Reconstructin of Inner Dialogue in the Psychotherapeutic Process (A Case Study) (original) (raw)
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Reconstruction of Inner Dialogue in the Psychotherapeutic Process (a Case Study)
Basing on Vygotsky’s cultural-historical methodology, Bakhtin’s conception of inner dialogue, and some ideas of object relations theory, the authors propose an integrative approach to self-awareness in psychotherapy. Serious attention is paid to the predictors of borderline personality disorders and comorbid illnesses: pathogenic family conditions of personality development and, in consequence of them, splitting and structural distortions of self-awareness. The descriptive-analytic, semiotic and dialogical procedures of analysis of verbal communications between patient and psychotherapist were elaborated and approbated.
2013
Basing on Vygotsky’s cultural-historical methodology, Bakhtin’s conception of inner dialogue, and some ideas of object relations theory, the authors propose an integrative approach to self-awareness in psychotherapy. Serious attention is paid to the predictors of borderline personality disorders and comorbid illnesses: pathogenic family conditions of personality development and, in consequence of them, splitting and structural distortions of self-awareness. The descriptive-analytic, semiotic and dialogical procedures of analysis of verbal communications between patient and psychotherapist were elaborated and approbated.
The evolution of the internal dialogue during the psychoanalytic psychotherapy process
American journal of psychotherapy, 1999
This article illustrates curative changes occurring in psychoanalytic psychotherapy by developing the internal dialogue in the mind. By the internal dialogue, I mean the internalization of the therapy process during the recurrent therapy sessions so that the external dialogue between therapist and patient becomes the corresponding internal structure of the patient. In this way, there is a development of the patient's capacity to identify himself and the therapist as separate, sentient, thinking, and reflecting individuals, who have a free internal world of their own. The evolution of the internal dialogue takes place by gradually progressing symbolization achieved through a four-step symbolization-reflectiveness approach. This process is one of the specific curative factors in the psychotherapeutic treatment of borderline patients. The psychodynamics are illustrated by material from one session each of the early and the final stages of therapy, showing a shift from monologue to ...
Voices of the self in psychotherapy: A qualitative analysis
The British journal of medical psychology, 2001
Approaches that view the self as constituted by socio-cultural processes and as plural, consisting of a multiplicity of states, positions, functions, etc., have flourished in the last decades. This paper explores the multi-voiced nature of the self, drawing upon Lacan's theory of subjectivity and Bakhtin's concept of dialogism. Subjectivity is seen as constituted through language as expressed in the speech of the subject's important early others. The psychoanalytic concept of transference, understood as a semiotic process of enacting early interpersonal patterns in the subject's present relations, provides a link between the unfolding of subjectivity in the present and its historical continuity. The articulation of subjectivity is discussed through a micro-analysis of extracts from sessions of a long-term psychoanalytic psychotherapy. The analysis demonstrates the enactment of transferential dialogical positions at the beginning of the therapy and traces their recogn...
THE DIALOGICAL VIEW OF PSYCHOTHERAPY: SOME THEORETICAL CONSIDERATIONS AND CRITICAL REMARKS
Dialogical theory is a helpful frame of reference for psychotherapy research, which provides a perspective for the study of psychotherapy process in terms of meaning construction and exchange. This paper will firstly review the basic features of the dialogical approach to the theory of Self and of the process of psychotherapy, as taken into account in the papers by Avdi , Gonçalves and Ribeiro , Martínez, Tomicic and Medina , and Leiman . On the whole, the authors use the term "dialogical" with reference to a general theory of therapeutic change. The implications of such an use of the dialogical concept will be discussed, with special focus on how the relationship between intrapsychic and intersubjective dimensions are taken into account, both at the levels of theory and methodology of analysis of the psychotherapy process.
Dialogical sequence analysis in studying psychotherapeutic discourse
International Journal of Dialogical Science, 2012
Dialogical sequence analysis (DSA) is a microanalytic method of analyzing utterances. Based on Mikahil Bakhtin's theory of utterance it states that, when communicating, individuals simultaneously position themselves with regard to the referential object and the addressee. Depending "about what" people are speaking and "to whom" they direct their words affect the style and composition of their utterances. Such positioning is semiotic in the sense that the referential object is always construed by personal and historically formed meanings. The historicity of subjective construal applies to the addressee as well. Utterances are often complicated by the fact that there are often hidden or invisible addressees in addition to the ostensible interlocutor. DSA developed in the context of psychotherapy supervision and process research. The article introduces a meta-model of psychotherapy process, which claims that all therapies strive to create a joint observational stance for making sense of clients' problematic experiences. Hence, the psychotherapies provide a natural laboratory within which internal experiences become tangible through expressions and utterances. The fundamental unit of analyzing the double positioning in relation to the topic and the addressees is semiotic position. Being a relational concept, it cannot be used to single out and categorize distinct units of speech. The way by which semiotic positions are identified in DSA will be illustrated by three excerpts from psychotherapy literature.
Journal of Psychology Research, 2021
The case of a 67-year-old man, who had a year-and-a-half long psychotherapy with the author of this article, is presented to illustrate the process of negotiation between client and therapist about the meaning of his symptoms. Mr. B's symptoms were intrusive pictures of a sexual nature, pointing towards obsessive-compulsive disorder. However, he had a number of psychotic breakdowns throughout his life and had been diagnosed as schizophrenic on several occasions. The exploration revealed that his construing of his symptoms-and, more so, his construing of self-were highly influenced by his 12 years of psychoanalytic psychotherapy. He was pre-emptively holding onto this framework, which might be explained by his limited ability to organize his experience around a functioning core identity. One of the lessons for the psychotherapist was about limitations in the person's ability to change. Some experiences might have occurred in formative years-whatever they may be-and work like imprinting (or "freezing of the meaning-making process"), which made the constructs developed at that time held on to as if "life depends upon them". In the case presented, both client and therapist moved slowly (if at all) towards re-construing of the disorder, respecting the existing framework that had almost become an identity. The main therapeutic tool was the psychotherapeutic relationship that worked as a "container" for a very fragile self.
This article provides a philosophical framework to help unpack varieties of self-knowledge in clinical practice. We start from a hermeneutical conception of " the self, " according to which the self is not interpreted as some fixed entity, but as embedded in and emerging from our relating to and interacting with our own conditions and activities, others, and the world. The notion of " self-referentiality " is introduced to further unpack how this self-relational activity can become manifest in one's emotions, speech acts, gestures, and actions. Self-referentiality exemplifies what emotions themselves implicitly signify about the person having them. In the remainder of the article, we distinguish among three different ways in which the self-relational activity can become manifest in therapy. Our model is intended to facilitate therapists' understanding of their patients' self-relational activity in therapy, when jointly attending to the self-referential meaning of what their patients feel, say, and do. Self-knowledge—and the lack thereof—is an important phenomenon in the understanding and treatment of people with personality disorders (PD). Although it has been recognized as an important therapeutic factor (Livesley, 2003), relatively little attention has been given to analyzing the concept of self-knowledge in psychotherapy and the treatment of PD. Roughly, self-knowledge is about having true (correct, adequate, adap-tive) beliefs about oneself. The targets of self-knowledge can range from oc-current mental states (such as when you know that you are now anxious or angry) to more complex and diachronic features of oneself, like knowing one's character traits and needs. More complex still, perhaps, is the acquisition of knowledge about the meaning of one's thoughts, feelings, and emotions toward self and others within the context of one's biography. In the treatment of PD, this whole range may come into focus. Patients with PD often experience occurrent emotions that they are unable to categorize. Treatment may then consist in helping them to learn to locate and