SlideShare a Scribd company logo

Martha Stark MD – Model 1 – The Interpretive Perspective of Classical Psychoanalysis.pptx

If deep and enduring psychodynamic change is the ultimate goal of treatment, then periodically juxtaposing seemingly contradictory “forces” (Hegel’s thesis and antithesis) will eventually jump-start the patient’s “adaptive recovery” by creating optimally stressful, growth-incentivizing “mismatch experiences.” I will be proposing use of something to which I refer as a “conflict statement” – a clinically useful and almost universally applicable therapeutic intervention strategically designed to target internal conflictedness between anxiety-provoking (but ultimately growth-promoting) forces pressing “yes” and anxiety-relieving (but growth-impeding) resistant counterforces defending “no.” The stress and strain of the “destabilizing dissonance” hereby created will provide the “therapeutic leverage” needed for the patient gradually, over time, to relinquish the tenacity of her rigid attachment to the defense in favor of a more flexible adaptation – a “compromise position” that will “reconcile their common truths” (Hegel’s synthesis) and transform conflict into collaboration. The strategic construction of conflict statements requires of the therapist that she be able both to support the patient’s defense by “being with the patient where she is” and to challenge the patient’s defense by “directing the patient’s attention to where the therapist would want her to go.” I will be offering specific clinical examples to demonstrate the impact of these powerfully impactful psychotherapeutic interventions. No pain, no gain…

1 of 50
Download to read offline
MODEL 1
CONFLICT
STATEMENTS
AND THE CREATION OF
COGNITIVE AND AFFECTIVE DISSONANCE
BETWEEN THE “PAIN” AND THE “GAIN”
1
MODEL 1
CLASSICAL PSYCHOANALYSTS TEND
TO FOCUS ON INTERNAL CONFLICT
BETWEEN ANXIETY – PROVOKING ID DRIVES
AND ANXIETY – ASSUAGING EGO DEFENSES
BUT I HAVE FOUND IT TO BE A LITTLE MORE
CLINICALLY USEFUL TO CONCEPTUALIZE
THIS DRIVE – DEFENSE CONFLICT
AS ONE THAT EXISTS BETWEEN
ANXIETY – PROVOKING BUT
ULTIMATELY EMPOWERING FORCES
PRESSING “YES”
AND ANXIETY – ASSUAGING
(DEFENSIVE) COUNTERFORCES
INSISTING “NO”
2
MODEL 1 CONFLICT STATEMENTS
“OPTIMALLY STRESSFUL” CONFLICT STATEMENTS
ALTERNATELY CHALLENGE AND THEN SUPPORT
THEY FIRST CHALLENGE BY
SPEAKING TO THE PATIENT’S
“ADAPTIVE CAPACITY TO KNOW”
AN ANXIETY – PROVOKING REALITY
AND THEN
WITH COMPASSION AND NEVER JUDGMENT
SUPPORT BY RESONATING
EMPATHICALLY WITH THE PATIENT’S
“DEFENSIVE NEED TO AVOID KNOWING”
THAT DISCOMFITING TRUTH
3
BE IT AN ANXIETY – PROVOKING TRUTH ABOUT
HER INTERNAL OR RELATIONAL DYNAMICS,
THE PRICE SHE PAYS FOR
MAINTAINING HER DEFENSES,
OR THE THERAPEUTIC WORK
SHE HAS YET TO DO
THE PATIENT DOES INDEED KNOW
“BUT” WOULD RATHER NOT
AND THEREFORE
– MADE ANXIOUS –
SHE DEFENDS
4
MODEL 1 CONFLICT STATEMENTS
STRATEGICALLY DESIGNED TO GENERATE
DESTABILIZING TENSION WITHIN THE PATIENT
BETWEEN HER KNOWLEDGE OF
ANXIETY – PROVOKING BUT AWARENESS – ENHANCING,
GROWTH – PROMOTING, AND
ULTIMATELY EMPOWERING REALITIES
AND THE DEFENSES SHE MOBILIZES
IN ORDER TO EASE THAT ANXIETY
THEIR FORMAT
“YOU KNOW THAT … , BUT YOU FIND YOURSELF … ”
FIRST THE THERAPIST CHALLENGES
BY HIGHLIGHTING AN ANXIETY – PROVOKING REALITY
AND THEN SHE SUPPORTS
BY RESONATING EMPATHICALLY WITH
THE ANXIETY – ASSUAGING DEFENSE
5
MODEL 1 CONFLICT STATEMENTS
“YOU KNOW THAT … , BUT YOU FIND YOURSELF … ”
THE THERAPIST FIRST CHALLENGES BY SPEAKING
DIRECTLY TO THE PATIENT’S OBSERVING EGO AND
ADAPTIVE CAPACITY TO KNOW SOME PAINFUL TRUTH
WHICH WILL INCREASE THE PATIENT’S ANXIETY
BUT THEN SUPPORTS BY RESONATING EMPATHICALLY
WITH THE PATIENT’S EXPERIENCING EGO AND
DEFENSIVE NEED TO DENY SUCH KNOWING
WHICH WILL DECREASE THE PATIENT’S ANXIETY
THE PATIENT DOES INDEED KNOW
“BUT” WOULD RATHER NOT
AND THEREFORE – MADE ANXIOUS – SHE DEFENDS
AND “FINDS HERSELF” THINKING, FEELING, OR DOING WHATEVER
SHE MUST IN ORDER TO PRESERVE THE STATUS QUO OF THINGS
6

Recommended

Martha Stark MD – 28 Feb 2022 – From Defense to Adaptation – The Ever-Evolvin...
Martha Stark MD – 28 Feb 2022 – From Defense to Adaptation – The Ever-Evolvin...Martha Stark MD – 28 Feb 2022 – From Defense to Adaptation – The Ever-Evolvin...
Martha Stark MD – 28 Feb 2022 – From Defense to Adaptation – The Ever-Evolvin...Martha Stark MD
 
Martha Stark MD – 11 Feb 2023 – The Art and The Science of Interpretation.pptx
Martha Stark MD – 11 Feb 2023 – The Art and The Science of Interpretation.pptxMartha Stark MD – 11 Feb 2023 – The Art and The Science of Interpretation.pptx
Martha Stark MD – 11 Feb 2023 – The Art and The Science of Interpretation.pptxMartha Stark MD
 
Martha Stark MD – Comprehensive Overview of the 4 Models – A Potpourri of Sli...
Martha Stark MD – Comprehensive Overview of the 4 Models – A Potpourri of Sli...Martha Stark MD – Comprehensive Overview of the 4 Models – A Potpourri of Sli...
Martha Stark MD – Comprehensive Overview of the 4 Models – A Potpourri of Sli...Martha Stark MD
 
Martha Stark MD – 13 Nov 2022 – Part 2 – The Art and The Science of Interpret...
Martha Stark MD – 13 Nov 2022 – Part 2 – The Art and The Science of Interpret...Martha Stark MD – 13 Nov 2022 – Part 2 – The Art and The Science of Interpret...
Martha Stark MD – 13 Nov 2022 – Part 2 – The Art and The Science of Interpret...Martha Stark MD
 
Martha Stark MD – 20 May 2022 – Practical Clinical Interventions for Incentiv...
Martha Stark MD – 20 May 2022 – Practical Clinical Interventions for Incentiv...Martha Stark MD – 20 May 2022 – Practical Clinical Interventions for Incentiv...
Martha Stark MD – 20 May 2022 – Practical Clinical Interventions for Incentiv...Martha Stark MD
 
Martha Stark MD – 4 May 2023 – Practical Clinical Interventions for Incentivi...
Martha Stark MD – 4 May 2023 – Practical Clinical Interventions for Incentivi...Martha Stark MD – 4 May 2023 – Practical Clinical Interventions for Incentivi...
Martha Stark MD – 4 May 2023 – Practical Clinical Interventions for Incentivi...Martha Stark MD
 
Martha Stark MD – 17 Feb 2023 – Seminar 1 – A How-To Playbook for the Middle ...
Martha Stark MD – 17 Feb 2023 – Seminar 1 – A How-To Playbook for the Middle ...Martha Stark MD – 17 Feb 2023 – Seminar 1 – A How-To Playbook for the Middle ...
Martha Stark MD – 17 Feb 2023 – Seminar 1 – A How-To Playbook for the Middle ...Martha Stark MD
 
Martha Stark MD – 20 Oct 2021 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 20 Oct 2021 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD – 20 Oct 2021 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 20 Oct 2021 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD
 

More Related Content

Similar to Martha Stark MD – Model 1 – The Interpretive Perspective of Classical Psychoanalysis.pptx

Martha Stark MD – 21 Apr 2023 – 1st of 3 Experiential Workshops on The Art an...
Martha Stark MD – 21 Apr 2023 – 1st of 3 Experiential Workshops on The Art an...Martha Stark MD – 21 Apr 2023 – 1st of 3 Experiential Workshops on The Art an...
Martha Stark MD – 21 Apr 2023 – 1st of 3 Experiential Workshops on The Art an...Martha Stark MD
 
Martha Stark MD – 29 Apr 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 29 Apr 2022 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD – 29 Apr 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 29 Apr 2022 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD
 
Martha Stark MD – 24 Mar 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 24 Mar 2022 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD – 24 Mar 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 24 Mar 2022 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD
 
Martha Stark MD – 24 Sep 2021 – A Heart Shattered, The Private Self, and Rele...
Martha Stark MD – 24 Sep 2021 – A Heart Shattered, The Private Self, and Rele...Martha Stark MD – 24 Sep 2021 – A Heart Shattered, The Private Self, and Rele...
Martha Stark MD – 24 Sep 2021 – A Heart Shattered, The Private Self, and Rele...Martha Stark MD
 
Martha Stark MD – 13 Nov 2022 – Part 1 – The Art and The Science of Interpret...
Martha Stark MD – 13 Nov 2022 – Part 1 – The Art and The Science of Interpret...Martha Stark MD – 13 Nov 2022 – Part 1 – The Art and The Science of Interpret...
Martha Stark MD – 13 Nov 2022 – Part 1 – The Art and The Science of Interpret...Martha Stark MD
 
Martha Stark MD – 19 Nov 2021 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 19 Nov 2021 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD – 19 Nov 2021 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 19 Nov 2021 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD
 
Martha Stark MD – 21 Jan 2023 – MASTER CLASS Part 1 – The Art and The Science...
Martha Stark MD – 21 Jan 2023 – MASTER CLASS Part 1 – The Art and The Science...Martha Stark MD – 21 Jan 2023 – MASTER CLASS Part 1 – The Art and The Science...
Martha Stark MD – 21 Jan 2023 – MASTER CLASS Part 1 – The Art and The Science...Martha Stark MD
 
Martha Stark MD – 2 Nov 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 2 Nov 2022 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD – 2 Nov 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 2 Nov 2022 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD
 
Martha Stark MD – 2 Jun 2023 – 3rd of 3 Experiential Workshops on The Art and...
Martha Stark MD – 2 Jun 2023 – 3rd of 3 Experiential Workshops on The Art and...Martha Stark MD – 2 Jun 2023 – 3rd of 3 Experiential Workshops on The Art and...
Martha Stark MD – 2 Jun 2023 – 3rd of 3 Experiential Workshops on The Art and...Martha Stark MD
 
