Friday, December 19, 2008

Countertransference 101

Over at Maggie's Farm, Dr. Bliss feels badly for a Baylor psychiatric resident who has a dilemma; she is attracted to her patient. Oddly enough, she is told by her supervisor that she is the only resident the supervisor has seen with this problem:

“I think you need to take this one to Dr Gabbard. I have never seen a resident with this problem before.” “Never!?” I thought, “I’m the only one!?” I worried incessantly about what was wrong with me to feel so incapacitated, unable to feel in control of the therapy in this particular case. I kept thinking in circular fashion, “I should not have this problem. I must stop it. I can’t stop it. I should not have this problem”—and on and on.


The therapist/patient attraction is psych 101. It's generally covered in supervision on counter-transference issues the first year of doing therapy, at least it was in my experience getting a PhD in psychology. Too bad this psychiatric resident wasn't prepared in advance--it would have helped her to deal with the situation without the guilt and anguish. Perhaps that is the difference between psychiatric training in preparing for the MD and psychological training for the PhD--the human component might be emphasized more for the PhD, both for the therapist and the patient.

Labels: , ,

37 Comments:

Blogger Danny said...

I am not a psychologist/psychiatrist, so here is my question, borne of total ignorance.
Shouldn't a person entering this profession, know better than to get involved with a patient? Seems like it would be a common sense knowledge.

6:57 AM, December 19, 2008  
Blogger Helen said...

Danny,

It is common knowledge--and therapists know not to do it, typically. However, being attracted to certain patients sometimes happens and the idea is for the supervisor to assist the trainee in understanding that the feelings are normal and how to cope with it without acting on it. If the therapist does not address the feelings, they can become overwhelming or cause anxiety and guilt as the Baylor resident mentioned, and can in turn, interfere with the therapy. The main goal is to help the patient progress and it is hard to do so, if the therapist does not acknowledge their own feelings, thoughts etc. in supervision. Certainly, in some cases, if the therapist cannot overcome their feelings, they should transfer the patient to another provider.

7:11 AM, December 19, 2008  
Blogger BobH said...

It would seem that "The Impossibility of Sex" by Suzie Orbach would be relevant.

7:42 AM, December 19, 2008  
Blogger Roci said...

It is also bad if, knowing the attractions are possible, the therapist manipulates the situation to exploit the patient.

This can be for sex, or for keeping the patient in repeat business.

8:43 AM, December 19, 2008  
Blogger Undertow said...

I know this may be a bit off topic but after reading the original article why is this man in therapy? He found letters between his wife and another man? The therapist should have recommended a good divorce lawyer!

9:15 AM, December 19, 2008  
Blogger TMink said...

No previous case of an erotic counter transference? Dude was not well trained enough to ask about it.

I recall a patient I worked with for a brief time. She was an underwear model. Yep, she was smoking. She presented with a history of sexual abuse and relationship problems. She had a same age boyfriend she loved and a couple of sugar daddies that she needed. We exchanged cards after the first visit and I started doing some paperwork after she left the office.

But I could not get her off my mind. It was like I could smell her, as if she was sitting on my lap! And she had left the office 20 minutes ago. Sadly, I knew what had to be done. I had to call my supervisor and find a transfer for her. I mean, usually you can work through these feelings, but I was hallucinating her smell, so I just needed to find her someone else to work with.

My supervisor was out, so I decided to call the young lady myself and tell her that she was being transfered to see another therapist who had more experience working with her issues. But I could not find her phone number in my notes, then I remembered. She had given me her card!

I took it out of my shirt pocket and smelled the perfuse it had liberally been dosed with! I wasn't hallucinating her smell, I was smelling her business card! I wasn't nuts, she was just used to leaving men quivering with desire in her wake and knew how to do it!

I still called my supervisor, we had a good laugh. And the patient got much better.

But since I had training about erotic counter transference, I knew what to do. Or at least I thought I did. 8)

Trey

9:27 AM, December 19, 2008  
Blogger Paul said...

Sexual attraction is something that cannot be turned on and off at will. At least with men, we will always notice an attractive woman and our behavior will change in response to that attraction. In most situations this attraction can be contained through various boundaries.

For example, if you are a businessman with an attractive young secretary, it is probably not wise to travel and have dinner alone with her if you wish to maintain a professional relationship. Despite his best intentions, his natural impulses, unless checked, will lead to an affair.

The problem with therapy is that the discussion may lead into topics that are typically private and emotional. It is difficult for a man and a woman to discuss such matters and remain professional if there is an underlying sexual attraction.

A hypothetical example - the girl that cuts my hair is young and attractive. But as we discuss things such as the weather and the news topics of the day, the relationship never has a chance to become improper. However, if we were to discuss our intimate and sexual feelings, the chance of the relationship going beyond the professional would be greatly enhanced.

As much therapy (not all) is based on intense feelings, I would argue that it might be wise to limit the situations in which the therapist and the client are of the opposite sex.

11:09 AM, December 19, 2008  
Blogger Nom dePlume said...

