Is there a name for this? (curious)

[Ceke2002]

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Say you're working in a peer group support, or group therapy situation (or whatever else) with a borderline patient, and you're trying really hard to set boundaries and establish clear expectations of the person (for example: manipulative behaviour will not be rewarded with a positive response) - and then you have friends and/or family come in and balls everything up by insisting on coddling the person no matter what, and also immediately casting you as the mean, uncaring, villain in the piece. Now I can think of a few names for this sort of behaviour, but is there like a specific psychiatric/psychotherapeutic term for this?

 

[Fan_of_Meehl]

Say you're working in a peer group support, or group therapy situation (or whatever else) with a borderline patient, and you're trying really hard to set boundaries and establish clear expectations of the person (for example: manipulative behaviour will not be rewarded with a positive response) - and then you have friends and/or family come in and balls everything up by insisting on coddling the person no matter what, and also immediately casting you as the mean, uncaring, villain in the piece. Now I can think of a few names for this sort of behaviour, but is there like a specific psychiatric/psychotherapeutic term for this?

Triangulation? Enmeshment?

 

[Ceke2002]

Triangulation? Enmeshment?

Thanks, both those things sound like they'd match the situation.

 

[romanticscience]

Coming from an object relations background, words that come to mind in this setting is defensive splitting through idealization/devaluation. You are the bad object and the family friends the good. The patient projects badness onto you and goodness onto the family/friend, creating an enactment that’s unpairs working through this conflict therapeutically.


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[Ceke2002]

Coming from an object relations background, words that come to mind in this setting is defensive splitting through idealization/devaluation. You are the bad object and the family friends the good. The patient projects badness onto you and goodness onto the family/friend, creating an enactment that’s unpairs working through this conflict therapeutically.


Sent from my iPhone using SDN mobile

Thank you. 🙂

 

[whopper]

The earlier German psychoanalysts came up with great names for phenomenon that regularly happen in psychotherapy but since they're all in German and not regularly taught in American training we start encountering this type of thing thinking it's all new to us.

One of the most frustrating things, at least for me, in practice are family members who screw things up. If a patient becomes violent in the hospital there's a solution for that specific situation....inject them with an antipsychotic (of course after all the rules of engagement are followed), but family members who screw things up puts you in what is often-times a no-win situation if they're enabling the problem and the patient's connection to them is problematically too much.

So it then puts you in the situation of either allow it to continue or confront when you have all your data-gathering completed and you are sure this is going on. Confrontation, aside from being uncomfortable will put you in the very bad situation of telling them that their relationship with their family member is unhealthy and could make the patient and family think you're trying to split them, and if you just let it linger you're not really doing your job are you?

I've found these family situations more frustrating than violent patients.

At least so far, the best approach I've come up with (and if anyone here has something better let me know) is I just tell them matter of factly what's going on as if it's an equation.
Factor X is making you do behavior Y. You either have to change factor X or change how you respond to it.
This way I'm not pointing blame at specific person and I'm also putting responsibility on the patient him/herself as part of the enmeshment.

 

[Crayola227]

Factor X is making you do behavior Y. You either have to change factor X or change how you respond to it.

Really like this approach, for a lot of conflicts, not just in psych but a lot of other situations too. Keeps coming around practical.

Sadly, it's often easier, at least on some level, to deal problems that can be seemingly addressed with an order, than with a discussion. Le sigh.

Any time your patient treatment plan has to lean quite a bit on the family, it's so many more degrees of difficult.