Martha Stark MD – 10 Jun 2022 – From Defense to Adaptation.pptx
Martha Stark MD – 10 Jun 2022 – From Defense to Adaptation.pptxMartha Stark MD – 10 Jun 2022 – From Defense to Adaptation.pptx
Martha Stark MD – 10 Jun 2022 – From Defense to Adaptation.pptxMartha Stark MD
 
Martha Stark MD – 14 Nov 2021 – A Heart Shattered, The Private Self, and A Li...
Martha Stark MD – 14 Nov 2021 – A Heart Shattered, The Private Self, and A Li...Martha Stark MD – 14 Nov 2021 – A Heart Shattered, The Private Self, and A Li...
Martha Stark MD – 14 Nov 2021 – A Heart Shattered, The Private Self, and A Li...Martha Stark MD
 
Martha Stark MD – 28 Apr 2023 – Seminar 2 – A How-To Playbook for the Middle ...
Martha Stark MD – 28 Apr 2023 – Seminar 2 – A How-To Playbook for the Middle ...Martha Stark MD – 28 Apr 2023 – Seminar 2 – A How-To Playbook for the Middle ...
Martha Stark MD – 28 Apr 2023 – Seminar 2 – A How-To Playbook for the Middle ...Martha Stark MD
 
Martha Stark MD – 24 Jun 2022 – Understanding Life Backward but Envisioning P...
Martha Stark MD – 24 Jun 2022 – Understanding Life Backward but Envisioning P...Martha Stark MD – 24 Jun 2022 – Understanding Life Backward but Envisioning P...
Martha Stark MD – 24 Jun 2022 – Understanding Life Backward but Envisioning P...Martha Stark MD
 
Martha Stark MD – 19 May 2023 – 2nd of 3 Experiential Workshops on The Art an...
Martha Stark MD – 19 May 2023 – 2nd of 3 Experiential Workshops on The Art an...Martha Stark MD – 19 May 2023 – 2nd of 3 Experiential Workshops on The Art an...
Martha Stark MD – 19 May 2023 – 2nd of 3 Experiential Workshops on The Art an...Martha Stark MD
 
Martha Stark MD – 21 May 2021 – The Refusal to Grieve
Martha Stark MD – 21 May 2021 – The Refusal to GrieveMartha Stark MD – 21 May 2021 – The Refusal to Grieve
Martha Stark MD – 21 May 2021 – The Refusal to GrieveMartha Stark MD
 
Martha Stark MD – 13 Apr 2023 – Grieving the Loss of Relentless Hope and Evol...
Martha Stark MD – 13 Apr 2023 – Grieving the Loss of Relentless Hope and Evol...Martha Stark MD – 13 Apr 2023 – Grieving the Loss of Relentless Hope and Evol...
Martha Stark MD – 13 Apr 2023 – Grieving the Loss of Relentless Hope and Evol...Martha Stark MD
 
Martha Stark MD – 5 Jun 2021 – A Heart Shattered and Relentless Despair.pptx
Martha Stark MD – 5 Jun 2021 – A Heart Shattered and Relentless Despair.pptxMartha Stark MD – 5 Jun 2021 – A Heart Shattered and Relentless Despair.pptx
Martha Stark MD – 5 Jun 2021 – A Heart Shattered and Relentless Despair.pptxMartha Stark MD
 
Martha Stark MD – 22 Feb 2023 – A Handy Reference Guide for all Therapists.pptx
Martha Stark MD – 22 Feb 2023 – A Handy Reference Guide for all Therapists.pptxMartha Stark MD – 22 Feb 2023 – A Handy Reference Guide for all Therapists.pptx
Martha Stark MD – 22 Feb 2023 – A Handy Reference Guide for all Therapists.pptxMartha Stark MD
 
Martha Stark MD – 11 Feb 2022 – A Heart Shattered, The Private Self, and A Li...
Martha Stark MD – 11 Feb 2022 – A Heart Shattered, The Private Self, and A Li...Martha Stark MD – 11 Feb 2022 – A Heart Shattered, The Private Self, and A Li...
Martha Stark MD – 11 Feb 2022 – A Heart Shattered, The Private Self, and A Li...Martha Stark MD
 
Martha Stark MD – 13 Apr 2023 – The Therapeutic Use of Optimal Stress to Prov...
Martha Stark MD – 13 Apr 2023 – The Therapeutic Use of Optimal Stress to Prov...Martha Stark MD – 13 Apr 2023 – The Therapeutic Use of Optimal Stress to Prov...
Martha Stark MD – 13 Apr 2023 – The Therapeutic Use of Optimal Stress to Prov...Martha Stark MD
 

Similar to Martha Stark MD – Model 1 – The Interpretive Perspective of Classical Psychoanalysis.pptx (20)

Martha Stark MD – 21 Apr 2023 – 1st of 3 Experiential Workshops on The Art an...
Martha Stark MD – 21 Apr 2023 – 1st of 3 Experiential Workshops on The Art an...Martha Stark MD – 21 Apr 2023 – 1st of 3 Experiential Workshops on The Art an...
Martha Stark MD – 21 Apr 2023 – 1st of 3 Experiential Workshops on The Art an...
 
Martha Stark MD – 29 Apr 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 29 Apr 2022 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD – 29 Apr 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 29 Apr 2022 – Relentless Hope – The Refusal to Grieve.pptx
 
Martha Stark MD – 24 Mar 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 24 Mar 2022 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD – 24 Mar 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 24 Mar 2022 – Relentless Hope – The Refusal to Grieve.pptx
 
Martha Stark MD – 24 Sep 2021 – A Heart Shattered, The Private Self, and Rele...
Martha Stark MD – 24 Sep 2021 – A Heart Shattered, The Private Self, and Rele...Martha Stark MD – 24 Sep 2021 – A Heart Shattered, The Private Self, and Rele...
Martha Stark MD – 24 Sep 2021 – A Heart Shattered, The Private Self, and Rele...
 
Martha Stark MD – 13 Nov 2022 – Part 1 – The Art and The Science of Interpret...
Martha Stark MD – 13 Nov 2022 – Part 1 – The Art and The Science of Interpret...Martha Stark MD – 13 Nov 2022 – Part 1 – The Art and The Science of Interpret...
Martha Stark MD – 13 Nov 2022 – Part 1 – The Art and The Science of Interpret...
 
Martha Stark MD – 19 Nov 2021 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 19 Nov 2021 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD – 19 Nov 2021 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 19 Nov 2021 – Relentless Hope – The Refusal to Grieve.pptx
 
Martha Stark MD – 21 Jan 2023 – MASTER CLASS Part 1 – The Art and The Science...
Martha Stark MD – 21 Jan 2023 – MASTER CLASS Part 1 – The Art and The Science...Martha Stark MD – 21 Jan 2023 – MASTER CLASS Part 1 – The Art and The Science...
Martha Stark MD – 21 Jan 2023 – MASTER CLASS Part 1 – The Art and The Science...
 
Martha Stark MD – 2 Nov 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 2 Nov 2022 – Relentless Hope – The Refusal to Grieve.pptxMartha Stark MD – 2 Nov 2022 – Relentless Hope – The Refusal to Grieve.pptx
Martha Stark MD – 2 Nov 2022 – Relentless Hope – The Refusal to Grieve.pptx
 
Martha Stark MD – 2 Jun 2023 – 3rd of 3 Experiential Workshops on The Art and...
Martha Stark MD – 2 Jun 2023 – 3rd of 3 Experiential Workshops on The Art and...Martha Stark MD – 2 Jun 2023 – 3rd of 3 Experiential Workshops on The Art and...
Martha Stark MD – 2 Jun 2023 – 3rd of 3 Experiential Workshops on The Art and...
 
Martha Stark MD – 10 Jun 2022 – From Defense to Adaptation.pptx
Martha Stark MD – 10 Jun 2022 – From Defense to Adaptation.pptxMartha Stark MD – 10 Jun 2022 – From Defense to Adaptation.pptx
Martha Stark MD – 10 Jun 2022 – From Defense to Adaptation.pptx
 
Martha Stark MD – 14 Nov 2021 – A Heart Shattered, The Private Self, and A Li...
Martha Stark MD – 14 Nov 2021 – A Heart Shattered, The Private Self, and A Li...Martha Stark MD – 14 Nov 2021 – A Heart Shattered, The Private Self, and A Li...
Martha Stark MD – 14 Nov 2021 – A Heart Shattered, The Private Self, and A Li...
 
Martha Stark MD – 28 Apr 2023 – Seminar 2 – A How-To Playbook for the Middle ...
Martha Stark MD – 28 Apr 2023 – Seminar 2 – A How-To Playbook for the Middle ...Martha Stark MD – 28 Apr 2023 – Seminar 2 – A How-To Playbook for the Middle ...
Martha Stark MD – 28 Apr 2023 – Seminar 2 – A How-To Playbook for the Middle ...
 
Martha Stark MD – 24 Jun 2022 – Understanding Life Backward but Envisioning P...
Martha Stark MD – 24 Jun 2022 – Understanding Life Backward but Envisioning P...Martha Stark MD – 24 Jun 2022 – Understanding Life Backward but Envisioning P...
Martha Stark MD – 24 Jun 2022 – Understanding Life Backward but Envisioning P...
 
Martha Stark MD – 19 May 2023 – 2nd of 3 Experiential Workshops on The Art an...
Martha Stark MD – 19 May 2023 – 2nd of 3 Experiential Workshops on The Art an...Martha Stark MD – 19 May 2023 – 2nd of 3 Experiential Workshops on The Art an...
Martha Stark MD – 19 May 2023 – 2nd of 3 Experiential Workshops on The Art an...
 
Martha Stark MD – 21 May 2021 – The Refusal to Grieve
Martha Stark MD – 21 May 2021 – The Refusal to GrieveMartha Stark MD – 21 May 2021 – The Refusal to Grieve
Martha Stark MD – 21 May 2021 – The Refusal to Grieve
 
Martha Stark MD – 13 Apr 2023 – Grieving the Loss of Relentless Hope and Evol...
Martha Stark MD – 13 Apr 2023 – Grieving the Loss of Relentless Hope and Evol...Martha Stark MD – 13 Apr 2023 – Grieving the Loss of Relentless Hope and Evol...
Martha Stark MD – 13 Apr 2023 – Grieving the Loss of Relentless Hope and Evol...
 
Martha Stark MD – 5 Jun 2021 – A Heart Shattered and Relentless Despair.pptx
Martha Stark MD – 5 Jun 2021 – A Heart Shattered and Relentless Despair.pptxMartha Stark MD – 5 Jun 2021 – A Heart Shattered and Relentless Despair.pptx
Martha Stark MD – 5 Jun 2021 – A Heart Shattered and Relentless Despair.pptx
 
Martha Stark MD – 22 Feb 2023 – A Handy Reference Guide for all Therapists.pptx
Martha Stark MD – 22 Feb 2023 – A Handy Reference Guide for all Therapists.pptxMartha Stark MD – 22 Feb 2023 – A Handy Reference Guide for all Therapists.pptx
Martha Stark MD – 22 Feb 2023 – A Handy Reference Guide for all Therapists.pptx
 
Martha Stark MD – 11 Feb 2022 – A Heart Shattered, The Private Self, and A Li...
Martha Stark MD – 11 Feb 2022 – A Heart Shattered, The Private Self, and A Li...Martha Stark MD – 11 Feb 2022 – A Heart Shattered, The Private Self, and A Li...
Martha Stark MD – 11 Feb 2022 – A Heart Shattered, The Private Self, and A Li...
 
