Academic journal article American Journal of Psychotherapy

The Conversational Model: An Outline

Academic journal article American Journal of Psychotherapy

The Conversational Model: An Outline

Article excerpt

This paper gives a brief outline of the Conversational Model which is among the best validated of currently employed psychotherapies. The theory is built around the idea that the central task of psychotherapy is to potentiate the emergence and amplification of that dualistic form of consciousness that William James called self. However, this state of mind cannot be acted upon as if it existed in isolation. Rather, it is part of an ecology that includes the form of relatedness that underpins it. No element of the ecology can change unless the other elements also change. Seen in this way, the form of relatedness is transformational. It is necessarily mediated by conversation consisting of more than its content, the simple transmission of information. The main point of the paper is that the form of the conversation manifests and constitutes not only a form of consciousness but also a form of relatedness. This conception provides a means of testing hypotheses of therapeutic action since it suggests that syntactical structuring, together with the other major elements of language, lexicon, and phonology, allow us to chart the waxings and wanings of personal being in the therapeutic conversation.

THE BACKGROUND

The Conversational Model is the name Robert Hobson (1920-1999) gave, in 1985 (1) an approach to psychotherapy that grew out of work with patients who had failed other treatment and who, in the language of the time, were "unanalysable." Many of these people would now be called "borderline." Although the approach arose out of experiences with severely damaged people, it has a general application. The purpose of this paper is to give a brief outline of the model in order to introduce it to American therapists who, because of its Anglo-Australian origins, may not be familiar with it.

The work began in 1965 with a focus on the "minute particulars" (1), through the use of audiotapes to study the therapeutic conversation. Here could be found in microscopic form not only systems of destruction of the sense of personal being but also "moments of aliveness," that are the germs of self. These data provided an important basis to the theory that Hobson and myself have struggled to grasp and formulate over the last three decades.

The project was launched, in publication terms, in 1971, when Hobson put forward certain of the main ideas of what he hoped would be a "testable model of psychotherapy" (2). Fostering a form of relatedness Hobson called "aloneness-togetherness" was seen as a central aim of therapy. This aim was additional to, and beyond, that of correcting distortions of habitual maladaptive forms of relatedness. Its purpose was the generation of self, which was understood as a dynamism, a process, arising in conversation as a third thing, between people (2, p. 97).

This paper outlines the subsequent elaboration of these original nuclear ideas. Self is conceived much as William James had done (3, 4). It has a core of "value" that can be damaged (5). Attacks upon this feeling are a major source of psychological trauma (6). Symbolic play provides a metaphor for the development of self (7), which cannot be generated by a "linear" form of language (8). Rather, therapy is directed towards a jointly created imaginative narrative arising out of play - like, non - linear mental activity (1, 2, 4, 6, 7, 8). Therapeutic interventions directed at "insight" and the "unconscious" risk invalidation and the creation of dependence (3, 9). Descriptions of the theory and method are given in Hobson (1) Meares (6, 7).

The model is one of the best validated of all currently employed psychotherapies. An abbreviated version of the model has been manualized as "psychodynamic-interpersonal" (PI) psychotherapy (10, 11). PI has shown to be effective in depression (12, 13, 14) in certain psychosomatic disorders (15) and to be cost-effective in treating repeated users of clinic services (16). A brief form of PI is useful in reducing repeated episodes of self-harm (17). …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.