Paul L. Wachtel

City College of New York | CCNY · Department of Psychology

Responding to Kenneth Frank’s paper on therapeutic action, the present paper focuses especially on Frank’s emphasis on emotion schemas as a central therapeutic target across the spectrum of approaches. While strongly agreeing with the value and importance of the emotion schema concept as a unifying foundation for understanding therapeutic action, t...

This chapter covers an integrative psychotherapy known as cyclical psychodynamics and features its origins, applicability, assessment, treatment, therapy relationship, case example, outcome research, and future directions. Cyclical psychodynamics is an approach to theory and therapy that centers on the repetitive interaction cycles that maintain ad...

This chapter covers an integrative psychotherapy known as cyclical psychodynamics and features its origins, applicability, assessment, treatment, therapy relationship, case example, outcome research, and future directions. Cyclical psychodynamics is an approach to theory and therapy that centers on the repetitive interaction cycles that maintain ad...

This article discusses Michael Westerman’s paper, “Interpersonal Defense Theory: An Integration of Philosophical Considerations, Psychoanalytic Concepts, and Perspectives on Interpersonal Processes That Provides a Guide for a Wide Range of Therapeutic Interventions” (Westerman, 2018). Among the issues it discusses are (1) the distinction between fe...

Building on the insights embodied in Stephen Mitchell’s critiques of the developmental tilt and the metaphor of the baby, this paper aims to further illuminate the limitations of theoretical models rooted in infantile prototypes and to point relational theory toward a more thoroughgoing understanding of the contextuality and relationality of every...

In this reply to comments by Paul Renn and Michael Westerman, I discuss the nature of relational discourse and the various meanings of multiplicity in the relational literature. In further discussing Mitchell’s (2000) case of Connie, cited also by Renn, I highlight the ways in which Mitchell understood that Connie’s sadness was perpetuated by the w...

This article reexamines the concepts of neutrality and abstinence in light of Gelso and Kanninen’s advocacy of a return to greater focus on these factors in the practice of psychotherapy. In considering Gelso and Kanninen’s arguments, it finds them to be too strongly weighed toward consideration of the ways departing from neutrality impedes the the...

This article describes an approach to the clinical use of attachment theory and research that is rooted in the cyclical psychodynamic perspective. Cyclical psychodynamics is a version of relational thought that emphasizes the way that early patterns of interpersonal transaction and subjective experience are perpetuated in the present via the occurr...

This article, based on an invited address to the Latin American Association of Integrative Psychotherapy, points to several considerations that are important in further advancing the progress of psychotherapy integration. First discussed is the "tribal" organization of our field, in which therapists (and even integrative therapists) derive their id...

Viene illustrato come il "mondo interno" dei desideri, delle fantasie, degli affetti e delle rappresentazioni del Se e dell’oggetto e il "mondo esterno" del comportamento manifesto e della realta sociale si co-creino continuamente. Sulla base della presentazione di due casi clinici e di una discussione teorica, vengono mostrati i limiti di una conc...

Much of psychoanalytic thought and practice is implicitly grounded in archaeological images and metaphors. This article uses the alternative image of the Moebius strip-an odd structure in which inside and outside are not separate but continually merge into each other to form a single surface-in order to stimulate new thinking about the phenomena th...

Comments on the article by S. Ziv-Beiman (see record 2015-39481-001 ), which discusses the dilemmas around the treatment of Dana, a patient with resistant trichotillomania. In the context of today’s atmosphere of increasing emphasis on quick and symptom-focused treatment, it was courageous of Ziv-Beiman not to focus on the trichotillomania; it was...

In this chapter, we will present an overview of the cyclical psychodynamic approach to psychotherapy integration (Wachtel, 1977). The cyclical psychodynamic method of psychotherapy was one of the first systems to achieve a good measure of true conceptual and methodological integration (Norcross, 1984). This approach to psychotherapy integration is...

This article, part of a special section on the Relational Foundations of Psychotherapy, describes a particular relational approach called cyclical psychodynamics. Cyclical psychodynamics is rooted both in the relational perspective in psychoanalysis and in an integrative melding of psychodynamic, cognitive-behavioral, systemic, and experiential poi...

