The importance of therapeutic alliance is described. Therapeutic alliance, transference, and transference acting-out are defined and distinguished from each other and the therapeutic task of helping the patient to convert transference acting-out to therapeutic alliance and transference is outlined. The differences in the form and content of the intrapsychic structure are described to show why different therapeutic techniques are necessary to establish the therapeutic alliance: Confrontation with the borderline and mirroring interpretation of narcissistic vulnerability with the Narcissistic Personality Disorder. A brief case illustrates each.
The emphasis in Dynamic Psychotherapy over the past few decades has shifted from a focus on insight and the recovery of early memories to a recognition that the quality of the patient-therapist relationship is the quintessential factor upon which the success of therapy depends. This involves both the real relationship and transference-countertransference elements, all within a systems-theory orientation.
My own physical disabilities as well as my performance anxiety during my childhood and adolescence impelled me to read many ancient and modern philosophers who had worked on the philosophy of human happiness and unhappiness. Thinking about their views and adapting them to my own life, I made myself distinctly less disturbed as well as less disturbable.
The development of cognitive-behavior therapy parallels major developments in how to conceptualize the role of cognition in psychopathology and behavior change. Dr. Meichenbaum will trace his "personal journey" as a clinician and researcher, noting the altering views of cognition from a behavioral, information processing and constructive narrative perspective. He will examine the therapeutic and research implications of this shift.
The split in the modern personality is between the head and the body, between the rational mind and irrational gut feelings. It reflects the split in this culture between science and the natural forces in life and nature which science attempts to control. The modern individual lives largely in his head and is out of touch with his body because he had deadened it to suppress the fear, the pain and the despair which he experienced in childhood.
In the ancient world, the philosopher was a physician of the soul who, employing the healing word (iatroi /ogoi), offered counsel to persons perplexed by problems in living. After the triumph of Christianity, the priest as confessor-counselor replaced the philosopher as rhetorician of consolation. With the birth of psychiatry, and especially since the Freudian revolution, we call helping persons with words "psychotherapy." I shall try to show that without a decisive separation of rhetorical healing from medical healing, psychotherapy as the secular cure of souls is doomed to extinction.
Madanes will present guidelines for the positive use of shame in couples and families. Stories from therapy will be told to reveal complicated problems in which shame, sex, power and love are interconnected. Looking at extreme cases of violence will throw light on when it is appropriate to experience shame and how to recover from the pain that shame represents.
In the 1990's all factors of therapy are changing. The way of financing therapy is changing, there are new types of clientele, there are striking differences in ideology and the training of therapists is becoming a new kind of enterprise.
Methods for training therapists customarily are directed to developing cognitive abilities. Using Milton Erickson as a model, an alternate, experiential approach is offered. The "evoking style" of the therapist determines the outcome of the treatment more than the theoretical and clinical methods to which the therapist ascribes.
The evolution of psychotherapeutic methods over the past 200 years from Mesmer through the psychoanalytic schools, behaviorism and current cognitive psychology tells a fascinating tale of our evolving understanding of human nature. In this address we will trace the development of fundamental techniques such as suggestion, free association, active imagination, gestalt dialogue, focusing, Erickson's indirect approaches and what I now call "The Basic Accessing Question."