Integrative Relational Psychotherapy

Format: DVD [Closed Captioned]
Running Time: Over 100 minutes
Item #: 4310793
ISBN: 978-1-59147-801-0
List Price: $99.95
Member/Affiliate Price: $69.95
Copyright: 2007
Availability: In Stock
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For individuals in the U.S. & U.S. territories

APA Psychotherapy Training Videos are intended solely for educational purposes for mental health professionals. Viewers are expected to treat confidential material found herein according to strict professional guidelines. Unauthorized viewing is prohibited.

Integrative Relational Psychotherapy is a demonstration and discussion of Paul L. Wachtel's approach to treating clients. In this approach, the therapeutic work centers on disrupting the vicious circles in which clients' interactions with others perpetuate the distressing affect states and the internal conflicts that generated their actions in the first place.

In this session, Dr. Wachtel works with a young woman who is experiencing stress in her marriage surrounding her husband's family and their overinvolvement in their life. Dr. Wachtel works with her to begin to define the boundaries she requires for her own well-being. They also start to look at the way she may be undermining her own efforts to achieve balance in her relationships.


Dr. Wachtel's approach to therapy is an integrative one. Centered in the relational version of psychoanalytic thought and practice, it includes elements of behavioral, family systems, and experiential approaches as well. The rooting in relational psychoanalysis leads to a strong concern with the therapeutic relationship and an understanding of that relationship that leaves room for a much wider range of possible interactions and interventions than traditional psychoanalytic approaches.

It includes such traditional psychoanalytic concerns as transference and countertransference, unconscious motives, fears, and conflicts, defensive processes, and attention to the subtleties of subjective experience. But it also includes a variety of considerations, derived in part from Dr. Wachtel's efforts to integrate ideas and methods from other approaches, which are not typically part of the thinking or the practice of psychoanalytically oriented therapists.

Among these additional concerns and perspectives is an emphasis on exposure as a process at least as important as insight. That is, overcoming problematic anxieties and conflicts is achieved not so much by knowing about them as it is by experiencing them. Because, from a psychoanalytic vantage point, the most relevant anxieties are often associated with one's own thoughts and feelings, the approach here brings together the skills of the psychoanalytic therapist in identifying and uncovering those feelings and the methods of behavioral and experiential therapists in actually bringing the person into contact with what he or she has avoided.

Especially pertinent to this approach, which Dr. Wachtel has described as based on cyclical psychodynamics, is attention to the ways in which people's difficulties are typically a reflection of vicious circles. These vicious circles include both the repetitive patterns that go on between people (here he draws particularly on interpersonal psychoanalysis, family systems approaches, and social psychology) and the ways in which the pattern of thoughts, feelings, and overt behaviors that characterizes each individual is organized circularly. One's internal state (including assumptions, expectations, predominant wishes, needs, and fears—both conscious and unconscious) leads the person to act in the world; and those actions have consequences—for example, leading others to respond in particular ways. The circle is completed when those consequences, as happens so often, serve to maintain or reproduce the same internal state, starting the cycle all over again.

The starting point for this analysis is arbitrary. What is crucial is to mobilize as many forms of intervention as possible that are at once sensitive to the patient's experience, vulnerabilities, and strengths, and capable of breaking the vicious circle and promoting a process of change. The DVD will illustrate the ways in which this point of view is put into action.

Work using this approach has primarily been directed toward individuals who suffer from anxiety or depression; who have difficulties in relationships; who feel constricted in their affective life; who experience a lack of vitality or meaning in their lives (with or without identifiable depression per se); who are thwarted in their careers or in other pursuits that are meaningful to them.

The approach has not been used very much with schizophrenia, bipolar disorder, or sociopathic disorders, and Dr. Wachtel is not sure how much it would have to be reworked and adapted for these populations.

About the Therapist

Paul L. Wachtel, PhD, is distinguished professor in the doctoral program in clinical psychology at City College and the Graduate Center of the City University of New York (CUNY). He did his undergraduate work at Columbia University, received his PhD in clinical psychology from Yale University, and is a graduate of the postdoctoral psychoanalytic training program at New York University, where he is also on the faculty. He is internationally recognized as an innovator in the field of psychotherapy and for his contributions to the application of psychological theory and research to the pressing social problems of our times.

A cofounder of the Society for the Exploration of Psychotherapy Integration, Dr. Wachtel is the author of many books, including Action and Insight; The Poverty of Affluence; Family Dynamics in Individual Psychotherapy; Therapeutic Communication; Psychoanalysis, Behavior Therapy, and the Relational World; and, most recently, Race in the Mind of America: Breaking the Vicious Circles Between Blacks and Whites. A number of his books have been widely described as classics in the field.

Suggested Readings
  • Arkowitz, H., & Messer, S. B. (Eds.). (1984). Psychoanalytic therapy and behavior therapy: Is integration possible? New York: Plenum Press.
  • Norcross, J. N., & Goldfried, M. R. (2005). (Eds.). Handbook of psychotherapy integration (2nd ed.). New York: Oxford University Press.
  • Frank, K. A. (1999). Psychoanalytic participation: Action, interaction, and integration. Hillsdale, NJ: Analytic Press.
  • Wachtel, E. F., & Wachtel, P. L. (1986). Family dynamics in individual psychotherapy. New York: Guilford Press.
  • Wachtel, P. L. (1993). Therapeutic communication: Principles and effective practice. New York: Guilford Press.
  • Wachtel, P. L. (1997). Psychoanalysis, behavior therapy, and the relational world. Washington, DC: American Psychological Association.
  • Wachtel, P. L. (1999). Race in the mind of America: Breaking the vicious circle between blacks and whites. New York: Routledge.
  • See also all issues of the Journal of Psychotherapy Integration, which is the leading journal in the field for integrative thinking in psychotherapy.

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