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On the last track we discussed control over switching. Two ways to help your client gain control over switching are overcoming host fears and facilitation of the switching process.
On this track we will discuss transference. For the purposes of this track, we will use Lang’s definition of transference. Lang defines transference as ‘responses by the client to his or her therapist that are primarily based on, and displaced from, the client's significant childhood figures. These significant childhood figures might be parents and siblings.’
This track will cover working with transference in multiples, principles of treating transference, and precipitants of transference reactions, as well as techniques described by Putnam for keeping the client straight and being real with the client.
Working with Transference in Multiples
If so, you might find that transference reactions in clients with DID are generally not well organized and may need to be worked with in a more step by step approach. Therefore, in the treatment of DID, therapists may find it productive not to search out, emphasize, or refer to passing transference phenomena unless they represent major obstacles to therapeutic progress.
Principles of Treating Transference
Precipitants of Transference Reactions
Technique: “Keeping the Client Straight”
Alan stated, “I think my obsession with the minute details of these therapy sessions has something to do with losing time when the others come out.” Do you have an Alan whose close attention to detail regarding client-therapist interactions could be explained as a compensation for time loss or amnesic episodes? Could admitting fallibility and asking for clarification help reduce some of your client’s transference reactions?
Being Real With the Client
Therefore, the technique of being real with the client can benefit DID clients who are unable to tolerate the traditional unresponsive, ‘neutral’ therapeutic stance advocated by psychoanalytic theory. Alan required me to relate to him in some way. Before I managed to do so, there was a break in the therapeutic alliance. You might find that this pressure to abandon your usual manner of relating to a client can produce feelings of being manipulated and having your therapeutic authority undermined. If so, you might consider discussing with your colleagues ways to achieve equilibrium between the reality based need of your client to be responded to in an active and direct manner and your need to maintain a therapeutic stance toward the client in which you are both comfortable and effective.
Clearly, your current therapeutic stance is effective, or you wouldn’t be practicing. However, I find, as with Alan, I must be flexible to be effective, yet rigid with regard to certain treatment boundaries. Otherwise, as you know, the therapy degenerates into chaos. Would you agree that such paradoxes permeate the treatment of DID?
On this track we have discussed transference. This track covered working with transference in multiples, principles of treating transference, and precipitants of transference reactions, as well as techniques for keeping the client straight and being real with the client.
On the next track we will discuss ‘talking through.’ ‘Talking through’ is a technique to ensure that as many alters as possible are actually listening.
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