Clients' representations of their therapists over the course of psychotherapy

Rosenzweig, Debra L.; Farber, Barry A.; Geller, Jesse D.

doi:10.1002/(sici)1097-4679(199603)52:2<197::aid-jclp11>3.0.co;2-f

Cited by 16 publications

(18 citation statements)

References 3 publications

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“…One of the ways in which therapy helps to accomplish these goals is by a process through which the client gradually comes to replace harshly critical and self-undermining internalized images and voices, with the more benign internalized voice or presence of their therapist. This process has long been recognized by clinicians, and has been confirmed and further articulated in a series of research studies using both qualitative and quantitative methodologies, in clients with different types of presenting issues who have received different approaches to therapy (Bender et al, 2003;Geller & Farber, 1993;Knox, Goldberg, Woodhouse, & Hill, 1999;Mosher & Stiles, 2009;Rosenzweig, Farber, & Geller, 1996;Wachholz & Stuhr, 1999).…”

Section: The Client's Internalized Image Of the Therapistmentioning

confidence: 84%

Narrative Case Studies and Practice-Based Learning: Reflections on the Case of "Mr. R"

McLeod¹

2016

PCSP

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Narrative case studies tell the story of therapy from the point of view of the client or therapist. Murase's (2015) case of "Mr. R" provides a powerful example of the potential of this form of case inquiry, as a means of enabling reflection and deeper understanding around the practice and process of therapy. The distinctive contribution of the case of Mr. R is discussed in relation to the personal learning of the author in respect of a series of domains: working with the contextual and cultural meaning of the client's issues, creating corrective everyday life interventions, repairing therapist-induced ruptures in the therapeutic alliance, and developing new understandings of the process of client internalisation of the image of the therapist. Theoretical implications of the case are explored, and some suggestions are offered around the further development of narrative case study methods and the concept of therapist wisdom.Key words: culture; everyday life; exemplar study; internalization; narrative; personal meaning; theoretical fluidity; therapy process; wisdom ______________________________________________________________________________ The case of Mr. R offers one of the relatively few English-language examples of the work of Dr Kayoko Murase (2015), for many years one of the most influential figures in psychotherapy in Japan. In addition, this case acts as an example of the rich tradition of case study inquiry that forms a key part of the evidence base for therapy theory and practice in that country. This case therefore possesses cultural and professional significance beyond its account of how therapy unfolded with a troubled young man. Constructing a commentary on this case has been a demanding task, because of the rich, multi-layered nature of the material that has been provided. In the following sections, I offer reflections on three key dimensions of the case: the therapy case study as a form of narrative inquiry, practice-based learning arising from reflection on the case of Mr. R and implications for theory.

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Section: The Client's Internalized Image Of the Therapistmentioning

confidence: 84%

Narrative Case Studies and Practice-Based Learning: Reflections on the Case of "Mr. R"

McLeod¹

2016

PCSP

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“…Likewise, these clients' representations enabled them to "continue the therapeutic dialogue" with their therapists when not actually in their presence, as proposed by Geller et al (1981). Clients' representations may indeed function as psychological connective tissue between sessions (Atwood & Stolorow, 1980;Rosenzweig et al, 1996). Self-perceived improvement in therapy, in fact, has been positively correlated with clients' tendency to use their internal representations as a way to continue the therapeutic dialogue (Wzontek et al, 1995).…”

Section: Clients' Deliberate Use Of Internal Representationsmentioning

confidence: 99%

“…It seems, then, that internal representations soothed the clients, as Geller (1987) and Rosenzweig et al (1996) suggested, reassured them in times of trouble or doubt, and enabled them to make use of the therapy itself. Such positive affective responses echo those suggested by Kantrowitz et al (1990), who stated that clients' improvement and readiness for termination were indicated by their ability to take on the selfregulatory functions once served by the therapist.…”

Section: Clients' Affective Response To Internal Representationsmentioning

confidence: 99%

“…Such changes in clients' internal representations, then, could illuminate other important changes occurring in clients. Client improvement, for instance, is believed to be related to the extent to which clients are able to evoke representations of the benignly influential components of the therapy relationship (Rosenzweig et al, 1996) and to their ability take on the selfregulatory functions that therapists once served (Kantrowitz et al, 1990).…”

Section: Changes In Internal Representations Over the Course Of Therapymentioning

confidence: 99%

“…Clients' improvement, furthermore, is believed to be related to the extent to which they are able to evoke representations of these benignly influential components of the therapy relationship (Rosenzweig, Farber, & Geller, 1996), such as the therapist himself or herself.…”

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confidence: 99%

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Clients' internal representations of their therapists.

Knox¹,

Goldberg²,

Woodhouse³

et al. 1999

Journal of Counseling Psychology

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Thirteen adults in long-term individual psychotherapy were interviewed regarding their internal representations (denned as bringing to awareness the internalized "image") of thentherapists. Results indicated that in the context of a good therapeutic relationship, clients' internal representations combined auditory, visual, and kinesthetic (i.e., felt presence) modalities; were triggered when clients thought about past or future sessions, or when distressed; occurred in diverse locations; and varied in frequency, duration, and intensity. Clients felt positively about their representations and used them to introspect or influence therapy within sessions, beyond sessions, or both. The frequency of, comfort with, and use of clients' internal representations increased over the course of therapy, and the representations benefited the therapy and therapeutic relationship. Therapists tended not to take a deliberate role in creating clients' internal representations, and few clients discussed their internal representations with their therapists.Clients' internal representations of their therapists can be defined as clients bringing to awareness the internalized "image" (occurring in visual, auditory, felt presence, or combined forms) of their therapists when not actually with them in session. In these internal representations, clients have an image of the living presence of their therapist as a person. Despite its apparent significance, the phenomenon of clients' internal representations of their therapists has not received a great deal of attention in the literature.

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Psychotherapists' representations of their patients

Geller¹,

Lehman²,

Farber³

2001

J Clin Psychol

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Using a new measure, the Patient Representation Inventory (PRI), this study investigated the nature of psychotherapists' working clinical models of their patients. The data provided by 73 therapists suggest that, regardless of experience level or theoretical orientation (cognitive-behavioral or psychodynamic), therapists tend to evoke such representations by accessing the words spoken during sessions and by recreating visual images of their patients' nonverbal contributions to the therapeutic dialogue. These representations tend to be in the service of more deeply understanding patients; their affective tone is suggestive of empathy, authenticity, and involvement. More-experienced therapists tend to evoke representations that rely largely on bodily sensations and the emotional atmosphere reflective of clinical interactions. Apparently, similarities and differences among therapists can be studied not only at the manifest level of clinical work, but at the representational level as well.

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Clients' representations of their therapists over the course of psychotherapy

Cited by 16 publications

References 3 publications

Narrative Case Studies and Practice-Based Learning: Reflections on the Case of "Mr. R"

Narrative Case Studies and Practice-Based Learning: Reflections on the Case of "Mr. R"

Clients' internal representations of their therapists.

Psychotherapists' representations of their patients

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