I agree that the missed appointment was an important, even necessary test at the very outset of therapy. There have been similar tests regarding payment of bills, etc. Since Joseph easily gets into dangerous or unhealthy situations (and had little protection growing up), an important challenge for me has been to provide a protective role while avoiding a critical or condescending demeanor. There have been times in the treatment when I was unsure about the precise nature of Joseph's testing: is he trying to find out whether he is worth protecting, or is he seeing whether his behavior merits criticism and/or condescension (i.e. will I treat him as if he doesn't know what he's doing)? I think the answer is both. Sometimes in practice this creates a thin line to walk. When I feel I need to intervene in a protective way, I often ask him whether he feels criticized by me: sometimes the answer is yes, sometimes no.
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