By Karen J. Maroda
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Additional info for Psychodynamic Techniques: Working with Emotion in the Therapeutic Relationship
I asked her what sites she went to. She blushed and said she often went to soft porn sites. I noted that she was interested in sex, but not sex with her boyfriend. She agreed and seemed relieved that I did not express any shock or disapproval about her interest in looking at nude pictures. I asked her about what kind of nudity 24 PSYCHODYNAMIC TECHNIQUES it was, and she replied that she looked at pictures of naked people and some sexual scenes, but nothing kinky or weird. I want to note here that Jennifer was not reluctant to answer my questions, but she also did not volunteer anything that wasn’t asked.
Saying something like “That must have been difficult for you” is often quite enough, even when the client has been severely traumatized. It will not be lost on her that you are listening, asking questions, encouraging her to say more, and registering empathic facial expressions. With this type of person, less is more. The rare client who routinely rejects even the most minimal empathy has a poor prognosis. One woman I treated could not articulate any real emotion other than anger (alexithymia).
Basic Empathy Most students of psychotherapy become familiar with the basic concept of empathy early in their training. They practice rephrasing other people’s statements, focusing particularly on the emotion that is direct or implicit. Higher levels of empathy require transcending the parrotlike responses practiced by new trainees, integrating observations of the client’s body language, facial expression of emotion, and the implications of the client’s expressed thoughts. When the client is in denial, or feels guilty about his emotions, the therapist’s ability to reflect what he is really feeling can be extraordinarily liberating.