Models of the mind: their role in the clinical teaching of psychoanalytic psychotherapy.
In acquiring psychoanalytic ideas, psychotherapy trainees are often hampered by preconceptions about what constitutes a psychoanalytic perspective. These preconceptions can even constitute unarticulated models of pathogenesis and cure, which organize how trainees assimilate a supervisor's suggestions. We have identified two such models: the "passive-learning" model and the "cathartic" model. Realizing that trainees are operating under one of these models can help the supervisor to understand many of their errors. A traditional model emphasizing conflict and compromise formation addresses the deficiencies of these models and provides an initial framework for a psychoanalytic understanding of psychopathology and change. Certain guidelines for technique arise from this model: understanding rather than trying to change behavior, attending to the patient's emotional set, and using the therapist's emotional set. We describe one resident's use of the compromise-formation model to overcome an impasse in his treatment of a patient, and discuss some implications for clinical supervision.
Harris
R F
RF
Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Palo Alto, CA 94304.
Ginsburg
R A
RA
D000328:Adult; D001291:Attitude of Health Personnel; D002399:Catharsis; D003220:Conflict, Psychological; D003479:Curriculum; D005260:Female; D006801:Humans; D007396:Internship and Residency; D001523:Mental Disorders / Q000523:psychology; D008611:Mentors / Q000523:psychology*; D009042:Motivation; D011570:Psychiatry / Q000193:education; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy / Q000193:education*; D014167:Transference, Psychology; D014473:Unconscious, Psychology