Process Note, Audio & Video
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- Опубликовано: 16 окт 2024
- In psychotherapy and psychoanalysis trainees and candidates are emcpiraged tp tale detailed process notes on their sessions with patients for presentation to fellow trainees and faculty in case seminars. But when the therapist is taking notes he or she is not fully present t the encounter with the patients. Sharing the content of a session with a supervisor is bad enough, yet unavoidable. Bit to audio or videotape a session is, in my view, a gross violation. The fact that many therapists today don't see this is a testament to their insensitivity and alienation.
I completely agree. That's why I only do it when it's absolutely necessary for me and I always always make sure I maintain my eye contact with my patient.
The soul, the heart, the essence of the person, the love, the need for absolute privacy - all these things seem to sometimes get diminished or forgotten and all the more so as we let such values go in favour of adapting to try and ensure the profession's survival, or time pressures to get people off waiting lists in health services, or to be seen as more scientific..... But our most precious resource is our ability to put those very values at the heart of all we do. Thank you for this reminder of the central importance of them.
Thank you, yes, so glad you agree.
I've wrestled with this issue for a few decades. In the end, direct access to at least some sessions may be a necessary evil for training if only to ensure patients aren't being harmed or neglected. However, in general i agree with you. Bollas made some great points about the erosion of confidentiality generally in The New Informants. Not only that, I am amazed at how fast patients themselves (especially younger ones) are to give up their own privacy in this age of the internet. It seems the internet has altered general expectations about privacy- for the worse.
Yea
Thank you for all you said here, I couldn’t agree more! The therapy room needs to be as little like a police interrogation room as possible! If someone was writing notes about me, apart from anything else, I would be distracted wondering what they were writing, it could be their shopping list for all I know.
Your red room there looks like the inside of a heart.
You’re absolutely right, Don! If individuals cannot discern the difference a verbal re-telling of a session and the permanent audio- or video-recording of one’s patient’s narrative, they have a serious cognitive impairment. Wow.
Thanks Racquel
Thank you for your thoughts on this topic. In your view, what do you then recommend the supervisee bring to supervision/consultation? ...What occurred via supervisee's memory in written form? or explain verbally 'a difficulty' in any particular patient hour?
The supervisee should take some time before the supervision hour to think about his week with his patient, to Winter what kind of reverie about the session or sessions that week. To note what puzzles what bothers him. Or what interests him particularly. If he is engaged with his patient he will want to discuss interesting or concerning matters that have arisen. He should begin to talk about these matters with his supervisor he may bring a few notes Georgia down not during the session but in the 10 minutes between sessions. No it’s on such thing as a dream and associations to it, or the therapists on emotional states in reaction to the patient. Out of such conversation patient and supervisor will try to understand what’s going on.
Please consider the possibility to make a video about how you prepare your new patients for the analytic work. For example, do you explain the process and the way it works in detail? Do you prepare them for the potential challenges of transference? It would be quite interesting for me to hear your approach. Thank you once again.
Good idea, I will give it some thought, thanks
Thank you for this.
Most welcome
Hello Dr. could u recommend some of the best literature about the development of the self? thank u.
In a sense i see psychoanalysis more sacret process than going to confession in a church. There are protocols how to guard that information. And what we choose to disclose voluntarily vs what chrurch forces us to disclose as well sort of voluntarily.
I was interested in whether or not you had any associations in the use of the word “OK” at the end, of all your lectures.
What comes to mind is Julian of Norwich: “ all will be well, and all will be well, and all manner of things shall be well.“
@@doncarveth does it have anything to do with an idea of termination in analysis
@@JoshBarzell no more than the end of every session. Or any departure.
@@doncarveth I think that’s what I was getting at: It’s your way of ending things.
