How patients deal with death-related triggers
I n ongoing psychotherapy, a patient's death anxiety is often signalled by the appearance of death-related themes, coupled with a variety of defensive responses. These compromised communications simultaneously reveal and conceal the unconscious death issues activated by a particular triggering event. And when the trigger involves a death-related trauma in the life of the therapist of which the patient is aware, the defences unconsciously mobilized by the patient may be all but intractable. The following vignette is illustrative:
Ms Banks was in once-weekly empowered psychotherapy with Dr Tyler, a woman psychiatrist. The patient, who was in her late thirties, suffered from episodes of severe anxiety and a chronic sense of insecurity.
Dr Tyler's teenage daughter had fallen ill with a serious form of bone cancer. On the Sunday before the session we will consider, the pastor of Dr Tyler's church had referred to the illness and had beseeched the congregation to pray for the young woman. Dr Tyler was at the hospital with her daughter, who