Story of Psychology - Morton Hunt [378]
She had no mothering beyond infancy—in fact, she became a caretaker before she was three, when her mother was permanently paralyzed as the result of an accident. In the therapeutic relationship I soon became the good mother hers hadn’t been able to be. I sympathized, I supported, I consoled, I “gave her permission” to play as well as work, and to express her anger to others and to me. She underwent what Franz Alexander [of the Chicago Psychoanalytic Institute] called a “corrective emotional experience” and more or less relived her childhood in different form. When, as in normal development, she began to internalize our relationship, she became able, like any healthy adult, to individuate—to be mother to herself.36
By the 1970s and 1980s a handful of psychiatrists and psychologists were developing the techniques of “short-term dynamic therapy” based on psychoanalytic principles. The distinguished science writer Dava Sobel reported in 1982 that although short-term dynamic psychotherapy had existed in various stages of research and refinement for about twenty years, it was now “burgeoning into a recognizable force, drawing converts and controversy.”37 Focusing on a single current problem troubling the patient, these methods do not use free association, probe the unconscious, strive for insight, or overhaul the personality; they rely chiefly on the patient’s transference.38 Unlike the psychoanalyst, the therapist actively confronts the patient with the evidence that he or she is behaving toward the therapist in an unrealistic way carried over from other relationships. The therapist sometimes does this even in the first session, as described (in abridged form here) by Peter E. Sifneos, a Boston psychiatrist:
PATIENT: I put on an act. I wear a mask. I give the impression that I’m different from what I really am. Before my girlfriend broke off our relationship, she said that she didn’t like going out with someone who is “a phony.” Mary, my previous girlfriend, had said the same thing, using different words, and so did Bob, my best friend. I know what they are all talking about. At times, even here, I have this great urge to show off and make you admire me.
THERAPIST: And where does this urge come from?
P: From very long ago. I used to put on an act to impress my mother. I remember one time when I made up a whole story about school. I told her that the teacher had said I was the best student she ever had. My mother was impressed, but you know, doctor, it wasn’t true. The teacher had complimented me, but I exaggerated it. I blew it out of proportion.
T: So you were trying to impress your mother, you are trying to impress your girlfriends, and Bob, and even here—
P: What do you mean by “even here”?
T: A minute ago you said that even here you had such a tendency.
P: Did I say that?
T: Yes, you did. Furthermore, why does it surprise you? If you put on an act with everyone else, why wouldn’t you put on an act with me?
P: It did occur to me that it was possible, but this is precisely what I don’t want to do. I’m here to understand why I do it so I can stop pretending. I want you to help me.39
In classical psychoanalysis, that point might not have been reached for months.
Going still further with this approach, in 1990 Moshe Talmon, a clinical psychologist at the Kaiser Permanente Medical Center in Hayward, California, wrote a book called Single-Session Therapy, in which he discussed how much could be achieved with some patients in the first session—often, especially in clinics, the only session—not by the offer of advice but by dynamic interactions.
In general, however, short-term psychodynamic therapy takes between six and twenty weekly sessions to achieve its limited goal, and has been reported effective for stress and bereavement disorders, late-life depression, and for certain emotional and personality disorders.40 For many psychotherapists, dynamic therapies, especially the shorter and more