The Psychotherapist’s Own Psychotherapy: Patient and Clinician Perspectives JESSE D. GELLER JOHN C. NORCROSS DAVID E. ORLINSKY, Editors OXFORD UNIVERSITY PRESS The Psychotherapist’s Own Psychotherapy This page intentionally left blank The Psychotherapist’s Own Psychotherapy Patient and Clinician Perspectives Edited by JESSE D. GELLER JOHN C. NORCROSS DAVID E. ORLINSKY 1 2005 3 Oxford New York Auckland Bangkok Buenos Aires Cape Town Chennai Dar es Salaam Delhi Hong Kong Istanbul Karachi Kolkata Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi São Paulo Shanghai Taipei Tokyo Toronto Copyright © 2005 by Oxford University Press, Inc. Published by Oxford University Press, Inc. 198 Madison Avenue, New York, New York 10016 Oxford is a registered trademark of Oxford University Press www.oup.com All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press. Library of Congress Cataloging-in-Publication Data The psychotherapist’s own psychotherapy : patient and clinician perspectives / edited by Jesse D. Geller, John C. Norcross, David E. Orlinsky. p. cm. Includes bibliographical references and index. ISBN-13 978-0-19-513394-3 ISBN 0-19-513394-3 1. Psychotherapists—Counseling of. 2. Psychotherapists—Mental health. 3. Psychotherapy patients. I. Geller, Jesse D. II. Norcross, John C., 1957– III. Orlinsky, David E. (David Elliot), 1936– RC451.4.P79P786 2004 616.89'14'023—dc22 2004049243 Rev. Chapter 7 first appeared in the International Review of Psychoanalysis, Vol. 2, 1975, 145–156. © Estate of Harry Guntrip. Portions of Chapter 10 were adapted from the Journal of Humanistic Psychology, Vol. 36, No. 4, Fall 1996, 31–41. © 1996 Sage Publications, Inc. Portions of Chapter 12 first appeared in the Family Therapy Networker, now the Psychotherapy Networker. © 1999, Family Therapy Networker. Used by permission. www.psychotherapynetworker.org 135798642 Printed in the United States of America on acid-free paper M ore than three-quarters of mental health professionals have under- gone personal psychotherapy on at least one occasion. Proportionally speaking, psychotherapists are probably the largest consumers of long-term psychotherapy. Many therapists relate that their own experience in personal treatment has been the single greatest influence on their professional de- velopment. Furthermore, research indicates that identifications with their own therapists are a key determinant of the ways in which therapists-in- training understand and apply therapeutic principles. Yet, until recently, little professional attention and scant empirical re- search has been devoted to the psychotherapist’s personal therapy. Conse- quently, there is no organized body of knowledge that summarizes what is known about psychotherapy with mental health professionals and that effec- tively guides the work of “therapist’s therapists.” Even less is published about conducting treatment with fellow therapists or the linkages between receiv- ing and conducting psychotherapy. The taboo against open examination of the psychotherapist’s own treatment is both revealing and troubling. This book is designed to realize two primary aims. The first is to syn- thesize and explicate the accumulated knowledge on psychotherapy with psychotherapists. The second and interrelated aim is to provide clinically tested and empirically grounded assistance to psychotherapists treating fel- low therapists, as well as to those clinicians who seek personal treatment themselves. In this respect, the intended audience for the book is large and diverse. The book is intended as a treatment reference for clinicians, of all profes- PREFACE sions and persuasions, who treat or intend to treat therapist-patients. It is also intended for graduate students who are contemplating or currently in- volved in personal therapy, for seasoned clinicians returning to personal therapy, and for educators who are responsible for training future thera- pists. Those who do not have specialized knowledge in this area but are intrigued by the inner workings of our profession will also be interested. STRUCTURE OF THE BOOK This edited volume brings together personal experiences, research findings, and clinical wisdom from “both sides of the couch.” For the sake of clarity, the book addresses separately receiving personal psychotherapy and con- ducting personal therapy. This structure allows us to embrace the perspec- tives of both patient and therapist, in contrast to previous literature that addressed only a single perspective. The Psychotherapist’s Own Psychotherapy is integrative in another sense. Multiple theoretical orientations are evident in the coeditors, the contri- butors, and the chapter contents. Both the patient and the clinician nar- ratives traverse the theoretical landscape. Ideological diversity prevails throughout. The book is divided into four parts: The Therapist’s Therapy in Differ- ent Theoretical Orientations; Being a Therapist-Patient; Being a Therapist’s