Martha Stark MD – 13 Apr 2023 – The Therapeutic Use of Optimal Stress to Prov...
Martha Stark MD – 13 Apr 2023 – The Therapeutic Use of Optimal Stress to Prov...Martha Stark MD – 13 Apr 2023 – The Therapeutic Use of Optimal Stress to Prov...
Martha Stark MD – 13 Apr 2023 – The Therapeutic Use of Optimal Stress to Prov...
 

More from Martha Stark MD

Martha Stark MD – Clinical Interventions – Chapter 2 of my WORKING WITH RESIS...
Martha Stark MD – Clinical Interventions – Chapter 2 of my WORKING WITH RESIS...Martha Stark MD – Clinical Interventions – Chapter 2 of my WORKING WITH RESIS...
Martha Stark MD – Clinical Interventions – Chapter 2 of my WORKING WITH RESIS...Martha Stark MD
 
Martha Stark MD – 1994 A Primer on Working with Resistance.pdf
Martha Stark MD – 1994 A Primer on Working with Resistance.pdfMartha Stark MD – 1994 A Primer on Working with Resistance.pdf
Martha Stark MD – 1994 A Primer on Working with Resistance.pdfMartha Stark MD
 
Martha Stark MD – 1994 Working with Resistance.pdf
Martha Stark MD – 1994 Working with Resistance.pdfMartha Stark MD – 1994 Working with Resistance.pdf
Martha Stark MD – 1994 Working with Resistance.pdfMartha Stark MD
 
Martha Stark MD – 28 Oct 2017 – Relentless Despair – Model 4.pptx
Martha Stark MD – 28 Oct 2017 – Relentless Despair – Model 4.pptxMartha Stark MD – 28 Oct 2017 – Relentless Despair – Model 4.pptx
Martha Stark MD – 28 Oct 2017 – Relentless Despair – Model 4.pptxMartha Stark MD
 
Martha Stark MD – Oct 2019 – The Transformative Power of Optimal Stress – Pre...
Martha Stark MD – Oct 2019 – The Transformative Power of Optimal Stress – Pre...Martha Stark MD – Oct 2019 – The Transformative Power of Optimal Stress – Pre...
Martha Stark MD – Oct 2019 – The Transformative Power of Optimal Stress – Pre...Martha Stark MD
 
Martha Stark MD – 27 Oct 2017 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 27 Oct 2017 – The Transformative Power of Optimal Stress.pptxMartha Stark MD – 27 Oct 2017 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 27 Oct 2017 – The Transformative Power of Optimal Stress.pptxMartha Stark MD
 
Martha Stark MD – 26 - 27 Apr 2019 – My Psychodynamic Synergy Paradigm – A C....
Martha Stark MD – 26 - 27 Apr 2019 – My Psychodynamic Synergy Paradigm – A C....Martha Stark MD – 26 - 27 Apr 2019 – My Psychodynamic Synergy Paradigm – A C....
Martha Stark MD – 26 - 27 Apr 2019 – My Psychodynamic Synergy Paradigm – A C....Martha Stark MD
 
Martha Stark MD – 22 Sep 2017 – Neuroinflammation and Depression – When the D...
Martha Stark MD – 22 Sep 2017 – Neuroinflammation and Depression – When the D...Martha Stark MD – 22 Sep 2017 – Neuroinflammation and Depression – When the D...
Martha Stark MD – 22 Sep 2017 – Neuroinflammation and Depression – When the D...Martha Stark MD
 
Martha Stark MD – 10 Dec 2016 – Limbic Kindling and Hypersensitivity to Stres...
Martha Stark MD – 10 Dec 2016 – Limbic Kindling and Hypersensitivity to Stres...Martha Stark MD – 10 Dec 2016 – Limbic Kindling and Hypersensitivity to Stres...
Martha Stark MD – 10 Dec 2016 – Limbic Kindling and Hypersensitivity to Stres...Martha Stark MD
 
Martha Stark MD – 16 Jun 2017 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 16 Jun 2017 – The Transformative Power of Optimal Stress.pptxMartha Stark MD – 16 Jun 2017 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 16 Jun 2017 – The Transformative Power of Optimal Stress.pptxMartha Stark MD
 
Martha Stark MD – 26 Jun 2009 – The Overwhelmed Heart.pptx
Martha Stark MD – 26 Jun 2009 – The Overwhelmed Heart.pptxMartha Stark MD – 26 Jun 2009 – The Overwhelmed Heart.pptx
Martha Stark MD – 26 Jun 2009 – The Overwhelmed Heart.pptxMartha Stark MD
 
Martha Stark MD – 21 Feb 2009 – The Wisdom of the Matrix – From Chaos to Cohe...
Martha Stark MD – 21 Feb 2009 – The Wisdom of the Matrix – From Chaos to Cohe...Martha Stark MD – 21 Feb 2009 – The Wisdom of the Matrix – From Chaos to Cohe...
Martha Stark MD – 21 Feb 2009 – The Wisdom of the Matrix – From Chaos to Cohe...Martha Stark MD
 
Martha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptx
Martha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptxMartha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptx
Martha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptxMartha Stark MD
 
Martha Stark MD – 4 Jun 2010 – EMFs and the Excitotoxic Cascade.pptx
Martha Stark MD – 4 Jun 2010 – EMFs and the Excitotoxic Cascade.pptxMartha Stark MD – 4 Jun 2010 – EMFs and the Excitotoxic Cascade.pptx
Martha Stark MD – 4 Jun 2010 – EMFs and the Excitotoxic Cascade.pptxMartha Stark MD
 
Martha Stark MD – 22 Jun 2018 – A Heart Shattered, Relentless Despair, and A ...
Martha Stark MD – 22 Jun 2018 – A Heart Shattered, Relentless Despair, and A ...Martha Stark MD – 22 Jun 2018 – A Heart Shattered, Relentless Despair, and A ...
Martha Stark MD – 22 Jun 2018 – A Heart Shattered, Relentless Despair, and A ...Martha Stark MD
 
Martha Stark MD – 30 Sep 2018 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 30 Sep 2018 – The Transformative Power of Optimal Stress.pptxMartha Stark MD – 30 Sep 2018 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 30 Sep 2018 – The Transformative Power of Optimal Stress.pptxMartha Stark MD
 
Martha Stark MD – 23 Mar 2019 – Contemporary Psychodynamic Psychotherapy.pptx
Martha Stark MD – 23 Mar 2019 – Contemporary Psychodynamic Psychotherapy.pptxMartha Stark MD – 23 Mar 2019 – Contemporary Psychodynamic Psychotherapy.pptx
Martha Stark MD – 23 Mar 2019 – Contemporary Psychodynamic Psychotherapy.pptxMartha Stark MD
 
Martha Stark MD – 20 Mar 2020 – Holistic Psychotherapy – Knowledge, Experienc...
Martha Stark MD – 20 Mar 2020 – Holistic Psychotherapy – Knowledge, Experienc...Martha Stark MD – 20 Mar 2020 – Holistic Psychotherapy – Knowledge, Experienc...
Martha Stark MD – 20 Mar 2020 – Holistic Psychotherapy – Knowledge, Experienc...Martha Stark MD
 
Martha Stark MD – 16 Apr 2020 – Holistic Psychotherapy – Healing the MindBody...
Martha Stark MD – 16 Apr 2020 – Holistic Psychotherapy – Healing the MindBody...Martha Stark MD – 16 Apr 2020 – Holistic Psychotherapy – Healing the MindBody...
Martha Stark MD – 16 Apr 2020 – Holistic Psychotherapy – Healing the MindBody...Martha Stark MD
 
Martha Stark MD – 7 Mar 2020 – Precipitating Disruption to Trigger Repair.pptx
Martha Stark MD – 7 Mar 2020 – Precipitating Disruption to Trigger Repair.pptxMartha Stark MD – 7 Mar 2020 – Precipitating Disruption to Trigger Repair.pptx
Martha Stark MD – 7 Mar 2020 – Precipitating Disruption to Trigger Repair.pptxMartha Stark MD
 

More from Martha Stark MD (20)

Martha Stark MD – Clinical Interventions – Chapter 2 of my WORKING WITH RESIS...
Martha Stark MD – Clinical Interventions – Chapter 2 of my WORKING WITH RESIS...Martha Stark MD – Clinical Interventions – Chapter 2 of my WORKING WITH RESIS...
Martha Stark MD – Clinical Interventions – Chapter 2 of my WORKING WITH RESIS...
 
Martha Stark MD – 1994 A Primer on Working with Resistance.pdf
Martha Stark MD – 1994 A Primer on Working with Resistance.pdfMartha Stark MD – 1994 A Primer on Working with Resistance.pdf
Martha Stark MD – 1994 A Primer on Working with Resistance.pdf
 
Martha Stark MD – 1994 Working with Resistance.pdf
Martha Stark MD – 1994 Working with Resistance.pdfMartha Stark MD – 1994 Working with Resistance.pdf
Martha Stark MD – 1994 Working with Resistance.pdf
 
Martha Stark MD – 28 Oct 2017 – Relentless Despair – Model 4.pptx
Martha Stark MD – 28 Oct 2017 – Relentless Despair – Model 4.pptxMartha Stark MD – 28 Oct 2017 – Relentless Despair – Model 4.pptx
Martha Stark MD – 28 Oct 2017 – Relentless Despair – Model 4.pptx
 
Martha Stark MD – Oct 2019 – The Transformative Power of Optimal Stress – Pre...
Martha Stark MD – Oct 2019 – The Transformative Power of Optimal Stress – Pre...Martha Stark MD – Oct 2019 – The Transformative Power of Optimal Stress – Pre...
Martha Stark MD – Oct 2019 – The Transformative Power of Optimal Stress – Pre...
 
Martha Stark MD – 27 Oct 2017 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 27 Oct 2017 – The Transformative Power of Optimal Stress.pptxMartha Stark MD – 27 Oct 2017 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 27 Oct 2017 – The Transformative Power of Optimal Stress.pptx
 
Martha Stark MD – 26 - 27 Apr 2019 – My Psychodynamic Synergy Paradigm – A C....
Martha Stark MD – 26 - 27 Apr 2019 – My Psychodynamic Synergy Paradigm – A C....Martha Stark MD – 26 - 27 Apr 2019 – My Psychodynamic Synergy Paradigm – A C....
Martha Stark MD – 26 - 27 Apr 2019 – My Psychodynamic Synergy Paradigm – A C....
 
Martha Stark MD – 22 Sep 2017 – Neuroinflammation and Depression – When the D...
Martha Stark MD – 22 Sep 2017 – Neuroinflammation and Depression – When the D...Martha Stark MD – 22 Sep 2017 – Neuroinflammation and Depression – When the D...
Martha Stark MD – 22 Sep 2017 – Neuroinflammation and Depression – When the D...
 
Martha Stark MD – 10 Dec 2016 – Limbic Kindling and Hypersensitivity to Stres...
Martha Stark MD – 10 Dec 2016 – Limbic Kindling and Hypersensitivity to Stres...Martha Stark MD – 10 Dec 2016 – Limbic Kindling and Hypersensitivity to Stres...
Martha Stark MD – 10 Dec 2016 – Limbic Kindling and Hypersensitivity to Stres...
 
