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Post by PigsnieLite on Aug 12, 2010 2:26:36 GMT -5
So existential dread is nihilism? So whut do you guys think of that letter writer? Do you find her completely annoying (as I do) or do you want to study her as you would a butterfly stuck on the end of a pin?
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Post by Avril on Aug 12, 2010 7:54:53 GMT -5
She sounds like many of my clients. Unfortunately she's got herself into a worse position because she either had the wrong therapist or gave up too soon.
I do find these cases fascinating. In the best case scenarios the client begins to find it fascinating too. Then there can be some movement. What is at the root of this malaise, this ennui? Of course it can be boring or annoying to those who don't know what's going on - it's her response too. At the same time, as you so accurately imply, Arch, she's indulging in a faffle of treacle - she can't move or she won't move, it's much the same.
You know, therapists don't so much study such cases as entomologists do butterflies, as enter the dark places with them.
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Post by Frito Freddie on Aug 15, 2010 21:03:27 GMT -5
Has a patient ever confessed a crime to you? Or the desire to commit a crime? Would you stop them before they say it?
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Post by Avril on Aug 16, 2010 3:06:42 GMT -5
As part of the preamble to a counselling or therapy session, we are required to inform clients that the session is confidential unless the client tells us s/he intends harm to her/himself or someone else. This is particularly the case where an infant or minor child might be harmed, where mandatory reporting comes into play.
As a result, we don't usually get people telling us in advance if they seriously intend hurting someone. We do get people confessing to having harmed others in domestic violence situations, but it's usually well after the fact with an intention to change and obvious remorse.
Personally, I've had a nurse confess to euthanasia of an elderly patient with gangrene and dementia and a few supervisees worried about their responsibility in cases of clients who have committed suicide while in their care. There was one man who was worried about harming his four year old son, who turned out to have given me false details and whom I never saw again after the first session. That was a worry, since what we uncovered in the session was a history of violent abuse in his own childhood that he had completely suppressed up to that point.
Most frequently, I get people who are suppressing their anger, and in the cathartic de-suppression of it in session, uncover an inner psychotic or homicidal maniac. This is great fun, usually, because I stipulate that whatever might get them into prison on the outside world is completely safe to express within the session room as long as they don't hurt themselves or me. I have a variety of toys such as a padded PVC baseball bat and various things to smash up and whack with said baseball bat until the anger is completely flat. It can take several sessions. There's a gestalt technique which allows them to destroy a cushion, or maybe just express themselves verbally to someone in their lives via the cushion. For those who aren't up to expressing their rage physically or verbally I use a silent eye-contact technique where they can 'send' me their anger and off-load it without the least judgement and with total acceptance, since I know that they are not their anger.
The hope and intention is that if they can consciously off-load their rage in this way in a therapy session, they won't need to act it out criminally on an unsuspecting family or public.
So, if a person expressed a wish to harm someone, I would encourage them to talk about it, experience their anger, hatred, resentment or rage, and then express it safely in the session room. If not there, then at the running track, gym, pool or football field. I've never had a client who actually hurt anyone if they've allowed themselves to go through this process.
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Post by PigsnieLite on Aug 17, 2010 4:16:14 GMT -5
I always say my favourite colour is pink to discombubulate people, but when I see the stoof Ive bought, I see an awful lot of Yellow. Could this be related to my aura? PS. How happy would you be if Manson uncovered his innur psychotic to you? Eeeek!
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Post by Avril on Aug 17, 2010 4:53:27 GMT -5
Well, there's a difference with a person with a psychosis. I usually refer these poor souls on to a psychiatrist as quickly as possible. (And look at upping my security.)
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