You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This paper describes therapeutic interventions used in individual therapy which do not rely upon interpretation or confrontation. Also discussed are the problems involved in guiding paraprofessional staff in their concurrent treatment of the patient. Examples are given of adolescents with character disorders who are very hostile, suspicious, defensive, and help-rejecting—the bane of therapists and counselors.
It is assumed that all acting out behavior functions as a defense against acknowledging and experiencing thoughts and feelings. When the patient uses these defenses against self-knowledge in treatment, they are called resistances. In treatment with adolescents and children they are known by the presence of (1) lengthy silence, (2) stereotyped repetitive or shallow talk, (3) refusal or objection to attending sessions. The analyst usually makes an attempt to understand the function of a defense-resistance and not remove it without being sure that a patient has, in his repertoire, adequate means of handling his inner and outer life. One of the major means of being sure that the patient is adequately defended is to support, join, or reflect the defense resistance. Interpretation or reality confrontation frequently demolishes defenses and may drive a person to assume more pathological forms of self-protection. The strengthening of defenses usually results in a temporary improvement of behavior, enhances the therapeutic alliance, and allows the patient to experience deep feelings, recall memories, and achieve syntheses between present and past. In sum, resistance-joining techniques tend to facilitate treatment.