ABSTRACT
When poised within a sturdy adult posture we, as therapists, are better able to effectively confront a patient who is profoundly avoidant of emotional work in treatment, and to set limits with a patient who has escalated into an aggressive or highly disrespectful, disparaging, or demanding mode.
Some of our anxious/fearful patients will attempt to distract us and themselves from the deeper work of engaging emotions using tangential storytelling, intellectual verbiage, or reported amnestic recall of emotional events and sensations. Other patients (narcissistic types) may avoid painful emotional material and the risk of exposed vulnerability via chronic lateness or last-minute cancellations, and then become critical when asked to make a commitment to be on time and to respectfully pay for missed time. To confront and engage these patients, securing the bond for effective healing and adaptive change, we begin with a stance of curiosity and discovery. From a position of curiosity and empathy for the vulnerable child underneath; the therapist can raise the patient’s awareness of their off-putting attitude/behaviour and help them develop healthier ways of relating in session and beyond.
