When the Therapist Falls Asleep During Session

Joseph Burgoin
The Psychotherapy Relationship
47

I dozed off for about ten seconds during a session today. Over the last 30 years, this has happened to me three times that I recall. The first time was with an elderly client, benignly psychotic but disengaged from the therapeutic process; briefly dozing made me realize I'd come to feel that I couldn't help her. The second time, I had just returned from abroad and went back to work too soon; I was jet-lagged and nodded off during what would have been night in my former time zone. Today, it happened with a client of long-standing. I'd finished another session immediately before this one and did not feel tired. It was mid-day and I'd slept reasonably well the night before. Just prior to my eyes closing, my client had told me she was feeling so tired she just wanted to drop off, fall to the ground and go to sleep.

I've experienced this kind of sleepiness before, with several different clients -- a sudden, out-of-the-blue feeling that my eyelids are so heavy I can't keep them open. (I've also felt tired on many other occasions -- my own fatigue, from stress or too little sleep the night before -- but not dozed off.) Usually I'm able to tell the difference between them, whether it's my own exhaustion or a ... well, a kind of communication. On the woo-woo scale of things, I'm fairly skeptical, but I do believe in something like ESP -- a capacity to perceive through a sensory apparatus other than one of the five usual suspects. I believe good therapists are highly sensitive in this area. In broad terms, you might think of it as a kind of countertransference response or a form of empathy.

Continue "When the Therapist Falls Asleep During Session"

Contempt as a Defense (Mine)

Joseph Burgoin
Shame/Narcissism
144

Last week, I decided to withdraw from my contract with New Harbinger for the publication of my book on defense mechanisms. If you've read my earlier post where I discussed what this book deal meant to me, you'll understand this was a very difficult and painful decision. The editorial committee had been enthusiastic about the first four chapters I sent them, offering useful suggestions that helped me improve the flow and clarify my message. When I received their comments for the next batch, it didn't take long for me to realize that I couldn't make the changes they were asking for. They wanted me to refocus the book, eliminate the broader social perspective and turn it into a self-help book like the other titles they publish. I have declined to do so and will return the small advance I received.

Watching myself react to their comments, I could see my familiar old defense mechanisms at work. I thought it might be useful to describe that experience. One of the points I often stress on this website, about what it means to be "after psychotherapy," is that your old issues and ways of coping with them (your defenses) don't disappear; you learn to recognize them as they come up, hopefully "disarm" them and find different ways of responding. So here's a faithful (and somewhat embarrassing) account of my process. Be nice.

My first reaction on reading their comments was indignation of the narcissistic variety. How dare they not recognize the brilliance of these chapters?! What set me off was their letter's opening: "These chapters substantially miss the mark." One of the rules in my writer's group is that you always begin your response to a reading with praise, by identifying what works and what you like about it first, hopefully defusing any automatic defensive reactions to the critique that follows. It was the way the first letter from New Harbinger had begun, in response to the early part of my book: "These chapters are very strong." I readily accepted their first set of suggestions but grew indignant in response to the second.

Continue "Contempt as a Defense (Mine)"

Anders Breivik, You and Me: What We Have in Common

Joseph Burgoin
Shame/Narcissism
·
Social Behavior
51

When an anti-Islamic loner explodes a bomb outside a government building, killing eight people, then travels to a nearby island where he guns down 69 more, we naturally view that man as a dangerous lunatic. His paranoid tirades against multi-culturalism and "Eurabia", along with his grandiose view of himself as crusading member of the fictional Knights Templar, make him seem delusional and psychotic -- someone entirely "other" and so unlike ourselves that he might as well belong to a different species. We would never do anything so cruel and violent, of course, and we find it virtually impossible to identify or empathize with this man in any way.

And yet, Anders Breivik is a member of the human race, just as we are. His emotional states and thought processes in fact differ only in degree and intensity from some of our own. I invite you to join me in an exploration of this troubled man's psychology -- not in order to create sympathy for him, not to blame society or violent online gaming platforms for his actions, not to argue on behalf of clemency from the court, but rather to learn something about ourselves and to make "insanity" seem a little less strange and "other". For what it's worth, my personal view is that Anders Breivik is so psychically damaged, so emotionally troubled that he will remain a danger to society while alive and should be permanently isolated to eliminate the possibility of his doing more violence.

Continue "Anders Breivik, You and Me: What We Have in Common"

Shame Trading

Joseph Burgoin
Shame/Narcissism
30

In a very early post on this site, I described people who view the world in terms of winners and losers, where one person will shore up his own self-image by triumphing over someone else, usually by demonstrating that he's more successful, better-looking, wealthier, more popular, etc. Feelings of contempt for the "loser" usually go along with such triumph. These dynamics also lie at the heart of different kinds of narcissistic behavior.

As I've discussed in many of my posts, the core narcissistic defense involves flight from unconscious feelings of profound shame about oneself -- how dysfunction in your family of origin has damaged you -- into an idealized false self meant to disprove all that damage. At the same time, the narcissist will project his damage into someone else, who then "carries" it for her. By triumphing over the other person, the narcissist "proves" that he has successfully rid himself of all that unwanted shame; humiliating the "loser" confirms his idealized self-image.

Continue "Shame Trading"

Video #3 – “The Transference Begins”

Joseph Burgoin
The Psychotherapy Relationship
53

I've now uploaded the third installation in my series on psychodynamic psychotherapy, which you can access through the video frame below. This one covers early manifestations of the transference and includes a lot of examples from recent sessions in my practice. It's a useful counterpart to my earlier post on the subject, fleshing out the ways that an understanding of the transference can shed light on a person's "outside" relationships and internal dynamics.

Can I ask a favor? I know that everyone dislikes receiving endless email notifications from all the websites we visit, but the number of people who subscribe to my channel has an impact on my standing in the YouTube community and how my channel ranks; if you watch the video and like it, would you mind subscribing? Many thanks.