How Do You Interact with Patients?

A term from modern psychoanalysis is “follow the contact.” If a patient is here and talking to me and they’re not contacting me, I let them talk. I don’t want to interfere. Every time I say something it alters their thinking process, so I’m very careful about what I say and when I say it. Some patients need a lot of feedback. I give them the feedback. I don’t believe in overly frustrating the patient. Some patients want to just talk, but if they contact me I respond.

Even if they don’t contact me, after a certain amount of time I may contact them just to make sure everything is okay. The other thing you watch is the stimulation level. If somebody is getting overstimulated by what they’re talking about, I may ask what’s called an “object-oriented” question: Something outside of the ego, “Hey, what did you have for breakfast?” It takes them away from the trauma that may be overwhelming them at the moment, sort of pull them back.

One of my favorite techniques is joining and mirroring. A great example of joining is what happened with my wife and my son. This is a true story. My son, who’s now 15, he was 11, 12, and he says, “Dad, you’re such a jerk.” I go, “Absolutely, I can be a real jerk.” Now what is he going to say? He goes and tells his mother, “Mom, you’re a real jerk.” She says, “No, I’m not.” They fight for three hours. Who’s the smarter parent? The one who joined the feeling. Let him have his feeling. Why tell him he’s wrong? Of course I can be a jerk, I’m human. People feel understood when you join them, so it really is a helpful technique. When somebody comes in … and you can’t bullshit somebody, you have to believe it … but if somebody has a bad feeling and I think they are right, I’ll tell them, “That does suck.” They feel understood when you join them.

The other side of it is called mirroring. They can say, “That’s making me crazy,” and I’ll go, “That’s making me crazy, too.” That’s called mirroring, so a little lesson in Psychoanalysis 101. Just to be understood is helpful to people. ~ Rafael Sharón, NCPsyA, SCPsyA, Psychoanalyst in Princeton NJ

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