what's love got to do with it - dr. Patricia Coughlin first day seminar summary
“We crave intimacy but fear vulnerability – you can’t have one with
out the other.”
140 therapists from all over the world met yesterday via zoom for the first of two days webinar with dr. Patricia Coughlin.
there are a lot of ways to learn therapy and as well to learn ISTDP, learning with dr. Coughlin is a unique and open mind and heart experience.
we started the day with an over view of defenses against emotional closeness, the most important take from this part was that some patients use defenses not against a specific feeling but as a way of relating against emotional closeness, what Davanzo called "tactical defenses", these defenses are design and operate to keep the therapist and other people away so unless address and deal with can sabotage the therapy process and no healing and progress can be made.
Vague and general Avoiding eye contact
Diversification Arms and legs crossed
Rate of speech Temper tantrums
Dr Coughlin is a true master at defense work and presented us 2 brilliants therapy work - the way she takes her time on the one hand - gathering data and build a deep dynamic case understanding regarding the patient conflicts and on the other hand take an active stance with the patient healing part.
a lot of people have the wrong idea about ISTDP - that it is too direct or to confrontative and that can happen in any therapy if the therapist jump ahead to challenge and press for felling's when defenses against emotional closeness are still in operate. this is why Dr Coughlin work is so important, "listen to the patient" with your eyes and ears, what is his conflict? what does we want to look out for (not getting in the shoes of the parent - the dominates). what are his health strives and wishes? his goals?
we learned how important it is to help patients be in the driven seat - this is how we can make sure we are doing therapy and not dominate and imposing our self's on patients - "the patient will is the engine of the therapy" (Davanloo) and we are here to serve the patient will, it is not on us but on the patient to take a stance and choose where he wants to go. patients don't have to do anything and we don't have the right to do it for them - we can't! - as Patricia says with the out most respect : "ask don't tell" so the patient will and choice is on line as a corrective emotional experience for many of our patients.
anther important take from the day was to follow the patient goal - as patients declare their goals we help them achieve them throw addressing anxiety and defenses that prevents their goals and throw feelings that serve the process as a means to an end.
way to often therapists give to much emphasis on feelings and forget that feelings are important but are just a means to an end and they are not the purpose as itself.
feelings are the tools the patients have in order to achieve their goals in therapy, when patients ask us for tools we know now that feelings are their tools - this is a great way of thinking on the functions the feelings are serving - the anger in the first case - that gave the dismissive patient feel assertive and confidence - the repairs the second 66 year old patient did as a function of the guilt feelings. it is not about getting breakthroughs but helping the patient getting to their goals.
as therapists we tend to look away from progress and this is not helping patients get better nor helping the therapist see the progress, Dr Coughlin bring to the patients awareness any progress in the session and invite them to take in the work that has been made, small steps and paying attention to shifts help the alliance and helps patients open up as they feel safe - seeing that therapy is a healing place for them.
with Dr Coughlin teaching we learned to be as effective and healing as we can be. Dr Coughlin doesn't lecture, she teaches you to think in a way of healing and that is emotional closeness at it's best.
I hope this is helpful as a short summary and will be adding more after the second day - starting the second day of learning with head on collision.
see you on December 13 and you can still join the second day of learning.