Therapist; and Epilogue. Part I presents the spectrum of theoretical viewpoints that have shaped the profession’s attitudes regarding personal therapy. It consists of five es- says about the diverse theoretical orientations that have guided the prac- tice of psychotherapy with psychotherapists. Part II features the experiences of distinguished psychotherapists undergoing psychotherapy. Six firsthand accounts by therapist-patients are followed by five research reviews on the experience of undergoing per- sonal treatment. In this and the subsequent part, the book moves from personal knowledge through systematic research and toward clinical wis- dom. This structure reflects the way knowledge of personal therapy has itself progressed—tacit knowledge via participation in undergoing and conducting personal therapy, through empirical research, and back to clinical wisdom. In the best scientist-practitioner tradition, first-person narratives are interwoven with contemporary research data on psychothera- pists’ own psychotherapy. All of the autobiographical chapters in part II were written specifically for this book, with one exception—Guntrip’s first-person account of his analyses with Fairbairn and Winnicott. It is an inspiring example of how one might write in a scholarly yet personal voice about the linkages among receiving personal therapy, selecting a theoretical orientation, and devel- oping a personal style of conducting therapy. Part III turns to the therapist’s therapist, again from both personal ex- periences and research reviews. Seven colleagues representing diverse theo- vi preface retical orientations share their lessons, mistakes, and recommendations in treating fellow mental health professionals. The three subsequent chapters are coauthored research reviews on the extant research on conducting per- sonal therapy. Chapter 25 reports on a new study, specifically commissioned for this book, on psychotherapists’ experiences in treating fellow clinicians. Both the contributing therapist-patients and therapists’ therapists fol- lowed common guidelines in preparing their psychobiographical chapters. The guidelines were formulated to (1) promote continuity among the chap- ters in the book; (2) afford convergence between the first-person accounts and the subsequent research-oriented chapters; and (3) permit compara- tive analyses between the complimentary experiences of therapists conduct- ing personal therapy (part III) and those receiving it (part II). The guidelines for the firsthand accounts are reproduced in the appendix. Our epilogue presents our efforts to synthesize the collective wisdom found in this volume and to advance the ultimate integration of the expe- riential, theoretical, and research perspectives on the psychotherapy of thera- pists. As is evident in the structure of the book, we attempt to integrate the experiences of, and linkages between, being a therapist-patient and being a therapist’s therapist. ACKNOWLEDGMENTS We want to thank Joan Bossert, our editor at Oxford University Press, for her superb advice and untiring patience in seeing this project to fruition. In editing a large book, one comes to appreciate that the Muses are not always on schedule. We are grateful to the contributors to this book for taking time from their busy schedules to write their chapters and for their willingness to take our editorial suggestions seriously. A very special thanks to those authors who accepted the challenge to write about their very pri- vate life experiences. Jesse Geller owes an immense debt to the following people for their varied help: Ruth Geller, Kenneth Pope, and Edie Wolkovitz. Each made contri- butions that were crucial and well timed. The Guntrip essay has been reprinted here with the kind permission of the International Review of Psychoanalysis. John Norcross gratefully acknowledges the research collaboration of Elizabeth Kurzawa, the internal funding of the University of Scranton, and the clerical assistance of Melissa Hedges and Dennis Reidy. As always, he appreciates his family’s loving tolerance of his writing commitments. David Orlinsky thanks his coeditors, Jesse Geller and John Norcross; his friends and colleagues in the SPR Collaborative Research Network (es- pecially but not only Professor M. Helge Rønnestad, Dr. Hadas Wiseman, and Dr. Ulrike Willutzki); and, as always, his wife, Marcia Bourland. preface vii John C. Norcross Clarks Summit, Pennsylvania David E. Orlinsky Chicago, Illinois Jesse D. Geller New Haven, Connecticut This page intentionally left blank CONTENTS Contributors xiii 1. The Question of Personal Therapy: Introduction and Prospectus 3 JESSE D. GELLER, JOHN C. NORCROSS, & DAVID E. ORLINSKY PART I. THE THERAPIST’S THERAPY IN DIFFERENT THEORETICAL ORIENTATIONS 2. The Training Analysis in the Mainstream Freudian Model 15 RICHARD LASKY 3. The Role of Personal Therapy in the Formation of a Jungian Analyst 27 THOMAS B. KIRSCH 4. Personal Therapy and Growth Work in Experiential-Humanistic Therapies 34 ROBERT ELLIOT & RHEA PARTYKA 5. Personal Therapy in Cognitive-Behavioral Therapy: Tradition and Current Practice 41 ANTON-RUPERT LAIREITER & ULRIKE WILLUTZKI [...]