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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.
Interpersonal reconstructive therapy is based on the assumption that every psychopathology is a gift of love, that is, people develop problematic patterns in an effort to stay connected and loyal, at least intrapsychically, with the important people from their past, particularly their parents and other childhood caretakers. More often than not, persistent "maladaptive" personality patterns represent a repetition of familiar behavior and perspectives that were appropriate given family dynamics during childhood but that have lost their adaptive quality in adulthood. Even clients considered "untreatable" can be helped if the clinician focuses consistently on the underlying attachments that organize the maladaptive patterns. The link between attachments with past figures and current functioning is made through three "copy processes":
The force that maintains the copy processes appears to be the unrecognized assumption that by acting as if the old rules are still in place, one can maintain the hope of getting psychically closer to the internalized representation of the early figure. By following these patterns, there is also a powerful wish that one might have another chance to "do it right" and finally be loved and accepted. Interpersonal reconstructive therapy involves learning to recognize these patterns and to understand where they originated and what they were and are for. With fuller awareness of these patterns, the client may be in a position to choose new behaviors and experience a more fulfilling life. Interventions from a number of schools of therapy may be appropriate, so long as they address the organizing patterns and their underlying attachments through one or more of the following five categories of therapist behaviors:
In working with clients, it is helpful to think about and at times share with the client a view of his or her personality as having two parts: the Regressive Loyalist and the Growth Collaborator (terms that are defined in the videotape). The therapist encourages constructive change and avoids enabling problem patterns by being strongly supportive of the Growth Collaborator while becoming progressively tougher on the Regressive Loyalist. Therapy may be short or long term, depending on the presenting problem and the maladaptive patterns. Patients with personality disorders, such as the one presented on this videotape, may need to be seen for a longer period of time than those who have isolated problem patterns. Dr. Benjamin identifies her approach as interpersonal reconstructive therapy. What does this imply to you? More specifically, what do you expect of her? Will Dr. Benjamin be active or passive? Will the session be structured or unstructured? Directive or nondirective? Will it focus on the past or on the present? Will the session focus on behaviors, on thoughts, or on feelings? What do you expect to be the relative balance between attention to technique and the interpersonal interaction? Return to Interpersonal Reconstructive Therapy for Passive–Aggressive Personality Disorder |
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