🖐Have just returned from a hedious camping trip that even a hardened marine would have baulked at .When recovered will watch take care R⚛
Dr carveth my analyst told me that even an expert analyst should have always a supervisor. What are your opinions on that? For me knowing that a third eye always could help my analyst saw what she may not have seen was actually pretty reassuring. And of course i had and have trusted my analyst after so many years. she is so ethical and very experr
That’s good, but I wouldn’t make it a requirement. Consultation from time to time is recommended
@@doncarveth I think maybe in special situations when Analyst experience so many Countertransferences he/she could really get help from the superviser. Or maybe in special cases like should the treatment terminate? Or handeling severe borderlines cases...
Valuable thoughts. Thank you!
11:38 in please be more specific here this is very concerning who is this man ? Generally agree , although i think Bion was referring to ego distortions and the oppressive tendency to project unwanted aspects onto the cl;ient ans thus pathologize them and avoid transference feelings ie forget means Zen like forgetting it is an ideal ! Also i totally agree about notes full stop i am similarly afflicted as explained witha Jungian Purer complex feelings aghh...thoughts interpretations and notes help me de limit my own personal sense of trauma , vulnerability and escape feelings things i do not want to feel ( overwhelmed maybe by echoes of past traumas goign back to the womb ) , ?
There is a whole can of worms then in 13-17:00 YES absolutely my interpretation of you is just my interpretation , my biases are in there from the start aren't they ? The element of projection is always at work isn't it ?
You're exposing and revealing hidden aspects of yourself as the other ( patient), becoming in the process more open , more vulnerable and even excited at the prospect of more discovery in the dark chasms of the mind and soul suddenly reveal themselves , this person this other human being is aware they have been recorded , all past sexual, past traumatic events exposed , rifled through in the hands of who , big brother , the state , the thought Police ( Sanhedrin of the psychiatric world ) , for what purpose ? Orwellian nightmares and security cameras its all happening sadly real time , we can't or I can't post "so called pandemic on Facebook it isn't allowed" it isn't factual bollocks , I'm sure nurses records of me post LSD tripped psychosis in my twenties when i went to view them had been carefully sifted through before I was allowed to read them just in case , it's all ready upon us Don!
YES Don on this we are in total agreement i might even go further , it is in supervision even that the biases of the therapist his petty dislikes might skew his memory of events to re establish a dyadic that is "power " based and us and them orientated a quasi superiority a pride in being the one whose done this , I have said so in my estimation of how nurses club together in the core assumption of their being "us" and them mentally ill , we are all disturbed and well if not mentally ill certainly not cosha .
This leads inevitably to all sorts of Zimbardo esque horrors , drug cocktails , all other forms of abuse under the rubric of treatment after all they are "ill" aren't they ? W
Who wouldn't get angry ? Yes it is not just a sacred space it is quintessentialy a sacred encounter full stop the greatest privilege on earth to be invited closer to another s soul !
After all who knows what Jesus revealed to his inner circle of disciples ?
Yes
@@doncarveth😅😅😅 yes
I think it’s interesting to look at the work that Marsha Hewitt is doing. She’s an analyst who is interested in telepathy. So, when that is also going on in the analytic space, your notes are only probably the one thing that is not happening; there’s much more going on...
Yes, but some folks, especially some who have radically extended Bionian idas about projective identification have moved in some rather Woo-Woo directions.
@@doncarveth I’m interested in consciousness, and Marsha Hewitt’s work has highlighted the possible deeper levels of awareness. I believe there is an unconscious - of the unconscious mind.
I am a little surprised that taking notes during session is part of the training. I am in training as well, luckily for me and for the patient this is not a requirement in our society, although my memory is horrible and taking notes after the session is a struggle.
I couldn't agree more about the smugness and arrogance that some senior analysts may have towards their 'established' ideas, proving that thinking and revisiting one's methods is not welcome. Contrary to what we do with our patients trying to promote constant re-thinking and reconsidering of the established. People get carried away with believing they 'know' what is what.
Yes. Amen
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👄. Very relevant for me as a psychotherapy student here at WSU in Sydney Australia 🇦🇺
Isn't this a smaller issue of a bigger problem, the complete neglect of patients on behalf of the training and college institutions and their clinics? Patient waitlists, terrible procedures, positivism, and taking weeks off because academic calendars say so...