Kicking the Patient: Immediacy in the Consulting Room

Abstract

A case is presented of an adolescent with a history of substance abuse. The case is discussed from the perspective of Time Limited Dynamic Psychotherapy (TLDP). The patient's Cyclical Maladaptive Pattern (CMP) involved remaining attached to significant others by avoiding all conflict and seeking to please them as much as possible out of a fear of abandonment. The therapist became “hooked” into counter-transference enactment–kicking the patient–thus playing the role of the rejecting adult figure that fails her. The patient and therapist were then able to break out of this cyclical pattern and forge a new kind of relationship. This experience led to the patient developing a healthier relational pattern in her life and, hopefully, may lead to her experience of God being able to break free from her expectations as well.

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