Transforming Negative Reactions to Clients: From Frustration to Compassion

Therapists are vulnerable to a wide range of uncomfortable emotions during the practice of psychotherapy. How a therapist manages these reactions has important consequences for the process and outcome of treatment. Spearheaded by three renowned scholars on psychotherapeutic practice, this edited volume will help therapists — established and novice — understand and constructively use the wide range of interfering feelings they experience in their working alliance with challenging patients.

Organized into three major parts, the chapters in Transforming Negative Reactions to Clients explore therapists' negative reactions across major therapeutic approaches and across various disorders, including borderline personality disorder. The concluding chapter contains practice and training recommendations.

Geared toward practicing therapists and supervisors who help novice psychotherapists deal with the potential harmful emotions they may experience in their training, Transforming Negative Reactions to Clients draws on integrative and relational psychotherapy, research on the therapeutic alliance, and social psychology research on the reattribution of motive.

Contributors

Preface

Introduction
Abraham W. Wolf, Marvin R. Goldfried, and J. Christopher Muran

I. Negative Reactions Across Therapeutic Approaches

1. Power Plays, Negotiation, and Mutual Recognition in the Therapeutic Alliance: "I Never Met a Patient I Didn't Like…Eventually"
   J. Christopher Muran and Clara Hungr
2. Cognitive Behavioral Therapy: A Rich but Implicit Relational Framework Within Which to Deal With Therapist Frustrations
   Phillip G. Levendusky and David H. Rosmarin
3. Therapist Negative Reactions: A Person-Centered and Experiential Psychotherapy Perspective
   Robert Elliott
4. Difficulties With Clients in Gottman Method Couples Therapy
   John M. Gottman and Julie S. Gottman
5. Managing Negative Reactions to Clients in Conjoint Therapy: It's Not All in the Family
   Laurie Heatherington, Myrna L. Friedlander, and Valentín Escudero
6. Compassion Amidst Oppression: Increasing Cultural Competence for Managing Difficult Dialogues in Psychotherapy
   Laura S. Brown

II. Borderline Personality Disorder

7. Therapist Compassion: A Dialectical Behavior Therapy Perspective
   Shelley McMain and Carmen Wiebe
8. Managing Negative Reactions to Clients With Borderline Personality Disorder in Transference-Focused Psychotherapy
   John F. Clarkin and Frank Yeomans

III. Managing Negative Reactions Across Other Disorders

9. Time-Limited Dynamic Psychotherapy: Working With Reactions to Chronically Depressed Clients
   Hanna Levenson
10. Pattern Recognition in the Treatment of Narcissistic Disorders: Countertransference From a Unified Perspective
    Jeffrey J. Magnavita
11. Negative Reactions to Substance-Using Clients: Where the Reactions Come From, What They Are, and What to Do About Them
    Frederick Rotgers

Conclusion and Clinical Guidelines
Abraham W. Wolf, Marvin R. Goldfried, and J. Christopher Muran

Index

About the Editors

Abraham W. Wolf, PhD, is a professor of psychology in psychiatry at the School of Medicine, Case Western Reserve University, and the former director of Psychotherapy Training at MetroHealth Medical Center. Dr. Wolf is a fellow and past president of APA's Division 29 (Division of Psychotherapy). He is the author of numerous articles in psychotherapy and health psychology. He is a consulting editor for Psychotherapy, Professional Psychology, Psychotherapy Research, and the Journal of Sex & Marital Therapy.

Marvin R. Goldfried, PhD, is a distinguished professor of psychology at Stony Brook University. He is the recipient of numerous awards from various psychological associations, a past president of the Society for Psychotherapy Research and the Society of Clinical Psychology, and the current president of APA's Division 29 (Division of Psychotherapy). He is the founder of the journal In Session and the author of numerous articles and books. Dr. Goldfried is a cofounder of the Society for the Exploration of Psychotherapy Integration, and the founder of AFFIRM: Psychologists Affirming Their Lesbian, Gay, Bisexual, and Transgender Family.

J. Christopher Muran, PhD, is the associate dean and a professor at the Derner Institute for Advanced Psychological Studies, Adelphi University, and the director of the Psychotherapy Research Program, Beth Israel Medical Center. Supported in part by the National Institute of Mental Health, his research has resulted in numerous publications, including such books as The Therapeutic Alliance in Brief Psychotherapy, Negotiating the Therapeutic Alliance: A Relational Treatment Guide, Self-Relations in the Psychotherapy Process, Dialogues on Difference: Diversity Studies of the Therapeutic Relationship, The Therapeutic Alliance: An Evidence-Based Guide to Practice, and Bringing Psychotherapy Research to Life: Understanding Change Through the Work of Leading Clinical Researchers. He is a fellow of APA and the managing editor of Psychotherapy Research.