Tag Archives: pattern

Therapy Gems: On Delivering the Right Intervention – Limit-Setting Versus Interpretation with the Troubling Client

RIght Intervention1
Jill Terminates Her Therapist
The client often threatened to fire her psychotherapist. She said she would find someone else to work with. A few times, she would say, “You’re not available enough. You’re too busy. I’m going to find someone else. You took a week off. Are you saying I need to find another therapist? You’re NEVER HERE!” Other times, she went for an assessment elsewhere, then she returned for her therapy appointment complaining about the limitations of the other psychotherapists she had consulted.

A 45 year-old woman, Jill, has Bipolar Disorder, Rapid Cycling, sometimes with psychotic features, and an underlying Borderline Personality Disorder. She grew up experiencing profound sexual abuse. She also suffers from chronic pain. Continue reading


Therapy Gem: Reification and Action with Comments on Anger Management and Intervention

Freud’s Study in Vienna

Two Errors in the Application of Psychological Constructs. Since psychoanalysis and psychology first became popular decades ago, the public has absorbed many of their tenets into popular thinking.  Many of those adoptions no longer represent the scientific or exact meaning psychoanalysts or psychologists gave to these terms and ideas.

For example, “ego” means the organization of personality functions which adapt a person’s needs and drives to his or her guiding ideals and/or reality constraints.  These personality functions of self-control, coping, sensation, perception, thinking, judgment, and will, among other functions, help us to satisfy our needs given the realities we face. So “Ego” only means an organized use of these functions in service of satisfying our drives and needs while adapting to 1) our physical and cultural environment, 2) all of our past learning, and 3) our internalized ideals.  “Ego” does not actually refer to any place or thing inside of us.

But since the late 1960s, the term “ego” in common parlance means something quite different, namely, narcissism or egotism, self-absorption.  When we say, “You have a big ego,” meaning something on the order of “You think you are important” or “You are self-centered,” we are almost implying the ego is a place inside of us.

So, many ideas in psychology have become popular, but the precision of meaning has been lost in the translation.  In some cases, the idea has been treated as if the concept represents a real thing.  For example, the term “ego,” as in “Your ego,” implies a tangible structure, a stable characteristic.  Whether people mean by “ego” merely self-absorption or whether they cross a line and treat the “ego” as something tangible certainly is an important discrimination!  As we shall see, the latter is an example of a fallacy named reification, treating a theoretical construct as if it is a reality.

So we have two errors in the popular use of psychological constructs.  First is that the meaning changes from a more precise construct to a more general, imprecise trait or characteristic of people.  The second is the reification of constructs.  That means the constructs are treated as if they were real parts of us.

Note: Before we become psychotherapists, we professionals are members of our culture.  So we grow up using language in these imprecise and sometimes reified ways.  We need to be much more careful in our use of constructs and language.  After all, as therapists, empathy and language are two of our very most crucial tools for promoting change.

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