Franz Alexander - Psychosomatic Work and Short-term Psychotherapy

Psychosomatic Work and Short-term Psychotherapy

Franz Alexander led the movement looking for the dynamic interrelation between mind and body. Sigmund Freud pursued a deep interest in psychosomatic illnesses following his correspondence with Georg Groddeck who was, at the time, researching the possibility of treating physical disorders through psychological processes.

Together with Freud and Sándor Ferenczi, Alexander developed the concept of autoplastic adaptation. They proposed that when an individual was presented with a stressful situation, he could react in one of two ways:

• Autoplastic adaptation: The subject tries to change himself, i.e. the internal environment.
• Alloplastic adaptation: The subject tries to change the situation, i.e. the external environment.

From the 1930s through the 1950s, numerous analysts were engaged with the question of how to shorten the course of therapy but still achieve therapeutic effectiveness. These included Alexander, Ferenczi, Peter Sifneos, David Malan, and Habib Davanloo. One of the first discoveries was that the patients who tended to benefit the most greatly from therapy were those who could rapidly engage, could describe a specific therapeutic focus, and could quickly move to an experience of their previously warded-off feelings. These also happened to represent those patients who were the healthiest to begin with and therefore had the least need for the therapy being offered. Clinical research revealed that these patients were able to benefit because they were the least resistant. They were the least resistant because they were the least traumatised and therefore had the smallest burden of repressed emotion. However, among the patients coming to the clinic for various problems, the rapid responders represented only a small minority. What could be offered to those who represented the vast bulk of patients coming for treatment? See further Intensive short-term dynamic psychotherapy.