In Constructivist Therapy, Dr. Robert A. Neimeyer demonstrates this client-centered, empathic form of therapy, showing how a psychotherapist might find the narrative threads that will help troubled individuals reweave the fabric of their lives. In this session, Dr. Neimeyer "leads from one step behind," helping a client whose son has died find a way to deal with the issues that she senses must be addressed. Watch the client invite Dr. Neimeyer to take the next necessary steps in allowing her to elaborate her relation to the problem, to articulate the deeply personal revelations that must find words and expression, and to look for hopeful possibilities.
Constructivist therapy is more of a theory of knowledge than a system of therapy. Constructivist theory holds that humans are meaning makers, and in a very real sense the meaning we create in turn creates our experience of the world. Thus, constructivists focus on the meaning clients attribute to their world and the ways these shape and constrain clients' sense of themselves, their relationships, and their difficulties.
In this approach, therapists pay close attention to where the client wants to go, both within the therapy session overall and moment-to-moment during the session. The client is central, and the therapist's job is to ask questions that will lead the client toward his or her own answers, not toward answers the therapist may have. Constructivists refer to this as "leading from one step behind."
Because of the centrality of the client, constructivist therapy has no fixed structure, seeking instead to follow the "affect trail" efficiently toward a rapid and deep contact with the client's central issues. In each conversational turn, therapy takes its orientation from the client, so it is important for the therapist to empathically enter the client's world of constructed meaning, whether conveyed verbally, coverbally or nonverbally in the client's responses.
However, the therapist is by no means a passive visitor to the client's experiential world but, rather, subtly directs the process of their exploration toward emotionally significant "growing edges" of the client's awareness, fostering greater contact with the painful discrepancies in the client's story and the often hidden purposes served by the problematic feeling, pattern, or behavior.
Discovering the significance of the symptom typically fosters the symbolization and articulation of new meaning, and an emerging sense of wholeness and possibility that permits the client to move forward in novel ways.
Robert A. Neimeyer, PhD, is director of psychotherapy in the Department of Psychology at the University of Memphis. He also maintains an active private practice in Memphis, Tennessee. Since completing his doctoral training in clinical psychology at the University of Nebraska in 1982, Dr. Neimeyer has published 20 books, including Constructivism in Psychotherapy and Constructions of Disorder (both with the American Psychological Association). The author of over 200 articles and book chapters, he is currently most interested in developing a narrative and constructivist framework for psychotherapy with special relevance to the experience of loss. Editor of the Journal of Constructivist Psychology, Dr. Neimeyer has been granted the Distinguished Research Award, the Distinguished Teaching Award, and the Eminent Faculty Award by the University of Memphis and has been elected a fellow of Division 12 (Society of Clinical Psychology) of the American Psychological Association.
