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In treatment, the psychotherapist is in a position of power. Often,
this power is unintentionally abused. While trying to embody a
compassionate concern for patients, therapists use accepted
techniques that can inadvertently lead to control, indoctrination,
and therapeutic failure. Contrary to the stated tradition and
values of psychotherapy, they subtly coerce patients rather than
respect and genuinely help them. The more gross kinds of patient
abuse, deliberate ones such as sexual and financial exploitation,
are expressly forbidden by professional organizations. However,
there are no regulations discouraging the more covert forms of
manipulation, which are not even considered exploitative by many
clinicians. In this book, noted psychiatrist Theo. L. Dorpat
strongly disagrees. Using a contemporary interactional perspective
Dorpat demonstrates the destructive potential of manipulation and
indoctrination in treatment. This book is divided into three parts.
Part I explores the various ways power can be abused. Part II
examines eleven treatment cases in which covert manipulation and
control either caused analytic failure or severely impaired the
treatment process. Cases discussed include the analyses of Dora and
the Wolf Man by Freud, the two analyses of Mr. Z by Kohut, as well
as other published and unpublished treatments. An interactional
perspective is used to examine the harmful short- and long-term
effects of using indoctrination methods as well as to unravel
conscious and unconscious communications between therapists and
patients that can contribute to manipulations. Part III shows
readers how to work using a non-directive, egalitarian approach in
both psychoanalytic psychotherapy and psychoanalysis.
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