Doorknob Bombshells in Therapy

The Deadline, the Brain, and Why It Is Important to End on Time

By: Daniela V. Gitlin

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Paperback | 7 October 2024 | Edition Number 1

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240 Pages

Dimensions(cm)
1.84 x 1.14 x 0.18

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It's a near-universal experience among mental health practitioners: a patient drops a bombshell--a critical disclosure that moves the treatment forward--on their way out, with a hand on the doorknob. This "doorknob moment" creates a stressful dilemma for clinicians, especially when the patient is distraught. Should the clinician end the session on time, or run over and be late for the next patient?

Here, seasoned psychiatrist Daniela V. Gitlin provides clinicians with a clear, evidence-based answer. By conceptualizing the functional differences between patient and therapist in the treatment relationship as a metaphor for the functional differences between right and left cerebral hemispheres, Gitlin's argument yields a comprehensive explanation for why doorknob moments occur, why they are necessary to prevent treatment stagnation, and why ending on time makes patients feel safer to deliver them.

Industry Reviews

Doorknob Bombshells in Therapy is an in-depth exploration
of the complicated and powerful relationship between a
patient and a therapist. By exploring the moment that leads
to the end of a therapy session, Dr. Gitlin provides insight in
the entire meaning of the therapeutic alliance that is built.--Jeffrey Stovall, MD, professor of clinical psychiatry, department of psychiatry and behavioral sciences, Vanderbilt University Medical Center
The last minutes of a therapy session may pose such challenges
as an 'exit line' or 'curtain call'; the patient delivers
a parting shot that either forces an extension of the time or
lingers as a message until the next appointment. Dr. Gitlin's
thoughtful and scholarly book focuses on the moment when
a patient, one hand often literally on the doorknob, drops a
'bombshell, ' ranging from a startling insight to a scary crisis.--Alvin Pam, PhD, clinical psychologist
With warmth and humility, Daniela Gitlin's new book elucidates
the importance of 'doorknob bombshells'--those highly
significant, last-minute revelations familiar to clinicians of
all stripes--and the rationale for respecting them by holding
fast to the therapeutic frame. Deftly integrating neurobiology
and attachment theory, Gitlin draws on her experiences as
both a psychiatrist and a writer to show how the process of
therapy parallels the creative process, and the potential for
doorknob moments to promote trust and growth in the therapeutic
relationship.--Karen Perlman, PhD, LP, NCPsyA

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