Examining the approach to couples work described by Virginia Goldner, this commentary analyzes a number of the most significant interventions introduced by Goldner, pointing to her skillful use of paradox, the ways in which her focus on her own participation in the events of the session enables the members of the couple to take more responsibility...

This paper examines how images of depth are employed in the psychoanalytic literature and how they illuminate or obfuscate. It examines as well the price of using familiar terminologies to introduce new ideas, a practice more common in psychoanalysis than in many other disciplines. By obscuring the differences between old ideas and new through usin...

Comments on the article by Aner Govrin (see record 2014-23073-001) on the vices and virtues of monolithic thought in the evolution of psychotherapy. Govrin’s article is difficult to discuss because the “Single Orientation” (SO) approach whose virtues he touts is not very well defined or spelled out. There is ambiguity in the degree to which Govrin...

Cyclical Psychodynamics and the Contextual Self articulates in new ways the essential features and most recent extensions of Paul Wachtel’s powerfully integrative theory of cyclical psychodynamics. Wachtel is widely regarded as the leading advocate for integrative thinking in personality theory and the theory and practice of psychotherapy. He is a...

The enormous contribution of David Shapiro to our understanding of personality and of clinical phenomena arose in the context of a psychoanalytic world that was largely dominated by what has now come to be called the one-person point of view. In this chapter, I will reexamine Shapiro's contribution from the vantage point of the two-person, intersub...

Reviews the book, Healing psychiatry: Bridging the science/humanism divide by David H. Brendel (see record 2006-07160-000). Early in his book, David Brendel asks, “Is psychiatry an empirical science that aims to diagnose and treat abnormal human behavior, or is it a form of humanism that addresses the inner workings and meanings of people’s subje...

Nella letteratura sulla ricerca in psicoterapia vi č molta confusione sulla differenza tra il concetto generale di pratica basata sulle evidenze ( ) e i criteri piů ristretti usati nel designare certi trattamenti come "validati empiricamente" o "supportati empiricamente". Invece di preoccuparsi giustamente di esaminare le evidenze dell'efficacia di...

From rather early in the development of the psychotherapy integration movement, there were implicit tensions between alternative understandings of the concept of psychotherapy integration and of its boundaries and aims. These tensions have been healthy and productive rather than divisive, sparking different models and different kinds of integrative...

Neal Miller's pioneering insights into the possibilities of synthesis between psychoanalytic and learning theory formulations of phenomena of anxiety, defense, psychopathology, and personality dynamics provided a key foundation for later efforts to integrate psychodynamic and cognitive-behavioral approaches to therapy. This paper highlights Miller'...

There has been much confusion in the literature of psychotherapy between the broad concept of evidence-based practice and the narrower set of criteria that have been employed in designating certain treatments as “empirically validated” or “empirically supported.” In contrast to the appropriate concern with examining the evidence for the efficacy of...

There has been increasing interest among analysts in the possibilities of enriching psychoanalytic thought through fuller incorporation of attachment theory and research. This paper offers a clinical illustration of the ways in which attention to an attachment perspective can lead to novel and useful ways of addressing the patient's issues. It also...

The Society for the Exploration of Psychotherapy Integration (SEPI) is an international organization devoted to exploring potential convergences and synergies between different approaches to psychotherapy and the different theoretical orientations from which those approaches derive. Originally founded in North America in 1983, SEPI now has members...

This paper illuminates how the “inner world” of wishes, fantasies, affects, and self- and object-representations and the “outer world” of overt behavior and social reality continuously and reciprocally co-create each other. Basing its presentation both on case material and theoretical analysis, it demonstrates the limitations of a linear, archaeolo...

The author provides a context for a series of papers on the state of psychotherapy and psychotherapy integration in different parts of the world. He points out that differences in cultural values and assumptions are as important to consider in attempting a comprehensive integration of different points of view in our field as differences in theoreti...

The aim of this study was to investigate the interrelationships of three measures of the therapeutic relationship and their validity in predicting treatment outcome, including the early identification of two treatment-failure conditions. Forty-eight patient-therapist dyads, in 30-session therapies for personality-disordered patients, were classifie...

This article examines a number of prominent trends in the conduct of psychological research and considers how they may limit progress in our field. Failure to appreciate important differences in temperament among researchers, as well as differences in the particular talents researchers bring to their work, has prevented the development in psycholog...

