Access Points

• Mission Statement by Jessica Broitman, 11/9/96
  • Case Specific by Jessica Broitman, 12/2/96
    • Could this be applied in work w/medical pts? by Ellen Dornelas, Ph.D., 12/10/96
      
      

Hi Ellen Welcome to the forum- You have a difficult task in helping people in only one intervention. Yet how crucial it must be for your patients continued life. Clearly you have a unique access to them in that moment of vulnerability. I am reminded of the work of Ann BLack. She works at a crisis center and often sees patients briefly around a crisis. Her work using CM has seemed short of a miracle. She tells of finding people in a unique state of readiness to listen and learn how to save themselves. It seems that coming so close to dying or extreme pain can allow one to pay attention in a way that regular therapeutic contact can't.

It reminds me also of the power of dreams. Weiss speaks about the strength of messages that we learn through our dreams. He says that the dream message carries much more conviction and authority that would a therapist or friend telling a patient the same information.

I think that you are right and core issues can be exposed and reachable at such times. From a CM perspective we would say that you would want to explore the underlying pathogenic beliefs that caused the patient pain and problems. This could be either in the present or in the past. The event that preceded the hospitalization may have reconfirmed a major traumatic belief system. The heart attacks could be seen as a punishment or warning that there was a danger in trying to achieve some goal. In that way it will be case specific to the particular way each person understands or take the fact that they have had the attack. It could be quite useful to explore their understanding out why they were sick.

The people who you are seeing are at the very least not protecting themselves. They know that smoking is killing them yet have difficulty stopping. One example of how CM theory might help is that in looking at the danger signs with them you might want to consider what beliefs they have about valuing their lives. Some of these people might not feel like they have a right even so basic as to live and take up space. One often sees this in patients who felt that they burdened or killed their own parents. They have often been neglected in their own childhood's and continue to neglect themselves out of a loyalty and compliance to their parents. They might carry the idea that their loved ones would be better off without them. Others might see that fact that their lives were spared as a sign that they are to be given another chance to make a better life or repair their current life. I am interested in hearing if any of these ideas fit with what you see.

• Using C-M with smokers after m.i. by Ellen Dornelas, 12/12/96
• how people respond to trauma by Jessica Broitman, 12/14/96