The document discusses barriers in interpersonal relationships, specifically in the nurse-patient context, citing therapeutic impasses like resistance and transference. It identifies resistance as the patient's avoidance of discussing troubling issues and outlines methods to overcome it, such as active listening and maintaining communication. Additionally, it explains transference as an unconscious redirection of feelings towards the nurse and provides strategies for nurses to help patients address these feelings appropriately.

1. BARRIERS OF IPR
and
METHODS OF
OVERCOMING
PART- 1
BY,
VEDANTHAVINOD
ASSISTANT LECTURER
CCON-MYSORE

2. BARRIERS OF INTERPERSONAL RELATIONSHIP
AND HOWTO OVERCOMETHEM :-
•Therapeutic impasses are the blocks/barriers in
the progress of the nurse-patient relationship.
•The therapeutic impasses, even though arise
due to different reasons but tend to impede
the therapeutic relationship.

3. The common impasses are as follows:
RESISTANCE
TRANSFERENCE
COUNTER
TRANSFERENCE
BOUNDARY
VIOLATIONS

4. RESISTANCE
Resistance is the patient's reluctance or
avoidance while talking about or experiencing
troubling aspects of oneself.
Causes:-
• Because the nurse moved too quickly into the
patient's feelings which makes them shrink

5. •Because of intentional or unintentionally
conveyed lack of respect Secondary If a
psychiatric patient exhibits resistance in
nurse patient relationship .
•it is better to provide him with related
benefits such as avoiding responsibilities, etc.

6. OVERCOMING RESISTANCE
•Active listening :- Improving clarification in the
information provided to the patient.
• Reflect the feelings of the patient so that
patient can understand and be aware of what is
going on in his/her mind.

7. •Explore the behavior to find the possible
reason for resistance.
• Maintain open communication with the
supervisor.Thus supervisor can help in
facilitating the communication.

8. TRANSFERENCE
Transference is an unconscious response
in which patients experience feelings and
attitudes toward the nurse that were
originally associated with other significant
persons of their life.

9. •This causes inappropriate intensity of the
patient's response.
•Transference reduces the self awareness by
allowing the patient to maintain an inaccurate
view of the world in which all people are seen
in a similar way.
•Transference responses are harmful to the
therapeutic process only if they were ignored
and unexamined.

10. TYPES
There are two types of transference:
1. Hostile transference
2. Dependent reaction transference

11. HOSTILETRANSFERENCE
• Hostile transference is the one in which the
patient internalizes the anger and hostility.
This may be expressed in the patient's
behavior as depression and discouragement.

12. DEPENDENT REACTION
TRANSFERENCE
•This is characterized by patients who are
submissive, subordinate and ingratiating; and
those who regard the nurse as god like figure.
•In this type of transference patient continues to
demand more from the nurse and when these
needs are not met, the patient is filled with
hostility and contempt.

13. OVERCOMINGTRANSFERENCE
•The relationship has to be maintained unless
otherwise it poses a serious barrier to therapy
or safety.
•The nurse should assist the client in sorting out
their past from the present.

14. •Assist the patient in identifying the
transference and reassign a new appropriate
meaning to the current nurse-patient
relationship.
•The goal is to guide the independence by
teaching them to assume responsibility of their
own behaviors, feeling and thoughts, and

15. •To assign the correct meaning to the
relationship based on the present
circumstances rather than corroborating to
the past.

16. ANY DOUBTS??

17. THANKYOU