"Take a sad song and make it better": What makes an interpretation growth facilitating for the patient?

Interpretations are considered to be an important active ingredient in psychodynamic treatment. Research shows mixed results regarding the empirical utility of interpretations, and continuing efforts are needed to investigate what makes interpretations helpful and effective. Our aim was to examine what allows an interpretation to facilitate growth, promoting the flourishing of the patient. We developed a coding system for evaluating the growth-facilitating elements of interpretation (GFI). The GFI is based on 3 scales: the optimal context for implementing the interpretation, the extent to which the interpretation includes positive regard and collaboration, and instills hope, and the immediate results of the interpretation. The GFI was used in a case study of a patient receiving supportive-expressive psychotherapy for depression. Analyses examined between-sessions and within-session processes. The integration of findings from the between-sessions and within-session analyses suggests that growth-facilitating techniques, manifest in growing positive regard, collaboration, and instilling hope, resulted in better outcomes, as reflected in the patient's new associations, mood, and self-esteem, as well as in alliance, attachment to the therapist, and reduction of depressive symptoms. The present study demonstrates the benefits of integrating the psychodynamic perspective with that of positive psychology, for building interpretations that facilitate hope, growth, and flourishing. The GFI shows promise both for psychotherapy research and clinical practice and helps bridge the gap between the two. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

An integrative relational point of view.

This article, part of a special section on the Relational Foundations of Psychotherapy, describes a particular relational approach called cyclical psychodynamics. Cyclical psychodynamics is rooted both in the relational perspective in psychoanalysis and in an integrative melding of psychodynamic, cognitive-behavioral, systemic, and experiential points of view. Central to its theoretical structure is a focus on the vicious and virtuous circles that perpetuate (or contribute to changing) personality patterns that may have originated in childhood but that persist because they often generate the very feedback from others that is necessary to keep them going. As a consequence of this latter focus, the relational foundation of cyclical psychodynamic therapy addresses in equal and dynamically reciprocal fashion both the therapeutic relationship in the consulting room and the key relationships outside the consulting room that play an essential role in the maintenance or change of the problematic patterns the person has come to therapy to work on.

One-person and two-person conceptions of attachment and their implications for psychoanalytic thought.

There has been increasing interest among analysts in the possibilities of enriching psychoanalytic thought through fuller incorporation of attachment theory and research. This paper offers a clinical illustration of the ways in which attention to an attachment perspective can lead to novel and useful ways of addressing the patient's issues. It also presents a number of cautions that it is necessary to be alert to if attachment thinking is to achieve its full potential in advancing psychoanalytic thought and practice. Conceptions of attachment and approaches to its study and clinical use actually vary quite substantially. Some are more one-person, static, and categorical. Others are more two-person, dynamic, and focused on the process whereby attachment patterns develop and are maintained over time. This paper explores the distinction between these two versions of attachment theory and research with two aims in mind - first, to refine our understanding of the potential role that attachment thinking can play in advancing the psychoanalytic paradigm; second, to utilize the insights achieved through examining the attachment paradigm to consider some broader issues in the construction of psychoanalytic theory more generally and its relational variant in particular.

Evaluating negative process: a comparison of working alliance, interpersonal behavior, and narrative coherency among three psychotherapy outcome conditions.

The aim of this study was to investigate the interrelationships of three measures of the therapeutic relationship and their validity in predicting treatment outcome, including the early identification of two treatment-failure conditions. Forty-eight patient-therapist dyads, in 30-session therapies for personality-disordered patients, were classified as premature dropout (DO), poor outcome (PO), or good outcome (GO) cases. Poor and Good Outcomes were determined by a reliable change score. Dropout cases were terminated during the first third of treatment, and patients cited dissatisfaction with the therapy or therapist. Assessment of working alliance, interpersonal behavior and a new measure of narrative coherency in the first third of treatment revealed that DO dyads had significantly poorer alliances and less coherent narratives in early sessions, while PO dyads, who ultimately completed the 30-session treatment protocol, unexpectedly demonstrated the highest degree of hostile complementarity. Clinical implications of the results are discussed.

Carl Rogers and the larger context of therapeutic thought.

Carl Rogers' classic account (see record 2007-14639-002) of the necessary and sufficient conditions for therapeutic personality change is examined in light of developments in theory and practice since the time he wrote. Rogers' ideas, which diverged from and were very largely a challenge to, the dominant psychoanalytic ideology of the era in which he wrote, are considered in relation to new theoretical developments in what has come to be called relational psychoanalysis. They are also considered in light of the greatly increased influence of and substantial evidence supporting behavioral and cognitive-behavioral approaches. Points of convergence and divergence among these approaches are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Full pockets, empty lives: a psychoanalytic exploration of the contemporary culture of greed.

This paper offers a psychoanalytic exploration of the dynamics of greed in individual lives and ways that those dynamics both reflect and influence the surrounding culture. The paper discusses the contradictions associated with the consumerist pursuit of wealth and goods, and finds evidence for the failure of such pursuit to provide the satisfaction that is anticipated. It also examines the implications for psychoanalytic theorizing on the ways in which ongoing social forces and institutions contribute to shaping the psyche.