Manifest Dream/Association Comparison: A Criterion to Monitor the Psychotherapeutic Field

Abstract

Summary The present work focuses on the transformations of the psychotherapeutic field through the relationship dynamics which occur within it. The first part of this article starts with a brief outline of the Gestalt psychological understanding of the field concept, also in its application to the psychotherapeutic situation, followed by a brief review of the introduction of the field concept into the psychoanalytic theory formation. After this, the first author first presents the theoretical concept underlying a new approach he has developed for observing the relationship dynamics in psychotherapy. Mirroring a formation of both psychoanalytic and Gestalt theory of the main author, this new approach is based on the combination of psychoanalytic and Gestalt psychological concepts. According to the clinical experience and insights of the author, the phenomenological and relational approach of Gestalt theory fits well with the psychoanalytic approach; on this basis, a criterion for recording the progress of therapy can be developed. This criterion is the phenomenology of the development of the qualities of the relationships of the client, as they become visible in his dream narrations and the subsequent associations in the analysis room and continue to develop during the session and the further course of therapy. The relationship dynamics in the dream narration is thus compared with those which develop in the course of the subsequent associations. This is demonstrated and further elaborated in the second part of this article on the basis of a clinical case. The clinical example shows how the relationship dynamics develop in this sense in the individual therapy sessions and over a longer course of therapy. The associated transformations of the therapeutic field give a good indication of the progress of therapy. The main author gained such insights into the transformations of the therapeutic field and the progression of therapy, which are visible in the course of therapy, from the careful application of the criterion “MDAC of relational dynamics”. In the specific case, there was also a high degree of correspondence between the results of the application of this phenomenological criterion and the empirical evidence of the symptom questionnaire, a self-report measure requested by the patient himself during the course of the therapy.

Working Together, Working Against Each Other, and Working Past Each Other in Therapy and Supervision. A Gestalt Psychological View on Structure and Dynamics of the Therapeutic Relationship

“…"The initial internal arrangement of the therapist can in fact favour beside the vicissitudes of the transference-countertransference an egalitarian atmosphere in which a series of dialogues will bring the patients, through the exchange of perspectives, toward slowly approaching recognizing themselves in their various components. It will then be possible to replace impulsive action with an awareness that enables greater freedom in decision-making [18]. From a psychoanalytic perspective, Trombini here emphasizes the effect that can emanate from an "egalitarian atmosphere" and thus also refers to the effect of field conditions in the overall therapeutic situation -in contrast to an exclusively person-centred view that focuses on the competent or incompetent therapist or the motivated or "difficult" patient for the success or tipping of the relationship.…”

Reconciliation of Time Perspectives as a Criterion for Therapy Completion

“…This change, as has been shown, is accompanied by symptomatic improvement and by the observable acquisition of analytic competencies by the patient (in the sense of Bolognini, 2008). Thus, the MDAC criterion is essentially an instrument for the assessment of progress in the development of the psychotherapeutic field (for a review, see Trombini, Corazza, & Stemberger, 2019).…”