Influences on patients’ developing mentalization

Yerushalmi, Hanoch

doi:10.1080/0803706x.2017.1292051

Cited by 1 publication

(3 citation statements)

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“…One way in which a psychotic patient can solve this dilemma is by determining the psychotherapist's subjectivity via their role in a delusional construction. The psychotherapist, confronted with what is essentially an obliteration of their subjectivity, can in these instances be thrown into situations where they have to tolerate high levels of anxiety and discomfort, while trying to construct a preliminary version of the patient's subjectivity (Brazil, 1988; Searles, 1967; Yerushalmi, 2018). In these instances, the possibility exists that the psychotherapist may hold the patient responsible for the negation of their subjectivity, providing the therapist with what might be viewed as a reasonable alibi for disengaging from a disturbing experience (Ivey, 2013).…”

Section: Resultsmentioning

confidence: 99%

“…In other words, she did not arrive with the intention or ability of finding out who I was, or of helping me to get to know her. My own subjectivity was subjugated (Yerushalmi, 2018).…”

Section: Case Materialsmentioning

confidence: 99%

“…My engagement with Leona was typified by a lack of the reciprocal acknowledgment of my and her respective subjectivities, and it often left me feeling like I had to respond to complicated psychopathology without a familiar sense of myself. What made the experience of being implicated in Leona's delusion particularly difficult for me was the fact that it subjugated my subjectivity, the place from where I might respond to her (Yerushalmi, 2018). Importantly, this countertransferential experience mirrored something important about Leona's experiences of her own subjectivity coming under threat.…”

Section: Case Materialsmentioning

confidence: 99%

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The Feared Therapist: On Being Part of the Psychotic Patient's Paranoid Delusion

Saayman¹

2020

Brit J Psychotherapy

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Psychosis can be understood as, in part, a disorder of the self. The various factors that contribute to the development of psychosis and the consequences of psychotic symptoms potentially impede the development of the patient's subjectivity, and can lead to a complete breakdown of the patient's ability to accurately represent their subjective experiences. The development of paranoid delusions partially functions to compensate for the patient's inability to make sense of their subjective experiences in relation to an acknowledged other, in this case the psychotherapist. When the patient confronts the psychotherapist with their paranoid delusion and implicates the psychotherapist as a dangerous object, the psychotherapist is potentially exposed to a complex and disturbing dynamic where their own subjectivity may be drawn into question. This paper aims to explore the psychotherapist's experiences of this dynamic in a clinical setting by making use of a composite narrative of a psychotic patient with paranoid delusions that implicate the psychotherapist. The psychotherapist's experiences are discussed via the following three themes: constructing the patient's subjectivity; the psychotherapist's use of their own experiences; and holding the balance between opposing realities.

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Section: Resultsmentioning

confidence: 99%

“…In other words, she did not arrive with the intention or ability of finding out who I was, or of helping me to get to know her. My own subjectivity was subjugated (Yerushalmi, 2018).…”

Section: Case Materialsmentioning

confidence: 99%

Section: Case Materialsmentioning

confidence: 99%

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