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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...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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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 |
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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 |
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