Psych 380 1nd Edition Lecture 4Outline of Current Lecture I. Case study; Steve. ExhibitionismII. Holding environmentIII. Transference/countertransferenceIV. Doctor/patient relationshipCurrent LectureI. Case study: Marya. Has a fear of driving/getting lost on the highwayb. She gets anxiety and increased heart ratec. She has had no phobias priord. Possibilitiesi. Afraid of getting older/retiringii. Metaphor: I don’t know where I’m going, I’m going to get lostiii. Life transition treatmentII. Case study: Stevea. 40 years oldb. 3 young childrenc. works as a truck driver, he is neat and clean besides the smell like gasolined. Calls and says he has a sexual problem.i. His sexual problem is that he masturbates in publice. He comes into the office and is a nervous wreckIII. Steve’s dialoguea. “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 exhibitionistd. 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. 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 behalfd. What is his agenda?V. 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?VI. 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.VII. Less good:a. He feels like a pervertb. He can’t control himselfc. Has lasting effect on the women who have seen him – may have emotionally violated themVIII. 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 judgedii. Felt open to share about himselfiii. He wanted to call to come in sooner.IX. Dr. Halgin wants to get to the root of this behaviora. Started with the event in the apartmentb. Did Steve have an unwanted sexual experience during childhood?c. When Dr. Halgin asks, Steve says that he doesn’t want to talk about iti. Without Steve sharing himself with Dr. Halgin, he won’t be able to help himii. 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 himiii. His parents also neglected him.iv. His parents allowed him to drink from the keg in their kitchen by the age of 8 or 9v. Steve dropped out of school and got into a lot of fights.X. Context of psychotherapya. This is a “holding environment”i. Walking into a room with a stranger, wanting to be held/accepted withoutbeing humiliatedii. Steve wants to be “held” like a small childiii. This involves intimate self-disclosure, it is an emotional experienceb. Catharsisi. Lots of emotional dirty laundryii. Cleansed by dialogueiii. Felt like he could be acceptedc. Safetyi. Confidentiality agreementii. Frame & boundaries1. Frame – image projecting should be in frame2. Set of rules set by patient/doctor3. “I respect you, you respect me”4. I’m here to talk to you5. Business relationship6. We are not friendsiii. 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 peeinginto his wastebasket.XI. Dr. Halgin is on the MA psychologists boarda. He deals with complaints against psychologistsb. Unethical decisionsc. There are boundaries for both clients and psychotherapistsAt 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 tableb. Countertransference – the script that the doctor is bringing to the tablec. Therapy is only a microcosm of the patient’s whole world – is typically only 50 minutes per week.XIII. There is a three part model to therapy sessionsa. Present concernsb. Past experiencesc. Therapeutic relationshipXIV. Back to Steve…a. Everyone wants him to stopb. 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.XV. Therapy has 3 stage; immediate, short-term, long-terma. Immediatei. Disgusting mental imageb. Short-termi. Couples therapy with wifec. Long-termi. Childhood experiencesii. Neglect from parentsiii. Sexual abuse from UncleXVI. 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 was low.c. While Steve was making great progress, relapse is likely for anyone with these experiences.d. Steve is sent to jail but continues therapye. When he gets