How can therapists treat patients' primitive anxieties and overwhelming terrors that are not accessible to verbal interpretation or insight? In psychotherapy the traumas suffered in infancy are often reawakened, and reexperienced in the safety of the therapeutic relationship. While they desperately seek attachment, their experience of connection is one of violation and humiliation. Their ways of attaching are at the center of what terrifies patients with early trauma and, in a successful therapy, they structure the development of the transference and come also to terrify the analyst. The therapist is confronted with humiliation and abuse from patients, who find behavioral ways to communicate their histories. These patients require a special connection, a new relational experience, before they can learn new relational paradigms. This book shows therapists how to understand the process of trauma re-creation, and move with the client through the reexperiencing of the early physical pain and psychological terror and the blaming of the therapist.
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Lawrence E. Hedges, Ph.D., ABPP, is a psychologist and psychoanalyst in private practice in Orange, California, specializing in the training of psychotherapists and psychoanalysts. He is director of the Listening Perspectives Study Center and the founding director of the Newport Psychoanalytic Institute. He holds faculty appointments at the California Graduate Institute and the University of California, Irvine, Department of Psychiatry. Dr. Hedges holds Diplomates from The American Board of Professional Psychology and The American Board of Forensic Psychology. He is the author of numerous papers and books on the practice of psychoanalytic psychotherapy.
Dr. Hedges has clarified the therapeutic dilemma in the treatment of a vast group of patients whose psychopatholoy became 'organized' during infancy and early childhood. When their distress becomes a reawakened in psychotherapy, the transference/countertransference situation relives the original terror―with accumulated dividends―and the kind of 'exorcism' for which many psychotherapists are unprepared. Hedges's contribution is a handbook and guide through the management of these terrors and is of inestimable value for all clinicians. (James S. Grotstein, M.D., UCLA School of Medicine)
Working closely with patients with early developmental trauma has intense emotional effects on any therapist. The unbearable narrative that result from such therapeutic encounters are candidly portrayed throughout this book. Dr. Hedges offers an invaluable aid to therapists working with primitive psychotic anxieties and their transferences into the therapeutic relationship. This book offers therapeutic and ethical approaches to both novice and seasoned therapists faced with nearly impossible challenges. It is gripping; it is thoughtful; it is a wonderful contribution to working with more primitive and psychotic transferences! (Karen K. Redding, Ph.D., UCLA Irvine)
In numerous richly developed and finely textured clinical vignettes, the 'art' of working through patients' terrifying transferences is compellingly demonstrated again and again. Hedges is clearly an outstandingly gifted and passionately courageous clinician who, as both therapist and writer, dares to go where most fear to tread. This is a deeply satisfying book that should be a required read for any clinician who is committed to working intensively with patients who have been traumatized. (Martha Stark, M.D., Boston Psychoanalytic Institute and Massachusetts Institute for Psychoanalysis)
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