The author responds to the commentaries of 13 experts on his 1980 American Psychologist article, “Investigation and its discontents: On some constraints on progress in psychological research.” Among the themes addressed are the role of theory in psychological research, the meanings and implications of “productivity” by scholars and researchers, the...

Carl Rogers' classic account (see record 2007-14639-002) of the necessary and sufficient conditions for therapeutic personality change is examined in light of developments in theory and practice since the time he wrote. Rogers' ideas, which diverged from and were very largely a challenge to, the dominant psychoanalytic ideology of the era in which...

This article examines critically the role of insight and of making the unconscious conscious in the light of contemporary understandings in psychoanalysis, in the broader discipline of psychotherapy, and in research on cognition and consciousness. Developments that led to reconceptualizations based on appreciation of the crucial role of anxiety and...

Chapter 8 discusses cyclical psychodynamics and integrative relational psychotherapy, and covers the approach, active intervention and the inclusion of a behavioral view, the continued importance of the psychodynamic perspective, applicability and structure, the therapy relationship, a case example, empirical research, and a discussion of future di...

This paper offers a psychoanalytic exploration of the dynamics of greed in individual lives and ways that those dynamics both reflect and influence the surrounding culture. The paper discusses the contradictions associated with the consumerist pursuit of wealth and goods, and finds evidence for the failure of such pursuit to provide the satisfactio...

This article explores convergences and divergences among 3 different approaches to termination in therapy. Of particular concern are questions of what constitutes the "reality" of termination. Is refusal to taper off sessions or to keep the door open for potential resumption of the work a useful aid in helping the patient come to terms with the rea...

This article explores convergences and divergences among 3 different approaches to termination in therapy. Of particular concern are questions of what constitutes the "reality" of termination. Is refusal to taper off sessions or to keep the door open for potential resumption of the work a useful aid in helping the patient come to terms with the rea...

In discussing the complexities and dialectical tensions inherent in the relational point of view, this commentary seeks to alert the reader to the simplifying dichotomies that can lead theory and clinical practice to be hostage to ideology. In exploring those dichotomies and their problematic implications for our work, emphasis is placed particular...

Eye movement desensitization and reprocessing (EMDR) originated as an application of a cognitive-behavioral point of view. Its further evolution, procedures, and professional reception, and even its approach to evaluating and checking its efficacy have been powerfully influenced by its cognitive-behavioral origins. As discussed in this chapter, EMD...

"Neurotic misery" is not the only treatable source of suffering that can be subtracted from the sum of unavoidable "everyday unhappiness." Social inequality and injustice represent another powerful source of unnecessary suffering that, in principle, can be modified and diminished. This article explores the implications of psychoanalytic understandi...

La resistencia es uno de los conceptos más problemáticos y potencialmente contraproducente en todo el campo de la psicoterapia. Al mismo tiempo es uno de los más cruciales, que apunta quizás hacia el factor -o más concretamente, conjunto de factores- más decisivos en la determinación del éxito o fracaso del trabajo terapéutico. Basándose en los art...

Resistance is one of the most problematic and potentially counterproductive concepts in the entire field of psychotherapy. It is at the same time one of the most crucial, pointing toward perhaps the single most important factor—or, more accurately, set of factors—in determining the success or failure of the therapeutic enterprise. Drawing on the ar...

The scale was developed with support from the National Institute of Mental Health (MH50246). It is a 44-item observer-based measure of therapist adherence to three time-limited psychotherapies in the Beth Israel Brief Psychotherapy Research Program: a integrative relational, a short-term dynamic, and a cognitive-behavioral model. It also includes a...

In contrast with many of the critics of psychoanalysis in recent years, Donald Spence (see record 1994-97367-000 ) brings to his examination of evidence and argument in psychoanalysis years of sophistication as both a psychoanalyst and a psychological researcher. This perspective enables him to see the flaws clearly but also to offer interesting id...

This text examines the 5 key theoretical orientations in contemporary psychotherapy: psychodynamic, experiential, cognitive-behavioral, family systems, and integrative. Contributors lay out the major concepts that define these enduring theories of psychotherapy, discuss the ideas of the theorists who have expanded them, describe the evolution of th...