Each of the links below goes to a brief description, or vignette, of a psychotherapy case published by me on the website Psychotherapy.Net. My approach to psychotherapy in these cases (psychodynamic and existential/humanistic) can be described as constructivist rather than empiricist and generally relies on unstructured dialogue to enter into the complexities of meaning in order to achieve useful insights and effective change. The vignettes are as follows:
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The longest in the series, this first vignette describes a clinical situation that often confuses inexperienced therapists: a client who can’t identify exactly what her problem is. For therapists trained in structured approaches this can be especially confounding. But unstructured psychotherapy may suggest a useful path.
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Beth: Replaying a crucial moment
How exploring the details of a difficult event in a client’s life can produce new insights and bring both therapist and client to a greater understanding.
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Sam: Interpretation in play therapy
Play therapy allows a child to engage freely in fantasy, and gives the therapist a highly unstructured medium for talking to a child about what is on his or her mind. At times, this can allow the therapist to effectively use one of the oldest techniques in psychotherapy: interpretation.
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What do you do with an adolescent patient who hates silence, but hates questions even more?
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Sometimes a patient is drawn to a theme or object that has intense symbolic value. This vignette describes such a case where the symbol suggested both what the patient needed and how it could be understood.
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A question raised by this client haunted me for years.
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Psyche and Sense 