It sounds to me as if Dr. Raymer handled the situation about as well as one could expect, especially as she is early in her career. I agree with Maggie that her supervisor was not helpful, though I saw her response more as lacking insight, than being cold.

I have read numerous books on therapy, and known many therapists, and have to say that both show a lot of blindness about human emotions. Specifically, patients' feelings for therapists are categerized as transference, and therapists' feelings for patients are categorized as counter-transference. In both cases, the assumption is that the person with the feelings is transferring to the the other person some feelings that originate in another relationship.

While I don't doubt that both transference and counter-transference happen, labeling all feelings that patients and therapists have about each other as a kind of transference is ridiculous. Patients and therapists are perfectly capable of having authentic feelings about each other, i.e. feelings that make sense, given who they are. Someone who thinks, "My therapist is a jerk," or "My patient is a really appealing person," may well be responding to the other as he or she is, not as a stand-in for another person.

I think the blindness towards authentic feelings in therapeutic relationships serves as a defense mechanism for therapists. Life is easier for them, if they can label all feelings in that relationship as transference. For therapists to acknowledge that they strongly like or dislike their patients, or vice versa, because of who they both are, is frightening. It removes the appearance of control that labels provide, and strips away the protective veneer of authority. Yet the failure to recognize the true origin of feelings brings its own danger, as patients may become alienated by what they perceive as the therapists' dishonesty or lack of insight.

It is better, surely, to understand which feelings involve transference, and which do not. I don't know if Dr. Raymer's feelings arose from counter-transference, or simply from the truth that her patient was the kind of man she finds attractive, but I have to believe that knowing the truth better enables her to make the right decisions.

12:45 PM, December 19, 2008  
Blogger Target said...

"I still called my supervisor, we had a good laugh. And the patient got much better."

--------------

Another excellent case study in the land of la-la psychologists, where pretty much everyone gets better. And even if they don't, the psychologists think very deep, insightful thoughts, much more deep and insightful than "normals", which is just good in and of itself.

The fact that reality is different, as described to me by several couples who have gone to marriage counseling (ALL got divorced) and a few who went to psychologists for other reasons, doesn't really matter.

The fact that depressive patients got better with the same average length of time by simply talking to friends vis-a-vis "psychological treatment" doesn't really matter.

The fact that objective studies of things like the Rorschach Test have shown that it doesn't have results any greater than chance doesn't matter.

Keep thinking your deep thoughts.

4:43 PM, December 19, 2008  
Blogger JG said...

Snake oil and investment help from Madhoff - that's where it's at.

I fear a placebo (if well executed and very convincing) would be more effective than some of the crap psychologists come up with.

Now excuse me, I have to go to Scream Therapy.

4:51 PM, December 19, 2008  
Blogger MB said...

Here's what I'm curious about:

I worked with a guy for years before I coincidentally found out that he had a doctorate in physics. His job was to apply quantum effects to new real world devices (an example of an older quantum device would be a tunnel diode). Extremely smart guy.

On the other hand, dopes like Dr. Phil (and as I understand it, he has some Psy.D degree that borders on a mail-order type thing, along with a suspension of his license that he ran from in Texas). But he's DOCTOR Phil.

Gee, I'm a DOCTOR too, but I personally wouldn't dream of shoving it in people's faces, especially if it's a crappy doctorate (like psychology, multidisciplinary studies or the like).

It only fools stupid people.

5:05 PM, December 19, 2008  
Blogger Roman Wolf said...

While I don't like it when people shove their doctorate in my face(it's an obvious sign of insecurity if they keep doing it), I have no problem with people with psychology doctorates. From my experience, you want someone who has a psychology background to interpret your various tests, not any bozo can do it correctly(just imagine having the worst HR person in your entire company interpret your psych tests).

As far as Transference issues, I agree in some of these relationships between the therapist and patient, there are legit sexual feelings based on appearance and such(unless all therapists get their brains replaced with computers when they graduate).

6:14 PM, December 19, 2008  
Blogger Danny said...

MB- I wouldnt write off a PhD from a good US University as casually as you seem to do. PhD degrees from Univs like Michigan, and the Ivys put their Clinical Psych grad students through some very rigorous academic and practical training. This is not the kind of degree that Dr Phil has.

More like what Helen has.

6:16 PM, December 19, 2008  
Blogger TMink said...

"As much therapy (not all) is based on intense feelings, I would argue that it might be wise to limit the situations in which the therapist and the client are of the opposite sex."

I think 90% of malpractice against psychologists happens when the shrink can't keep his hands to himself.

Trey

6:38 PM, December 19, 2008  
Blogger MB said...

"From my experience, you want someone who has a psychology background to interpret your various tests, not any bozo can do it correctly(just imagine having the worst HR person in your entire company interpret your psych tests)."

----------

I guess it depends on what psych test.

There admittedly isn't a whole lot of information on objective studies of certain tests. Psychologists don't like it. So please don't nail me with the "it's not peer reviewed" crap or the "I didn't personally like the methodology in the peer-reviewed study" crap. Just take a look:

Evocative Images: The Thematic Apperception Test and the Art of Projection, by Lon Gieser and Morris I. Stein (publishers). American Psychological Association, 1999.

