From John Appel jappel21@op.net
Mary Powers.
Here is a continuation of my reply to your post re Leslie.
<Leslie said "Did my father tell you about their not bringing me up? And
you answer "Yes, he did tell me".
<'m wondering about this because although I understand you have the
rationale of supporting her autonomy, you have chosen to do it by lying
to
her. Her father did not tell you anything of the kind. Perhaps you
felt he
"told" you this by implication, but I don't buy it. It's a bit risky to
"validate" by fudging the truth - what would happen if she found out?>
I didn't lie to Leslie. Her father said to me in the previous interview,
�The key to the problem is the fact hat her mother contracted phlebitis
at Leslie�s birth. She had wanted a boy, not a girl and blamed Leslie
for her phlebitis. She has never been able to take care of Leslie and
there has always been hostility between them.� In her following session
with me, Leslie she immediately asked, �Did my father tell you about
their not bringing me up?�I replied,�Yes, he did tell me.� This answer
was true. What makes you think I lied? I quite agree lying is not a good
idea. Not only is it repugnant morally, but counterproductive. As you
say what would happen if she found out, as she surely would? My alliance
with her would shatter..
<In PCT therapy, MOL, the kind of answer that people are learning to do
is
for focused on going up a level - not confirming a statement at the same
level
(whether or not by a lie). For example: It's important to you for me to
know that. Or, you want me to have heard that from your father. Or...
Obviously there is nothing wrong with sticking to the same level until
you
get a good feel for the next level, but the heart and soul of MOL (and
we
hypothesize ALL therapies) is getting up to the next level...and the
next...>
Saying, <�It�s important to you for me to know that.�> I agree would be
a good comment. It appears to be a comment a psychoanalyst would make.
Ii would help the patient understand him, or her, self better-- which is
the goal of psychoanalysis, or at least was the goal. Now there is a
consensus in analytic circles that something more than
�interpretations�
of a patient's conscious and unconscious motives is required, Self
knowledge, Insight, is not enough to cause therapeutic change. The
analytic community has not yet agreed as to levels will suggest what,
if any thing, is required. You may well know all this. Perhaps MOLL
provides an answer.
However treating psychotic insane-- patients, making interpretations is
futile. Telling Leslie, for example the reason she attempted to strangle
nurses, particularly older women nurses was because she identified them
with her mother whom she unconsciously wished to kill because of her
mother's failure to bring her up up Here comes my own theory. I suggest
rewarding patients� autonomous behavior does work . I have clinical
records of 35 psychotic patients successfully treated in this way. And
that was why I was so eager to reward Leslie�s autonomous act of asking
me a question. Her father, or mother never �listened to her�--rewarded
her. I would try to do better. This is why she said my �listening� was
�the most wonderful thing that has happened in my [her] life.�
I hope some of the above makes sense to you and that you will respond.
I will comment further on your last post soon.
yours
John Appel=
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Date:�J/10/99 1900 PM
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