Making a Difference in Patients' Lives : Emotional Experience in the Therapeutic Setting book cover
1st Edition

Making a Difference in Patients' Lives
Emotional Experience in the Therapeutic Setting

ISBN 9780881634945
Published April 24, 2008 by Routledge
336 Pages

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Book Description

Winner of the 2009 Gradiva Award for Outstanding Psychoanalytic Publication!

Within the title of her book, Making a Difference in Patients' Lives, Sandra Buechler echoes the hope of all clinicians.  But, she counters, experience soon convinces most of us that insight, on its own, is often not powerful enough to have a significant impact on how a life is actually lived. Many clinicians and therapists have turned toward emotional experience, within and outside the treatment setting, as a resource. How can the immense power of lived emotional experience be harnessed in the service of helping patients live richer, more satisfying lives?

Most patients come into treatment because they are too anxious, or depressed, or don’t seem to feel alive enough. Something is wrong with what they feel, or don’t feel. Given that the emotions operate as a system, with the intensity of each affecting the level of all the others, it makes sense that it would be an emotional experience that would have enough power to change what we feel. But, ironically, the wider culture, and even psychoanalysts, seem to favor "solutions" that aim to mute emotionality, rather than relying on one emotion to modify another. We turn to pharmaceutical, cognitive, or behavioral change to make a difference in how life feels. Because we are afraid of emotional intensity, we cut off our most powerful source of regulation.

In clear, jargon-free prose that utilizes both clinical vignettes and excerpts from poetry, art, and literature, Buechler explores how the power to feel can become the power to change. Through an active empathic engagement with the patient and an awareness of the healing potential inherent in each of our fundamental emotions, the clinician can make a substantial difference in the patient’s capacity to embrace life.

Table of Contents

Introduction: Meaningfully Impacting Patients' Lives. Basic Assumptions About Human Emotions. Empathic Recovery of Emotional Balance. Empathic Responses to Shame. Facing Painful Regret. Joy as a Universal Antidote. Grief. Empowering and Disorienting Anger. Special Section - Training: Nurturing the Capacity to Make a Difference. Thinking Analytically. Emotional Preparation for Practicing Psychoanalysis. Developing the Personal Strengths of a Psychoanalyst in Sum: Making a Difference.

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Sandra Buechler, Ph.D., is a Training and Supervising Analyst at the William Alanson White Institute in New York City.  She also supervises at Columbia Presbyterian Medical Center and at the Institute for Contemporary Psychotherapy.  A member of the editorial board of Contemporary Psychoanalysis, she is the author of Clinical Values: Emotions that Guide Psychoanalytic Treatment (Analytic Press, 2004), and has written papers on the analyst's experiences of loneliness, loss, joy, and other aspects of the clinician's feelings.


"Sandra Buechler breaks the mold with Making A Difference in Patients' Lives. Aimed at teaching and inspiring those who do clinical work, Dr. Buechler has produced an instructive clinical book that is both practical and poetic. Strongly advocating for deep emotional experience as essential for change, she does not hesitate to discuss her own feelings and what it means to her to be a therapist. She succeeds at a task that is rarely attempted - defining therapy as both deeply personal and profoundly professional." - Karen J. Maroda, Ph.D., ABPP, Medical College of Wisconsin

"Dr. Buechler has again succeeded in integrating key principles of emotion theory and her psychodynamic approach to therapy. In this book the discussion of emotion-cognition interactions is quite sophisticated, as when she acknowledges the frequent occurrence of emotions in meaningful patterns. Her treatment of the potentially adaptive role of emotions in behavior change should prove quite helpful to practicing therapists." - Carroll E. Izard, Ph.D., Trustees Distinguished Professor, University of Delaware

"In this remarkably influential volume, Sandra Buechler, a polished writer and seasoned clinician, not only shares her evolving ideas about how to become a better psychoanalyst, but also, in so doing, provides a synthesis of emotion theory with what self psychologists have long understood about the powerful use of the empathic mode in promoting therapeutic change… a unique and important contribution to the psychoanalytic self psychology literature…. Buechler’s ideas are relevant to all psychotherapists utilizing a psychoanalytic framework for understanding the treatment process, not only to psychoanalysts training candidates in formal psychoanalytic institutes. Tightly organized and highly informative." - Linda A. Chernus, Psychoanalytic Social Work

"Sandra Buechler, a wise psychoanalytic psychotherapist in New York City...brings her human experience as woman and mother, as a participant in the human condition, to bear on her work as therapist. It is a splendid book by an experienced clinician and teacher, an eloquent self-portrait of an active and committed therapist, brimming with clinical examples and helpful advice to both beginners and veterans in the field. It is a clarion call for emphasizing the role of emotions in life and in therapy rather than of intellectualized insight and theory... Buechler's book is a passionate segue and reaffirmation of the basic Freudian method....Buechler's pre-eminent focus on feelings and emotions and the life histories of her patients ...enabled her to build many bridges of emotional sharing between patient and therapist as they journey together, temporarily or interminably, in search of love, justice, and truth, making a difference where they can." - Zvi Lothane, M.D., The American Journal of Psychoanalysis

"An overview, exploration and celebration of her life's work, Sandra Buechler's book is a passionate exegisis about what she believes to be the core and curative potential of the therapeutic relationship...Communicating a very intimate and vivid sense of her work as an analyst, Buechler describes emotion theory and how it shapes her interpersonal perspective, and proposes that a full understanding and deployment of therapeutic impact is best served from within this framework...Her voice is a lively, honest, and compelling one, and at times quite moving, as she weaves together an exposition of her theoretical principles and techniques with clinical scenarios, moments from poetry and literature, and meditations about mortality... Buechler brings a creative, fertile, and imaginative way of thinking to a discussion of psychoanalytic process, one that can usefully stir one's thinking, one's own associations, and one's emotional life no matter what theoretical orientation one brings, or tries not to bring, to the consulting room."  - Daria Colombo, International Journal of Psychoanalysis 

"A book notable for the author's refreshing style, by turns conversational, poetic, and down-to-earth." - Dwarakanath G. Rao, Journal of the American Psychoanalytic Association