Projective Measures of Personality and Psycho-Pathology: How Well Do They Work? By Scott O. Lilienfeld in: Skeptical Inquirerer, Vol. 23, No. 5, p. 32: September/October 1999.

The Scientific Status of Projective Techniques. By Scott O. Lilienfeld, James M. Wood and Howard N. Garb.

----------------------

I'm tired of typing those in, but I'll type more later.

Customary psychological tests like Rorschach ACCORDING TO EVERY OBJECTIVE STUDY are not much better than chance.

Now I agree that some experimental psychology tests, for instance giving random questions like "Do you like cooked carrots or raw carrots" and then statistically evaluating the results along the lines of various pathologies or abilities, are useful, these can be developed by ANYONE once you get the idea and they can then be graded on a computer basis.

IN FACT, psychologists will fuck it up, because they don't get the idea of letting the statistical results be what they are - they have to superimpose their theories.

In short, I'm just not impressed. Sorry.

6:38 PM, December 19, 2008  
Blogger MB said...

Combine that with this: The stupidest people on any campus are majoring in elementary education (clearly No. 1 on the retard scale), education in general, women's studies, psychology, social work and (later on) "multidisciplinary studies".

It doesn't get better at the Master's or doctorate level. Just longer time to diddle around in school without having to work.

6:42 PM, December 19, 2008  
Blogger MB said...

And if anyone's interested: I was there myself in academia. I later woke up as to what is real and what is just arrogant pretension.

I'm starting to hate arrogant pretension, and that's all a lot of psychology DOCTORS have. That's all.

6:45 PM, December 19, 2008  
Blogger MB said...

Love,

Important DOCTOR MB

LOL

6:47 PM, December 19, 2008  
Blogger JG said...

I guess I'm a doctor too (JD - at least it says "Doctor" on the diploma), so I get to also be important and boss people around who haven't written a long paper on PMS or something.

7:01 PM, December 19, 2008  
Blogger JG said...

Sometimes you get psychological trends that truly harm people.

There was a trend in the 1980s towards "recovered memories", if anyone remembers that.

Even proponents of psychology have to admit that there are some practitioners who are either truly evil or massively stupid. And yes, more than some other fields. I would probably trust a used-car salesman before I would trust a recovered memories specialist.

7:06 PM, December 19, 2008  
Blogger JG said...

Sorry, I didn't mean to cut down used-car salesmen by placing them in the same category. LOL

7:07 PM, December 19, 2008  
Blogger br549 said...

Gee guys...did someone pour fox urine in your Wheaties?

7:51 PM, December 19, 2008  
Blogger TMink said...

^5 br5.

Trey

10:28 PM, December 19, 2008  
Blogger Michael M. Butler said...

Look closely at the interchange-- “I think you need to take this one to Dr Gabbard. I have never seen a resident with this problem before.” “Never!?” I thought, “I’m the only one!?”

I understand the reaction of the resident. But with my more mature (or saturnine?) perspective, I'd say the notable operative phrase is "I have never seen..."

Oh, it was there, probably; but the person / mentor quoted never saw it. [rueful headshake]

9:20 AM, December 20, 2008  
Blogger NJArtist said...

The female psychologist should not worry one iota: as can be seen from the more recent article on the two teens in Philly, if she has heterosexual sex, she will not be blamed or punished; she may go unnamed.

9:46 AM, December 20, 2008  
Blogger Ken Gross said...

I'm not a therapist, nor have I taken a claas in psychology, but I've tried to educate myself on this fascinating subject.

I'm not a fan of the "transference" explanation here. If one person has feelings for and about another, they must take ownership of them. If this doctor chooses to act out of her feelings, it will be her responsibility and consequence.

She did the right thing by going to her supervisor, however she wasn't honest. I am going to assume that one of her responses to her feelings led her to be less than true. It seems to me that the supervisor ought to ask enough probing questions to at least delve into the situation to partially understand it. Once some understanding has occured it is then very easy to tell the young doctor that the sessions are over and a new, in this case, male therapist will be assigned.

2:38 PM, December 22, 2008  
Blogger Michael M. Butler said...

You are going to assume she was "led to be less than true" (what a curious circumlocution...)?

I don't see any evidence of untruth. I applaud your superior midreading skills. :)

8:08 PM, December 22, 2008  
Blogger 信次 said...

