Meeting Glauco feels like an adventure, as he wears many hats, he is passionate about his work as a head of Mental Health Unit of Hospital de Emergencias Villa El Salvador, but above all he is passionate about studying.
He has studied a master’s degree in Health Management, and is currently pursuing two more master’s degrees, one in Clinical Epidemiology and the other in Personality Disorders.
He is also trained and certified in Rational Emotive Behavior Therapy (REBT), Dialectical Behavior Therapy (DBT) and Transference Focused Therapy (TFP).
Dedicated to the study and treatment of complex patients
Glauco has dedicated almost his entire professional career to the study and treatment of complex patients. Along his path he met several years ago with “patients who had many problems, with chronic complications, various comorbidities and with whom the technical tools that I had did not work”. He began to search for evidence-based therapies in the literature and came across TFP. “That’s when I understood that there were more than just symptoms, there was a human side of the patients, I realized what it means to address and look at the entire identity of a person, their interpersonal difficulties and above all a way to understand and work with strong emotional crises of patients that I found very difficult to handle with other approaches”.
The discovery of TFP
In his search to find what would be useful to help his patients, he started finding articles by Dr. Otto Kernberg and Richard Hersh, among others. He was quickly struck by the emphasis of the therapeutic contract, highlighting that contracting not only “puts the patient first” but also provides great care and protection to the therapist as a person. This was new and very appealing for Glauco who decided to definitely dig deeper into the study of patients with personality pathology with TFP.
Glauco says that what he found most challenging about TFP has been the prejudice of some colleagues and the scientific community of his country, still focused on classical analytic techniques. “I see that as a therapy that still carries great stigma and this cannot be appealing to young therapists seeking training”. “Somehow”, Glauco says, “this stigma is passed on to patients. We cannot continue to work without diagnoses, without goals, without clarity of what is being done, wasting patients’ time and adding to their suffering. Our patients come with great fears and we must start by explaining to them what we do with clarity, we must start by making them lose their fear of this technique”.
The challenges of managing transference and countertransference
As he started his training in TFP, Glauco was met with another challenge: the management of transference and counter transference. “I realize that once I understand the dominant dyad it is difficult for me to make it explicit to the patient, I realize that I fear the patient’s reaction and this fear makes me lose control of the session”. On the other hand, Glauco tells us that since he has been practicing TFP he has also gained several benefits, today he has clearer personal limits, “it has helped me to put forward conditions and agreements to the patient for making clear how the process will be from the beginning, I know what my role and what the patient’s role is”.
The future of TFP
We asked him about what are the challenges that TFP will face in the future. He thinks the stigma around the technique is the biggest challenge for trainees and patients. He says “It cannot be seen as a hard technique, but neither should we fall into being overvalidating with patients who don’t respect limits, we must be seen as therapists with a technique in which the patient really works and strives to get ahead”.
To conclude, Glauco mentioned the importance of diffusing knowledge about TFP “I think we are growing, more and more people are interested, but we must continue and go out to the world and continue to spread knowledge”.