Kristin Østlie1,2, Erik Stänicke2,3, Hanne Haavind2. 1. a Lovisenberg Hospital , Oslo , Norway. 2. b Department of Psychology , University of Oslo , Oslo , Norway. 3. c Diakonhjemmet Sykehus, BUP Vest , Oslo , Norway.
Abstract
OBJECTIVE: To explore ways that psychotherapists and suicidal patients handle suicidality as a topic, and how it impacts the bond between them. METHOD: Nineteen suicidal patients and their therapists participated in a naturalistic study. Patients were interviewed before they started in therapy, and both patients and therapists were interviewed after three sessions and after one year. RESULTS: Whether suicidality was frequently or seldomly addressed during the sessions did not bear any direct influence on the establishment of a working alliance. Rather, the sense of being engaged in a process of change followed from the therapist's capacity to establish a wide listening perspective, with sensitivity towards their own uncertainties, as well as to implicit and explicit messages about the patient's state of mind. The "private theories" of suicidality and cure that were held by the two parties tended to converge as a result of their work together. If convergence was not established early on, what mattered was their capacity to detect and work on their divergences. Unaddressed divergences led to vicissitudes and eventually resignation. CONCLUSIONS: Listening and exploring divergences in private theories of cure mattered for the creation of a viable working alliance directed at the patient's efforts to live their life.
OBJECTIVE: To explore ways that psychotherapists and suicidal patients handle suicidality as a topic, and how it impacts the bond between them. METHOD: Nineteen suicidal patients and their therapists participated in a naturalistic study. Patients were interviewed before they started in therapy, and both patients and therapists were interviewed after three sessions and after one year. RESULTS: Whether suicidality was frequently or seldomly addressed during the sessions did not bear any direct influence on the establishment of a working alliance. Rather, the sense of being engaged in a process of change followed from the therapist's capacity to establish a wide listening perspective, with sensitivity towards their own uncertainties, as well as to implicit and explicit messages about the patient's state of mind. The "private theories" of suicidality and cure that were held by the two parties tended to converge as a result of their work together. If convergence was not established early on, what mattered was their capacity to detect and work on their divergences. Unaddressed divergences led to vicissitudes and eventually resignation. CONCLUSIONS: Listening and exploring divergences in private theories of cure mattered for the creation of a viable working alliance directed at the patient's efforts to live their life.
Entities:
Keywords:
listening perspective; private theories of suicidality and cure; psychotherapy; suicidality; working alliance