I am very struck by how this appears to be a treatment of attitude. You have been very consistent in displaying your respect and understanding for this trouble man throughout the treatment. Regardless of the difficult material he presented, it comes across that you have respect and genuine concern for this man. I believe that he knows this and is greatly helped by it. The steadfast way in which you have emphasized that he has the right to be decent and feel deserving has translated into his beginning to treat and think of himself as a decent person.
He is telling you more and more about his problems, and the messages he received from his father. The story about his masturbating against his father and his father’s inability to stop him and talk about it with him in the moment was very telling. Joseph instead experiences feeling shammed in front of others. This must be a part of his belief that people will want him to think poorly about him and expect him to do poorly in the world. To feel free to express his pain and disappointment in his father with you must have been very therapeutic for him. I am pleased to learn that he is feeling well enough about himself to try to enter a relationship but have a concern that it might be difficult for him and bring an increase in his paranoid ideation. I look forward to hearing how it progresses!
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