情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣用品,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,情趣,美國aneros,rudeboy,英國rudeboy,英國Rocksoff,德國Fun Factory,Fun Factory,英國甜筒造型按摩座,甜筒造型按摩座,英國Rock Chic ,瑞典 Lelo ,英國Emotional Bliss,英國 E.B,荷蘭 Natural Contours,荷蘭 N C,美國 OhMiBod,美國 OMB,Naughti Nano ,音樂按摩棒,ipod按摩棒,美國 The Screaming O,美國TSO,美國TOPCO,美國Doc Johnson,美國CA Exotic,美國CEN,美國Nasstoy,美國Tonguejoy,英國Je Joue,美國Pipe Dream,美國California Exotic,美國NassToys,美國Vibropod,美國Penthouse,仿真按摩棒,矽膠按摩棒,猛男倒模,真人倒模,仿真倒模,PJUR,Zestra,適趣液,穿戴套具,日本NPG,雙頭龍,FANCARNAL,日本NIPPORI,日本GEL,日本Aqua Style,美國WET,費洛蒙,費洛蒙香水,仿真名器,av女優,打炮,做愛,性愛,口交,吹喇叭,肛交,魔女訓練大師,無線跳蛋,有線跳蛋,震動棒,震動保險套,震動套,TOY-情趣用品,情趣用品網,情趣購物網,成人用品網,情趣用品討論,成人購物網,鎖精套,鎖精環,持久環,持久套,拉珠,逼真按摩棒,名器,超名器,逼真老二,電動自慰,自慰,打手槍,仿真女郎,SM道具,SM,性感內褲,仿真按摩棒,pornograph,hunter系列,h動畫,成人動畫,成人卡通,情色動畫,情色卡通,色情動畫,色情卡通,無修正,禁斷,人妻,極悪調教,姦淫,近親相姦,顏射,盜攝,偷拍,本土自拍,素人自拍,公園露出,街道露出,野外露出,誘姦,迷姦,輪姦,凌辱,痴漢,痴女,素人娘,中出,巨乳,調教,潮吹,av,a片,成人影片,成人影音,線上影片,成人光碟,成人無碼,成人dvd,情色影音,情色影片,情色dvd,情色光碟,航空版,薄碼,色情dvd,色情影音,色情光碟,線上A片,免費A片,A片下載,成人電影,色情電影,TOKYO HOT,SKY ANGEL,一本道,SOD,S1,ALICE JAPAN,皇冠系列,老虎系列,東京熱,亞熱,武士系列,新潮館,情趣用品,情趣,情趣商品,情趣網站,跳蛋,按摩棒,充氣娃娃,自慰套,G點,性感內衣,情趣內衣,角色扮演,生日禮物,生日精品,自慰,打手槍,潮吹,高潮,後庭,情色論譠,影片下載,遊戲下載,手機鈴聲,音樂下載,開獎號碼,統一發票號碼,夜市,統一發票對獎,保險套,做愛,減肥,美容,瘦身,當舖,軟體下載,汽車,機車,手機,來電答鈴,週年慶,美食,徵信社,網頁設計,網站設計,室內設計,靈異照片,同志,聊天室,運動彩券,大樂透,威力彩,搬家公司,除蟲,偷拍,自拍,無名破解,av女優,小說,民宿,大樂透開獎號碼,大樂透中獎號碼,威力彩開獎號碼,討論區,痴漢,懷孕,美女交友,交友,日本av,日本,機票,香水,股市,股市行情, 股市分析,租房子,成人影片,免費影片,醫學美容,免費算命,算命,姓名配對,姓名學,姓名學免費,遊戲,好玩遊戲,好玩遊戲區,線上遊戲,新遊戲,漫畫,線上漫畫,動畫,成人圖片,桌布,桌布下載,電視節目表,線上電視,線上a片,線上掃毒,線上翻譯,購物車,身分證製造機,身分證產生器,手機,二手車,中古車,法拍屋,歌詞,音樂,音樂網,火車,房屋,情趣用品,情趣,情趣商品,情趣網站,跳蛋,按摩棒,充氣娃娃,自慰套, G點,性感內衣,情趣內衣,角色扮演,生日禮物,精品,禮品,自慰,打手槍,潮吹,高潮,後庭,情色論譠,影片下載,遊戲下載,手機鈴聲,音樂下載,開獎號碼,統一發票,夜市,保險套,做愛,減肥,美容,瘦身,當舖,軟體下載,汽車,機車,手機,來電答鈴,週年慶,美食,徵信社,網頁設計,網站設計,室內設計,靈異照片,同志,聊天室,運動彩券,,大樂透,威力彩,搬家公司,除蟲,偷拍,自拍,無名破解, av女優,小說,民宿,大樂透開獎號碼,大樂透中獎號碼,威力彩開獎號碼,討論區,痴漢,懷孕,美女交友,交友,日本av ,日本,機票,香水,股市,股市行情,股市分析,租房子,成人影片,免費影片,醫學美容,免費算命,算命,姓名配對,姓名學,姓名學免費,遊戲,好玩遊戲,好玩遊戲區,線上遊戲,新遊戲,漫畫,線上漫畫,動畫,成人圖片,桌布,桌布下載,電視節目表,線上電視,線上a片,線上a片,線上翻譯,購物車,身分證製造機,身分證產生器,手機,二手車,中古車,法拍屋,歌詞,音樂,音樂網,借錢,房屋,街頭籃球,找工作,旅行社,六合彩,水噹噹,台中隆鼻,果凍隆乳,改運整型,自體脂肪移植,新娘造型,婚禮顧問,下川島,常平,常平,珠海,澳門機票,香港機票,貸款,貸款,信用貸款,宜蘭民宿,花蓮民宿,未婚聯誼,網路購物,婚友,婚友社,未婚聯誼,交友,婚友,婚友社,單身聯誼,未婚聯誼,未婚聯誼, 婚友社,婚友,婚友社,單身聯誼,婚友,未婚聯誼,婚友社,未婚聯誼,單身聯誼,單身聯誼,白蟻,白蟻,除蟲,老鼠,減肥,減肥,在家工作,在家工作,水噹噹,台中隆鼻,果凍隆乳,改運整型,自體脂肪移植,新娘造型,婚禮顧問,下川島,常平,常平,珠海,澳門機票,香港機票,貸款,貸款,信用貸款,宜蘭民宿,花蓮民宿,未婚聯誼,網路購物,婚友,婚友社,未婚聯誼,交友,婚友,婚友社,單身聯誼,未婚聯誼,未婚聯誼, 婚友社,婚友,婚友社,單身聯誼,婚友,未婚聯誼,婚友社,未婚聯誼,單身聯誼,單身聯誼,白蟻,白蟻,除蟲,老鼠,減肥,減肥,在家工作,在家工作,婚友,單身聯誼,未婚聯誼,婚友,交友,交友,婚友社,婚友社,婚友社,大陸新娘,大陸新娘,越南新娘,越南新娘,外籍新娘,外籍新娘,台中坐月子中心,搬家公司,搬家公司,中和搬家,台北搬家,板橋搬家,新店搬家,線上客服,網頁設計,線上客服,網頁設計,植牙,關鍵字,關鍵字,seo,seo,網路排名,自然排序,網路排名軟體,交友,越南新娘,婚友社,外籍新娘,大陸新娘,越南新娘,交友,外籍新娘,視訊聊天,大陸新娘,婚友社,婚友,越南新娘,大陸新娘,越南新娘,視訊交友,外籍新娘,網路排名,網路排名軟體,網站排名優化大師,關鍵字排名大師,網站排名seo大師,關鍵字行銷專家,關鍵字,seo,關鍵字行銷,網頁排序,網頁排名,關鍵字大師,seo大,自然排名,網站排序,網路行銷創業,汽車借款,汽車借錢,汽車貸款,汽車貸款,拉皮,抽脂,近視雷射,隆乳,隆鼻,變性,雙眼皮,眼袋,牙齒,下巴,植牙,人工植牙,植髮,雷射美容,膠原蛋白,皮膚科,醫學美容,玻尿酸,肉毒桿菌,微晶瓷,電波拉皮,脈衝光,關鍵字,關鍵字,seo,seo,網路排名,自然排序,網路排名軟體,英語演講,托福,Toastmaster,汽車借款,汽車借款,汽車借款,汽車貸款,汽車貸款,借錢,借貸,當舖,借款,借貸,借錢,週轉,

