A warm welcome to you Jim- I think you will be a great addition to the forum. I think our theories have much in common which is a good basis for learning from each other. I wanted to try address the question of our goals when dealing with a patient. I think we share the idea that a patient's beliefs are the cause of pathology. We don't find it useful to separate the deep, present or past issues as we seen them as all interacting and related to each other. The problem for us is not what technique one uses, as we have seen that many different techniques will be helpful to many different patients. Rather - the question for us is what is the real problem that a patient is wanting our help with. We find that the answers do emerge spontaneously in the therapeutic situation as it is the patient's intent to tell us how to help him or her.
We do not pull for a deep transference but find that patient's bring into treatment a particular way of thinking and feeling about a problem, themselves and us. They often teach best about it by how they treat us. We refer to this as testing. There are many analytic theories that emphasize the transference relationship but ours is not one of them. We develop a case specific plan for helping a patient based on our assessment of their unconscious and conscious plan. This may be an area of theoretical difference as we believe that much of the patient's work is going on unconsciously. We think you can and must ask your patient for their goals but you must be prepared to intuit their validity from the way they interact with you, their history and actions in the outside world. Often for example a patient will enter treatment saying that they seem to have a problem getting along with a spouse or mate, going through with a marriage agreeing to have a child, etc. and ask for help to do so. It becomes clear that they are unhappy in the relationship but feel guilty allowing themselves to have what they really want and fear the consequences of their actions thus inhibiting their actions. The last case discussed in the case conference would be an example of a person presenting conflicting and inexact goals. If we would accept their stated goals and help them achieve them we would miss the real issue the patient was dealing with. How does this fit with your clinical experience?