Relationship with the therapist

• The Case of Gary III - Life in a malevolent world. by Jim Pretzer, 10/25/97
  
  

The clear and evident success of the approach taken by Dr. Pretzer supports the theoretical structure that underlies it. Two questions:

1) I've noticed that in a couple of articles written about your presentations at professional meetings, you've been quoted as saying that it is important to help the patient identify the affect responsible for or associated with the uncomfortable thought. Within the discipline of the therapies that I have based on the affect/script theory of Silvan Tomkins, we identify nine innate affects that are with us from birth to death, and which are responsible for all emotional experience. Do you also have a specific list of affects, and if so, do you try to establish that list with the patient as a lingua franca, a common language that can allow you to know what each is talking about? Our group has found that it makes a great deal of difference when we teach patients that the range of experience between fear and terror is quite something else from the range between distress and anguish. (The former is normally associated with rapid heartbeat and the sense of too-much-too-fast, while the latter conveys the sense of too-much at a steady level.) Common lay language allows the elision of these two biological phenomena (normal physiological affect protocols) into the term "anxiety."

2) Just as Gary has changed in his ability to relate to those in his workplace, it would seem logical to expect that he has also changed in his relationship with you. Did you find him qualitatively different? Is it normal or usual for a cognitive/behavioral therapist to discuss with the patient how s/he feels about the therapist? Is data from the patient-therapist relationship utilized in treatment? Would you ever ask a patient "How do you feel about me at this moment?" or "Do you feel that as a result of therapy you experience me any differently?"

• Affect, Relationship with Therapist in CT by Jim Pretzer, 10/31/97