Rethinking therapeutic action

Abstract

Like other core psychoanalytic constructs, the theory of therapeutic action is currently in flux, as theorists of differing persuasions propose different mechanisms. In this article, the authors attempt to integrate developments within and without psychoanalysis to provide a working model of the multifaceted processes involved in producing change in psychoanalysis and psychoanalytic psychotherapy. A theory of therapeutic action must describe both what changes (the aims of treatment) and what strategies are likely to be useful in facilitating those changes (technique). The authors believe that single-mechanism theories of therapeutic action, no matter how complex, are unlikely to prove useful at this point because of the variety of targets of change and the variety of methods useful in effecting change in those targets (such as techniques aimed at altering different kinds of conscious and unconscious processes). Interventions that facilitate change may be classified into one of three categories: those that foster insight, those that make use of various mutative aspects of the treatment relationship and a variety of secondary strategies that can be of tremendous importance. They propose that, in all forms of psychoanalytic treatment, we would be more accurate to speak of the therapeutic actions, rather than action.

Patients' experiences of forensic psychotherapy

“…Patients are more likely to remember statements or actions of their therapist which seemed unexpected or outside of the therapeutic frame, and remember much less of the day-to-day work which nevertheless may be internalized to become part of the self. However, the identification by our patients of several different therapist techniques and experiences that they found helpful echoes the view of many contemporary psychoanalytic theorists who accept that there are multiple modes of therapeutic action (Gabbard & Westen, 2003).…”

Walking in the lost child's tracks: revisiting the therapeutic nature of reclaiming

“…It may have been the only way that the child could, without words, make something known to the therapist. In this viewwhich is additional to the giving of interpretations out of the therapist's initiative and from the patient internalising aspects of the therapist's personality (Gabbard and Westen, 2003) -something has been co-created between child and therapist.…”

My Use of Humor in Therapy: A Performance-in-Practice Self-Study

“…to the use of humor." 9 Having completed my literature review, I realized that I had not formally analyzed how I use humor in my own therapeutic work. To do so, I did a 6-month "performancein-practice" self-study in which I paid attention to my use of humor in therapy.…”