Making a Difference in Patients' Lives: Emotional Experience in the Therapeutic Setting (Psychoanalysis in a New Key Book Series)

338 Pages·2008·3.52 MB·English

by  Sandra Buechler

Making a
Difference in
Patients’ Lives
Psychoanalysis in a New Key Book Series
Volume 8
RT20992.indb 1 3/27/08 9:59:28 AM
Psychoanalysis in a New Key Book Series
DONNEL STERN, PH.D., SERIES EDITOR
Volume 1
Clinical Values:
Emotions Tat Guide Psychoanalytic Treatment
Sandra Buechler
Volume 2
What Do Mothers Want?
Contemporary Perspectives in Psychoanalysis and Related Disciplines
Sheila Brown
Volume 3
Te Fallacy of Understanding / Te Ambiguity of Change
Edgar A. Levenson
Volume 4
Prelogical Experience:
An Inquiry into Dreams & Other Creative Processes
Edward S. Tauber and Maurice R. Green
Volume 5
Prologue to Violence:
Child Abuse, Dissociation, and Crime
Abby Stein
Volume 6
Wounded by Reality:
Understanding and Treating Adult Onset Trauma
Ghislaine Boulanger
Volume 7
Coasting in the Countertransference:
Conficts of Self Interest between Analyst and Patient
Irwin Hirsch
Volume 8
Making a Diference in Patients’ Lives:
Emotional Experience in the Terapeutic Setting
Sandra Buechler
RT20992.indb 2 3/27/08 9:59:54 AM
Making a
Difference in
Patients’ Lives
Emotional Experience
in the Therapeutic Setting
SANDRA BUECHLER
New York London
RT20992.indb 3 3/27/08 9:59:54 AM
“Clearances” from Opened Ground: Selected Poems 1966-1996 by Seamus Heaney. Copyright © 1998 by
Seamus Heaney. Reprinted by permission of Farrar, Straus and Giroux, LLC.
“The Writer” from The Mind-Reader, copyright © 1971 and renewed 1999 by Richard Wilbur, reprinted
by permission of Harcourt, Inc.
“Something I’ve Not Done” from Writings to an Unfinished Accompaniment, copyright ©1979 by W.S.
Merwin. Reprinted by permission of the Wylie Agency.
Routledge Routledge
Taylor & Francis Group Taylor & Francis Group
270 Madison Avenue Taylor & Francis Group
New York, NY 10016 27 Church Road
Hove, East Sussex BN3 2FA
© 2008 by Taylor & Francis Group, LLC
Routledge is an imprint of Taylor & Francis Group, an Informa business
Printed in the United States of America on acid-free paper
10 9 8 7 6 5 4 3 2 1
International Standard Book Number-13: 978-0-88163-494-5 (Softcover) 978-0-88163-443-3 (Hardcover)
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, trans-
mitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter
invented, including photocopying, microfilming, and recording, or in any information storage or retrieval
system, without written permission from the publishers.
Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are
used only for identification and explanation without intent to infringe.
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the Routledge Web site at
http://www.routledge.com
RT20992.indb 4 3/27/08 9:59:55 AM
For Daphne, Isaac, their parents, and George
RT20992.indb 5 3/27/08 9:59:55 AM
RT20992.indb 6 3/27/08 9:59:55 AM
Contents
Introduction: Meaningfully Impacting Patients’ Lives ix
1. Basic Assumptions about Human Emotions 1
2. Empathic Recovery of Emotional Balance 25
3. Empathic Responses to Shame 53
4. Facing Painful Regret 89
5. Joy as a Universal Antidote 111
6. Grief 137
7. Empowering and Disorienting Anger 167
Special Section Training: Nurturing the Capacity to Make a Difference 197
8. Thinking Analytically 203
9. Emotional Preparation for Practicing Psychoanalysis 227
10. Developing the Personal Strengths of a Psychoanalyst 255
Epilogue: Making a Difference 293
References 299
Index 309
vii
RT20992.indb 7 3/27/08 9:59:55 AM
RT20992.indb 8 3/27/08 9:59:55 AM
Introduction
Meaningfully Impacting Patients’ Lives
In the preface to her biography of Frieda Fromm-Reichmann, Horn-
stein (2000) describes the analyst’s well documented devotion:
She was willing to try practically anything that might help them, which
was a great deal more than most other psychiatrists were willing to do.…
‘She would have swung from the chandelier like Tarzan if she thought it
would help,’ Joanne Greenberg later observed. (xv–xvi)
Gail Hornstein’s biography of Frieda Fromm-Reichmann is the
moving story of one woman’s determination to make a diference in
the lives of her patients. When I read it I had the thought that Fromm-
Reichmann’s ferce will and clarity of purpose probably helped her
remain hopeful, even when working with very severely disturbed
patients. Personally, I have ofen felt calmed and centered by my own
certainty that I will expend whatever efort the work with someone
requires. But sheer determination is not enough. What else is needed
for a clinician to have a meaningful impact on her patients’ lives?
Making a Diference in Patients’ Lives is my efort to formulate what
emotion theory, interpersonal psychoanalysis, and my own clini-
cal experience have taught me about having a signifcant emotional
impact in treatment. Te fundamental tenets of emotion theory can
suggest much to the clinician. Tey have powerful implications for
our understanding of therapeutic action.
I draw on both my own clinical experiences and treatment
accounts contributed by others to explore the clinical relevance of
concepts taken from emotion theory. What can its precepts tell us
about how one person afects the way life feels to someone else? For
example, in her moving personal chronicle (in Casey, 2001) Martha
Manning writes about what made her own depression bearable:
I kept going only for my daughter. Every morning, Keara stumbles semi-
conscious into the bathroom and turns on the shower. Within the space
ix
RT20992.indb 9 3/27/08 9:59:55 AM