Engaging the Impulsive Patient in Psychotherapy
Although the scope of analytic psychotherapy has broadened over the past twenty years to include patients with impulsive disorders, this enlarged treatment focus has occurred without a technical or theoretical framework to guide innovative techniques. The concept of impulsivity as a character trait and/or symptom is broad and includes a range of disorders. While it is important to make distinctions among the different types of clinical disorders, I shall use in this paper a more general definition of impulsivity, namely: those behaviors which occur under emotional stress and result in a negative impact upon the individual or those around him. In chronically impulsive individuals, however, certain behavioral patterns can become autonomous, distinct from the emotional pressures that were their point of origin. In such patients, impulsive behavior may continue to occupy their lives to such an extent that both the development and consequent substitution of sublimating activities is obviated.
KeywordsTherapeutic Alliance Impulsive Behavior Psychotherapeutic Intervention Impulsive Trait Delinquent Youth
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