9:05 PM, February 12, 2009  
Blogger look said...

情趣用品,
性感睡衣,
免費視訊聊天,
視訊交友網,
美姬圖影,
情境坊歡愉用品,
花美姬情趣用品,
成人圖片,
臺灣情色網,
嘟嘟情人色網,
色情網站,
情境坊歡愉用品,
徵信,
徵信公司,
徵信,
外遇,
徵信,
徵信,
抓姦,
徵信,
外遇,
徵信,
徵信社,
徵信社,
抓姦,
徵信社,
徵信社,
徵信社,
,
,
整型,
視訊聊天,
視訊交友,
AV女優,
色情,
A片,
A片,
情趣用品,
情色,
A片,
色情影片,
情趣用品,
A片,
AV女優,
視訊聊天室,
聊天,
情趣用品,
情惑用品性易購,
情侶歡愉用品,
A片,
情趣,
情惑用品性易購,
辣妹視訊,
自慰套,
情侶歡愉用品,
寄情築園小遊戲,
aio交友愛情館,
美女視訊,
色情A片,
情趣用品,
徵信社,
情趣用品,
A片,
美女視訊,
色情A片,
AV女優,
A片,
辣妹視訊,
自慰套,
情侶歡愉用品,

10:32 PM, March 14, 2009  
Blogger fshfghsf said...

