ABSTRACT
This chapter discusses the process of establishing trust one step at a time. A consistently held container allows trust to build. Many therapists believe that enmeshment builds trust and are loathe to hold their frame for fear the patient will view them as unkind. Authentic trust does not come easily as it replicates challenges in the patient’s other relationships and historical family dynamics. Positive feelings emerge after negativity is flushed out. The author describes Masterson’s concepts: the therapeutic alliance, the middle phase of treatment, therapeutic neutrality, and the therapeutic stance. The author discusses types of transference and patient negativity, including Reich’s quintessential teaching on resistance. Techniques of working with resistance are covered as well as therapists’ fear of exploring patients’ resistance. Covert examples of resistance are covered. If these feelings and attitudes are avoided, the treatment is ineffective. Patients need to work on their negativity as it destroys their lives. Negative feelings will be directed toward the therapist; they must not be ignored. Many therapists dislike confrontation, hate conflict, and keep the dialogue friendly and supportive at all times bypassing an essential aspect of the patient’s personality. Types of transference are defined with patient examples and teaching tools are given.
