myself-obsolete","status":"publish","type":"post","link":"http:\/\/blog.stevenreidbordmd.com\/?p=894","title":{"rendered":"My goal as a therapist: to make myself obsolete"},"content":{"rendered":"
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\"therapyforever\"<\/a>Traditional\u00a0psychodynamic\u00a0therapy\u00a0is often caricatured as endless, with a complacent therapist silently growing cobwebs, listening to a patient who never plans to leave. \u00a0This isn’t completely unfounded: there are therapeutic advantages to losing track of time, “swimming in the material,” and letting one’s therapeutic focus be broad. \u00a0The patient’s chief complaint, i.e., the ostensible reason for coming, often gives way to more troubling underlying conflicts and concerns that might never appear in more directed or time-limited work. \u00a0Highly defended material may be uncovered and worked through in the fullness of time.<\/p>\n

All the same, and as many critics have pointed out, this is a cozy arrangement. \u00a0If the therapist is happy to have a paid hour, and the patient is gratified to pay for the undivided attention of a caring doctor, nothing need change. \u00a0Ever. \u00a0Many patients\u00a0fear\u00a0becoming emotionally dependent on their therapists, i.e., finding it too comfortable to stop. \u00a0And some therapists, being human, are not above maintaining a pleasant status quo.<\/p>\n<\/div>\n

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Psychoanalysts and analytic psychotherapists anticipate this concern, and hold that a patient’s dependency, like everything else, can be explored, understood, and overcome. \u00a0However, in highly non-directive therapy, i.e., with a mostly silent therapist, this can take a long time and be painful for the patient in the meantime.<\/p>\n

My approach to dynamic work is more interactive. \u00a0While I believe transference and countertransference<\/a>\u00a0are highly useful tools, and that both manifest and latent content are important, I also strive to help paients in the here and now, whenever doing so doesn’t interfere with long-term gains.<\/p>\n

In this light, I often tell patients that\u00a0I aim to make myself obsolete<\/strong>\u00a0in their lives. \u00a0Saying this can quell dependency fears, but it’s open-ended enough that I’m not promising how long (or briefly) we’ll work together, nor that I guarantee they won’t feel dependent along the way. \u00a0I can’t promise these, because I don’t know. \u00a0But I can give my word that I won’t allow myself to get so comfortable with our arrangement that I forget why we’re meeting at all. \u00a0It’s a comforting statement that has the advantage of being true. \u00a0It feels good to have a patient not need me anymore, a little like the bittersweet feeling when a child goes off to college. \u00a0And in a way, hearing myself say so out loud helps me remember it.<\/p>\n

The trade-off, a psychoanalyst might point out, is that I short-circuit any\u00a0fantasies\u00a0patients might harbor that I seek to trap them, that I want them to feel dependent. \u00a0Patients might gain more insight about themselves if I let such fantasies germinate, and then collaboratively explore them. \u00a0It’s an important point to keep in mind, but on balance I usually feel this modest bit of support helps the therapeutic alliance much more than it forestalls exploration.<\/p>\n

A successful psychotherapy is when a patient leaves with the satisfaction that she “got what she came for,” and no longer needs, or even wants, to see a therapist. \u00a0And a successful psychotherapy practice is one where patients come (in need) and go (improved), the therapist becoming obsolete one patient at a time.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"\n

Traditional psychodynamic therapy is often caricatured as endless, with a complacent therapist silently growing cobwebs, listening to a patient who never plans to leave. This isn’t completely unfounded: there are therapeutic advantages to losing track of time, “swimming in the material,” and letting one’s therapeutic focus be broad. The patient’s chief complaint, i.e., the […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[8],"tags":[37,31,53,25,24],"class_list":["post-894","post","type-post","status-publish","format-standard","hentry","category-psychotherapy","tag-countertransference","tag-insight","tag-psychodynamics","tag-termination","tag-transference","odd"],"aioseo_notices":[],"_links":{"self":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/894","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=894"}],"version-history":[{"count":1,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/894\/revisions"}],"predecessor-version":[{"id":896,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/894\/revisions\/896"}],"wp:attachment":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=894"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=894"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=894"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}