Martha Stark MD – 16 Jun 2017 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 16 Jun 2017 – The Transformative Power of Optimal Stress.pptxMartha Stark MD – 16 Jun 2017 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 16 Jun 2017 – The Transformative Power of Optimal Stress.pptx
 
Martha Stark MD – 26 Jun 2009 – The Overwhelmed Heart.pptx
Martha Stark MD – 26 Jun 2009 – The Overwhelmed Heart.pptxMartha Stark MD – 26 Jun 2009 – The Overwhelmed Heart.pptx
Martha Stark MD – 26 Jun 2009 – The Overwhelmed Heart.pptx
 
Martha Stark MD – 21 Feb 2009 – The Wisdom of the Matrix – From Chaos to Cohe...
Martha Stark MD – 21 Feb 2009 – The Wisdom of the Matrix – From Chaos to Cohe...Martha Stark MD – 21 Feb 2009 – The Wisdom of the Matrix – From Chaos to Cohe...
Martha Stark MD – 21 Feb 2009 – The Wisdom of the Matrix – From Chaos to Cohe...
 
Martha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptx
Martha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptxMartha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptx
Martha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptx
 
Martha Stark MD – 4 Jun 2010 – EMFs and the Excitotoxic Cascade.pptx
Martha Stark MD – 4 Jun 2010 – EMFs and the Excitotoxic Cascade.pptxMartha Stark MD – 4 Jun 2010 – EMFs and the Excitotoxic Cascade.pptx
Martha Stark MD – 4 Jun 2010 – EMFs and the Excitotoxic Cascade.pptx
 
Martha Stark MD – 22 Jun 2018 – A Heart Shattered, Relentless Despair, and A ...
Martha Stark MD – 22 Jun 2018 – A Heart Shattered, Relentless Despair, and A ...Martha Stark MD – 22 Jun 2018 – A Heart Shattered, Relentless Despair, and A ...
Martha Stark MD – 22 Jun 2018 – A Heart Shattered, Relentless Despair, and A ...
 
Martha Stark MD – 30 Sep 2018 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 30 Sep 2018 – The Transformative Power of Optimal Stress.pptxMartha Stark MD – 30 Sep 2018 – The Transformative Power of Optimal Stress.pptx
Martha Stark MD – 30 Sep 2018 – The Transformative Power of Optimal Stress.pptx
 
Martha Stark MD – 23 Mar 2019 – Contemporary Psychodynamic Psychotherapy.pptx
Martha Stark MD – 23 Mar 2019 – Contemporary Psychodynamic Psychotherapy.pptxMartha Stark MD – 23 Mar 2019 – Contemporary Psychodynamic Psychotherapy.pptx
Martha Stark MD – 23 Mar 2019 – Contemporary Psychodynamic Psychotherapy.pptx
 
Martha Stark MD – 20 Mar 2020 – Holistic Psychotherapy – Knowledge, Experienc...
Martha Stark MD – 20 Mar 2020 – Holistic Psychotherapy – Knowledge, Experienc...Martha Stark MD – 20 Mar 2020 – Holistic Psychotherapy – Knowledge, Experienc...
Martha Stark MD – 20 Mar 2020 – Holistic Psychotherapy – Knowledge, Experienc...
 
Martha Stark MD – 16 Apr 2020 – Holistic Psychotherapy – Healing the MindBody...
Martha Stark MD – 16 Apr 2020 – Holistic Psychotherapy – Healing the MindBody...Martha Stark MD – 16 Apr 2020 – Holistic Psychotherapy – Healing the MindBody...
Martha Stark MD – 16 Apr 2020 – Holistic Psychotherapy – Healing the MindBody...
 
Martha Stark MD – 7 Mar 2020 – Precipitating Disruption to Trigger Repair.pptx
Martha Stark MD – 7 Mar 2020 – Precipitating Disruption to Trigger Repair.pptxMartha Stark MD – 7 Mar 2020 – Precipitating Disruption to Trigger Repair.pptx
Martha Stark MD – 7 Mar 2020 – Precipitating Disruption to Trigger Repair.pptx
 

Recently uploaded

(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
(DENGUE).pptx Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
 
RADIATION THERAPY IN BILIARY TRACT CANCER
RADIATION THERAPY IN BILIARY TRACT CANCERRADIATION THERAPY IN BILIARY TRACT CANCER
RADIATION THERAPY IN BILIARY TRACT CANCERKanhu Charan
 
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...semualkaira
 
KOSHTA CONCEPT IN AYURVEDA BY VIJAY R K
KOSHTA CONCEPT IN AYURVEDA  BY  VIJAY R KKOSHTA CONCEPT IN AYURVEDA  BY  VIJAY R K
KOSHTA CONCEPT IN AYURVEDA BY VIJAY R Kvinaykumarrkumabar
 
Shodhanagha snehapana.pptx Dr Akshay Shetty
Shodhanagha snehapana.pptx Dr Akshay ShettyShodhanagha snehapana.pptx Dr Akshay Shetty
Shodhanagha snehapana.pptx Dr Akshay ShettyAkshay Shetty
 
Psychedelic Treatment Planning: Opportunities in Integrated Care
Psychedelic Treatment Planning: Opportunities in Integrated CarePsychedelic Treatment Planning: Opportunities in Integrated Care
Psychedelic Treatment Planning: Opportunities in Integrated CareBrian Peacock
 
Autism and Savant Syndrome|Study|The Good doctor .pptx
Autism and Savant Syndrome|Study|The Good doctor .pptxAutism and Savant Syndrome|Study|The Good doctor .pptx
Autism and Savant Syndrome|Study|The Good doctor .pptxScripted Symptoms
 
Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap...
Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap...Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap...
Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap...Subrata Roy
 
CHRONIC IMMUNE-MEDIATED Demyelinating Neuropathies
CHRONIC IMMUNE-MEDIATED Demyelinating NeuropathiesCHRONIC IMMUNE-MEDIATED Demyelinating Neuropathies
CHRONIC IMMUNE-MEDIATED Demyelinating NeuropathiesMohamed AbdElhady
 
Seminario Biología Molecular Manuela Álvarez Ramírez
Seminario Biología Molecular Manuela Álvarez RamírezSeminario Biología Molecular Manuela Álvarez Ramírez
Seminario Biología Molecular Manuela Álvarez Ramírezmanuelaalvarezr
 
Staphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badrStaphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badrssuser06f49d
 
Seminario biología molecular Kevin Duque
Seminario biología molecular Kevin DuqueSeminario biología molecular Kevin Duque
Seminario biología molecular Kevin Duquekevinestebanduque
 
Finger Clubbing by Dr. Samuel2 Alawode.pptx
Finger Clubbing by Dr. Samuel2 Alawode.pptxFinger Clubbing by Dr. Samuel2 Alawode.pptx
Finger Clubbing by Dr. Samuel2 Alawode.pptxAlawode Samuel2
 
Biochemistry of Carbohydrates for MBBS, BDS, Lab Med 2024.pptx
Biochemistry of Carbohydrates for MBBS, BDS, Lab Med 2024.pptxBiochemistry of Carbohydrates for MBBS, BDS, Lab Med 2024.pptx
Biochemistry of Carbohydrates for MBBS, BDS, Lab Med 2024.pptxRajendra Dev Bhatt
 
Fetal and Neonatal Physiology - Dr Faiza.pdf
Fetal and Neonatal Physiology - Dr Faiza.pdfFetal and Neonatal Physiology - Dr Faiza.pdf
Fetal and Neonatal Physiology - Dr Faiza.pdfMedicoseAcademics
 
How to be a successful physician intrapreneur
How to be a successful physician intrapreneurHow to be a successful physician intrapreneur
How to be a successful physician intrapreneurArlen Meyers, MD, MBA
 
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICSPAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICSDr.Shrikrushna Sobaji
 
Anesthesia Implications in cannabis Users.pptx
Anesthesia Implications in cannabis Users.pptxAnesthesia Implications in cannabis Users.pptx
Anesthesia Implications in cannabis Users.pptxhrowshan
 
Measles.pptx Department of Physiotherapy, SHUATS, Prayagraj
Measles.pptx Department of Physiotherapy, SHUATS, PrayagrajMeasles.pptx Department of Physiotherapy, SHUATS, Prayagraj
Measles.pptx Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
 

Recently uploaded (20)

(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
 
RADIATION THERAPY IN BILIARY TRACT CANCER
RADIATION THERAPY IN BILIARY TRACT CANCERRADIATION THERAPY IN BILIARY TRACT CANCER
RADIATION THERAPY IN BILIARY TRACT CANCER
 
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
 
A rare case of Omental & Fibroid Torsion
A rare case of Omental & Fibroid TorsionA rare case of Omental & Fibroid Torsion
A rare case of Omental & Fibroid Torsion
 
KOSHTA CONCEPT IN AYURVEDA BY VIJAY R K
KOSHTA CONCEPT IN AYURVEDA  BY  VIJAY R KKOSHTA CONCEPT IN AYURVEDA  BY  VIJAY R K
KOSHTA CONCEPT IN AYURVEDA BY VIJAY R K
 
Shodhanagha snehapana.pptx Dr Akshay Shetty
Shodhanagha snehapana.pptx Dr Akshay ShettyShodhanagha snehapana.pptx Dr Akshay Shetty
Shodhanagha snehapana.pptx Dr Akshay Shetty
 
Psychedelic Treatment Planning: Opportunities in Integrated Care
Psychedelic Treatment Planning: Opportunities in Integrated CarePsychedelic Treatment Planning: Opportunities in Integrated Care
Psychedelic Treatment Planning: Opportunities in Integrated Care
 
Autism and Savant Syndrome|Study|The Good doctor .pptx
Autism and Savant Syndrome|Study|The Good doctor .pptxAutism and Savant Syndrome|Study|The Good doctor .pptx
Autism and Savant Syndrome|Study|The Good doctor .pptx
 
Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap...
Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap...Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap...
Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap...
 
CHRONIC IMMUNE-MEDIATED Demyelinating Neuropathies
CHRONIC IMMUNE-MEDIATED Demyelinating NeuropathiesCHRONIC IMMUNE-MEDIATED Demyelinating Neuropathies
CHRONIC IMMUNE-MEDIATED Demyelinating Neuropathies
 
Seminario Biología Molecular Manuela Álvarez Ramírez
Seminario Biología Molecular Manuela Álvarez RamírezSeminario Biología Molecular Manuela Álvarez Ramírez
Seminario Biología Molecular Manuela Álvarez Ramírez
 
Staphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badrStaphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badr
 
Seminario biología molecular Kevin Duque
Seminario biología molecular Kevin DuqueSeminario biología molecular Kevin Duque
Seminario biología molecular Kevin Duque
 
Finger Clubbing by Dr. Samuel2 Alawode.pptx
Finger Clubbing by Dr. Samuel2 Alawode.pptxFinger Clubbing by Dr. Samuel2 Alawode.pptx
Finger Clubbing by Dr. Samuel2 Alawode.pptx
 
Biochemistry of Carbohydrates for MBBS, BDS, Lab Med 2024.pptx
Biochemistry of Carbohydrates for MBBS, BDS, Lab Med 2024.pptxBiochemistry of Carbohydrates for MBBS, BDS, Lab Med 2024.pptx
Biochemistry of Carbohydrates for MBBS, BDS, Lab Med 2024.pptx
 
Fetal and Neonatal Physiology - Dr Faiza.pdf
Fetal and Neonatal Physiology - Dr Faiza.pdfFetal and Neonatal Physiology - Dr Faiza.pdf
Fetal and Neonatal Physiology - Dr Faiza.pdf
 
