Therapeutic Communication Knowing What to Say When

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  • Edition: 1st
  • Format: Hardcover
  • Copyright: 1993-03-19
  • Publisher: The Guilford Press
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For every therapist who has ever thought, "I understand my patient, but what should I say at this moment?", this book will provide practical, enlightening assistance. A trained psychoanalyst known for his integration of active methods from other orientations, Paul L. Wachtel examines in great detail precisely what the therapist can say to contribute to the process of healing and change. The reader is shown - through numerous examples, including annotated transcripts of actual therapy sessions - why some communications are particularly effective, while others, though addressing essentially the same content, actually promote the problems being treated. A uniquely practical book, Therapeutic Communication also offers the reader an exploration of theory that integrates psychodynamic principles with insights and discoveries from other approaches. Opening chapters probe how vicious circles perpetuate the patient's difficulties and how intrapsychic conflict and interpersonal realities mutually create each other. Later chapters explore communication strategies that will help resolve these difficulties. Dr. Wachtel illuminates the evaluative nature of seemingly "neutral" comments, and demonstrates how the therapist can generate communications that foster the patient's progress. Other chapters highlight how to build on the patient's strengths; how to promote and amplify change processes and help the patient "own" his insights through what Dr. Wachtel calls "attributional interpretations"; and how to utilize the art of gentle inquiry, phrasing questions in ways that protect the patient's self-esteem and mobilize his capacity to change. Rounding out the work is a comprehensive chapter on theprocess of "working through", and a concluding chapter by Ellen Wachtel insightfully extending the book's ideas to work with couples. Jargon-free prose and respect for multiple psychotherapeutic perspectives make this book valuable not only to psychodynamically oriented therapists, but to practitioners from other orientations as well. It is important reading for clinical psychologists, psychiatrists, social workers, marital and family counselors, psychiatric nurses, and pastoral counselors. Its unusually clear style, vivid clinical illustrations, and innovative ideas make the book an excellent psychotherapy text for courses at both the advanced and introductory level.

Table of Contents

The Talking Cure
Cyclical Psychodynamics I: Vicious Circles
Cyclical Psychodynamics II: The Centrality of Anxiety
Cyclical Psychodynamics III: Insight, the Therapeutic Relationship, and the World Outside
Accusatory and Facilitative Comments: Criticism and Permission in the Therapeutic Dialogue
Exploration, Not Interrogation
Building on the Patient's Strengths
Affirmation and Change
Attribution and Suggestion
Reframing, Relabeling, and Paradox
Therapist Self-Disclosure: Prospects and Pitfalls
Achieving Resolution of the Patient's Difficulties: Resistance, Working Through, and Following Through
Postscript: Therapeutic Communication with Couples
Ellen F. Wachtel
References 294(8)
Index 302

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