title: When what I wish makes me worse ... to make coherence flexible.
abstract: This paper describes a psychotherapeutic constructivist intervention oriented to the resolution of implicative dilemmas, in order to promote personal change. It presents a clinical case study of a client with depression and with some dependent and obsessive functioning. The Repertory Grid Technique was administered along with symptom assessment (SCL-90-R) both at beginning and end of the psychotherapeutic process. Exploring themes emerged from Repgrid, several narratives, experiential and metaphoric strategies were used in order to explore and reconstruct meanings associated with the five implicative dilemmas found. The therapeutic process succeeds at solving dilemmas as found in the post-therapy assessment. This resolution was accompanied by symptom reduction. In conclusion, the utility of implicative dilemmas as a marker to understand the therapeutic impasse and dysfunctional system coherence is discussed, as well as the efficacy of the strategies used in this clinical case concerning its adaptation to working with implicative dilemmas that prevent therapeutic process.
authors.affiliation: Department of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal. eugeniaf@iep.uminho.pt
authors.forename: Eugénia Maria
authors.initials: EM
authors.lastname: Fernandes
mesh_terms: D000328:Adult; D003071:Cognition / Q000502:physiology; D003859:Dependent Personality Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D009034:Mother-Child Relations; D009770:Obsessive Behavior / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D012649:Self Concept; D016896:Treatment Outcome