Cargando…

Instability and Uncertainty Are Critical for Psychotherapy: How the Therapeutic Alliance Opens Us Up

Tschacher and Haken have recently applied a systems-based approach to modeling psychotherapy process in terms of potentially beneficial tendencies toward deterministic as well as chaotic forms of change in the client’s behavioral, cognitive and affective experience during the course of therapy. A ch...

Descripción completa

Detalles Bibliográficos
Autor principal: Connolly, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8777103/
https://www.ncbi.nlm.nih.gov/pubmed/35069367
http://dx.doi.org/10.3389/fpsyg.2021.784295
_version_ 1784636990088544256
author Connolly, Patrick
author_facet Connolly, Patrick
author_sort Connolly, Patrick
collection PubMed
description Tschacher and Haken have recently applied a systems-based approach to modeling psychotherapy process in terms of potentially beneficial tendencies toward deterministic as well as chaotic forms of change in the client’s behavioral, cognitive and affective experience during the course of therapy. A chaotic change process refers to a greater exploration of the states that a client can be in, and it may have a potential positive role to play in their development. A distinction is made between on the one hand, specific instances of instability which are due to techniques employed by the therapist, and on the other, a more general instability which is due to the therapeutic relationship, and a key, necessary result of a successful therapeutic alliance. Drawing on Friston’s systems-based model of free energy minimization and predictive coding, it is proposed here that the increase in the instability of a client’s functioning due to therapy can be conceptualized as a reduction in the precisions (certainty) with which the client’s prior beliefs about themselves and their world, are held. It is shown how a good therapeutic alliance (characterized by successful interpersonal synchrony of the sort described by Friston and Frith) results in the emergence of a new hierarchical level in the client’s generative model of themselves and their relationship with the world. The emergence of this new level of functioning permits the reduction of the precisions of the client’s priors, which allows the client to ‘open up’: to experience thoughts, emotions and experiences they did not have before. It is proposed that this process is a necessary precursor to change due to psychotherapy. A good consilience can be found between this approach to understanding the role of the therapeutic alliance, and the role of epistemic trust in psychotherapy as described by Fonagy and Allison. It is suggested that beneficial forms of instability in clients are an underappreciated influence on psychotherapy process, and thoughts about the implications, as well as situations in which instability may not be beneficial (or potentially harmful) for therapy, are considered.
format Online
Article
Text
id pubmed-8777103
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-87771032022-01-22 Instability and Uncertainty Are Critical for Psychotherapy: How the Therapeutic Alliance Opens Us Up Connolly, Patrick Front Psychol Psychology Tschacher and Haken have recently applied a systems-based approach to modeling psychotherapy process in terms of potentially beneficial tendencies toward deterministic as well as chaotic forms of change in the client’s behavioral, cognitive and affective experience during the course of therapy. A chaotic change process refers to a greater exploration of the states that a client can be in, and it may have a potential positive role to play in their development. A distinction is made between on the one hand, specific instances of instability which are due to techniques employed by the therapist, and on the other, a more general instability which is due to the therapeutic relationship, and a key, necessary result of a successful therapeutic alliance. Drawing on Friston’s systems-based model of free energy minimization and predictive coding, it is proposed here that the increase in the instability of a client’s functioning due to therapy can be conceptualized as a reduction in the precisions (certainty) with which the client’s prior beliefs about themselves and their world, are held. It is shown how a good therapeutic alliance (characterized by successful interpersonal synchrony of the sort described by Friston and Frith) results in the emergence of a new hierarchical level in the client’s generative model of themselves and their relationship with the world. The emergence of this new level of functioning permits the reduction of the precisions of the client’s priors, which allows the client to ‘open up’: to experience thoughts, emotions and experiences they did not have before. It is proposed that this process is a necessary precursor to change due to psychotherapy. A good consilience can be found between this approach to understanding the role of the therapeutic alliance, and the role of epistemic trust in psychotherapy as described by Fonagy and Allison. It is suggested that beneficial forms of instability in clients are an underappreciated influence on psychotherapy process, and thoughts about the implications, as well as situations in which instability may not be beneficial (or potentially harmful) for therapy, are considered. Frontiers Media S.A. 2022-01-07 /pmc/articles/PMC8777103/ /pubmed/35069367 http://dx.doi.org/10.3389/fpsyg.2021.784295 Text en Copyright © 2022 Connolly. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychology
Connolly, Patrick
Instability and Uncertainty Are Critical for Psychotherapy: How the Therapeutic Alliance Opens Us Up
title Instability and Uncertainty Are Critical for Psychotherapy: How the Therapeutic Alliance Opens Us Up
title_full Instability and Uncertainty Are Critical for Psychotherapy: How the Therapeutic Alliance Opens Us Up
title_fullStr Instability and Uncertainty Are Critical for Psychotherapy: How the Therapeutic Alliance Opens Us Up
title_full_unstemmed Instability and Uncertainty Are Critical for Psychotherapy: How the Therapeutic Alliance Opens Us Up
title_short Instability and Uncertainty Are Critical for Psychotherapy: How the Therapeutic Alliance Opens Us Up
title_sort instability and uncertainty are critical for psychotherapy: how the therapeutic alliance opens us up
topic Psychology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8777103/
https://www.ncbi.nlm.nih.gov/pubmed/35069367
http://dx.doi.org/10.3389/fpsyg.2021.784295
work_keys_str_mv AT connollypatrick instabilityanduncertaintyarecriticalforpsychotherapyhowthetherapeuticallianceopensusup