Moving Beyond the Comfort Zone in Psychotherapy

Making emotional contact and inviting patients to use therapeutic relationships for their relational and developmental aims is a risky and intimate proposition. But, as the author of this book argues, therapists must be willing to engage deeply with patients to work from within the relationship extending the therapeutic relationship to reach the private experience of self and other and offer new relational experience. Moving beyond traditional thinking, the author presents a relational approach that integrates psychoanalytic thinking with the latest findings from infant research to give therapists the theoretical framework to orient the treatment and maintain psychic equilibrium and safety during times of arousing and destabilizing affect and relational scenarios. A therapeutic stance, which is fluid and open to intrapsychic and interpersonal influence, allows for the experience and elaboration of complex unconscious affects and shifting points of identification. Compelling clinical narratives bring the reader into the consulting room and show how the therapist may forge deep emotional connection within a bounded therapeutic relationship that relies upon mutual influence and self-revelation and opens up relational space to ultimately rearrange a patient's experience of self and other.

Table of Contents:
Chapter 1 Creating a Safe Place Chapter 2 Bounded Intimacy Chapter 3 Startling Affect and Relational Formulation of Experience Chapter 4 Self-Revelation in the Therapeutic Relationship: Balancing Expressiveness and Restraint Chapter 5 Exceptional Requests in the Therapeutic Relationship Chapter 6 The Role of Supervision and consultation in Making Meaning and Keeping One's Balance Chapter 7 References

About the Author :
Nancy A. Bridges, LICSW, BCD is an instructor in psychiatry at Harvard Medical School and Cambridge Health Alliance and associate clinical professor at Smith College School for Social Work. She maintains a private psychotherapy and consultation practice.

Review :
In Moving Beyond the Comfort Zone in Psychotherapy, Nancy A. Bridges offers an accessible, engaging, and clinically focused text situated in the relational tradition. Overall, Moving Beyond the Comfort Zone in Psychotherapy's strengths-it'saccessibility, clinical detail and focus, and candor-all make it a worthwhile read, particularly for less experienced therapists. It would provide a useful stimulus for discussion and self-reflection among trainees and supervisees. The more experiencedclinician will likely appreciate Bridges' choice of clinical vignettes, which address a variety of difficult clinical situations that most experienced therapists have faced at one time or another... This very informative and readable book is a valuable addition to those teaching psychotherapy and psychoanalysis particularly for students beyond the initial phase of training. This book met the author's goal of helping the reader conceptualize some very difficult issues in psychotherapy. Ms. Bridges has chosen to address some of the traditionally uncomfortable boundary issues in psychotherapy, and she has done so in a well-written book that clearly conveys her empathetic approach as well as her willingness to take risks with and for her patients with the goal of their own progress. This book would be helpful to others who wonder or worry about how to be helpful to patients in these times when therapy reaches points when the boundaries are challenged. Moving Beyond the Comfort Zone in Psychotherapy overflows with illuminating theoretical explanations, clinical wisdom, and clear examples that are thought-provoking for advanced clinical social workers and sufficiently detailed for those who are in the early phase of their professional development. This book, based on extensive bibliographical research and many years of experience as a clinical social worker, supervisor, and educator, should find its way into the well-used libraries of clinical supervisors and classrooms of clinical social work education. Equipped with the best of traditional psychodynamic theory and new insights from infancy research and the relational perspective, Nancy Bridges takes her readers on a journey into the largely unexplored affective interior of the clinical encounter. Compelling case vignettes illuminate the shadowy recesses of such phenomena as therapeutic aggression, destabililzing sexual and aggressive arousal in both patient and clinician, the risks and rewards of therapist self-revelation, and the therapeutic management of exceptional patient requests. Joining Bridges on her courageous excursion beyond the clinical comfort zone is well worth the trip for beginners and seasoned clinicians alike. Nancy Bridges takes on the difficult topic of therapists' intense affective and erotic feelings about patients. She provides a balanced,broad -ranging rich discussion including the use of supervision and consultation. It will be an invaluable resource for therapists and their teachers . Following in the heartfelt and highly empathic tradition of clinicians like Searles, Coltart, and Russell, Nancy Bridges makes us feel deeply about the therapeutic process and stimulates our intellectual curiosity about why and how we intervene. She says we must be knocked off our perches routinely if the process goes well. And she does not hesitate to provide dozens of case studies where she backs up her theoretical stand with detailed descriptions of actual interventions with her patients. Bridges' writing style is both accessible and emotionally engaging. Moving Beyond the Comfort Zone in Psychotherapy succeeds in the challenging task of making the reader comfortable with the notion of being uncomfortable as an essential part of the process. I highly recommend this book for everyone who is invested in translating relational theory into practice. Nancy Bridges reminds us all that erotic feelings and fantasies permeate the increasingly intimate relationships that patients and therapists construct together over the course of treatment. There is no more useful lesson that contemporary therapists can learn. Wise as well as keen, this valuable book shows us the essential conditions for effective work. In Moving Beyond the Comfort Zone in Psychotherapy, Nancy A. Bridges offers an accessible, engaging, and clinically focused text situated in the relational tradition. Overall, Moving Beyond the Comfort Zone in Psychotherapy's strengths-it's accessibility, clinical detail and focus, and candor-all make it a worthwhile read, particularly for less experienced therapists. It would provide a useful stimulus for discussion and self-reflection among trainees and supervisees. The more experienced clinician will likely appreciate Bridges' choice of clinical vignettes, which address a variety of difficult clinical situations that most experienced therapists have faced at one time or another. It is clear from the text that Bridges thoughtfully and respectfully incorporates traditional psychodynamic and analytic theory into her clinical formulations and interventions.