How to be a successful physician intrapreneur
How to be a successful physician intrapreneurHow to be a successful physician intrapreneur
How to be a successful physician intrapreneur
 
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICSPAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
 
Anesthesia Implications in cannabis Users.pptx
Anesthesia Implications in cannabis Users.pptxAnesthesia Implications in cannabis Users.pptx
Anesthesia Implications in cannabis Users.pptx
 
Measles.pptx Department of Physiotherapy, SHUATS, Prayagraj
Measles.pptx Department of Physiotherapy, SHUATS, PrayagrajMeasles.pptx Department of Physiotherapy, SHUATS, Prayagraj
Measles.pptx Department of Physiotherapy, SHUATS, Prayagraj
 

Martha Stark MD – Model 1 – The Interpretive Perspective of Classical Psychoanalysis.pptx

  • 1. MODEL 1 CONFLICT STATEMENTS AND THE CREATION OF COGNITIVE AND AFFECTIVE DISSONANCE BETWEEN THE “PAIN” AND THE “GAIN” 1
  • 2. MODEL 1 CLASSICAL PSYCHOANALYSTS TEND TO FOCUS ON INTERNAL CONFLICT BETWEEN ANXIETY – PROVOKING ID DRIVES AND ANXIETY – ASSUAGING EGO DEFENSES BUT I HAVE FOUND IT TO BE A LITTLE MORE CLINICALLY USEFUL TO CONCEPTUALIZE THIS DRIVE – DEFENSE CONFLICT AS ONE THAT EXISTS BETWEEN ANXIETY – PROVOKING BUT ULTIMATELY EMPOWERING FORCES PRESSING “YES” AND ANXIETY – ASSUAGING (DEFENSIVE) COUNTERFORCES INSISTING “NO” 2
  • 3. MODEL 1 CONFLICT STATEMENTS “OPTIMALLY STRESSFUL” CONFLICT STATEMENTS ALTERNATELY CHALLENGE AND THEN SUPPORT THEY FIRST CHALLENGE BY SPEAKING TO THE PATIENT’S “ADAPTIVE CAPACITY TO KNOW” AN ANXIETY – PROVOKING REALITY AND THEN WITH COMPASSION AND NEVER JUDGMENT SUPPORT BY RESONATING EMPATHICALLY WITH THE PATIENT’S “DEFENSIVE NEED TO AVOID KNOWING” THAT DISCOMFITING TRUTH 3
  • 4. BE IT AN ANXIETY – PROVOKING TRUTH ABOUT HER INTERNAL OR RELATIONAL DYNAMICS, THE PRICE SHE PAYS FOR MAINTAINING HER DEFENSES, OR THE THERAPEUTIC WORK SHE HAS YET TO DO THE PATIENT DOES INDEED KNOW “BUT” WOULD RATHER NOT AND THEREFORE – MADE ANXIOUS – SHE DEFENDS 4
  • 5. MODEL 1 CONFLICT STATEMENTS STRATEGICALLY DESIGNED TO GENERATE DESTABILIZING TENSION WITHIN THE PATIENT BETWEEN HER KNOWLEDGE OF ANXIETY – PROVOKING BUT AWARENESS – ENHANCING, GROWTH – PROMOTING, AND ULTIMATELY EMPOWERING REALITIES AND THE DEFENSES SHE MOBILIZES IN ORDER TO EASE THAT ANXIETY THEIR FORMAT “YOU KNOW THAT … , BUT YOU FIND YOURSELF … ” FIRST THE THERAPIST CHALLENGES BY HIGHLIGHTING AN ANXIETY – PROVOKING REALITY AND THEN SHE SUPPORTS BY RESONATING EMPATHICALLY WITH THE ANXIETY – ASSUAGING DEFENSE 5
  • 6. MODEL 1 CONFLICT STATEMENTS “YOU KNOW THAT … , BUT YOU FIND YOURSELF … ” THE THERAPIST FIRST CHALLENGES BY SPEAKING DIRECTLY TO THE PATIENT’S OBSERVING EGO AND ADAPTIVE CAPACITY TO KNOW SOME PAINFUL TRUTH WHICH WILL INCREASE THE PATIENT’S ANXIETY BUT THEN SUPPORTS BY RESONATING EMPATHICALLY WITH THE PATIENT’S EXPERIENCING EGO AND DEFENSIVE NEED TO DENY SUCH KNOWING WHICH WILL DECREASE THE PATIENT’S ANXIETY THE PATIENT DOES INDEED KNOW “BUT” WOULD RATHER NOT AND THEREFORE – MADE ANXIOUS – SHE DEFENDS AND “FINDS HERSELF” THINKING, FEELING, OR DOING WHATEVER SHE MUST IN ORDER TO PRESERVE THE STATUS QUO OF THINGS 6
  • 7. ANXIETY – PROVOKING BUT ULTIMATELY AWARENESS – ENHANCING INTERVENTIONS FIRST THE REALITY WHAT THE PATIENT REALLY DOES KNOW AND THEN THE DEFENSE / THE RESISTANCE WHAT IS FUELING IT “YOU KNOW THAT ULTIMATELY YOU’LL NEED TO LET JOSE GO BECAUSE HE, LIKE YOUR DAD, REALLY ISN’T AVAILABLE IN THE WAY THAT YOU WOULD HAVE WANTED HIM TO BE; BUT, FOR NOW, ALL YOU CAN THINK ABOUT IS HOW DESPERATELY YOU WANT TO BE WITH HIM AND HOW HORRIBLE IT WOULD BE TO LOSE HIM.” “YOU KNOW THAT EVENTUALLY YOU’LL NEED TO MAKE YOUR PEACE WITH THE REALITY OF JUST HOW LIMITED YOUR MOTHER IS; BUT YOUR FEAR IS THAT WERE YOU EVER TO LET YOURSELF REALLY FEEL THE PAIN OF THAT, YOU WOULD NEVER RECOVER.” “YOU KNOW THAT SOMEDAY YOU’LL HAVE TO LET SOMEBODY IN IF YOU’RE EVER TO HAVE A MEANINGFUL RELATIONSHIP; BUT, IN THE MOMENT, THE THOUGHT OF MAKING YOURSELF THAT VULNERABLE IS SIMPLY INTOLERABLE. THERE’S NO WAY YOU’RE WILLING TO RUN THE RISK OF BEING HURT EVER AGAIN.” 7
  • 8. JUST AS WITH THE EVER – EVOLVING SANDPILE MODEL OF CHAOS THEORY SO TOO THE MODEL 1 “INTERPRETIVE” THERAPIST WILL BE GENERATING ITERATIVE CYCLES OF DISRUPTION AND REPAIR BY WAY OF STRATEGICALLY DESIGNED CONFLICT STATEMENTS THAT ALTERNATELY CHALLENGE AND THEN SUPPORT THEREBY PROVIDING BOTH IMPETUS AND OPPORTUNITY FOR THE MODEL 1 PATIENT TO EVOLVE INCREMENTALLY FROM “DEFENSIVE RESISTANCE” TO EVER – HIGHER LEVELS OF “ADAPTIVE AWARENESS” 8
  • 9. ONGOING CHALLENGE AND THEN SUPPORT WITH “OPTIMALLY STRESSFUL” CONFLICT STATEMENTS DESIGNED TO FACILITATE THE DEVELOPMENT OF “DUAL AWARENESS” ANXIETY – PROVOKING, THEN ANXIETY – ASSUAGING COGNITIVE, THEN AFFECTIVE HEAD, THEN HEART KNOWLEDGE, THEN EXPERIENCE OBJECTIVE, THEN SUBJECTIVE OBSERVING EGO, THEN EXPERIENCING EGO ADULT, THEN CHILD RATIONAL, THEN IRRATIONAL RESPONSE, THEN REACTION LEFT BRAIN, THEN RIGHT BRAIN ADAPTIVE CAPACITY, THEN DEFENSIVE NEED ADAPTATION, THEN DEFENSE 9
  • 10. MODEL 1 CONFLICT STATEMENTS “YOU KNOW THAT ULTIMATELY YOU WILL NEED TO CONFRONT – AND GRIEVE – THE REALITY THAT TOM IS NOT AVAILABLE IN THE WAYS THAT YOU WOULD HAVE WANTED HIM TO BE AND THAT UNTIL YOU MAKE YOUR PEACE WITH THAT PAINFUL REALITY YOU WILL CONTINUE TO BE MISERABLE; BUT, IN THE MOMENT, ALL YOU CAN THINK ABOUT IS HOW ANGRY YOU ARE THAT HE DOESN’T TELL YOU MORE OFTEN THAT HE LOVES YOU.” “YOU KNOW THAT YOU WON’T FEEL TRULY FULFILLED UNTIL YOU ARE ABLE TO GET YOUR THESIS COMPLETED; BUT YOU CONTINUE TO STRUGGLE, FEARING THAT WHATEVER YOU MIGHT WRITE JUST WOULDN’T BE GOOD ENOUGH OR CAPTURE WELL ENOUGH THE ESSENCE OF WHAT YOU ARE TRYING TO SAY.” “YOU KNOW THAT IF YOUR RELATIONSHIP WITH ELANA IS TO SURVIVE, YOU WILL NEED TO TAKE AT LEAST SOME RESPONSIBILITY FOR THE PART YOU ARE PLAYING IN THE INCREDIBLY ABUSIVE FIGHTS THAT YOU AND SHE ARE HAVING; BUT YOU TELL YOURSELF THAT IT ISN’T REALLY YOUR FAULT BECAUSE IF SHE WEREN’T SO PROVOCATIVE, THEN YOU WOULDN’T HAVE TO BE SO VINDICTIVE!” 10
  • 11. BY CALLING THE PATIENT’S ATTENTION TO THE CONFLICT THAT EXISTS WITHIN HER BETWEEN THE “OBJECTIVE REALITY” THAT SHE “KNOWS” WITH HER HEAD AND THE “SUBJECTIVE EXPERIENCE” THAT SHE “FEELS” WITH HER HEART MODEL 1 CONFLICT STATEMENTS CAN BE STRATEGICALLY FORMULATED TO PRECIPITATE (DEFENSIVE) DISRUPTION IN ORDER TO TRIGGER (ADAPTIVE) REPAIR 11
