Wednesday, March 20, 2013

Clinical Technique: 'I statements' and 'you statements'

In Freud's essay on negation he mentions how an unconscious thought can be seen in the patient's denial of it. This is one of the points that critics of Freud like to latch on to because it shows that the psychoanalyst is always right. It's sad to think that such people have never cared for others enough to be struck by negations.

I was working with a patient's dream and there was a plane in it but no particular type came to her mind. I asked her 'What the first type of plane that comes to your mind?' She said a passenger plane. I asked her what her first association to a passenger plane was and she mentioned that her brother and his girlfriend when on a trip last summer. Then she began 'It's not like I wanted to go...'. It seemed very strange to me that she would begin like that- as if I would be thinking that and she needed to set me straight. I waited for her to finish off her thought and then I asked her, 'How does it feel if you say 'I wanted to go on the trip'?  She repeated it, and said it felt right and then proceeded to tell me more about how she used to be her brother's mentor and how they had reversed roles and now he's doing better than her.

Suffice it to say that we entered into important information and that we worked closer to some of the issues at work in her melancholia.

This patient had a classic melancholia. Even though she had been to university and was young she soon began to self-revile in the session. She was 'lazy', she was 'stupid', she couldn't 'get her shit together', etc. At the same time, her father began to appear from links in her dreams and slips. In classic form her reproaches didn't really fit her but did fit her father very well. I waited for a few sessions for the attacks to build and for any other info about the father to appear. Then I asked her to relax and take a few breaths, and then say all the self-reproaches as 'you statements' and see how it feels. I read her the words she had used in her self-reproaches and she said them: 'you are lazy, you are stupid...' and after cycling through it twice I asked if anyone came to mind. She had a strange look on her face and said 'my father'.

The self-reproaches didn't come up again after that.

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