Learning Psychotherapy: Rationale and Ground Rules

Hilde Bruch sets out to accomplish what has, until now, been virtually impossible - the teaching of psychotherapy by use of the written word, communicating the wisdom of a lifetime. Perhaps Dr. Bruch's unique success at a task that has been tried and tried again, only to result in stereotyped do's and don'ts, stems from her own learning experiences with two great teachers: Harry Stack Sullivan and Frieda Fromm-Reichmann.

Dr. Bruch shares her knowledge of the essential purpose of intensive psychotherapy as it has been shaped over her many years as a psychiatrist, psychoanalyst, and teacher. She sets forth a theoretical frame in straightforward and unmystical language without minimizing the complexities of demand that therapy makes on both patient and therapist.

The reader accompanies the therapist from his first encounter with the stranger who comes to him with his trouble through the various steps that lead to the resolution of the problems. The patient is viewed as a participant in a multifaceted system of many experiences and people, not as an individual isolated from the world around him. In Dr. Bruch's conception, psychotherapy is a situation where two people interact and try to come to an understanding of one another, with the specific goal of accomplishing something beneficial for the complaining person. The factors that help or hinder the attainment of this interaction are spelled out in the book, and the entire process of learning psychotherapy is thereby illumination.

Hilde Bruch was Professor of Psychiatry at Baylor College of Medicine and the author of several books including Eating Disorders.

1. When Strangers Meet

First Reactions
Assessment of a Stranger
Therapeutic Purpose
Keeping the Interview Going
Social Amenities
Living Conditions
Formal Professional Arrangements
The Fee
A Literary Example

2. Personality in the Making

Psychoanalytic Theory
Misuse of Terminology
The Interpersonal Theory of Psychiatry
Modern Studies of Early Development
Theory and Therapy

3. The World Around

Contact with Relatives and Associates
Therapeutic Involvement of the Family
Family Interference
Aloofness from the Family
Hospitalization
Medication

4. The Patient Speaks

Fears and Expectations
Previous Therapy
Style of Communication
Nonverbal Communication
Dreams
Art Work
Schizophrenic Communication

5. On Talking and Listening

The Beginner's Dilemma
Theoretical Concepts
The Therapist's Style
History Taking
Exploring Feelings
Defining the Relationship

6. On Teaching and Learning

Grand Rounds
Electronic Teaching Aids
Individual Supervision
Styles of Supervision
Interactional Patterns
Developing Self-Awareness
Unstated Messages
Supervision as Therapy

7. The Therapeutic Experience

The Case of the Former Nun
The Doctor-Patient Relationship
The Hostile Patient
Sexual Problems
Working Through
Indications of Progress
Termination

8. The Next Step

Therapy for Therapists
Some Books
Last Words