At Mon, 12 Mar 2001 17:56:49 -0600 (CST), Jim Choate <ravage@EINSTEIN.ssz.com> wrote:

Cool, we've got two wanna be head-shrinkers. This is gonna be fun.

A common countertransference issue with these clients is outrage or punitive anger. They are manipulative individuals who are consistently stubborn, demanding, help-rejecting, critical, and inclined to ridicule both the treatment process and the service providers. Subject Choate has predictably responded in exactly this fashion to the onset of treatment. Identify all avoidance and anxiety-arousing situations. Address these issues with anxiety-management behavioral intervention techniques (Turkat, 1990, pp. 88-89). Cognitive therapy can help these individuals understand that they expect the worst from others and then proceed to behave in such a way that brings out the worst from these same people (Stone, 1993, p. 363). Group therapy provides individuals with PAPD with an opportunity to learn how to manage their hostility. When their hostility emerges, group leaders can comment on hostile behavior and encourage other group members to respond. The group leader can assist these individuals to process what it is they want or need at that moment and to rehearse appropriate behavior within the group context (Ries, TIP #9, 1994, p. 72). Free, encrypted, secure Web-based email at www.hushmail.com