看房子,買房子,建商自售,自售,台北新成屋,台北豪宅,新成屋,豪宅,美髮儀器,美髮,儀器,髮型,EMBA,MBA,學位,EMBA,專業認證,認證課程,博士學位,DBA,PHD,在職進修,碩士學位,推廣教育,DBA,進修課程,碩士學位,網路廣告,關鍵字廣告,關鍵字,課程介紹,學分班,文憑,牛樟芝,段木,牛樟菇,日式料理, 台北居酒屋,日本料理,結婚,婚宴場地,推車飲茶,港式點心,尾牙春酒,台北住宿,國內訂房,台北HOTEL,台北婚宴,飯店優惠,台北結婚,場地,住宿,訂房,HOTEL,飯店,造型系列,學位,牛樟芝,腦磷脂,磷脂絲胺酸,SEO,婚宴,捷運,學區,美髮,儀器,髮型,牛樟芝,腦磷脂,磷脂絲胺酸,看房子,買房子,建商自售,自售,房子,捷運,學區,台北新成屋,台北豪宅,新成屋,豪宅,學位,碩士學位,進修,在職進修, 課程,教育,學位,證照,mba,文憑,學分班,網路廣告,關鍵字廣告,關鍵字,SEO,关键词,网络广告,关键词广告,SEO,关键词,网络广告,关键词广告,SEO,台北住宿,國內訂房,台北HOTEL,台北婚宴,飯店優惠,住宿,訂房,HOTEL,飯店,婚宴,台北住宿,國內訂房,台北HOTEL,台北婚宴,飯店優惠,住宿,訂房,HOTEL,飯店,婚宴,台北住宿,國內訂房,台北HOTEL,台北婚宴,飯店優惠,住宿,訂房,HOTEL,飯店,婚宴,結婚,婚宴場地,推車飲茶,港式點心,尾牙春酒,台北結婚,場地,結婚,場地,推車飲茶,港式點心,尾牙春酒,台北結婚,婚宴場地,結婚,婚宴場地,推車飲茶,港式點心,尾牙春酒,台北結婚,場地,居酒屋,燒烤,美髮,儀器,髮型,美髮,儀器,髮型,美髮,儀器,髮型,美髮,儀器,髮型,小套房,小套房,進修,在職進修,留學,證照,MBA,EMBA,留學,MBA,EMBA,留學,進修,在職進修,牛樟芝,段木,牛樟菇,關鍵字排名,網路行銷,关键词排名,网络营销,網路行銷,關鍵字排名,关键词排名,网络营销,PMP,在職專班,研究所在職專班,碩士在職專班,PMP,證照,在職專班,研究所在職專班,碩士在職專班,SEO,廣告,關鍵字,關鍵字排名,網路行銷,網頁設計,網站設計,網站排名,搜尋引擎,網路廣告,SEO,廣告,關鍵字,關鍵字排名,網路行銷,網頁設計,網站設計,網站排名,搜尋引擎,網路廣告,SEO,廣告,關鍵字,關鍵字排名,網路行銷,網頁設計,網站設計,網站排名,搜尋引擎,網路廣告,SEO,廣告,關鍵字,關鍵字排名,網路行銷,網頁設計,網站設計,網站排名,搜尋引擎,網路廣告,EMBA,MBA,PMP
,在職進修,專案管理,出國留學,EMBA,MBA,PMP
,在職進修,專案管理,出國留學,EMBA,MBA,PMP
,在職進修,專案管理,出國留學,婚宴,婚宴,婚宴,婚宴

住宿,民宿,飯宿,旅遊,住宿,民宿,飯宿,旅遊,住宿,民宿,飯宿,旅遊,住宿,民宿,飯宿,旅遊,住宿,民宿,飯宿,旅遊,住宿,民宿,飯宿,旅遊,住宿,民宿,飯宿,旅遊,美容,美髮,整形,造型,美容,美髮,整形,造型,美容,美髮,整形,造型,美容,美髮,整形,造型,美容,美髮,整形,造型,美容,美髮,整形,造型,美容,美髮,整形,造型,設計,室內設計,裝潢,房地產,設計,室內設計,裝潢,房地產,設計,室內設計,裝潢,房地產,設計,室內設計,裝潢,房地產,設計,室內設計,裝潢,房地產,設計,室內設計,裝潢,房地產,設計,室內設計,裝潢,房地產,設計,室內設計,裝潢,房地產,進修,在職進修,MBA,EMBA,進修,在職進修,MBA,EMBA,進修,在職進修,MBA,EMBA,進修,在職進修,MBA,EMBA,進修,在職進修,MBA,EMBA,進修,在職進修,MBA,EMBA,進修,在職進修,MBA,EMBA,住宿,民宿,飯店,旅遊,美容,美髮,整形,造型,設計,室內設計,裝潢,房地產,進修,在職進修,MBA,EMBA,羅志祥,周杰倫,五月天,蔡依林,林志玲,羅志祥,周杰倫,五月天,蔡依林,林志玲,羅志祥,周杰倫,五月天,蔡依林,羅志祥,周杰倫,五月天,蔡依林

11:57 PM, April 05, 2009  
Blogger 天天看正妹 said...

