Displaying agency problems at the outset of psychotherapy

Abstract

In order to present him-or herself at the outset of psychotherapy as a credible client, the person needs to, on one hand, formulate a sense of lost agency in accounts of his/her life situation, and on the other, to present him-or herself as willing and able to take part in conversational selfexploration. In this study we looked in detail at how one person, seeking psychotherapy, constructed accounts that served this double function. We sought to develop the usefulness of the concept of agency as an integrative theoretical construct of core processes in therapy and introduced a model of five aspects of agentic vs. non-agentic presentation, developed and applied in an earlier study on clients in semi-mandatory counselling. The results show how those aspects -relationality, causal attribution, intentionality, historicity, and reflexivity -were present in, or lacking from, accounts given by this one client entering voluntary psychotherapy. We conclude that qualitative process research could benefit from considering loss of agency as one crucial object of psychotherapy and the ongoing discursive formulations and re-formulations of the client's more or less agentic positions as central to the process of therapy.

Changes in the sense of agency: Implications for the psychotherapy of bulimia nervosa‐ A case study

“…There is as a focus in both approaches on maladaptive thought processes and behaviors, as well as on psychoeducation. The main difference is that the current model focuses on painful emotional experiences and themes that arise in different phases of a patient's Mackrill () and Wahlström and Seilonen () s sense of agency. These experiences are often barriers to behavioral change.…”