The Gift of Therapy

In all of these instances I invariably examine the incident the following session

though sexual feelings may be experienced in the therapy relationship and should be expressed and discussed, they will never be acted upon

If a patient is in great despair because of, let us say, a cancer recurrence or any other awful life event and asks during the session to hold my hand or for a hug, I would no sooner refuse than to decline to help an old woman facing a snowstorm put on her overcoat. If I can find no way to ease the pain, I may ask what he/she would like from me that day—to sit in silence,
to ask questions and more actively guide the sessions? To move my chair closer? To hold hands? To the best of my ability, I try to respond in a loving, human way, but later, as always, I debrief: I talk about what feelings my actions produced, and I share my feelings as well.

Do touch. But make sure the touch becomes grist for the interpersonal mill

Things have happened here that are reflective of what happens in your social life, but there is one fundamental difference—and that’s what is unique about the therapy situation: I’m not going to break off contact and I’m going to be available for you to find out something you’ve never been privy to in past relationships—the feelings evoked in the other person by your actions

Remember Timing is all-important: interpretations are most effective when the patient’s affect has sufficiently diminished to permit him to assume a more dispassionate view of his behavior

Don’t lose touch with patients’ initial complaints. As the following vignette illustrates, the reasons for seeking therapy given in the first session may serve you in good stead during difficult phases of therapy.

termination decisions. Behavior change in the therapy situation is obviously not enough: patients must transfer their change into their life environment

such techniques are useful not as ends in themselves, but to generate data for subsequent exploration

there are as many explanations as there are explanatory systems. None at the time proved to make the crucial difference.
But the search for explanation kept us engaged and our engagement ultimately made the difference. She took the plunge and chose to relate deeply to me, and I did not shrink away from her. I was not destroyed by her rage, I remained close to her, I held her hand when she was most despairing, I stayed alive and did not fall victim to her cursed karma