Beyond Psychotherapy: Dialectical Therapy

Journal of Psychotherapy Integration - Tập 9 - Trang 365-396 - 1999
Tullio Carere-Comes1
1Bergamo, Italy

Tóm tắt

Dialectical therapy is a common factors approach to psychotherapy integration, in which four general therapeutic strategies are taken as the cardinal points of a map of the field. It is said to be “beyond psychotherapy” because what is commonly referred to as psychotherapy is more than psychological treatment. It is a dialectic between two basic levels or axes: the psychological remaking, which deals with defect-driven disorders, and the philosophical uncovering, which deals with conflict-driven problems. The first level can be graphically represented as the horizontal axis of the field, connecting a “maternal” and a “paternal” pole, in which the therapist responds to the basic psychological needs of secure attachment and responsible cooperation. The second level can be represented as the vertical axis of the field, connecting a K (knowledge) vertex and an O (unknown) vertex, in which the therapist responds to the basic philosophical needs of knowledge (“know thyself)” and of unknown as unknowable (the noumenon of all phaenomena, the source of generative and healing powers). A map is necessary to organize the basic therapeutic needs and the range of responses to them in a coherent pattern. As a good map can help in orienting empirical research, this in turn can help in constructing better maps.

Tài liệu tham khảo

Basseches, M. (1997a). A developmental perspective on psychotherapy process, psychotherapists' expertise, and “meaning-making conflict” within therapeutic relationships: A two-part series. Journal of Adult Development, 4, 17–33. — (1997b). A developmental perspective on psychotherapy process, psychotherapists' expertise, and “meaning-making conflict” within therapeutic relationships: Part II. Journal of Adult Development, 4, 85–106. Bernardi, E. R. (1989). The role of paradigmatic determinants in psychoanalytic understanding. International Journal of Psychoanalysis, 70(2), 341–357. Bion, W. R. (1962). Learning from experience. London: Heinemann. — (1970). Attention and interpretation. London: Tavistock. Bowlby, J. (1988). A secure base. London: Routledge. Carere-Comes, T. (1974). Principi di terapia psichiatrica. Milano: Edizioni Libreria Cortina. — (1998). Il campo della psicoterapia. Un modello a quattro vertici. Psychomedia Telematic Review, http://www.psychomedia.it/pm/modther/modtec/carere1.htm — (in press). Assimilative and accommodative integration: The basic dialectics. Journal of Psychotherapy Integration. Eigen, M. (1985). Toward Bion's starting point: Between catastrophe and faith. International Journal of Psychoanalysis, 66, 321–330. Fornaro, M. (1993). Kohut: il metodo e le illusioni dell'empatia. Psicoterapia e scienze umane, 3, 87, 109. Freud, S. (1912a). The dynamic of transference. Standard Edition, 12, 97–108. Freud, S. (1912b). Recommendations to physicians practicing psychoanalysis. Standard Edition, 12, 111–120. Gadamer, H. G. (1965). Verità e metodo, Milano: Fratelli Fabbri, 1972. Galimberti, U. (1979–1987). Psichiatria e fenomenologia. Milano: Feltrinelli. Gill, M. (1954). On the history of the psychoanalytic movement. Journal of the American Psychoanalytic Association, 2, 771–797. — (1984). Psychoanalysis and psychotherapy: A revision. International Review of Psychoanalysis, 11, 161–179. Goldfried, M. R. (1980). Toward delineation of therapeutic change principles. American Psychologist, 35, 991–999. Hanna, F. J. (1994). A dialectic of experience: A radical empiricist approach to conflicting theories in psychotherapy. Psychotherapy, 31, 124–136. Heidegger, M. (1927/1962). Being and time. New York: Harper and Row. Hoffman, I. Z., & Gill, M. M. (1988). Clinical reflection on a coding scheme. International Journal of Psychoanalysis, 69, 55–64. Katz, G. A. (1998). Where the action is: The enacted dimension of analytic process. Journal of the American Psychoanalytic Association, 46, 4. Kierkegaard, S. (1844). Il concetto delp'angascia. In Opere. Casale M.: PIEMME. (1995). Killigmo, B. (1989). Conflict and deficit: Implications for technique. International Journal of Psychoanalysis, 70, 65–80. Kohut, H. (1984). How does analysis cure? Chicago and London: The University of Chicago Press. Langs, R. (1986). Diventare uno psicoanalista comunicativo. Psicoterapia e scienze umane, 20,3, 273–277. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press. Liotti, G. (1999). Disorganized attachment, models of borderline states and evolutionary psychotherapy. In: P. Gilbert, K. Bailey (Eds.), Genes on the couch: Explorations in evolutionary psychotherapy. Hove: Psychology Press. Messer, S. B. (1992). A critical examination of belief structures in integrative and eclectic psychotherapy. In J. C. Norcross and M. R. Goldfried (1992). Handbook of psychotherapy integration. New York: Basic Books. Migone, P., & Liotti, G. (1998). Psychoanalysis and cognitive-evolutionary psychology: An attempt at integration. International Journal of Psychoanalysis, 79,6: 1071–1095. Nussbaum, M. (1996). The therapy of desire. Princeton: Princeton University Press. Peterfreund, E. (1983). The process of psychoanalytic therapy. New York: The Analytic Press. Piaget, J. (1959). The language and thought of the child. London: Routledge and Kegan Paul. Poland, W. S. (1984). On the analyst's neutrality. Journal of the American Psychoanalytic Association, 32, 283–300. Safran, J. D., & Messer, S. B. Psychotherapy integration: A postmodern critique. Clinical Psychology: Science and Practice, 4, 140–152. Sandler, J. (1976). Countertransference and role-responsiveness. International Review of Psychoanalysis, 3, 43–47. Sandler, J. (1992). Reflections on developments in the theory of psychoanalytic technique. International Journal of Psychoanalysis, 73, 189–198. Sarri, F. (1997). Socrate e la nascita del concetto occidentale di anima. Milano: Vita e pensiero. Sartre, J. P. (1960). Critica della ragione dialettica. Milano: Il Saggiatore. (1963). Spinelli, A. (1987). Come ho tentato di diventare saggio. La goccia e la roccia. Bologna: Il Mulino. Stevenson, J., & Meares, R. (1992). An outcome study of psychotherapy for patients with borderline personality disorder. American Journal of Psychiatry, 149, 358–362. Stricker, G., & Gold, J. R. (1996). Psychotherapy integration: An assimilative, psychodynamic approach. Clinical Psychology: Science and Practice, 3, 47–58. Thöma H. & Kächele, H. (1987). Psychoanalytic practice. Springer, Berlin. Wachtel, P. L. (1977). Psychoanalysis and behavior therapy. New York: Basic Books. Wallerstein, R. S., & DeWitt K. N. (1997). Intervention modes in psychoanalysis and in psychoanalytic psychotherapies: A revised classification. Journal of Psychotherapy Integration, 7, 129–150. Winnicott, D. W. (1965). The maturational process and the facilitating environment. London: Hogart Press.