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Alliance rupture‐repair processes in intensive short‐term dynamic psychotherapy: Working with resistance
Author(s) -
Abbass Allan A.,
Town Joel M.
Publication year - 2021
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.23115
Subject(s) - feeling , alliance , psychology , psychotherapist , context (archaeology) , anxiety , resistance (ecology) , compassion , social psychology , psychiatry , paleontology , ecology , political science , law , biology
Intensive short‐term dynamic psychotherapy (ISTDP) was developed to manage treatment impasses preventing the experiencing of feelings related to childhood attachment interruptions, such as parental loss. According to ISTDP theory, certain categories of patients will exhibit habitual patterns of responding within the treatment relationship (called defenses) to certain anxiety‐provoking thoughts and feelings. Such defensive behaviors interrupt awareness of one's own feelings, self‐directed compassion and engagement in close human attachments, including the bond with the therapist. Rupture‐repair sequences in ISTDP are primarily considered in the context of a patient's defenses and the responses a therapist has to these defenses. By understanding and clarifying these defenses, this risk of subsequent misalliance, that is negative shifts or ruptures in the alliance, are minimized. In this paper we summarize ISTDP theory and technique through the use of clinical vignettes to illustrate defense management as a rupture‐repair equivalent in ISTDP.