Terms in this set (130)

Our clients do indeed change us almost as much as we change them. Even though we know, understand, and enforce the rules and guard against infection by clients, and even though they are amateurs at influence, befuddled and distracted as they are with their own concerns, we cannot remain completely unaffected. We are touched by their goodness and the joy and privilege we feel in being allowed to get so close to a human soul. And we are sometimes affected by their malicious
and destructive energy. Whenever we enter a room with another life in great torment, we will find no escape from our own despair. And we will find no way to hold down the elation we feel as a witness to another person's transformation—just as we are the catalyst for our own.

The decision to be a therapist is also a commitment to our own growth.
-therapists are willing to subject themselves to the trials and tribulations of their work in order to become more authentic and real.
-Most therapist understand that they jeopardize their own emotional well-being when they intimately encounter the pain of others.

Our professional effectiveness, not to mention our personal well-being, is
affected by the intimate relationships that have become the trademark of our work. We live with the pressure of trying to meet our own and others' expectations. Despite our best efforts to convince ourselves of our limitations, we feel responsible for clients' lives. We experience repetition and boredom that comes from having an assembly line of people walk through our offices, not
to mention the added stress of supervisors and quality review boards looking over our shoulder to monitor our progress. We feel inadequate for not knowing enough, for not being able to help more people, and for not doing it more often. When we do manage to make a significant difference in someone's life, we then struggle with helping make the changes last. And as a result of these
close encounters with people in pain, our own issues are constantly touched, our old wounds reopened.

Ou professional effectiveness, not to mention our personal well-being is affected by the intimate relationships that have become the trademark of our work.
-Over time, many practitioners become desensitized to human emotion, and experience an acute overdose of feeling; they learn to keep boundaries firmly in place and turn off their emotions.
-We experience intimacy, discomfort, and countertransference reactions that permanently alter our perceptions and internal structure. The more clients talk about subjects that touch on our own unresolved issues, the more insecure and uneasy we may feel about ourselves.
-It can involve the way the therapist responds to the client's transferential feelings, triggering strong reactions to being treated as a parent, or authority figure, or some other ghost from the past. Like so many other processes in therapy, countertransference can be classified in terms of whether the reactions are essentially reactive, induced, displaced, or projected. In each case, there is the likelihood of some degree of distortion that can lead to treatment difficulties as well as the possibility that such feelings will have either beneficial or detrimental effects.
-it is evident that these personal reactions can be used as significant turning points in the therapy, a means by which the therapist can offer feedback and impressions that might otherwise be withheld
Whether we catch ourselves being overprotective, overly solicitous, aloof, or downright hostile, it is evident that we have very different feelings and reactions to certain clients. A brief glimpse at the appointment calendar reminds us of those people we eagerly await and those we dread. We are friendlier with some clients than with others. Some of them are greeted cordially with an
open smile and an offer of a beverage, whereas others are coolly directed to their place with a reminder of their delinquent bill.
Part of being a therapist involves working with those individuals who, for a variety of reasons, will test your patience, flexibility, and resourcefulness in ways you've never imagined were possible. In some cases, they push your buttons and ignite a whole host of strong personal reactions that may or may not be related to the client's own issues.

Borderline personalities, sociopathic personalities, and those with conduct disorders test a therapist's patience and defenses like few others. The prognoses are poor; progress, if any, is slow; and the therapist is likely to be on the receiving end of manipulation, dramatic and painful transference, and projective identification. A number of studies on the client behaviors that therapists experience as most stressful create a consistent portrait of most frequently mentioned occurrences: threats of suicide, expressions of anger, demonstrations of hostility, severe depression, abject apathy, and premature termination.

•Suffer from physiological disorders (strokes, closed head injuries)
• Experience extreme psychotic symptoms (major hallucinations, delusions)
• Have hidden agendas (workers' compensation or court referrals)
• Violate boundaries (chronic lateness or missed appointments)
• Externalize blame ("It's not my fault")
• Refuse to accept responsibility ("You fix me")
• Are argumentative (hostile, skeptical, aggressive)
• Fear intimacy (avoidant or seductive behavior)
• Are flooded with emotion and overwhelmed
• Push your buttons (bring up your own unresolved issues)
• Are impatient ("Fix me quick")
• Are literal and concrete (unable to access or express internal states)
• Are actively suicidal
• Have poor impulse control (offenders, substance abusers)
• Are in life circumstances (homelessness, poverty) that make therapy seem useless when compared with what is really needed most
• Have limited command of your favored language (literally and figuratively)