In Personality-Guided Therapy Over Time, Dr. Jeffrey J. Magnavita demonstrates his unified model of conceptualizing personality dysfunction and focusing treatment using four well-established constructs as pattern recognition tools. His approach tailors psychotherapy to each client, systematically interweaving therapeutic modalities, strategies, and interventions using a biopsychosocial perspective.
A unified framework allows for the holistic blending of many therapeutic strategies by selecting from the array of evidence-based approaches. A systemic perspective is used to organize the many levels of analysis possible in therapy and to see which therapeutic technique or model works best for an individual client.
In this series of six sessions, Dr. Magnavita works with a woman in her 40s to uncover her feelings about her family distancing themselves from her after she came out as a lesbian. During the initial interview it also emerges that she uses alcohol in a destructive fashion to deal with her emotions.
Treatment centers on helping the client recognize her self-defeating patterns emanating from issues related to growing up in a dysfunctional family and resolving the emotional attachments that keep her stuck. Over the course of six sessions she becomes more aware of her feelings and discovers more adaptive ways to deal with them in order to extricate herself from these repetitive patterns.
Personality-guided relational psychotherapy offers a unified framework that encompasses four domains of human functioning to conceptualize personality dysfunction and focus treatment. These four levels begin at the micro-level of analysis and become increasingly more macroscopic in focus, and can be conceptualized as nested aspects of relational systems.
The four levels are
- biological–intrapsychic matrix
- dyadic–interpersonal matrix
- relational–triadic matrix
- sociocultural–familial matrix
All human psychopathology is an expression of a dysfunctional personality system broadly conceived. Within each of these matrices there is an array of methods which can be incorporated to enhance differentiation and integration among the various component subsystems, and thereby create a more functional personality system.
For example, the primary considerations when working in the biological–intrapsychic matrix are the interrelations among anxiety regulation—defensive operations—emotion/cognition. Various strategies and techniques from an array of psychotherapeutic models can be incorporated, such as emotional identification, intensification, and processing, anxiety management techniques, cognitive restructuring, and so forth.
Within the dyadic–interpersonal matrix all interpersonal processes and structures can be viewed as an expression of early relational schemata. The main foci are the relationship with the therapist and with significant others. Thus, while working in this matrix, therapeutic methods and techniques that assist in creating awareness and restructuring relational schemata are useful.
In the relational–triadic configuration, we examine the processes that occur when a third party is triangulated to stabilize a dyad. These triangular configurations are commonly seen in child and adolescent disorders, as well as in couples in which an affair is occurring. Multigenerational processes are often transmitted in triangular configurations in that generational conflicts that have not been resolved are transmitted to successive generations.
Various types of family systems can become dysfunctional and create a fertile environment for personality dysfunction in their members. The sociocultural system is composed of a number of mesosystems, such as family, social institutions, and community and political systems. Interventions can be made at any level to shape these systems and enhance functioning, such as community interventions, social change, educations and so forth.
Using a unified framework, clinicians can orient their treatment interventions to the domains of functioning that are most amenable to change.
Jeffrey J. Magnavita, PhD, ABPP, FAPA, is a licensed psychologist and marriage and family therapist in active clinical practice. A diplomate of the American Board of Professional Psychology and fellow of the American Psychological Association (APA), he is the recipient of the 2006 Award for Distinguished Professional Contribution to Independent or Institutional Practice in the Private Sector from APA for his work in unifying psychotherapy and personality systematics.
He authored Restructuring Personality Disorders: A Short-Term Dynamic Approach; Relational Therapy for Personality Disorders; Personality-Guided Relational Psychotherapy: A Unified Approach; Theories of Personality: Contemporary Approaches to the Science of Personality; was the volume editor of the Comprehensive Handbook of Psychotherapy: Psychodynamic/Object Relations: Volume I; Handbook of Personality Disorders: Theory and Practice; and serves as the editor of the forthcoming Evidence-Based Treatment of Personality Disorders: Principles, Methods, and Processes.
In addition to his many texts, Dr. Magnavita has published extensively in the field and is on the editorial boards of the Professional Psychology, Research, and Practice, Journal of Clinical Psychology/In Session: Psychotherapy in Practice and Psychotherapy: Theory, Research, Practice, Training.
He was elected the president of Division 29 (Psychotherapy) of APA for the year 2010 and has previously made a highly acclaimed DVD demonstrating his approach in a single session.
Most recently he was the founder of the Unified Psychotherapy Project and has created a task force to map the current methods and techniques of psychotherapy. He has served as affiliate professor in Clinical Psychology at the University of Hartford and is a clinical affiliate at Hartford Hospital.
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- Magnavita, J. J. (2005). Personality-guided relational psychotherapy: A unified approach. Washington, DC: American Psychological Association.
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