EXPLANATORY TECHNIQUES

          Common explanatory techniques used within the physician-patient relationship

can be divided into three levels [Novalis et al, p 58] : 1] communication, 2]
confrontation, and 3] reflections that go beyond the patient’s awareness.

First level: communication:

          Managing the transference
          Talking to the patient
          Listening to the patient
          Generating and conveying empathy
          Helping the patient test reality
          Reassuring [its cognitive aspects]
          Observing
          Expressing interests and concern
          Echoing
          Tracking
          Commenting
          Restating
          Eliciting current life reports [here-and-now emphasis]
          Encouraging ventilation and expression of emotions [balance with control of
the emotions, a directive technique]

Second level: confrontation:

          Directing attention to inconsistencies in behavior
          Directing attention to conflicting goals and motivations

Third level: reflections that go beyond the patient’s awareness:

          Clarification [of information available to the patient but of which he or she is
not apparently aware]
          Explanation [of mental mechanism responsible for patient’s behavior or
thinking, e.g., benign projections or introjections]
          Interpretations:
                   Defenses
                   Limited and on the surface
                   Inexact, incomplete and upwards
                   Avoided, delayed softened, and controlled
                   Displaced, universalized, generalized, normalized, and metaphorical
                   Association of past and present activities
                   Psychodynamic life narrative
                   Of transference [limited in the early stages]
          The following techniques, while invaluable in the treatment of some psychiatric
disorders, are usually avoided in the psychiatric management of Regulation
Disordered patients:  anonymous therapist, abstinence/neutral attitude, professional
detachment, blank screen, uninvolved/inactive attitude, deep or genetic interpretations
of transference, dream analysis, encouragement of fantasy, and encouragement of
regression.