Sisyphus'Tests

    The Case of Otto Menu

    • COMMENTS, QUESTIONS, AND ANSWERS by Editor, 6/26/96

    Sisyphus'Tests
    by Jessica Broitman, 7/12/96

    Norm-

    You are asking great difficult questions!

    There are something's to think about that can help one sort out what kind of test a patient is presenting - but one doesn't always know.

    One of the things that I like about Weiss' theory is that it relies on the real data. The way that the patient responds is very informative and guides your understanding. The research group closely studies cases and seeks to understand the therapeutic process. The research has been published and a bibliography is listed in the forum. We shift and change as we learn more about the patient's plan and needs. The answers are always case specific so one must reconsider your question for each patient in each session. There are even times when the same issues can be used in different ways for the same patient.

    One way to gain insight into the patient's plan and tests is to closely watch your reaction to him. If you have a very unusual strong response to the material it may be an indication of a passive into active test. These kinds of tests often feel like you are in a spell and sinking fast. They aren't simple exchanges of data. You feel helpless, over responsible, guilty, etc. Transference tests place the patient in the position of receiving the same treatment that they had as a child. You have much more room to breath!

    In passive into active tests you are getting the traumatic experience first hand. One must look to the patient's individual data to see how they were treated. Otto 's punishment was so out of line for his behavior that it caused trauma. When Don hospitalized him it was an appropriate form of protection that relieved Otto. I f we had seen Otto become more anxious and worried we would have to reconsider our formulation.

    You can't expect to always get the test right. You can't. But one must respond to the data and adjust your style as needed.

    Your last question asks is the patient reenacting a rejection test or an autonomy test? One must look to the patient's history and use the best information and signals you have. If one can't tell as the history could lend itself to both you can lay it out for the patient and ask their help. I have been known to ask "Which mistake should I make today"?


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