... what therapists do when the patient is a therapist is premised on unsystematized, often unverbalized, assumptions about the similarities and differences between the psychotherapy of therapists and the psychotherapies offered to other “types” of patients There is no simple answer to the question: What distinguishes the psychotherapy of therapist-patients from the psychotherapy of nontherapist patients?... or theoretical papers concerning therapist-patients in a distant, general, and abstract way Far more research attention has been devoted to the intellectual training and supervision of therapists than to the psychotherapy of therapistpatients Only in the last 15 years have systematic efforts to conceptualize and research the psychotherapy of psychotherapists appeared regularly in the literature These... exclusively on the characteristics of therapist-patients and their experiences in receiving personal therapy Many important questions about the psychotherapy of psychotherapists have not been answered or even asked by empirical investigators 8 the psychotherapist’s own psychotherapy WHAT IS MISSING? In this regard, it is noteworthy that two crucial questions about the psychotherapy of psychotherapists. .. Considerations and Empirical Research REBECCA C CURTIS & MAZIA QAISER 365 Boundaries and Internalization in the Psychotherapy of Psychotherapists: Clinical and Research Perspectives JESSE D GELLER 379 EPILOGUE The Patient Psychotherapist, the Psychotherapist’s Psychotherapist, and the Psychotherapist as a Person DAVID E ORLINSKY , JESSE D GELLER , & JOHN C NORCROSS 405 APPENDIX Guidelines for Firsthand Accounts... conducting psychotherapists 10 the psychotherapist’s own psychotherapy personal treatment It is intended to be both descriptive and prescriptive, as the personal narratives and the research reviews both point to evidencebased practices At the same time, we hope the clinical accounts and research reviews will stimulate others to consider the fundamental, yet neglected, questions surrounding the psychotherapy. .. blank The Psychotherapist’s Own Psychotherapy This page intentionally left blank 1 THE QUESTION OF PERSONAL THERAPY Introduction and Prospectus Jesse D Geller, John C Norcross, & David E Orlinsky P ersonal treatment for psychotherapists receiving it, recommending and conducting it—is at the very core of the profession of psychotherapy Personal therapy or analysis is, in many respects, at the center of the. .. distinct ways First, the book concerns itself with psychotherapists both receiving personal therapy (part II) and conducting it (part III) The research literature and the therapist’s therapists’ accounts demonstrate the direct relevance of each to the other Second, in both parts II and III of the book, we integrate personal experiences with research findings The narrative and empirical perspectives have... interacted with each other when it comes to the psychotherapy of therapists It is only when clinical experiences and empirical research are in close dialogue with one another that true progress is made in understanding therapeutic change The third integrative structure of this book reflects the traditional meaning of psychotherapy integration: the synthesis of different psychotherapy systems or theoretical orientations... that there is a genuine and unambiguous need to advance our understanding of the therapeutic challenges that are more or less particular to the psychological treatment of patients who are themselves therapists or therapists-in-training As was mentioned in the preface, this book brings together theoretical, clinical, experiential, and research perspectives to bear on the question: What distinguishes the. .. Therapy: Their Primary Reasons and Presenting Problems JOHN C NORCROSS & KELLY A CONNOR 192 The Selection and Characteristics of Therapists’ Psychotherapists: A Research Synthesis JOHN C NORCROSS & HENRY GRUNEBAUM 201 Outcomes and Impacts of the Psychotherapists Own Psychotherapy: A Research Review DAVID E ORLINSKY , JOHN C NORCROSS , M HELGE RØNNESTAD , & HADAS WISEMAN 214 PART III BEING A THERAPIST’S THERAPIST . The Psychotherapist’s Own Psychotherapy: Patient and Clinician Perspectives JESSE D. GELLER JOHN C. NORCROSS DAVID E. ORLINSKY, Editors OXFORD UNIVERSITY PRESS The Psychotherapist’s Own Psychotherapy This. in the coeditors, the contri- butors, and the chapter contents. Both the patient and the clinician nar- ratives traverse the theoretical landscape. Ideological diversity prevails throughout. The. this volume and to advance the ultimate integration of the expe- riential, theoretical, and research perspectives on the psychotherapy of thera- pists. As is evident in the structure of the book,