Psych 380 1nd Edition Lecture 4 Outline of Current Lecture I Case study Steve Exhibitionism II Holding environment III Transference countertransference IV Doctor patient relationship Current Lecture I II III Case study Mary a Has a fear of driving getting lost on the highway b She gets anxiety and increased heart rate c She has had no phobias prior d Possibilities i Afraid of getting older retiring ii Metaphor I don t know where I m going I m going to get lost iii Life transition treatment Case study Steve a 40 years old b 3 young children c works as a truck driver he is neat and clean besides the smell like gasoline d Calls and says he has a sexual problem i His sexual problem is that he masturbates in public e He comes into the office and is a nervous wreck Steve s dialogue a I m a loser a hardened criminal I ve done three strings in jail b I ll give you a month to cure me just give me the shock c For 25 years I ve been an exhibitionist d It started when I was 14 years old I saw a woman in an another apartment building changing I began to masturbate and then she saw me Instead of stopping I just kept going because it excited me The woman came to our apartment and yelled at my mother but my mother just told her to go to hell e I ve been married for 8 years f I just got arrested a week ago for masturbating in my car at a Stop Shop parking lot A woman coming out of the store saw me doing it I tried to drive away but the cops caught up to me These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute IV V VI VII VIII IX Dr Halgin s concerns a Is he suicidal b Do I need to disclose this to the police c Is he using me in order to help him in court testify on his behalf d What is his agenda What brought him to treatment a He feels like he is possessed b While court is part of it he really wants to stop this behavior c He gave up drinking for his children but he couldn t stop masturbating d What is the motivation for the behavior you are trying to stop e What are the good less good things about the behavior Steve says that he is excited by the thought of a woman being attracted to him a He wants her to want to be with him Less good a He feels like a pervert b He can t control himself c Has lasting effect on the women who have seen him may have emotionally violated them They plan to meet next week Steve shows up 20 minutes late a Dr Halgin notes that it is important to read into a person s script b Steve says I m surprised you are still here Nobody waits up for me c This scripts says that the people who are close to him don t have faith in him d Steve says that he was excited to come back i Didn t feel judged ii Felt open to share about himself iii He wanted to call to come in sooner Dr Halgin wants to get to the root of this behavior a Started with the event in the apartment b Did Steve have an unwanted sexual experience during childhood c When Dr Halgin asks Steve says that he doesn t want to talk about it i Without Steve sharing himself with Dr Halgin he won t be able to help him ii Is he not ready to talk about it iii Does he need help talking about it d Steve agrees to talk about it i When he was 6 he went on a camping trip with his brother uncle family ii When he was in the tent with his uncle his uncle touched him inappropriately and was rubbing up against him iii His parents also neglected him iv His parents allowed him to drink from the keg in their kitchen by the age of 8 or 9 v Steve dropped out of school and got into a lot of fights X XI Context of psychotherapy a This is a holding environment i Walking into a room with a stranger wanting to be held accepted without being humiliated ii Steve wants to be held like a small child iii This involves intimate self disclosure it is an emotional experience b Catharsis i Lots of emotional dirty laundry ii Cleansed by dialogue iii Felt like he could be accepted c Safety i Confidentiality agreement ii Frame boundaries 1 Frame image projecting should be in frame 2 Set of rules set by patient doctor 3 I respect you you respect me 4 I m here to talk to you 5 Business relationship 6 We are not friends iii Several of Dr Halgin s patients have broken the frame of their relationship 1 Ex he was treating a fellow psychologist who told him that she followed him to the mall that weekend and often watched his car through binoculars from the library 2 Ex He kept getting calls in the middle of the night and all he could hear was a gurgling sound It turns out it was a college student he was treating and he would call him when he was drunk and peeing into his wastebasket Dr Halgin is on the MA psychologists board a He deals with complaints against psychologists b Unethical decisions c There are boundaries for both clients and psychotherapists At this point in lecture we watched a part of the movie Good Will Hunting This movie is depicts the intimate relationship because a psychologist and his patient XII Important to know transference and countertransference a Transference the script that the client is bringing to the table b Countertransference the script that the doctor is bringing to the table XIII XIV XV XVI c Therapy is only a microcosm of the patient s whole world is typically only 50 minutes per week There is a three part model to therapy sessions a Present concerns b Past experiences c Therapeutic relationship Back to Steve a Everyone wants him to stop b In order to stop this behavior Dr Halgin tells Steve that whenever he is tempted to do the behavior to imagine his daughter is watching him It puts such a disgusting image in his mind that it will prevent him from doing it Therapy has 3 stage immediate short term long term a Immediate i Disgusting mental image b Short term i Couples therapy with wife c Long term i Childhood experiences ii Neglect from parents iii Sexual abuse from Uncle Dr Halgin saw Steve for 2 years a After 2 years Steve asked Dr Halgin to testify for him in court b Dr Halgin agreed When asked the likelihood of Steve returning to this behavior he said that it …