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CHAPTER TWO: It’s never the same again

Penny Rawson Karnac Books ePub

Loss of a partner

Once the loved one is dead, life is never the same again. This applies especially to couples, whether married, co-habiting, or living as “domestic partners”, and to children and parents. Those, in other words, whose lives are closely entwined whether practically, emotionally, or both. Although life will never be the same again when one partner dies that is not to say that it will never again be good. Indeed, it could even be better, but for sure it will not be the same. It is this disconcerting fact that contributes to the sense of loss and grief. Yes, of course we miss the person who is no longer there, but we also miss the pattern of life that we had evolved around that loved one. The things we did together, the music we listened to, the places we visited. The time we had our meals, the favourite TV programmes, activities, pastimes. Some of these may have been done or not done in deference to the deceased, so there can also be a sense of pleasure that, as Joan said, “Now I can do this all I want to or when I want to and how I want to”.

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CHAPTER NINE: Concluding chapter: Brief psychodynamic psychotherapy: A contextual framework and key principles

Penny Rawson Karnac Books ePub

The previous chapter examined a variety of broad statements, which are to be found in the literature, with regard to the essential ingredients of brief therapy, but there is not a consistent view. This chapter gives a brief overall picture of the process leading to my conclusions and issues arising from these.

In order to try and avoid some of the pitfalls observed with the aforementioned generalizations I need to find a way of articulating my findings in a concise and accessible way. My conclusions also need to be set in the context of the research process and certain limitations of the study clarified. However I do not plan to reiterate the limitations that have already been pointed out in the methodology section such as the limited number of cases in the empirical work or bias in view of these coming from my colleagues clinical practices and my own, but rather draw attention to some more general limitations. These limitations are of a broader nature and wider application but are none the less relevant. I point to some of the strengths of the process also. Then follows a final formulation of my findings. This takes into account the whole process of the investigation, from the empirical work undertaken and the work of the key early proponents, to setting these findings against the views of the newer proponents and more recent revisions of the pioneers. Following this concise and clear exposition of the key principles and shortening factors in brief therapy, which answered my initial questions, a new insight as to this shortening process unexpectedly emerged. I share with the reader some reflections on the process that led to the final conjecture.

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CHAPTER SEVEN: Activity

Penny Rawson Karnac Books ePub

This approach to therapy is active. It is not just the therapist who is active but also the client. The client doing homework , or work between sessions on their own is one aspect of this. This has already been touched upon. It is a very important way in which the therapy is speeded up. On average, the client, one must remember, sees the therapist for just an hour per week. If clients can be helped to work on their issues between sessions, progress will be quicker.

Working with the client/homework/ giving them the tools

The joint aspect of the therapy work is emphasized in their working on the issues between sessions. This homework may take the form of a specific exercise, or it may be suggested that the client seek out relevant people in their past lives to talk to, or they might decide to research a particular time in their lives. The homework might be to be aware of a particular emotion that occurs as they go about their day to day activities and to monitor it. This, initially, is just to heighten awareness. Later on, the client and therapist may discuss and look for alternative ways that the client might respond that might change a situation for the better. More will be said about this idea later. The important thing with regard to the homework is that it arises out of the session and that it takes the work forward.

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CHAPTER FIVE: Jointly agreed time scale: contract part II

Penny Rawson Karnac Books ePub

The importance of the jointly made contract re focus and time

In brief therapy one of the elements that helps to speed the process is the making of a contract. This is worked out jointly with the client and therapist. The contract includes three essential elements: the focus, the time scale, and the joint agreement about both of them. The focus has already been looked at in some detail in earlier chapters, and the joint nature of the work of brief therapy also. Here, I explore more about the time aspect. Those who wish to explore the aspect of contract in more depth might wish to consult Rawson, 2002, pp. 137–158.

Time/number of sessions

How long should the contract be? For those readers who come from a long-term therapy background, I am aware that there may be some resistence to the idea of brief work, although the fact that you are reading this is perhaps sign of openness to the concept. I find the following exercise is quite useful.

Time exercise

I wonder how you would feel if asked, say at a training group, to do the following exercise. This exercise is one that is quite often used to heighten our awareness and sensitivity to disabled issues and also as an exercise in trust. You are asked to pair up. One then would be blindfolded and the other would be asked to lead their partner around and to experience this situation for 10 minutes. What would be your reaction? Usually, if I do this in a training session, most in the group are horrified at the time scale and the whole exercise and are wondering if they can keep it up for that time and what is the point, etc. They are much relieved when I say they do not to have to do it! I then ask them to be very aware of what they feel as I go on to the next exercise. I suggest you try it, too. I repeat the above, but say we will do it for just one minute. In the feedback that follows they are all much more positive; even if they can’t see the point they are prepared to go along with it for that short time as it feels manageable and the issues of trust also seem more possible for that length of time. Some have quite strong and visible reactions to both ideas, but all are much more relaxed with the short one.

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CHAPTER ELEVEN: Conclusion

Penny Rawson Karnac Books ePub

To conclude, then, I have presented the reader with a basic guide as to the key concepts in the practice of brief psychodynamic psychotherapy. This is a brief psychody-namic method that deals with the past through the present, in order to improve the present and future. It is not a superficial, sticking plaster approach. I have not laboured aspects of transference or countertransference, nor other basic aspects of therapy in general, since these are part of the knowledge I would expect of the experienced therapist. Rather, I stress aspects such as activity, flexibility, and the fusion of skills, an agreed focus and time span for the work, and the importance of the first session, all of which can enable the work to move on more swiftly. These aspects were stressed in turn by the earlier proponents of the brief method. One recalls that most of the early proponents were analysts, so the stress on these aspects was really very innovative. In the above pages I have attempted to highlight the key issues and to demonstrate how these ideas can be incorporated into the brief work in practice.

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