Co-Creating Safety: Healing the Fragile Patient

by Jon Frederickson

Overview

Create a Safe Space for Patients, Do you have patients who are crippled by fear and anxiety? Would you like to help the 50 percent of patients who drop out of therapy before they have received its full benefits? To be successful, therapists must know how to make therapy a safe place. Only if patients feel sate in their body and with the therapist can they feel safe enough to change. Co-Creating Safety provides clear, systematic steps for assessing and meeting patients' needs. Every technique is illustrated with a specific vignette. The vignettes-representing hundreds of therapeutic impasses taken from actual sessions-show therapists what to say so they can, Assess and respond to patients' needs moment by moment, Help patients develop and keep an effective focus that leads to change, Help regulate patients' anxiety, Deactivate misperceptions of the therapist and therapy, Help patients see and let go of defenses that cause their symptoms, Help patients overcome their fears so they can face their feelings, Help patients let go of insecure attachment, strategies to form a healing relationship, When patients feel safe enough to change, they can begin to heal.

Product Details

ISBN-13:	9780988378803
Publisher:	Seven Leaves Press
Publication date:	12/15/2020
Pages:	568
Product dimensions:	6.00(w) x 8.90(h) x 1.30(d)

About the Author

Jon Frederickson, MSW, is the founder of the ISTDP Institute and a faculty member at the Washington School of Psychiatry in Washington, DC. He is the author of Psychodynamic Psychotherapy, Co-Creating Change, and The Lies We Tell Ourselves.

Table of Contents

Acknowledgments ix

Introduction When the Center Cannot Hold xi

Part 1 Building a Secure Attachment

Chapter 1 Anxiety: The Signal of Danger 3

Chapter 2 Declaring a Problem: Is It Safe to Depend? 91

Chapter 3 Declaring Ones Will: Is It Safe to Have a Separate Will? 117

Chapter 4 Psychodiagnosis: Co-Creating an Effective Focus 143

Chapter 5 Co-Creating a Therapeutic Alliance: Making the Unconscious Will to Health Conscious 169

Part 2 Strengthening the Patient

Chapter 6 Systems of Self-Protection: The Hierarchy of Affect Thresholds 189

Chapter 7 Declaring Ones Feelings: Is It Safe to Share Feelings? 207

Chapter 8 Restoring Lost Capacities 287

Part 3 Integrating the Patient

Chapter 9 Denial: Learning to Face Reality 309

Chapter 10 Splitting: Learning to Tolerate Complex Feelings and Realities 347

Chapter 11 Projection: Learning to Feel Inside What We Placed Outside 381

Chapter 12 Severe Fragility: Pseudohallucinations and Pseudodelusions 421

Chapter 13 Projective Identification and Countertransference: Learning to Bear What Is Inside Ourselves 459

Conclusion 475

References 479

Index 513

About the Author 527

Editorial Reviews

2021-02-03
A therapist examines how to help some of the most at-risk psychiatric patients in this health care book.

This latest work from Frederickson dissects the nature of extreme vulnerability in patients, the factors that go into producing a particular delicacy in some people, and the added duties caregivers have toward this group. “Our task as therapists is to help the fragile patients recover their freedom to love, to live, and to create a life that matters,” the author writes. Therapists can complacently imagine that their patients are composed entirely of their histories, diagnoses, and genetics, but Frederickson stresses that this would be a mistake. If he and his fellow therapists do this, “we relate to dead concepts rather than living persons.” Instead, therapists must “mobilize the self-creative capacity to act.” The goal is not to steamroll patient anxiety in order to commence therapy but rather to create the feeling of personal safety necessary for healing. If the therapist rushes ahead without taking care to regulate the patient’s anxiety, Frederickson points out, the caregiver will become a source of danger rather than a fount of help. He makes a comparison with a shattered plate. No one would equate any of the broken pieces with the whole plate, and therapists need to differentiate between the symptoms of anxiety and the signs of the more severe “splitting” and “dissociation” that the condition often presages. The author uses an array of techniques in order to convey a large amount of complicated information: charts, graphs, anecdotes, dialogue examples, extensive secondary references, and bullet points fill the text. Frederickson’s tone is affirming throughout and always on the side of the patient. “No therapist should act as the captain,” he writes. “Our task is to help the patient become the skipper of her own ship.” The author’s fellow professionals will learn a great deal from these pages, but the layperson will find them very informative as well.

A smart, sympathetic, and detailed overview of the most vulnerable patients.

Kirkus Reviews