Kleiven Gøril Solberg, Hjeltnes Aslak, Råbu Marit, Moltu Christian
District General Hospital of Førde, Førde, Norway.
Department of Clinical Psychology, University of Bergen, Bergen, Norway.
Front Psychol. 2020 Dec 15;11:591146. doi: 10.3389/fpsyg.2020.591146. eCollection 2020.
To explore how clients in clinical settings experience the process of opening up and sharing their inner experiences in the initial phase of therapy.
Two psychotherapy sessions of clients ( = 11) were videotaped and followed by interviews. Interpersonal process recall was used to obtain in-depth descriptions of clients' immediate experiences in session. A follow-up interview was conducted 3 months later. The interviews were analyzed using thematic analysis.
The data revealed how and why clients distanced themselves from inner experiences in the initial phase of therapy. The overarching theme was "Holding back and struggling to open up," which included four subthemes: (a) fearing the intensity and consequences of negative emotions; (b) experiences of being incapable and bodily stuck; (c) being insecure about one's worthiness and right to share inner experiences with the therapist; and (d) struggling with feeling disloyal to loved ones.
The participants held back because they feared different consequences of opening up. A range of concerns led participants to distance themselves from their inner experiences and/or to refrain from openly talking about them to the therapist. Concerns related to appropriate interpersonal conduct as client were especially important. This knowledge is highly relevant to clinicians when building safety for psychotherapeutic work.
探讨临床环境中的来访者在治疗初始阶段如何体验敞开心扉并分享内心体验的过程。
对11位来访者的两次心理治疗过程进行录像，并在治疗后进行访谈。采用人际过程回忆法深入描述来访者在治疗过程中的即时体验。3个月后进行随访访谈。运用主题分析法对访谈内容进行分析。
数据揭示了来访者在治疗初始阶段如何以及为何与内心体验保持距离。总体主题为“克制与挣扎着敞开心扉”，包括四个子主题：（a）害怕负面情绪的强度和后果；（b）感到无能为力和身体僵滞的体验；（c）对自身与治疗师分享内心体验的价值和权利缺乏安全感；（d）纠结于对亲人不忠的感觉。
参与者有所克制是因为他们害怕敞开心扉带来的不同后果。一系列担忧导致参与者与内心体验保持距离，和/或避免向治疗师公开谈论这些体验。与作为来访者的恰当人际行为相关的担忧尤为重要。这一知识对于临床医生在为心理治疗工作营造安全感时具有高度相关性。
