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Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3706
Experience:  35 years treating individuals, couples, families with mental health and substance abuse prob's
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To help solve a personal problem could you tell me please.

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To help solve a personal problem could you tell me please. When a psychiatrist asks a patient a question and says, tell me the first thing that comes into your mind. Could you tell me what that answer reveals to you? Is it a truth that is lying under the surface and difficult to bring into the open or is there something else that is being revealed? The answer to this would help a personal problem Many thanks for any help you can give me. Fen W.

Bill :

Hello- Thank you for asking the question. I have over 30 years of experience working with individuals, couples and families & am happy to reply.

Bill :

I am happy to help with this-


When a Psychiatrists or Therapist asks this question they are using the psychoanalytic technique called "free association"

Bill :

What comes to mind first is usually the truth and often a person "double thinks" their initial thought for a number of defensive reasons.




What does 'double thinks' mean please.

Bill :

Double think mean if I ask you the first thing that come to mind and you reject it you and respond with some other answer- you are double thinking- meaning not saying what was the first thing that came to mind.


Example of this would be if I ask you to tell me the first thing that comes to mind when thinking about your husband and your thought to yourself was "He's a pain in the ........." and you instead say - "He's okay"

That is double thinking- not saying what you really thought but something more tolerable for you.


Bill :

Is that clear?


Bill :

A simple technique of psychodynamic therapy is free association in which a patient talks of whatever comes into their mind. This technique involves a therapist reading a list of words (e.g. mother, childhood etc.) and the patient immediately responds with the first word that comes to mind. It is hoped that fragments of repressed memories will emerge in the course of free association.

Free association may not prove useful if the client shows resistance, and is reluctant to say what he or she is thinking. On the other hand, the presence of resistance (e.g. an excessively long pause) often provides a strong clue that the client is getting close to some important repressed idea in his or her thinking, and that further probing by the therapist is called for.

Freud reported that his free associating patients occasionally experienced such an emotionally intense and vivid memory that they almost relived the experience. This is like a "flashback" from a war or a rape experience. Such a stressful memory, so real it feels like it is happening again, is called an abreaction. If such a disturbing memory occurred in therapy or with a supportive friend and one felt better--relieved or cleansed--later, it would be called a catharsis.

Frequently, these intensely emotional experiences provided Freud a valuable insight into the patient's problems.



Thank you, XXXXX XXXXX being very helpful, so could I ask you one more please?


Bill :

Sure- Happy to help



My husband is trying to get to grips with some deep connections which he still has to his mother which hav e been stronger than his feelings to his wife. When I suggested a scenario involving his mother and me he immediately responded with 'that would be a painful decision' Do you think that reflects what is really going on at a deeper level? Thank

you again for any help Fen


Sorry, I should have dded. He then said, I shouldn't have said that I don't know what I mean


Bill :

Fen- This is the essence of what is related above about "resistance" and is a productive sign in the process of good psychotherapy. Without resistance or self doubt there can be no progress. Your husbands resistance suggests that there is much underlying pain in relationship to his mother- which I am sure the Therapist would notice.


Without question this material related to his mother is "grist for the mill" in therapy and in a slow productive process of good therapy, this information will come out. It sounds as though he is a bit overwhelmed at this point -respect this and in time- more will come.



Bill :

Does this make sense?



Yes it does and thank you very much for so much detailed information, you have ben very helpful Bye Fen


Bill and other Mental Health Specialists are ready to help you
Customer: replied 4 years ago.

Your help has helped me to understand more about the attitude I can possible learn to accept with this problem. It's an invaluable lesson for me too.Thanks so much

Always happy to help.

You can always contact me directly at the following link:

Kindest regards, Bill

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