Reflections on the Therapeutic Journey: Uncovering the Layers

Abstract

Personality disorders are present in approximately 9–14% of the general population. These behaviors are pervasive and emit distress and agony in a wide variety of life’s areas, thus taking a call for a well-formulated therapeutic paradigm. Life carrying shades of interpersonal conflicts, impulsivity, heightened emotionality with underlying maladaptive perceptions often acts as a medium of distress for not only themselves but significant others as well. This in turn influences the therapeutic sessions with them. The present paper describes in detail the therapists’ journey with patients with personality disorders, as to how their unrealistic demands, expectations, cognitive errors often color the therapeutic relationship. The paper further moves to describe the barriers especially to mention the personality characteristics, viz stubbornness, unwillingness to change, unrealistic expectation of instant improvement, and difficulty to openness. It acts as a hindrance further shifting the therapeutic goals, thus putting an abrupt end to the therapeutic journey. Issues of counter-transference including difficulty in handling manipulative behavior, therapists’ own emotional burnout, and inability to handle the covert threats have also been mentioned. Thus, taking a cue from the barriers, urgent need is required to formulate practical evidence-based therapeutic interventions for such patients keeping in view the cultural settings.