By David E. Engle PhD, Hal Arkowitz PhD
Why is switch usually so difficult to complete, even for those that spend huge time, cash, and energy within the test? How can treatment consumers get unstuck and paintings gradually towards wanted objectives? This booklet provides an integrative version of ambivalence in psychotherapy and provides powerful, useful how one can realize and care for it. Emphasis is given to 2 strategies with major empirical aid: motivational interviewing and the two-chair method. together with in-depth case examples and transcripts, the e-book demonstrates the way to use those interventions as stand-alone remedies or combine them with different cures for consumers being affected by addictive behaviors, melancholy, anxiousness, and different usually encountered difficulties.
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Additional resources for Ambivalence in Psychotherapy: Facilitating Readiness to Change
This is “the demand for understanding, empa- thy, and care from the therapist—often to the exclusion of problem solving or a rational perspective” (2001, p. 58). When such demands are not satisfactorily met, the patient may resort to a number of strategies that are resistant including rumination, escalation of intensity, devaluation of the therapist, emotional distancing, splitting the transference, and noncompliance with homework. • Self-consistency. Some instances of resistance are caused by the tendency of people to maintain self-consistency, predictability, and control 30 AMBIVALENCE IN PSYCHOTHERAPY that is associated with their negative thinking.
Refusal or other failure to follow through on therapy homework assignments. 2. Repeatedly making decisions and taking actions that run counter to what was agreed upon in session. 3. High levels of expressed emotion toward the therapist ranging from excessive flirtation to overt hostility. 4. In-session avoidances such as silences, overly frequent usage of “I don’t know,” and abrupt topic shifts. 5. Gratuitous debates with the therapist. 6. Relapses in functioning that occur when the client has difficulty enduring the increased anxiety that accompanies initial attempts to function more adaptively.
Is to keep clearly in mind that the patient is most often in conflict. Often, the primary challenge facing the therapist is to find a route into the experience of conflict, to access the complexity beneath the apparently monolithic attitudes that (at a terribly high cost) protect the patient from the less acknowledged side of his conflict. Finding potential tiny chinks in the defensive armor without becoming adversarial is the key to inquiry that is effective and therapeutic. (1993, p. 89) Wachtel also points to the dialectic between acceptance and change, emphasizing the need for the therapist to be able to see the world through the client’s eyes, understanding and appreciating his or her perspective and why the client has found it necessary to live his or her life as he or she does.
Ambivalence in Psychotherapy: Facilitating Readiness to Change by David E. Engle PhD, Hal Arkowitz PhD