Synopses & Reviews
Rich in clinical detail, this book examines therapeutic communication styles and their effect on the outcome of treatment. Paul Wachtel presents examples of crucial moments in the therapeutic process and several things the therapist could say in response, each with different consequences and implications for the overall treatment. Examining the way psychic problems originate, persist, and evolve, Wachtel illuminates the dynamic processes that perpetuate problematic relational patterns in the patient's history and suggests communication strategies that lead to their resolution. Integrating psychodynamic theories with insights and discoveries from other approaches, the author presents a new theory of psychological disorder and change. A concluding chapter by Ellen Wachtel, a couples therapist, extends the ideas presented in the book to work with couples. This volume will be very useful for clinical psychologists, psychiatrists, counseling psychologists, social workers, psychiatric nurses, pastoral counselors, and marital and family counselors.
For every therapist who has ever thought, "I understand my patient, but what should I say at this moment?", this book will provide practical, enlightening assistance. A trained psychoanalyst known for his integration of active methods from other orientations, Paul L. Wachtel examines in great detail precisely what the therapist can say to contribute to the process of healing and change. The reader is shown - through numerous examples, including annotated transcripts of actual therapy sessions - why some communications are particularly effective, while others, though addressing essentially the same content, actually promote the problems being treated. A uniquely practical book, Therapeutic Communication also offers the reader an exploration of theory that integrates psychodynamic principles with insights and discoveries from other approaches. Opening chapters probe how vicious circles perpetuate the patient's difficulties and how intrapsychic conflict and interpersonal realities mutually create each other. Later chapters explore communication strategies that will help resolve these difficulties. Dr. Wachtel illuminates the evaluative nature of seemingly "neutral" comments, and demonstrates how the therapist can generate communications that foster the patient's progress. Other chapters highlight how to build on the patient's strengths; how to promote and amplify change processes and help the patient "own" his insights through what Dr. Wachtel calls "attributional interpretations"; and how to utilize the art of gentle inquiry, phrasing questions in ways that protect the patient's self-esteem and mobilize his capacity to change. Rounding out the work is a comprehensive chapter on theprocess of "working through", and a concluding chapter by Ellen Wachtel insightfully extending the book's ideas to work with couples. Jargon-free prose and respect for multiple psychotherapeutic perspectives make this book valuable not only to psychodynamically oriented therapists, but to practitioners from other orientations as well. It is important reading for clinical psychologists, psychiatrists, social workers, marital and family counselors, psychiatric nurses, and pastoral counselors. Its unusually clear style, vivid clinical illustrations, and innovative ideas make the book an excellent psychotherapy text for courses at both the advanced and introductory level.
This uniquely practical volume examines precisely what the therapist can say at key moments to enhance therapeutic effectiveness and the process of healing and change. Through vivid clinical illustrations, the book illuminates why some communications in therapy are particularly effective, while others addressing essentially the very same content may actually be countertherapeutic. Wachtel's powerful integrative theory also provides new insights into how psychological disorder evolves, how it is maintained, and how psychotherapy contributes to change.
A uniquely practical guide and widely adopted text, this book shows precisely what therapists can say at key moments to enhance the process of healing and change. Paul Wachtel explains why some communications in therapy are particularly effective, while others that address essentially the same content may actually be countertherapeutic. He offers clear and specific guidelines for how to ask questions and make comments in ways that facilitate collaborative exploration and promote change. Illustrated with vivid case examples, the book is grounded in an integrative theory that draws from features of psychodynamic, cognitive-behavioral, systemic, and experiential approaches.
New to This Edition
* Reflects nearly 20 years of advances in the field and refinements of the author's approach.
*Broader audience: in addition to psychodynamic therapists, cognitive-behavioral therapists and others will find specific, user-friendly recommendations.
*Chapter on key developments and convergences across different psychotherapeutic approaches.
*Chapter on the therapeutic implications of attachment theory and research.
See also Wachtel's Relational Theory and the Practice of Psychotherapy, which explores a new direction in psychoanalytic thought that can expand and deepen clinical practice.
About the Author
Paul L. Wachtel, PhD, is CUNY Distinguished Professor in the doctoral program in clinical psychology at City College and the Graduate Center of the City University of New York. He received his doctorate in clinical psychology from Yale University and is a graduate of the postdoctoral program in psychoanalysis and psychotherapy at New York University, where he is also a faculty member. Dr. Wachtel has lectured and given workshops throughout the world on psychotherapy, personality theory, and the applications of psychological theory and research to the major social issues of our time. He has been a leading voice for integrative thinking in the human sciences and was a cofounder of the Society for the Exploration of Psychotherapy Integration. Dr. Wachtel is a recipient of the Hans H. Strupp Memorial Award for psychoanalytic writing, teaching, and research; the Distinguished Psychologist Award from Division 29 (Psychotherapy) of the American Psychological Association (APA); and the Scholarship and Research Award from Division 39 (Psychoanalysis) of APA.
Table of Contents
1. Rethinking the Talking Cure: The Therapist Speaks Too
I. Theoretical and Empirical Foundations
2. The Continuing Evolution of Psychotherapy: New and Converging Developments in Psychoanalytic, Cognitive-Behavioral, Systemic, and Experiential Approaches
3. Attending to Attachment: Accelerating Interest in the Therapeutic Implications of Attachment Theory and Research
4. Cyclical Psychodynamics I: Vicious and Virtuous Circles
5. Cyclical Psychodynamics II: Anxiety, Exposure, and Interpretation
6. Cyclical Psychodynamics III: Insight, the Therapeutic Relationship, and the World Outside
II. Clinical Applications and Guidelines
7. Accusatory and Facilitative Comments: Criticism and Permission in the Therapeutic Dialogue
8. Exploration, Not Interrogation
9. Building on the Patient’s Strengths
10. Affirmation and Change
11. Attribution and Suggestion
12. Reframing, Relabeling, and Paradox
13. Therapist Self-Disclosure: Prospects and Pitfalls
14. Achieving Resolution of the Patient's Difficulties: Resistance, Working Through, and Following Through
15. Therapeutic Communication with Couples, Ellen F. Wachtel