  • 12. MODEL 1 CONFLICT STATEMENTS “YOU KNOW THAT EVENTUALLY YOU’LL NEED TO FACE THE REALITY THAT YOUR MOTHER WAS NEVER REALLY THERE FOR YOU AND THAT YOU WON’T GET BETTER UNTIL YOU LET GO OF YOUR HOPE THAT MAYBE SOMEDAY YOU’LL BE ABLE TO MAKE HER CHANGE; BUT YOU’RE NOT QUITE YET READY TO DEAL WITH ALL THE PAIN AROUND THAT BECAUSE YOU ARE AFRAID THAT YOU MIGHT NEVER SURVIVE THE HEARTBREAK AND DESPAIR YOU WOULD FEEL WERE YOU TO FACE THAT DEVASTATING REALITY.” “YOU KNOW THAT YOUR NEED FOR YOUR CHILDREN TO UNDERSTAND YOUR PERSPECTIVE MIGHT BE A BIT UNREALISTIC; BUT YOU TELL YOURSELF THAT YOU HAVE A RIGHT TO THEIR RESPECT – AND THEIR FORGIVENESS.” “YOU’RE COMING TO UNDERSTAND THAT YOUR ANGER CAN PUT PEOPLE OFF; BUT YOU TELL YOURSELF THAT YOU HAVE A RIGHT TO BE AS ANGRY AS YOU WANT BECAUSE OF HOW MUCH YOU HAVE SUFFERED OVER THE YEARS.” “YOU KNOW THAT IF YOU ARE EVER TO GET ON WITH YOUR LIFE, YOU’LL HAVE TO LET GO OF YOUR CONVICTION THAT YOUR CHILDHOOD SCARRED YOU FOREVER; BUT IT’S HARD NOT TO FEEL LIKE DAMAGED GOODS WHEN YOU GREW UP IN A HORRIBLY ABUSIVE HOUSEHOLD WITH A MEAN AND NASTY MOTHER WHO WAS ALWAYS CALLING YOU A LOSER.” 12
  • 13. THE CREATION OF INTERNAL TENSION BETWEEN “PAIN” AND “GAIN” 13
  • 14. IN ORDER TO INCREASE THE PATIENT’S AWARENESS OF HER AMBIVALENT ATTACHMENT TO HER DYSFUNCTION THE MODEL 1 “INTERPRETIVE” THERAPIST FIRST CHALLENGES BY HIGHLIGHTING WHAT THE PATIENT IS COMING TO UNDERSTAND AS THE PRICE SHE PAYS FOR CLINGING TO HER DYSFUNCTION AND THEN SUPPORTS BY RESONATING EMPATHICALLY WITH WHAT THE THERAPIST IS COMING TO UNDERSTAND AS THE INVESTMENT THE PATIENT HAS IN HOLDING ON TO HER DYSFUNCTION EVEN SO BACK AND FORTH – BACK AND FORTH IN AN EFFORT TO MAKE THE AMBIVALENTLY HELD DEFENSE LESS EGO – SYNTONIC AND MORE EGO – DYSTONIC 14
  • 15. IN ESSENCE MODEL 1 CONFLICT STATEMENTS STRIVE TO CREATE INCENTIVIZING TENSION WITHIN THE PATIENT BETWEEN HER DAWNING AWARENESS OF JUST HOW COSTLY HER DEFENSES HAVE BECOME WITH AN EYE TO MAKING THEM MORE EGO – DYSTONIC AND HER NEW – FOUND UNDERSTANDING OF JUST HOW INVESTED SHE HAS BEEN IN HOLDING ON TO THEM EVEN SO WITH AN EYE TO HIGHLIGHTING HOW EGO – SYNTONIC THEY ARE ULTIMATELY THE EVER – INCREASING INTERNAL DISSONANCE RESULTING FROM HER EVER – EVOLVING AWARENESS OF BOTH THE COST AND THE BENEFIT OF MAINTAINING HER ATTACHMENT TO HER DYSFUNCTIONAL DEFENSES WILL GALVANIZE THE PATIENT TO TAKE ACTION IN ORDER TO RESOLVE THE INTERNAL TENSION 15
  • 16. TO THAT END THE MODEL 1 “INTERPRETIVE” THERAPIST WILL THEREFORE REPEATEDLY HIGHLIGHT BOTH THE “PRICE PAID” (PAIN) AND THE “INVESTMENT IN” (GAIN) AS LONG AS THE “GAIN” IS GREATER THAN THE “PAIN” MORE EGO – SYNTONIC THAN EGO – DYSTONIC THE PATIENT WILL “MAINTAIN” THE DEFENSE AND “REMAIN” ENTRENCHED BUT AS A RESULT OF THE PATIENT’S EVER – EVOLVING AWARENESS OF BOTH THE “PRICE PAID” AND HER “INVESTMENT IN” ONCE THE “PAIN” BECOMES GREATER THAN THE “GAIN” MORE EGO – DYSTONIC THAN EGO – SYNTONIC THE STRESS AND “STRAIN” OF THE COGNITIVE AND AFFECTIVE DISSONANCE BETWEEN THE “PAIN” AND THE “GAIN” WILL BE SUCH THAT IT WILL PROVIDE THE IMPETUS NEEDED FOR THE PATIENT GRADUALLY … 16
  • 17. … TO RELINQUISH HER ATTACHMENT TO THE DYSFUNCTIONAL DEFENSE THEREBY RESOLVING THE STRUCTURAL CONFLICT NEUROTIC / INTRAPSYCHIC CONFLICT THAT HAD EXISTED BETWEEN THE UNTAMED BUT ULTIMATELY GROWTH – PROMOTING ID DRIVE AND THE RESISTIVE AND GROWTH – IMPEDING BUT ANXIETY – RELIEVING EGO DEFENSE 17
  • 18. AS A RESULT OF “WORKING THROUGH” THE DEFENSE / THE RESISTANCE THE NOW STRONGER AND MORE INSIGHTFUL EGO WILL BE BETTER ABLE TO “REGULATE” THE ID’S NOW TAMER AND MORE MANAGEABLE ENERGIES SUCH THAT – NO LONGER THWARTED – THEIR POWER CAN BE HARNESSED BY THE EGO AND CHANNELED INTO MORE CONSTRUCTIVE ENDEAVORS AND WORTHWHILE PURSUITS THEIR MODULATED ENERGY NOW PROVIDING THE PROPULSIVE FUEL FOR ACTUALIZATION OF POTENTIAL 18
  • 19. IN OTHER WORDS ONGOING USE OF “OPTIMALLY STRESSFUL” MODEL 1 CONFLICT STATEMENTS WILL GENERATE HEALING CYCLES OF DISRUPTION IN REACTION TO THE CHALLENGE AND REPAIR IN RESPONSE TO THE SUPPORT AT EVER – HIGHER LEVELS OF ADAPTIVE CAPACITY SUCH THAT “ID ENERGY” ONCE “REINED IN” BY “EGO RESISTANCE” WILL BE “FREED UP” AND CAN THEN BE USED TO “EMPOWER” THE “REALIZATION OF LIFE GOALS” 19
  • 20. FREUD’S (1937) “HORSE AND RIDER” IS INDEED AN APT METAPHOR FOR THE THERAPEUTIC ACTION IN MODEL 1 FREUD’S RIDER A NOW STRONGER AND MORE EMPOWERED EGO BY VIRTUE OF THE GREATER AWARENESS IT HAS OF ITS INTERNAL CONFLICTEDNESS WILL NOW BE MORE SKILLED AT HARNESSING THE QUANTUM POWER OF THE HORSE A NOW BETTER REGULATABLE ID BY VIRTUE OF THE WORKING THROUGH PROCESS, WHICH HAS TAMED, MODIFIED, AND INTEGRATED ITS ENERGIES SUCH THAT HORSE AND RIDER WILL NOW BE ABLE TO MOVE FORWARD HARMONIOUSLY AND IN SYNC NO LONGER IN CONFLICT BUT IN COLLABORATION 20
  • 21. IN ESSENCE THE DEFENSIVE NEED TO “REIN THE HORSE IN” WILL HAVE BECOME INCREMENTALLY TRANSFORMED INTO THE ADAPTIVE CAPACITY TO “GIVE THE HORSE FREE REIN” AS STRUCTURAL CONFLICT EVOLVES INTO STRUCTURAL COLLABORATION AND “JAMMED UP” EVOLVES INTO “EMPOWERED” AND “ACTUALIZED” 21
  • 22. PARENTHETICALLY AS WE SIT WITH OUR PATIENTS THERE IS ALWAYS TENSION WITHIN US AS WELL DIALECTICAL TENSION BETWEEN ON THE ONE HAND OUR VISION OF WHO WE THINK THE PATIENT COULD BE WERE SHE BUT ABLE / WILLING TO MAKE HEALTHIER CHOICES AND ON THE OTHER HAND OUR RESPECT FOR THE REALITY OF WHO SHE IS AND FOR THE CHOICES, NO MATTER HOW UNHEALTHY, THAT SHE “FINDS HERSELF” FEELING COMPELLED TO MAKE WE ARE THEREFORE ALWAYS STRUGGLING TO FIND AN OPTIMAL BALANCE WITHIN OURSELVES BETWEEN WANTING THE PATIENT TO CHANGE AND ACCEPTING THE REALITY OF WHO SHE IS 22
  • 23. IMPORTANTLY MODEL 1 CONFLICT STATEMENTS BY LOCATING WITHIN THE PATIENT THE CONFLICT BETWEEN HER ANXIETY – PROVOKING KNOWLEDGE OF A DISCOMFITING REALITY AND HER ANXIETY – ASSUAGING NEED TO AVOID DEALING WITH IT THE THERAPIST IS DEFTLY SIDESTEPPING THE POTENTIAL FOR CONFLICT BETWEEN THE PATIENT AND HERSELF 23
  • 24. MORE SPECIFICALLY WHEN THE THERAPIST INTRODUCES A CONFLICT STATEMENT WITH “YOU KNOW THAT … ” SHE IS FORCING THE PATIENT TO TAKE RESPONSIBILITY FOR WHAT THE PATIENT REALLY DOES KNOW BECAUSE IF THE THERAPIST IN A MISGUIDED ATTEMPT TO URGE THE PATIENT FORWARD RESORTS SIMPLY TO TELLING THE PATIENT WHAT THE THERAPIST KNOWS NOT ONLY DOES THE THERAPIST RUN THE RISK OF FORCING THE PATIENT TO BECOME EVER – MORE ENTRENCHED IN HER DEFENSIVE STANCE OF PROTEST BUT ALSO THE THERAPIST WILL BE ROBBING THE PATIENT OF ANY INCENTIVE TO TAKE RESPONSIBILITY FOR HER OWN DESIRE TO GET BETTER 24
  • 25. IN OTHER WORDS AS A RESULT OF THE JUDICIOUS USE OF CONFLICT STATEMENTS THAT FORCE THE PATIENT TO BECOME AWARE OF – AND TO TAKE RESPONSIBILITY FOR – HER OWN STATE OF INTERNAL “DIVIDEDNESS” ABOUT GETTING BETTER THE THERAPIST WILL BE ABLE MASTERFULLY TO AVOID GETTING DEADLOCKED IN A POWER STRUGGLE WITH THE PATIENT A POWER STRUGGLE THAT CAN EASILY ENOUGH ENSUE IF THE THERAPIST TAKES IT UPON HERSELF TO REPRESENT THE “VOICE OF REALITY” AND OVERZEALOUSLY ADVOCATES FOR THE PATIENT TO DO THE “RIGHT” THING A STANCE THAT THEN LEAVES THE PATIENT – MADE ANXIOUS – NO CHOICE BUT TO BECOME THE “VOICE OF OPPOSITION” 25
