My Notes on H. Davanloo-
Taken
from the text: Unlocking the Unconscious
The
essential initial stages are:
1
challenging the resistance that is a series of defenses and
2. Bring
into the open the intense transference feelings
3
examine the present and past relationships with regards to these transferences,
which then leads to the core neurosis
The
main aim of therapy is to have the client experience his true feelings, by
overcoming his resistance. Overcoming the basic mechanism underlying neuroses,
namely repression,
Interpretation
is used to weaken defenses.
Davanloo's
approach is mainly for the bulk of patients who suffer from longstanding,
complex psychoneurotic disorders and character d/o that are not well motivated
and are highly resistant.
Therapy's
goal is to experience the client's true feelings about the present and the
past. Pressure towards feelings. A key question is to ask what you experience when you feel anxious,
uncomfortable, annoyed, and sad.
Common
defenses;
Diversionary tactics tentativeness, selective
memory
Vagueness, distancing, silence, a whole range
of
Obsessional defenses such as intellectualization
rationalization isolation and rumination and a wide range of
Regressive defenses such as projection,
introjection and weepiness.
Other
defenses: self-defeating and self-sabotaging/ detachment/ withdrawn/ sarcasm/
defense of isolation/ client's needs to defeat the therapeutic relationship
passivity simply silence, denial
One
is always to monitor the balance between resistance and the therapeutic
alliance.
Resistance
is handled by probing by the process of challenge and pressure.
Each
time the resistance is penetrated there is an increase in the therapeutic
alliance.
A
heavy emphasis is put on the patient's present experience in the therapist-client
relationship, and the ongoing interaction with the therapist.
Clarification
of the defenses is the first step in therapy while continuing to exert pressure
towards the experience of feeling.
Attempts
are made to have the clients' own defenses become ego-dystonic, have them turn
on themselves
When
the pt become angry with the therapist early in therapy it is often because the
therapist is not allowing the client to continue to use his/her usually
defenses. One then attempts to develop links with these defenses in the present
relationship and then back to the past and some of the relationships that are/
were in conflict. Transference- resistance
Often
use the statement "what do you feel right now?" for direct question
of the transference in the therapeutic relationship
Pressure
to give up the defenses- Frequent use of "What are we going to do right
now?"
When
there is challenge to the transference in the T-C relationship the first layer
of feeling is usually anger for not letting the client use their usual
defenses. Underneath this layer is usually the unconscious anxiety-laden guilt
feeling of closeness, and destroyed relationships. Anger is usually used as a defense
to feelings of guilt and remorse about past relationships. Beneath this anger
we always see very positive feelings Out of this new resistance comes the
transference resistance towards the therapist
Looking
for the pts core neurotic structure. Looking for self-defeating patterns
Once
a breakthrough occurs then interpretations of relationships outside the T-C
relationship can then take place. At this point, the pt. is constantly made
aware of how he/she has been defending himself. The three corners of
this triangle then are 1. Defense 2. /
Anxiety 3. / Impulse/Underlying Feelings. - Otherwise known as the triangle of
conflict. The second triangle consists of 1 Transference /2 current
relationships 3 /Past relationships
The
shorthand of TCP is often used for this triangle.
Residual
resistance is that resistance that remains after there has been a challenge to
the main resistance
Summary:
Phase 1; Pre-interpretation phase- the challenge to the resistance accompanied
by a rise in the transference and transference feelings Pressure towards
feelings that lead to resistance. Clarifying and challenging the resistance is
made Phase 2 the unlocking of the unconscious
Early
in therapy, Davanloo style, current and past C-P relationships are not examined
more importantly the transference feelings in the T-P relationship
Content should not be
pursued pre-maturely or the process becomes simply cognitive and intellectual There is no place for
interpretations in this technique until there has been a breakthrough.
Interpretation alone cannot produce a breakthrough this quickly [so says
Davanloo]
Defiance
and detachment are simply ways of expressing anger indirectly. It is also a
defense against the emergence of many other painful feelings.
Aug
2008