免費視訊聊天 ut聊天室辣妹視訊UT影音視訊聊天室 吉澤明步QQ美女視訊秀 85cc免費影片aa影片下載城sex免費成人影片aaa片免費看短片美女視訊 sex383線上娛樂場av969 免費短片日本免費視訊aa影片下載城視訊網愛聊天室影音視訊交友 咆哮小老鼠分享論壇sex520免費影片aa免費影片下載城aio辣妺視訊 aio辣妹交友愛情館 jp成人影片aio交友愛情館馬子免費影片免費線上a片18成人85cc影城0204movie免費色咪咪視訊網pc交友s383視訊玩美女人34c高雄視訊聊天jp成人免費視訊辣妹 kk777視訊俱樂部xxxpandalive173影音視訊聊天室 sex520-卡通影片成人免費視訊 完美女人13060 免費視訊聊天sexy girl video movie辣妹妹影音視訊聊天室UT視訊美女交友視訊情色網百事無碼a片dvd線上aa片免費看18禁成人網ut聊天室kk俱樂部視訊激情網愛聊天 情人小魔女自拍卡通aa片免費看夜未眠成人影城aio性愛dvd辣妹影片直播拓網視訊交友視訊聊天室ggoo168論壇視訊辣妹love104影音live秀 美女show-live視訊情色yam交友辣妹妹影音視訊聊天室s383情色大網咖視訊aaa俱樂部台灣情色網無碼avdvdsexy diamond sex888入口Show-live視訊聊天室

4:43 PM, April 16, 2009  
Blogger 天天看正妹 said...

免費 a 片aaaaa片俱樂部影片aaaaa片俱樂部dodo豆豆聊天室sex520網路自拍美女聊天室天堂免費線上avdvd援交av080影片aa影片下載城aaa片免費看短片成人圖片區18成人avooogo2av免費影片sexdiy影城免費線上成人影片bonbonsex0951影片下載日本av女優sex888免費看影片免費視訊78論壇辣妹有約辣妹no31314視訊dudu sex免費影片avdvd情色影片免費色咪咪影片網av080免費試看日本美女寫真集辣妹脫衣麻將視訊聊天室性福免費影片分享日本美女寫真集,kk視訊aio交友愛情館免費成人美女視訊bt論壇色情自拍免費a片卡通tw 18 net卡通18美少女圖色情漫畫777美女小護士免費 aa 片試看百分百成人情色圖片a片免費觀賞sexy girls get fuckedsexy girl video movie情色文學成人小說sex888免費看eyny 伊莉論壇sexdiy影城自拍情色0204movie免費影片aio免費aa片試看s383情色大網咖sexy girl video movie草莓牛奶AV論壇台灣論壇18禁遊戲區環球辣妹聊天室 90691拓網aio交友愛情館拓網學生族視訊777美女 sex888影片分享區hi5 tv免費影片aa的滿18歲卡通影片sex383線上娛樂場sexdiy影城免費a片線上觀看真人美女辣妹鋼管脫衣秀比基尼辣妹一夜情視訊aio交友愛情館

4:43 PM, April 16, 2009  
Blogger 天天看正妹 said...

A片-無碼援交東京熱一本道a片免費視訊聊天室微風成人免費視訊聊天 ut聊天室av1688影音視訊天堂免費 a 片85cc免費影城亞洲禁果影城微風成人av論壇sex520免費影片JP成人網免費成人視訊aaa影片下載城免費a片 ut交友成人視訊85cc成人影城免費A片aa的滿18歲影片小魔女免費影片小魔女免費影城免費看 aa的滿18歲影片sex383線上娛樂場kk777視訊俱樂部aa的滿18歲影片85cc免費影片a片免費看A片-sex520plus論壇sex520免費影片視訊做愛聊天室avdvd-情色網qq美美色網ut13077視訊聊天sex383線上娛樂場sex888sex520免費影片sex999免費影片情色視訊sex85cc免費影片aaa片免費看短片aa影片下載城aaaaa片俱樂部影片aaaaa片俱樂部小魔女免費影片台灣論壇免費影片免費卡通影片線上觀看線上免費a片觀看85cc免費影片免費 a 片免費A片aa影片下載城ut聊天室辣妹視訊UT影音視訊聊天室 日本免費視訊aaaa 片俱樂部aa的滿18歲影片aaa片免費看短片aa免費看aaaa片免費看影片aaa片免費看短片5278論壇情色偷拍免費A片sex520免費影片後宮0204movie免費影片av俱樂部aaaa彩虹頻道免費影片 杜蕾斯成人免費卡通影片線上觀看85cc免費影片線上觀賞免費a片卡通aaa的滿18歲卡通影片sex520免費影片

4:43 PM, April 16, 2009  
Blogger 徵信 said...

外遇外遇外遇外遇外遇外遇外遇外遇外遇 外遇
外遇 外遇外遇 外遇 外遇
外遇 外遇 外遇
外遇


外遇 外遇
外遇
外遇 外遇外遇
外遇

外遇 外遇外遇 外遇 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 ,
外遇 外遇 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇外遇 外遇外遇 外遇 外遇

