Clinical Papers

Papers by Allen M. Siegel, MD

 

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Therapeutic Reactivation of Mourning

“A bright 15 year old boy named Sam finishes his breakfast, takes his dish to the sink, and kisses his much loved mother goodbye as he leaves for school in the morning. His timid father sits quietly on a rickety chair in the corner, dressed in overalls, ready for work in the trainyards. A boarder, taken in to help the family meet expenses, sleeps upstairs.

The boy returns home from school later that day and sees a crowd milling about outside his house. Blue lights flash atop police cars. Red lights of an ambulance join the pulsating collection. The boy’s heart drops. He knows something is wrong as he runs to see what. His father walks across the lawn to greet him. ‘Something’s happened to your mother,’ he says. They go inside and father tells him his mother is dead. Murdered, strangled with her own stockings.”

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A Psychotherapeutic Treatment Informed by the Perspective of Heinz Kohut’s Psychology of the Self

Winston came for consultation because he recognized a troubling pattern in himself with regard to relationships with women. He noticed that after he became intensely involved, he inevitably found a flaw that ended the relationship. It always appeared to be something trivial, like how they held a fork, chewed their food, or perhaps they were too angelic. After noticing the fatal flaw Winston withdrew and shortly thereafter ended the relationship.

In answer to the question of, ‘why was he coming now?’ Winston responded that he had been through this experience three times recently and had injured three lovely people. Something was wrong. He did not want to be hurtful any longer and he felt that if we met a few times I could help him see what the problem was and then he could correct it.

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Clinical and Theoretical Aspects of the Fee

“The fee is that point in the treatment setting where the external world and its representations in the internal worlds of both patient and the analyst intersect, and sometimes even collide. How do we set our fee? How do we feel about it? Is it too high? Is it high enough? Is it too low? When do we raise it? How do we feel about it in comparison to another therapist’s fee?

Money is neutral to neither patient nor therapist. The therapist’s fee expresses one’s sense of competence and confidence; one’s feeling of fullness or deprivation; one’s greed or largess; one’s envy or contentment. Present as an issue in every treatment, the capacity of the therapist to explore the meanings of the fee as freely as he or she explores any other issue is a function of what the fee means to the therapist.

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eSupervision

“The thing that has been,
it is that which shall be;
And that which is done
is that which shall be done:
And there is nothing new under the sun.
Is there any thing whereof it may be said,
‘See, this is new?’

Kohelet (Eccleseastes) 1:9-10

“Long valued for their ironic truth, Kohelet’s words have lost their hold on the 21stcentury. eBay, email, eToys, eEveryThing – the sun no longer sets without a cyberspace headline. We learn of cyber-viruses that threaten our world, of cyber-entrepreneurs who morph into millionaires, and of mega-mergers between cyber-companies. Virtual University, Drugstore.com, surely something new is upon the land, only now the land is the entire planet. Expanded by cyberspace, borders have been swapped for Borders.com. Whether in a jungle or atop an ocean, we are no longer removed from office, school, or home.”

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