Chapter 6 The Reformulation Sessions Flashcards
Reformulation requires of therapists what two key CAT/therapuetic abilities?
Empathy towards the patient whilst also thinking reciprocally
Reformulation focuses primarily on what?
The acquisition and enactment of RRPs
How might case formulation be defined?
As the selection and arrangement of data according to the therapist’s theoretical understanding of the issues to be addressed in therapy
A key attribute of the psychotherapy file is that it encourages the patient to practise…?
Putting thoughts to feelings
A reformulation letter should contain what eleven elements?
Emphasis on the provisional nature of the letter
An outline of childhood experiences whilst avoiding reinforcing this as a wholly objective account
A summary of the main history and what brought the patient to therapy
Acknowledgement of subjective experience
Acknowledgement of strengths
Links between past and present state
Consideration of what has been learned in initial sessions
Use of patient images and metaphors
Description of TPs and TPPs and focus on current patterns - snags, traps, dilemmas
An outline of the work of therapy and reference to the impact of the patient’s procedures on the therapuetic relationship
A realistic suggestion of what might be achieved in therapy
Recognising countertransference feelings can become an immediate way of recognising what?
The patient’s expectations of reciprocating procedures or attempts to elicit them
SDR sets out to describe what two central aspects of CAT?
Core reciprocal role repertoires derived from the past and which are now repeated in current procedures
The idea of ‘core pain’ is analogous to James Mann’s (1973) what?
‘Chronically endured pain’
In constructing an SDR, procedures in relation to what should be considered?
The self and others
The term ‘self state’ refers specifically to what CAT concept?
The Multiple Self State Model of BPD
Once states of mind are reliably identified, what should therapists aim to do next?
Begin working on RRPs
Re ‘self states’ the therapist should help the patient to do what?
To describe the dominant mood or behaviour of each state and also the sense of self and others
Recognise the degree to which feelings are accessed or cut off and the accompanying symptoms
Both poles of the RR pattern may be described by patients as subjectively experienced states, but in other cases only one pole will have been recognised as experienced subjectively. How might this be understood?
As the reciprocal being perceived in, or elicited from (in psychoanalytic terms ‘projected into’), others
Partial dissociation between RRPs is indicated diagrammatically by what method?
By locating core repertoires in separate boxes which define the separate self states
As as a theoretical concept, ‘self state’ should be distinguished from which similar terms?
‘State’, ‘state of mind’, ‘state of being’, which describe the subjective experiences associated with playing a particular role in relation to others or an aspect of self
Abrupt state switches, a common feature of BPD, reflect which three types if instability?
Response shifts in relation to the same reciprocal
Role reversals while in a given self state, for example from victim to abuser
Self state switches
The aim of an SDR is to explain all major problematic role procedures in what terms?
In general terms
“The self is a confederacy of states rather than a…?
…single nation”
What are the four types of cores used in sequential diagrams?
Basic: single RRP
French Loaf: RRPs co-exist, mobilized appropriately, smooth transitions
Split Egg and SSSD: abrupt transitions, often inappropriate, some roles exteme
Dialogic Sequence Analysis: traces rapid shifts between roles and RRPs
When thinking about reciprocal role patterns it can be useful to note what three elements?
Descriptions of past and present relationships
How the self is cared for, managed and judged
The emerging relationship with the therapist
In general exits are left until recognition has occurred. In what two sets of circumstances might an exception be made?
Where symptoms or other procedures threaten the therapy
Where serious self-harm is a possibility
RRPs ought also to consider what other outcomes of a given procedure?
Positive outcomes
What four important theoretical concepts ought SDRs to embody?
An emphasis on the reciprocal nature of procedures
That each role is implicitly or explicitly directed to its reciprocal
That the reciprocal may be part of the self or another
That a given RRP may be manifest in procedures described in either pole