外遇 外遇

外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇 , 外遇劈腿劈腿劈腿劈腿劈腿劈腿劈腿劈腿喜帖囍帖卡片外遇外遇 外遇 外遇外遇 外遇
外遇 外遇 外遇 外遇剖析 外遇調查 外遇案例 外遇諮詢 偷情 第三者外遇話題 外遇發洩 感情挽回 徵信社 外遇心態 外遇 通姦 通姦罪 外遇徵信社徵信社外遇 外遇 抓姦徵信協會徵信公司 包二奶 徵信社 徵信 徵信社 徵信社 徵信社 徵信社 徵信 徵信 婚姻 婚前徵信 前科 個人資料 外遇 第三者 徵信社 偵探社 抓姦 偵探社 偵探社婚 偵探社 偵探社偵探家事服務家事服務家電維修家事服務家事服務家事服務家事服務家事服務持久持久持久持久持久持久持久離婚網頁設計徵信社徵信社徵信徵信社外遇離婚協議書劈腿持久持久持久持久持久劈腿剖析徵信徵信社外遇外遇外遇外遇徵信社徵信社徵信社徵信社徵信社徵信社徵信徵信社徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信徵信社徵信社徵信社徵信社徵信社徵信社徵信社徵信社徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信公會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信公會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信公會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 徵信協會 劈腿 劈腿 劈腿 劈腿 劈腿 劈腿 劈腿 劈腿 劈腿 劈腿 劈腿 劈腿 劈腿 劈腿

3:16 AM, April 22, 2009  
Blogger 9988 said...

080中部人聊天室ut080聊天室080苗栗人聊天室080視訊聊天室18成人網080聊天網007色情貼圖網080 聊天室18成人avooo080視訊辣妹聊天室18禁地少女遊戲6k聊天室aaaaa片俱樂部a383成人影城a383girl影音城383洪爺影城69成人聊天室383成人影城999成人情色論壇383成人論壇777成人論壇4u成人論壇85cc免費影城383成人影城-免費a片aaaaa片俱樂部影片85cc免費影片38ga成人aa免費看aa的滿18歲影片av女優報報aa影片下載城aio交友愛情館aaa片免費看短片av成人網AV女優王國aa免費看aaaa片免費看影片BT成人論壇av1688影音娛樂網癡漢論壇男人色色網熊貓成人圖片痴漢俱樂部男人幫論壇男人百分百貼圖區甜心寶貝直播維克斯討論區線上免費a片米克成人情色論壇絕色成人影城線上卡通a片線上a片下載線上 a片線上色咪咪影片網愛俱樂部金瓶影片交流區聊天室尋夢園美女交友聊天室遊戲天堂美女交友 網站dodo成人聊天室自拍盜攝館色情小說色色網 視訊交友色色網-免費視訊色情視訊聊天室色情豆豆聊天室蜜雪兒免費小說視訊聊天室視訊美女34c萍水相逢遊戲區視訊美女視訊聊天交友視訊美女館視訊美女ggoo麗的線上小遊戲辣妹視訊豆豆交友聊天室視訊交友高雄網視訊交友網視訊情人高雄網辣妹聊天室hi5 tv免費成人影片kiss文學區hilive tv免費電影tw18台灣18成人網sogo論壇showlive影音聊天網sex383線上娛樂場plus論壇p2pQQ美美色網sex520免費影片watchshow情色視訊聊天室免費av18禁影片免費ava片線上看免費av18禁做愛視訊免費a片免費視訊-童顏巨乳免費視訊妹妹聊天室免費視訊聊天室免費視訊聊天免費視訊辣妹八國聯軍成人論壇凱渥名模寫真集免費交友聊天室南部人聊天室台北69情色貼圖區台灣kiss色情貼圖台灣成人網嘟嘟情人色網嘟嘟成人聊天室夜未眠成人影城咆嘯小老鼠 成人影片論壇嗆辣妹影音視訊聊天小莉影像館小魔女拍自天堂小老鼠分享論壇小魔女自拍天堂寄情築園小遊戲尋夢園成人視訊聊天室微風 成人論壇微風成人 影片區後宮電影院入口影音視訊交友網巨乳辣妹寫真視訊情色文章情色小站情色圖貼情色典獄長情色交友網情人視訊聊天室成人免費視訊聊天成人聊天室成人話題聊天室成人影城成人情色小說成人影片區搜樂論壇新豆豆聊天室成人交友歐美模特兒寫真曼雪兒免費小說櫻桃不夜城情色論壇本土自拍寫真浪漫月光論壇洪爺免費影城洪爺色情電影一葉晴成人論壇一夜情聊天室上班族1對1視訊亞洲成人圖片區伊利論壇伊莉成人討論區交友聊天室激情成人網愛聊天室亞洲情色視訊交友sexdiy影城aaaaa片俱樂部影片正妹交友ggoo正妹視訊gogokk777視訊俱樂部

9:46 AM, May 05, 2009  
Blogger 1798 said...

視訊做愛視訊美女無碼A片情色影劇kyo成人動漫tt1069同志交友網ut同志交友網微風成人論壇6k聊天室日本 avdvd 介紹免費觀賞UT視訊美女交友..........................

6:38 AM, May 20, 2009  
Blogger 1122 said...

5278影片網5278影片網視訊聊天室v6 04u成人4u成人358成人影城358成人影城3388影片區3388影片區25xxx成人影城25xxx成人影城24h免費成人頻道24h免費成人頻道視訊交友173視訊聊天173視訊聊天173liveshow視訊美女173liveshow視訊美女視訊聊天室v6 0080視訊聊天室

4:33 AM, June 08, 2009  

Post a Comment

<< Home