CHAPTER 9 YOU DON'T LOVE ME ANYMORE A Case Illustrating the Collaborative Construction of the Psychodynamic Formulation USING THE THREE TRIANGLES TO TRANSLATE PSYCHODYNAMIC UNDERSTANDING INTO CLINICAL ACTION From the first moment of the patient's telling his story -- or not telling it, for that matter -- the therapist has access to two potent sources of dynamic information: the content of the story, manifest and latent, and the interactive process between herself and the patient. Taking whatever the patient offers, the therapist uses it as the starting point of a dynamic interaction. The schema of the three triangles helps the clinician remain oriented in the thicket of clinical material. She can categorize emerg- ing clinical material as defense, signal affect, or genuine emotional experience and then aim specific interventions at that phenomenon. The therapist also can see the different defense, signal affect and core affect constellations that underlie particular self states and self-other pat- terns. Finally, she can explore "the genetic and adaptive relevance" of these patterns ( Mann & Goldman, 1982): where they arose, other situ- ations in which they operate, and -- a particular emphasis in AEDP -- those in which they do not. The moment-to-moment translation of patient material into the categories of the triangle of conflict is equally useful for rapid assessment of the impact of a given intervention (e.g., Did it make the patient more or less defensive? Did it lead to greater or -187- |