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Life-threatening illness in the analyst.

B Fajardo1

  • 1Chicago Institute for Psychoanalysis, USA. Fajardo@mindspring.com

Journal of the American Psychoanalytic Association
|August 18, 2001
PubMed
Summary

Practicing psychotherapy during a life-threatening illness requires careful consideration of therapist self-disclosure, informed by "one-body" versus "two-body" transference perspectives. Effective practice involves distinct phases and necessitates supervisory support for ethical decision-making.

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Area of Science:

  • Psychology
  • Psychotherapy
  • Psychoanalysis

Background:

  • Review of literature on therapists practicing during life-threatening illnesses.
  • Exploration of differing attitudes toward therapist self-disclosure.
  • Introduction of "one-body" and "two-body" perspectives on transference.

Observation:

  • Therapist self-disclosure is influenced by the emphasis on transference interpretation versus patient needs within the therapeutic alliance.
  • Clinical vignettes illustrate themes from the author's experience practicing during a life-threatening illness.
  • Three distinct phases of therapeutic work during illness are identified, each with unique demands on the therapist and patient.

Findings:

  • The therapist's internal state significantly impacts patient needs and reactions during different phases of illness.
  • Effective practice during a life-threatening illness is contingent upon specific conditions.
  • Supervisory support is crucial for therapists navigating clinical and ethical decisions, especially when facing terminal illness.

Implications:

  • Understanding transference perspectives is key to managing self-disclosure in therapy.
  • Therapists require robust support systems, including personal analysis, to manage the complexities of practicing during severe illness.
  • Ethical and clinical decision-making is paramount for therapists facing their own mortality or serious health challenges.

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