Images of the Psychotherapist: A Theoretical and Methodological Perspective

Abstract

This paper presents a theoretical and methodological approach to studying the ways in which psychotherapy patients create and interpret mental representations of their therapists and the psychotherapeutic process both during therapy and after termination. A network of measures, The Therapist Representation Inventory, was developed to specify the interrelationships between the stylistic, functional and formal properties of such symbolic evocations across different states of consciousness and in different situations. It includes a method of examining the ability to formulate a concept of the psychotherapist and guidelines for interpreting both the thematic content and conceptual level of that object representation. The second scale measures the ability to specify the formal properties of therapist representations, as distinct from their particular contents. The third instrument seeks to identify the functions which therapist “introjects” serve for a given individual. Normative data, based upon a sample of 206 psychotherapists who themselves have been patients in psychotherapy and/or psychoanalysis indicate that the vividness of the representation and the use of the representation for the purpose of continuing the therapeutic dialogue are significantly correlated with self-perceived improvement.

Psychotherapists' representations of their patients

“…This factor reflects the extent to which therapists are able to visualize patients' facial expressions and gestures. This factor structure essentially replicates that obtained in previous studies of both patients' and supervisees' representations of their therapists and supervisors, respectively (Geller et al, 1982;Geller & Schaffer, 1992).…”

“…Previous research has indicated that patients (e.g., Geller et al, 1982; and therapists-in-training (e.g., Geller & Schaffer, 1992) bring into awareness the felt presence of their therapists and their supervisors primarily through imagistic (visual and auditory) and lexical means. It is not surprising, therefore, that therapists tend to rely more heavily on visual and lexical modes of representation, rather than on an experiential-intuitive mode, when thinking about their patients between sessions.…”

“…This measure is a modified version of both the Therapist Representation Inventory-II (TRI-II; Geller, Behrends, Hartley, Farber, & Rohde, 1992) and the Supervisory Representation Inventory (Geller & Schaffer, 1992), instruments used by Geller and his colleagues to investigate the ways that patients and supervisees construct, retrieve, and use representations of their therapists and supervisors, respectively (e.g., Farber & Geller, 1994;Geller, Cooley, & Hartley, 1982;Orlinsky, Geller, Tarragona, & Farber, 1993;Rosenzweig, Farber, & Geller, 1996). As an analogue to these instruments, the PRI is designed to assess the form, phenomenological properties (e.g., frequency, vividness, duration), affects, and themes associated with therapists' mental representations of their patients.…”

“…The remaining items on this scale were chosen to assess the extent to which a preoccupation with boundary issues (e.g., Johnson & Farber, 1996) characterizes therapists' mental representations of their patients in their physical absence (e.g., "I wish I could be friends with my patients," "I imagine our talking to each other outside the therapy office"). These items are modifications of those found in the Therapist Involvement Scale (Geller et al, 1982), a measure of patients' representations of their therapists. Again, each item on the PTS is rated on a 9-point Likert-type scale wherein 1 ϭ not at all characteristic and 9 ϭ highly characteristic.…”

Clients' internal representations of their therapists.

“…Such negative emotional experiences reflected clients' dependency fears, anxiety, and sadness. Geller et al (1981) described clients who were unable to internalize the therapist as a benignly influential other, as well as clients who mourned the loss of the therapist, either between sessions or after termination. The inability to internalize the therapist as a benign other may be reflected in those clients who expressed fears of being dependent, as well as in those who experienced anxiety.…”