  • 26. IT IS TRULY AN UNTENABLE SITUATION FOR THE THERAPIST TO BE THE ONE REPRESENTING THE HEALTHY (ADAPTIVE) “VOICE OF YES” AND FOR THE PATIENT TO BE THEN STUCK IN THE POSITION OF HAVING TO COUNTER WITH THE UNHEALTHY (DEFENSIVE) “VOICE OF NO” AND SO IT IS THAT IN THE FIRST PART OF A CONFLICT STATEMENT, THE THERAPIST HIGHLIGHTS WHAT THE PATIENT, AT LEAST ON SOME LEVEL, REALLY DOES KNOW EVEN THOUGH SHE MIGHT SOMETIMES BE UNWILLING / UNABLE TO ACT IN ACCORDANCE WITH THAT KNOWLEDGE IN SUM BY LOCATING THE CONFLICT SQUARELY WITHIN THE PATIENT AND NOT WITHIN THE INTERSUBJECTIVE FIELD BETWEEN PATIENT AND THERAPIST, CONFLICT STATEMENTS FORCE THE PATIENT TO TAKE OWNERSHIP OF BOTH SIDES OF HER AMBIVALENCE ABOUT GETTING BETTER 26
  • 27. ALSO NOTE THE IMPLICIT MESSAGE DELIVERED BY THE THERAPIST IN THE SECOND PART OF A CONFLICT STATEMENT WHEN SHE USES SUCH TEMPORAL EXPRESSIONS AS “FOR NOW” – “RIGHT NOW” “AT THE MOMENT” – “IN THE MOMENT” “AT THIS POINT IN TIME” WHICH SHE WILL DO WHEN SHE IS ADDRESSING THE PATIENT’S “INVESTMENT IN” THE DYSFUNCTIONAL DEFENSE “YOU KNOW YOU’RE PAYING A STEEP PRICE FOR YOUR REFUSAL TO STOP SMOKING, OF PARTICULAR CONCERN BECAUSE OF YOUR RECURRENT LUNG INFECTIONS; BUT, IN THE MOMENT, YOU FIND YOURSELF FEELING THAT YOU SIMPLY MUST HAVE THE CIGARETTES IN ORDER TO RELIEVE THE MASSIVE ANXIETY THAT YOU ARE FEELING BECAUSE OF THE LAWSUIT.” THE THERAPIST IS ATTEMPTING TO HIGHLIGHT THE FACT THAT EVEN IF, FOR NOW, THE PATIENT WOULD SEEM TO BE INVESTED IN PROTESTING HER RIGHT TO MAINTAIN THINGS AS THEY ARE, AT ANOTHER POINT IN TIME THAT MIGHT CHANGE 27
  • 28. IN SUM “OPTIMALLY STRESSFUL” CONFLICT STATEMENTS ARE DESIGNED TO PROVOKE THE RELINQUISHMENT OF DYSFUNCTIONAL DEFENSES BY GENERATING COGNITIVE AND AFFECTIVE DISSONANCE WITHIN THE PATIENT THE “WISDOM OF THE BODY” IS SUCH THAT IT CANNOT TOLERATE THE DISTRESS OF DISEQUILIBRIUM FOR ANY EXTENDED PERIOD OF TIME AND WILL THEREFORE BE “PROVOKED” TO TAKE ACTION IN ORDER TO RESOLVE THE INTERNAL TENSION AND RESTORE HOMEOSTATIC BALANCE 28
  • 29. ULTIMATELY, IT WILL BE THE PATIENT’S EVER – EVOLVING CAPACITY BOTH TO RECOGNIZE (WITH HER HEAD) AND TO EXPERIENCE (WITH HER HEART) THE FUNDAMENTAL CONFLICT BETWEEN “COST” AND “BENEFIT” THAT WILL PROMPT HER TO RELINQUISH HER DYSFUNCTION THAT IS, TO SURRENDER HER UNHEALTHY DEFENSES – DESPITE THEIR ERSTWHILE USEFULNESS – IN FAVOR OF HEALTHIER ADAPTATIONS AS SHE EVOLVES FROM “DEFENSIVE RESISTANCE” TO “ADAPTIVE AWARENESS,” EXPANDED CONSCIOUSNESS, AND ACTUALIZED POTENTIAL 29
  • 30. 30
  • 31. MODEL 1 THE INTERPRETIVE PERSPECTIVE OF CLASSICAL PSYCHOANALYSIS “STRUCTURAL CONFLICT” BETWEEN “ANXIETY – PROVOKING” – BUT ULTIMATELY “GROWTH – PROMOTING” – FORCES PRESSING “YES” AND “ANXIETY – RELIEVING” – BUT “GROWTH – IMPEDING” – COUNTERFORCES DEFENDING “NO” 31
  • 32. MOST OF OUR PATIENTS ARE CONFLICTED ABOUT MOST THINGS MOST OF THE TIME WITH ONE PART OF THEM INVESTED IN MAINTAINING “SAME OLD, SAME OLD” AND ANOTHER PART OF THEM BEGINNING TO APPRECIATE – ALBEIT IT WITH EVER – INCREASING ANXIETY – BOTH THE “PRICE PAID” FOR THAT MISPLACED LOYALTY AND THE “ENLIVENING POSSIBILITY” OF “SOMETHING NEW, DIFFERENT, AND BETTER” MODEL 1 CONFLICT STATEMENTS ARE UNIVERSALLY APPLICABLE INTERVENTIONS THAT TARGET THESE STATES OF “INTERNAL DIVIDEDNESS” OR “CONFLICTEDNESS” ON THE ONE HAND HIGHLIGHTING THE PATIENT’S EVER – EVOLVING “AWARENESS” OF HER “INVESTMENT IN” “SAME OLD, SAME OLD” ON THE OTHER HAND HIGHLIGHTING THE PATIENT’S EVER – EVOLVING “AWARENESS” OF THE “PRICE PAID” FOR THAT INVESTMENT AND OF THE “POTENTIAL” FOR “SOMETHING NEW, DIFFERENT, AND BETTER” 63
  • 33. AS WE KNOW, “MINIMALLY STRESSFUL” STATEMENTS SECURE THE ATTACHMENT AND LAY THE GROUNDWORK BUT DO NOT SPECIFICALLY CATALYZE DEEP AND ENDURING CHANGE “OPTIMALLY STRESSFUL” CONFLICT STATEMENTS, HOWEVER, ARE STRATEGICALLY DESIGNED TO OFFER AN ARTFUL COMBINATION OF CHALLENGE – BY HIGHLIGHTING EITHER THE “PRICE PAID” FOR “OLD BAD” AND / OR THE “ENLIVENING POSSIBILITY” OF “NEW GOOD” – AND SUPPORT – BY RESONATING EMPATHICALLY WITH THE “INVESTMENT IN” “OLD BAD” – THE NET RESULT OF THIS INTUITIVELY TITRATED BLEND OF CHALLENGE – WHICH PROVOKES THE PATIENT’S ANXIETY – AND SUPPORT – WHICH EASES IT – WILL BE THE GENERATION OF GALVANIZING OPTIMAL STRESS NECESSARY IF DEEP AND ENDURING PSYCHODYNAMIC CHANGE IS THE ULTIMATE GOAL 64
  • 34. “LEVERAGING” THE PATIENT’S ANXIETY ON THE ONE HAND “MINIMALLY STRESSFUL” STATEMENTS ARE STRATEGICALLY DESIGNED TO “BE WITH THE PATIENT WHERE SHE IS” – “HOMEOSTATIC ATTUNEMENT” – – “SUPPORT” THAT WILL DECREASE HER ANXIETY – THE NET RESULT OF WHICH WILL BE TO “PROMOTE THE THERAPEUTIC ALLIANCE,” “SECURE THE ATTACHMENT,” AND “SET THE STAGE” ON THE OTHER HAND “OPTIMALLY STRESSFUL” STATEMENTS ARE STRATEGICALLY DESIGNED FIRST TO “DIRECT THE PATIENT’S ATTENTION TO WHERE WE WOULD WANT HER TO GO” – “DISRUPTIVE ATTUNEMENT” – – “CHALLENGE” THAT WILL INCREASE HER ANXIETY – AND THEN TO “BE WITH THE PATIENT WHERE SHE IS” – “SUPPORT” THAT WILL DECREASE HER ANXIETY – THE NET RESULT OF WHICH WILL BE TO “CREATE INTERNAL TENSION AND DISSONANCE” AND, THEREBY, “INCENTIVIZING LEVERAGE” SALMAN AKHTAR (2012) 65
  • 35. 66 DO I CHALLENGE? OR SUPPORT? OR PERHAPS DO BOTH?
  • 36. INDEED WE ALL FIND OURSELVES SOMETIMES VERY CONFUSED ABOUT WHAT TO DO NEXT! 36
  • 37. “WORKING THROUGH THE RESISTANCE” OPTIMALLY STRESSFUL MODEL 1 CONFLICT STATEMENTS “YOU KNOW THAT … , BUT (MADE ANXIOUS) YOU FIND YOURSELF THINKING / FEELING / DOING IN ORDER NOT TO HAVE TO KNOW … ” 37
  • 38. TWO KINDS OF CONFLICT – “CONVERGENT” AND “DIVERGENT” – A. KRIS (1985) DIVERGENT CONFLICT – “EITHER / OR” SITUATIONS TWO “MUTUALLY EXCLUSIVE” FORCES SHALL I WEAR MY BLUE DRESS OR MY RED DRESS TONIGHT? CONVERGENT CONFLICT – “BOTH / AND” SITUATIONS ONE OF THE FORCES – AN ANXIETY – PROVOKING (ID) “FORCE” – PROMPTS MOBILIZATION OF A SECOND FORCE – AN ANXIETY – RELIEVING (EGO) “COUNTERFORCE” – YOU KNOW THAT SOMETIMES YOU FEEL ANGRY WITH YOUR WIFE – THE ANXIETY – PROVOKING “FORCE” – BUT YOU (MADE ANXIOUS) WOULD RATHER NOT THINK ABOUT THAT RIGHT NOW – THE DEFENSIVE “COUNTERFORCE” – YOU KNOW THAT YOUR MOTHER WILL PROBABLY NEVER APOLOGIZE – THE ANXIETY – PROVOKING “FORCE” – BUT YOU (MADE ANXIOUS) FIND YOURSELF CONTINUING TO HOPE THAT PERHAPS SOMEDAY SHE WILL – THE DEFENSIVE “COUNTERFORCE” – 38
  • 39. THE “STRUCTURAL CONFLICTS” – aka “NEUROTIC CONFLICTS” OR “INTRAPSYCHIC CONFLICTS” – OF CLASSICAL PSYCHOANALYTIC THEORY ARE “CONVERGENT CONFLICTS” MODEL 1 CONFLICT STATEMENTS ARE DESIGNED TO ADDRESS THESE “CONVERGENT (“BOTH / AND”) CONFLICTS” WITH AN EYE TO GENERATING INTERNAL TENSION BETWEEN ANXIETY– PROVOKING (BUT ULTIMATELY GROWTH – PROMOTING) FORCES AND ANXIETY – RELIEVING (BUT GROWTH – IMPEDING) RESISTANT COUNTERFORCES “YOU KNOW THAT YOUR MOTHER WILL PROBABLY NEVER APOLOGIZE BUT YOU FIND YOURSELF CONTINUING TO HOPE THAT PERHAPS SOMEDAY SHE WILL.” MODEL 1 CONFLICT STATEMENTS ARE NOT DESIGNED TO ADDRESS “DIVERGENT (“EITHER / OR”) CONFLICTS” YOU WOULD NOT ADVANCE THE CAUSE MUCH WERE YOU TO SAY TO YOUR PATIENT “YOU KNOW THAT YOU COULD WEAR YOUR BLUE DRESS TONIGHT BUT YOU FIND YOURSELF THINKING THAT PERHAPS YOU SHOULD WEAR YOUR RED DRESS INSTEAD.” 39
