Brief Psychodynamic Psychotherapy As Developed By David Malan
This psychotherapy is time limited, the maximum number of sessions is 30. The therapy is focussed in that the therapist concentrates on one theme and discusses this theme with the patient before the therapy begins. The focus can be a superficial conflict or a conflict that is deeply embedded in the patient’s life. The therapy has the best results if the conflict that is chosen is related to the central conflict from the patient’s childhood. The therapist takes an active role during the therapy. He sees to it that the focus is the central theme in each session. Anything outside the focus is neglected, anything related to the focus is given attention to. The therapist makes use of resistance, transference, countertransference and interpretation and uses the Malan triangles (see picture). These triangles are a picture of the structure of the patient’s conflict and of the persons related to that conflict. The patient defends (defence mechanism) against the hidden feeling, expression of which to others in the present or to the parent in the past (origin of the conflict) is unacceptable and cause for anxiety. Both triangles stand on its apex. In the Triangle of Conflict (first used by Ezriel ) this means that the hidden feeling/impulse lies under the defence and the anxiety. In the Triangle of Persons (developed by Menninger ) that what happened in the relation to the Parent lies under and is prior to what happens in relationship to Others or to the Therapist (transference). Malan linked both triangles: the hidden feeling is related to one or more categories of the Triangle of Persons. Nearly every intervention of the therapist is reflected in the triangles. The therapist needs to realise at every moment in the therapy which area of which triangle is at stake. The aim of the therapy is to give the patient insight into his behaviour pattern by working through the defence, bringing the hidden feeling/impulse into awareness, making clear how these have impacted the relationship of the patient with others in the present, with his parents in the past. Contra-indications for this therapy are very impulsive or self-destructive behaviour, serious attempts at suicide, long period of hospitalisation, electroshocks treatments, strong phobic or obsessive complaints (from a non-published list made by H.P.Hildebrand .
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Triangle Of Conflict
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Triangle Of Persons
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