Abstract
Splitting as a psychological defence by patients who struggle to process dichotomies remains an important focus in current therapy trials. Such case research done in a cross-cultural context of therapist and patient is limited. The present qualitative case report involves a 44-year-old male who had two conflicting fears, inherently making those fears inaccessible since resolving one fear exacerbated the other opposing fear. We provide a narrative discussion of the case learning from the therapist-in-training and her supervisor. Building a solid relational focus grounded in a social constructionist approach played a vital role in the therapeutic and supervisory process. In this process, attention to therapy as a performed conversation, humility, patience, dialogue, persuasion and self-awareness were crucial concepts. This case report marks how a developmental space for both patient and therapist was co-created and how resolving of splitting tendencies could commence.
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References
Anderson, H., & Gehart, D. (2012). Collaborative Therapy: Relationships And Conversations That Make a Difference. Routledge.
Brons, L. (2015). Othering, an analysis. Transcience, a Journal of Global Studies, 6(1), 69–90.
Doom, J., VanZomeren-Dohm, A., & Simpson, J. (2016). Early unpredictability predicts increased adolescent externalizing behaviors and substance use: A life history perspective. Development and Psychopathology. https://doi.org/10.1017/S0954579416000948
Drinane, J. M., & Worthington, E. L. (2017). Microaggressions and cultural humility in psychotherapy. In J. E. L. Worthington, & &. J. D. E. Davis, Handbook of humility: Theory, research, and applications (pp. 316–328). Routledge/Taylor & Francis Group.
Egan, G. (2014). The skilled helper: A client centered approach. Cengage Learning.
Fleuridas, C., & Krafcik, D. (2019). Beyond four forces: The evolution of psychotherapy. SAGE Open. https://doi.org/10.1177/2158244018824492
Gergen, K. J. (1994). Exploring the postmodern - perils or potentials. American Psychologist, 49(5), 412–416. https://doi.org/10.1037//0003-066X.49.5.412
Gibson, J. (2015). A relational approach to suffering: A reappraisal of suffering in the helping relationship. Journal of Humanistic Psychology. https://doi.org/10.1177/0022167815613203
Green, H. (2018). Team splitting and the ’borderline personality: a relational frame. Psychoanalytic Psychotherapy. https://doi.org/10.1080/02668734.2018.1487465
Hanks, H., & Stratton, P. (2007). On learning from the patience. Child Clinical Psychology and Psychiatry, 12, 341–348.
Harris, S., & Didericks, K. (2014). Understanding humility and its role in relational therapy. Contemporary Family Therapy, 36, 380–391.
Holzman, L., & Mendez, R. (2003). Psychological Investigations: A Clinician's Guide to Social Therapy. New York Hove: Brunner-Routledge.
Holzman, L., & Newman, F. (2012). Activity and performance (and their discourses) in social therapeutic method. In A. Lock, & T. Strong, Discursive Perspectives in Therapeutic Practice. United Kingdom: OUP Oxford.
Klein, M. (2015). The Psychoanalysis of Children - Scholar’s (Choice). . Bibliolife DBA of Bibilio Bazaar II LLC.
Lingiardi, V., Muzi, L., Tanzilli, A., & Carone, N. (2018). Do therapists’ subjective variables impact on psychodynamic psychotherapy outcomes? A systematic literature review. Clinical Psychology & Psychotherapy, 25, 85–101. https://doi.org/10.1002/cpp.2131
Mieda, T., & Oshio, A. (2020). Dichotomous thinking and personality traits: From the viewpoints of the big five and HEXACO. Japanese Psychological Research. https://doi.org/10.1111/jpr.12299
Morales, K. C. (2019). Cultural humility, therapeutic relationship, and outcome: Between-therapist, within-therapist, and within-client effects. Digital Repository at the University of Maryland. https://doi.org/10.13016/jvpi-m2qn
Newman, F., & Holzman, L. (2003). All power to the developing! Annual Review of Critical Psychology. Retrieved from https://www.researchgate.net/profile/Lois_Holzman/publication/237567710_All_power_to_the_developing/links/5596b87a08ae5d8f3932801d/All-power-to-the-developing.pdf.
Richardson, E., & Boag, S. (2016). Offensive defences: The mind beneath the mask of the dark triad traits. Personality and Individual Differences, 92, 148–152.
Rowden, T., Harris, S., & Wickel, K. (2014). Understanding humility and its role in relational therapy. Contemporary Family Therapy, 36(3), 380–391.
Slife, B., & Wiggins, B. (2009). Taking relationship seriously in psychotherapy: Radical relationality. Journal of Contemporary Psychotherapy: on the Cutting Edge of Modern Developments in Psychotherapy, 39(1), 17–24. https://doi.org/10.1007/s10879-008-9100-6
Staszak, J. Other/Otherness. In: Kitchin & Thrift (Ed.). International Encyclopedia of Human Geography: A 12-Volume Set. Oxford : Elsevier Science, 2009.
Suor, J., Sturge-Apple, M., Davies, P., & Cicchetti, D. (2017). A life history approach to delineating how harsh environments and hawk temperament traits differentially shape children’s problem-solving skills. Journal of Child Psychology and Psychiatry, 58(8), 902–909.
Tonner, P. (2017). Wittgenstein on forms of life: A short introduction. Electronic Journal for Philosophy, 24(1), 13–18.
Wachtel, P. (2008). Relational theory and practice of psychotherapy. Guilford Press.
Weiss, H. (2015). Three papers on splitting: A brief introduction. International Journal of Psychoanalysis. https://doi.org/10.1111/1745-8315.12328
Wittgenstein, L. (1953). Philosophical interventions (1st ed.). (G. Anscombe, Trans.) United Kingdom: Oxford, Blackwell.
Worthen, V. (2018). Patience is a development virtue and common. 39(1), Article 9. Retrieved March 2021, from https://scholarsarchive.byu.edu/irp/vol39/iss1/9.
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All authors contributed to the study conception, design and data analysis. Kyli Benadie performed material preparation and data collection. She wrote the first draft of the manuscript, and both authors commented on previous versions of the manuscript. Both authors read and approved the final manuscript.
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Ethical clearance from the Sefako Makgatho Health Sciences University Research Ethics Committee was received. The researchers also obtained approval from the hospital's CEO, to report on the case.
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This retrospective case study involving a human participant was under the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Benadie-Chowles, K., Pistorius, A.G. Progress in Resolving Splitting Tendencies: A Qualitative Case Report of Facing Conflicting Fears with Relationality, Humility, and Patience. J Contemp Psychother 51, 341–348 (2021). https://doi.org/10.1007/s10879-021-09508-5
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DOI: https://doi.org/10.1007/s10879-021-09508-5