Doorknob Bombshells in Therapy: The Deadline, the Brain, and Why It Is Important to End on Time

by Daniela V. Gitlin

Overview

What should a therapist do when a patient reveals critical information at the end of a session?

It’s a near-universal experience among mental health practitioners: a patient drops a bombshell—a critical disclosure that moves the treatment forward—on their way out, with a hand on the doorknob. This “doorknob moment” creates a stressful dilemma for clinicians, especially when the patient is distraught. Should the clinician end the session on time, or run over and be late for the next patient?

Here, seasoned psychiatrist Daniela V. Gitlin provides clinicians with a clear, evidence-based answer. By conceptualizing the functional differences between patient and therapist in the treatment relationship as a metaphor for the functional differences between right and left cerebral hemispheres, Gitlin’s argument yields a comprehensive explanation for why doorknob moments occur, why they are necessary to prevent treatment stagnation, and why ending on time makes patients feel safer to deliver them.

Product Details

ISBN-13:	9781324052593
Publisher:	Norton, W. W. & Company, Inc.
Publication date:	09/17/2024
Pages:	240
Product dimensions:	4.50(w) x 7.30(h) x 0.70(d)

About the Author

Daniela V. Gitlin, MD, is a psychiatrist in private practice in Plattsburgh, New York. Her first book, Practice, Practice, Practice: This Psychiatrist’s Life, was selected as a Finalist by the 2021 International Book Awards in the Health: Psychology and Mental Health category.

Editorial Reviews

"The last minutes of a therapy session may pose such challenges as an ‘exit line’ or ‘curtain call’; the patient delivers a parting shot that either forces an extension of the time or lingers as a message until the next appointment. Dr. Gitlin’s thoughtful and scholarly book focuses on the moment when a patient, one hand often literally on the doorknob, drops a ‘bombshell,’ ranging from a startling insight to a scary crisis."

Alvin Pam

"Doorknob Bombshells in Therapy is an in-depth exploration of the complicated and powerful relationship between a patient and a therapist. By exploring the moment that leads to the end of a therapy session, Dr. Gitlin provides insight in the entire meaning of the therapeutic alliance that is built."

Jeffrey Stovall

"With warmth and humility, Daniela Gitlin’s new book elucidates the importance of ‘doorknob bombshells’—those highly significant, last-minute revelations familiar to clinicians of all stripes—and the rationale for respecting them by holding fast to the therapeutic frame. Deftly integrating neurobiology and attachment theory, Gitlin draws on her experiences as both a psychiatrist and a writer to show how the process of therapy parallels the creative process, and the potential for doorknob moments to promote trust and growth in the therapeutic relationship."

Karen Perlman