Short-term psychoanalytic psychotherapy: "a construction zone".
Therapists will discover gaps in the personal narratives of their patients. The first five years of life are generally lost to the veil of infantile amnesia, and utterly unlikely to be recovered even in the deepest and longest psychoanalytic treatments. Subsequent history will be lost to semiotic incompetence and may be lost to conflict-based misunderstanding. Freud indicated that therapist and patient should try to fill those gaps with "constructions," conjectures, or hypotheses on what might have happened. Despite Freud's endorsement of the procedure, reconstructions were neglected until the 1970s forward. If controversial in psychoanalysis, constructions have been neglected in short-term psychoanalytic psychotherapy, where the therapist cannot wait for the sea to give up its dead. Because the therapist providing brief therapy must proceed before all the data are in, constructions are arguably more necessary in short-term psychoanalytic psychotherapy; it is, literally, a construction zone. The focus is on "clarification of experience" and not "repressed memories." The use of constructions in short-term psychoanalytic psychotherapy is illustrated in two brief vignettes. After a discussion of the use of constructions, ten guidelines are formulated for their use, before, finally, the two protagonists in psychoanalysis's most famous construction square off and air their opinions on the matter.
VA Minneapolis Medical Center, One Veterans Drive (116B), Minneapolis, MN 55417, USA. Charles.Peterson@med.va.gov
Charles A
CA
Peterson
D000368:Aged; D006801:Humans; D008297:Male; D008568:Memory; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011369:Professional-Patient Relations; D011572:Psychoanalysis / Q000379:methods; D011614:Psychotherapy, Brief / Q000379:methods*