PSYCHVINE

Category: impulsivity

During session 3, Dr. Smelt helped Fred understand the connection between his thoughts and feelings. Fred agreed to complete several written exercises called thought sheets during the week. Today he brings into the session his first efforts. The following session segment shows how Fred deals with his assignment. “Good morning Fred,” Dr. Smelt begins, “I think we’re moving to the point where outlining a goal or two each session makes sense. What would you like to accomplish today?” Fred says…

Fred begins this session by asking Dr. Smelt, “How’s it going, Doc? Did you have a good week?” “Just fine, Fred. But I’d like to know how your week went.” “Nothing much happened. Work has been a real bitch though.” “I remember you work for the city in I.T. What kinds of problems have you been having?” Dr. Smelt queries. “I’m overloaded with crap. Too many meetings, too many bosses. Morale sucks. What else do you want to know?” “I…

“Before we go any further,” Dr. Smelt says, “I want to tell you a bit about confidentiality.” “No need,” Fred interrupts, “I know that bull shit. You tell me you’re like a priest, but if the judge wants to know something, you’ll tell him. That’s the real world. All this stuff about confidentiality is a way for you to get me to spill my guts. But, I’m not telling you anything that could get me into more trouble with the…

Only rarely would Dr. Smelt take a referral from the courts. She tended to avoid clients with questionable motivation for therapy which she often found to be the case with such referrals. However, today she makes an exception because the judge made a special plea for her to see this particular patient. The background information that Dr. Smelt received from the court included some of the following: Client name: Fred J. Age: 44 Background information: Fred was arrested for the…

Dr. Smelt begins this session by collaborating with Kimberly on an agenda. Kimberly decides she mostly wants to focus on something her boyfriend, Ray, did a few days ago that really got her upset. They also agree to review her progress to date. Dr. Smelt queries, “So, what happened that got you so upset, Kimberly?” “There was this friend of Ray’s whose dog had puppies. Incredibly, without even asking my permission, Ray goes and brings one of them home. I…

In the blog, Session 3.5, Dr. Smelt and Kimberly discovered that much of Kimberly’s anger with her boyfriend seemed to originate in grief and anger concerning her previous ex as well as her son. Sometimes people find that anger is easier to feel than sadness. But acknowledging what’s truly going on, helps pave the way toward more realistic, non-angry thoughts. They continue: “Hey, Dr. Smelt,” as Kimberly begins session four, “I wanted to tell you that last week’s session really…

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