Dissertation/Thesis Abstract

From Self-doubt to Uncertainty in the Analytic Act: A Narrative Study of Therapist Maturation
by Roeske, Danielle, Psy.D., California Institute of Integral Studies, 2014, 197; 3594745
Abstract (Summary)

This qualitative study explored and analyzed the narrative experiences of senior psychotherapists and their capacity to tolerate and make meaning of uncertainty in their clinical work. While research on therapist development tends to agree that the maturation of the clinician is an ongoing process (Bruss & Kopala, 1993; Eckler-Hart, 1987; Gold, 2005; Guinee 1998; Kaslow & Rice, 1985; Lamb, Baker, Jennings & Yarris, 1982; Solway, 1985; Suran & Sheridan, 1985), little research has been conducted that documents this process from the perspective of the senior analyst. In addition, despite widespread acknowledgment of uncertainty as an ever-present phenomenon among clinicians, there have been few studies that address how a relationship to uncertainty unfolds. In other words, how does one move from a primary position of insecure self-doubt into an openness and tolerance for analytic uncertainty? This study employed a theoretical framework to help organize the inquiry and data analysis. Using Ogden's (1986) interpretation of Klein's (1946/1994) paranoid-schizoid/depressive model, the experiential constructs of analytic uncertainty and insecure self-doubt were explored in the form of an ongoing dialectic. Semistructured interviews were conducted among eight San Francisco Bay Area psychoanalytically oriented psychologists and data were analyzed through open coding. The results yielded a total of 11 core themes and 9 subthemes, distributed among 3 principle sections: Integration of Uncertainty, Early Encounters With Uncertainty and Self-Doubt, and Abstract Analysis: An Ongoing Dialectic. Key findings from the present study include (a) uncertainty is core to analytic work and is what allows for creative discovery; (b) despite its value, uncertainty is difficult to bear; (c) early encounters with clinical uncertainty often lead to feelings of self-doubt; (d) self-doubt, when experienced as a personal failing, has a tendency toward shutting therapists down; (e) therapists' experiences of self-doubt and uncertainty remain in an ongoing dialectic; and (f) faith is the impetus behind tolerance for uncertainty and it enables productive use of self-doubt.

Indexing (document details)
Advisor: Wilkinson, Tanya
Commitee: Buscemi, Raymond
School: California Institute of Integral Studies
Department: Clinical Psychology
School Location: United States -- California
Source: DAI-B 75/01(E), Dissertation Abstracts International
Subjects: Clinical psychology
Keywords: Faith, Self-doubt, Therapist development, Uncertainty
Publication Number: 3594745
ISBN: 978-1-303-39467-6
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