Psikoterapide Direnci Anlamak ve Dirençle Çalışmak

Öz

Farklı terapi yaklaşımlarına göre tanımı değişen bir terim olan direnç, kısaca psikoterapide değişime yönelik bir karşı çıkma olarak tanımlanabilir. Her terapi sürecinin bir gerçeği olması ve terapinin sonucunu etkilemesi sebebiyle direnci anlamak önemlidir. Geleneksel olarak direnç, danışana ait bir özellik olarak görülür ve tedaviyi engelleyen bir faktör olarak kabul edilir. Buna rağmen, direncin son dönemdeki kavramsallaştırmaları onu danışanın bir özelliği olmaktan çıkarıp terapist ve danışanın ortak şekilde katkıda bulunduğu ve terapi süresince devam eden bir süreç olarak tanımlamaktadır. Ayrıca, direncin tedaviye bir engel teşkil ettiği yönündeki inanışın giderek değiştiği ve direncin vaka formülasyonu ve danışana göre şekillendirilmiş terapötik müdahaleleri planlamada kullanılabilecek önemli bir bilgi kaynağı olduğu yönündeki fikrin yaygınlaştığı görülmektedir. Bu makalede, direncin kavramsallaştırılması ve psikoterapide dirençle nasıl çalışılabileceği bir vaka örneğinden yola çıkılarak anlatılacaktır. Bu vakayla yürütülen psikoterapi çalışmasına dayanarak yazar, direncin bu süreçteki kaynaklarını ve tedavi amaçlarına ulaşmayı kolaylaştırmak için kullandığı müdahaleleri tartışacaktır

Anahtar Kelimeler

• direnç, psikoterapi, vaka örneği

Understanding and Working Through Resistance in Psychotherapy

Öz

The term resistance has a variety of definitions based on different therapy approaches; but it briefly indicates an opposition to change in psychotherapy. The term resistance was first used by the psychoanalytic model in the early 1900s. Today, it is possible to find as many models of resistance as the theories of psychotherapy. It is necessary to understand resistance because it is a fact of every clinical situation; that is there is always a certain amount of client opposition in psycho-therapy; and resistance affects the treatment outcome. Traditionally, resistance has been viewed as a characteristic of the client and seen as an obstacle to treatment. However, there has been a major change in how we view resistance today. As opposed to the early view that resistance stems from the client, recent conceptualizations of resistance take into account the mutual role of both the client and the therapist. Thus, resistance is seen as a relational and two-person phenomenon rather than a negative client characteristic. Parallel to this change, therapists are encouraged to explore their own contribution to resistance and work on their own emotions towards clients which are not helpful in the treatment process. Furthermore, the traditional view of resistance as a roadblock to psychotherapy has shifted to-wards a more positive view of resistance which emphasizes the richness of information re-sistance provides about clients and us as therapists, as well as the adaptive functions resistance may serve for clients. So, resistance is now seen as a source of information to guide case formulation and interventions designed specifically for that client. Additionally, it is now believed that resistance may not necessarily be dysfunctional. In some cases what we call resistance might be clients’ best available and adaptive strategy to resolve problems. In this paper, after a brief review of the definition and theoretical models of resistance, a case example will be used to discuss the conceptualization of resistance and working through resistance in psychotherapy. Based on the psychotherapy work with this case, the author will out-line the sources of resistance, as well as specific interventions she used to facilitate working to-wards the treatment goals. The author will highlight the importance of understanding the mean-ing and function of resistance in the psychotherapy process, the therapist’s responsibility to ana-lyze his/her contribution to resistance, and working through resistance rather than working against it.

Anahtar Kelimeler

• resistance,psychotherapy,case study

Kaynakça

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