  • 40. “WORKING THROUGH THE RESISTANCE” 📕 📕 OPTIMALLY STRESSFUL CONFLICT STATEMENTS ARE STRATEGICALLY DESIGNED FIRST TO INCREASE ANXIETY BY “CHALLENGING” THE DEFENSE YOU HAVE THE “ADAPTIVE CAPACITY” TO “KNOW” ... , AND THEN TO DECREASE ANXIETY BY “SUPPORTING” THE DEFENSE BUT YOU HAVE THE “DEFENSIVE NEED” TO “RESIST” THAT “KNOWING” ... ALL WITH AN EYE FIRST TO “MAKING EXPLICIT” THE CONFLICT WITHIN THE PATIENT BETWEEN THE “HEALTHY PART” OF HER – THAT DOES INDEED “KNOW” – AND THE “LESS – HEALTHY PART” OF HER – THAT “RESISTS” THAT “KNOWING” – AND THEN TO “GENERATING GROWTH – INCENTIVIZING DISSONANCE” BETWEEN THOSE TWO “PARTS” OF HER “SELF – EXPERIENCE” 71
  • 41. OPTIMALLY STRESSFUL MODEL 1 CONFLICT STATEMENTS FIRST “CHALLENGE” BY “DIRECTING THE PATIENT’S ATTENTION TO WHERE YOU WANT HER TO GO” AND THEN “SUPPORT” BY “RESONATING EMPATHICALLY WITH WHERE SHE IS” “YOU KNOW THAT IF YOU ARE EVER TO GET ON WITH YOUR LIFE, YOU’LL HAVE TO LET GO OF YOUR CONVICTION THAT YOUR CHILDHOOD SCARRED YOU FOREVER. BUT IT’S HARD NOT TO FEEL LIKE DAMAGED GOODS WHEN YOU GREW UP IN A HORRIBLY ABUSIVE HOUSEHOLD WITH A MEAN AND NASTY MOTHER WHO KEPT TELLING YOU THAT YOU WERE A LOSER.” “YOU’RE COMING TO UNDERSTAND THAT YOUR ANGER CAN PUT PEOPLE OFF. BUT YOU TELL YOURSELF THAT YOU HAVE A RIGHT TO BE AS ANGRY AS YOU WANT BECAUSE OF HOW MUCH YOU HAVE HAD TO SUFFER OVER THE COURSE OF THE YEARS.” “YOU KNOW THAT IF YOUR RELATIONSHIP WITH ELANA IS TO SURVIVE, YOU’LL NEED TO TAKE AT LEAST SOME RESPONSIBILITY FOR THE PART YOU’RE PLAYING IN THE INCREDIBLY ABUSIVE FIGHTS THAT YOU AND SHE HAVE BEEN HAVING. BUT YOU TELL YOURSELF THAT IT ISN’T REALLY YOUR FAULT BECAUSE IF SHE WEREN’T SO PROVOCATIVE, THEN YOU WOULDN’T HAVE TO BE SO VINDICTIVE!” 72
  • 42. PLEASE NOTE AS TEMPTING AS IT MIGHT BE FOR THE THERAPIST TO HIGHLIGHT – IN THE FIRST PORTION OF HER CONFLICT STATEMENT – SOMETHING THAT SHE WOULD WISH THE PATIENT ALREADY KNEW, IF THE PATIENT REALLY DOES NOT YET KNOW IT, THEN IT IS BETTER THAT THE THERAPIST RESIST HER TEMPTATION TO “LEAD THE WITNESS” IN THAT WAY “YOU KNOW THAT YOUR UNRESOLVED FEELINGS ABOUT YOUR DAD ARE MAKING IT DIFFICULT FOR YOU TO FIND AN APPROPRIATE LIFE PARTNER ... ” SAYING THIS TO SOMEONE WHO DOES NOT ACTUALLY KNOW THIS RUNS THE RISK OF MAKING THE PATIENT EVEN MORE DEFENSIVE FURTHERMORE, THAT’S “CHEATING”! – SO IT’S NOT FAIR ... 73
  • 43. BY LOCATING WITHIN THE PATIENT THE CONFLICT BETWEEN WHAT SHE (ADAPTIVELY) “KNOWS” AND WHAT SHE, MADE ANXIOUS, (DEFENSIVELY) “FINDS HERSELF” “THINKING, FEELING, OR DOING” IN ORDER NOT TO HAVE TO CONFRONT THAT “ANXIETY – PROVOKING REALITY,” THE THERAPIST IS DEFTLY SIDESTEPPING THE POTENTIAL FOR CONFLICT BETWEEN HERSELF AND THE PATIENT MORE SPECIFICALLY WHEN THE THERAPIST INTRODUCES A CONFLICT STATEMENT WITH “YOU KNOW THAT … , ” SHE IS FORCING THE PATIENT TO TAKE RESPONSIBILITY FOR WHAT THE PATIENT – ALBEIT BEGRUDGINGLY – REALLY DOES KNOW 74
  • 44. IF, INSTEAD, THE THERAPIST – IN A MISGUIDED ATTEMPT TO URGE THE PATIENT FORWARD – RESORTS SIMPLY TO TELLING THE PATIENT WHAT THE THERAPIST KNOWS, NOT ONLY WILL THE THERAPIST BE RUNNING THE RISK OF FORCING THE PATIENT TO BECOME EVER – MORE ENTRENCHED IN HER DEFENSIVE STANCE OF PROTEST BUT THE THERAPIST WILL ALSO BE DEPRIVING THE PATIENT OF ANY INCENTIVE TO TAKE RESPONSIBILITY FOR HER OWN DESIRE TO GET BETTER 75
  • 45. IN OTHER WORDS AS A RESULT OF THE JUDICIOUS AND ONGOING USE OF CONFLICT STATEMENTS THAT FORCE THE PATIENT TO BECOME AWARE OF – AND TO TAKE RESPONSIBILITY FOR – HER STATE OF “INTERNAL DIVIDEDNESS” ABOUT, FOR EXAMPLE, GETTING BETTER – IN OTHER WORDS, HER “AMBIVALENCE” – THE THERAPIST WILL BE ABLE MASTERFULLY TO AVOID GETTING DEADLOCKED IN A POWER STRUGGLE WITH THE PATIENT A POWER STRUGGLE THAT CAN EASILY ENOUGH ENSUE IF THE THERAPIST TAKES IT UPON HERSELF TO REPRESENT THE (ADAPTIVE) “VOICE OF REALITY” BY OVERZEALOUSLY ADVOCATING FOR THE PATIENT TO DO THE “RIGHT / HEALTHY” THING – A STANCE THAT THEN LEAVES THE PATIENT, MADE ANXIOUS, NO CHOICE BUT TO BECOME THE (DEFENSIVE) “VOICE OF OPPOSITION” – 76
  • 46. PLEASE ALSO NOTE THE IMPLICIT MESSAGE DELIVERED BY THE THERAPIST IN THE SECOND PART OF A CONFLICT STATEMENT WHEN SHE USES SUCH “TEMPORAL EXPRESSIONS” AS “FOR NOW” / “RIGHT NOW” / “AT THE MOMENT” “IN THE MOMENT” / “AT THIS POINT IN TIME” WHICH SHE WILL DO WHEN SHE IS ADDRESSING THE PATIENT’S “INVESTMENT” IN THE “DYSFUNCTIONAL DEFENSE” THE THERAPIST IS ATTEMPTING TO HIGHLIGHT THE FACT THAT EVEN IF, FOR NOW, THE PATIENT WOULD SEEM TO BE ENTRENCHED IN PROTESTING HER NEED TO MAINTAIN THINGS AS THEY ARE, AT ANOTHER POINT IN TIME, THAT COULD CHANGE 77
  • 47. OPTIMALLY STRESSFUL MODEL 1 CONFLICT STATEMENTS FIRST “CHALLENGE” THE DEFENSE TO “PROVOKE” ANXIETY AND THEN “SUPPORT” THE DEFENSE TO “EASE” IT “YOU KNOW THAT ULTIMATELY YOU WILL NEED TO CONFRONT AND GRIEVE THE REALITY THAT TOM, LIKE YOUR DAD, IS NOT AVAILABLE IN THE WAYS THAT YOU WOULD HAVE WANTED HIM TO BE AND THAT UNTIL YOU MAKE YOUR PEACE WITH THAT PAINFUL REALITY YOU WILL CONTINUE TO BE MISERABLE. BUT, IN THE MOMENT, ALL YOU CAN THINK ABOUT IS WHAT YOU CAN DO TO MAKE HIM LOVE YOU MORE.” “YOU KNOW THAT SOMEDAY YOU WILL HAVE TO LET SOMEBODY IN IF YOU’RE EVER TO HAVE A MEANINGFUL RELATIONSHIP. BUT, AT THE MOMENT, THE THOUGHT OF MAKING YOURSELF THAT VULNERABLE IS SIMPLY OUT OF THE QUESTION. THERE IS ABSOLUTELY NO WAY YOU ARE WILLING TO RUN THE RISK OF BEING HURT EVER AGAIN.” 78
  • 48. MORE SPECIFICALLY IN ORDER TO SPOTLIGHT THE “AMBIVALENCE” OF THE PATIENT’S “ATTACHMENT” TO HER “DEFENSE” AND TO GENERATE TENSION WITHIN THE PATIENT BETWEEN HER “EVER – EVOLVING AWARENESS” OF BOTH THE “COST” AND THE “BENEFIT” OF CLINGING TO THE DEFENSE WHENEVER POSSIBLE THE THERAPIST WILL THEREFORE OFFER “PRICE – PAID” CONFLICT STATEMENTS THAT HIGHLIGHT BOTH THE “PAIN” AND THE “GAIN” “YOU KNOW THAT < PAIN > ... , BUT YOU REMAIN < GAIN > EVEN SO ... ” “YOU KNOW THAT < PRICE PAID > ... , BUT YOU REMAIN < INVESTED IN > EVEN SO ... ” IN THE HOPE OF MAKING THE “AMBIVALENTLY HELD DEFENSE” “LESS EGO – SYNTONIC” AND “MORE EGO – DYSTONIC” AND OF THEREFORE GALVANIZING THE PATIENT TO “TAKE ACTION” TO “RESOLVE THE INTERNAL DISSONANCE” AND “RESTORE THE HOMEOSTATIC BALANCE” 48
  • 49. MODEL 1 “PRICE – PAID” CONFLICT STATEMENTS FIRST “CHALLENGE” THE DEFENSE BY “DIRECTING THE PATIENT’S ATTENTION” TO THE “PAIN / COST / PRICE PAID” FOR “OLD BAD” AND THEN “SUPPORT” THE DEFENSE BY “RESONATING EMPATHICALLY” WITH THE (SECONDARY) “GAIN / BENEFIT / PAY OFF” OF “OLD BAD” “YOU KNOW THAT YOU ARE PAYING A STEEP PRICE FOR YOUR REFUSAL TO STOP SMOKING – OF PARTICULAR CONCERN BECAUSE OF YOUR RECURRENT LUNG INFECTIONS. BUT, AT THIS POINT, YOU ARE NOT QUITE YET PREPARED TO TAKE THAT STEP BECAUSE YOU FEEL YOU HAVE SO LITTLE ELSE IN YOUR LIFE THAT GIVES YOU ANY REAL PLEASURE.” “YOU KNOW THAT YOU WILL NEED SOMEDAY TO GET SERIOUS ABOUT LOSING THE EXTRA WEIGHT BECAUSE IT REALLY IS BEGINNING TO IMPACT YOUR HEALTH. BUT, RIGHT NOW, YOU CAN’T IMAGINE BEING ABLE TO PUT YOURSELF ON A RESTRICTIVE DIET BECAUSE YOU ARE ALREADY FEELING SO DEPRIVED IN ALL THE OTHER AREAS OF YOUR LIFE.” 49
  • 50. 50