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Therapist Interpretation

A therapist interpretation is a technique that introduces the client to a new, theoretically based frame of reference. An interpretation goes beyond the explicit and observable client content and involves communicating an inferred component with the intention of adding new knowledge, understanding, or meaning.

Psycnodynamic Approaches

Interpretation is the central technique in psychoanalysis and in most psycnodynamic therapies in which achieving insight and new understanding is considered therapeutic. In early psychoanalytic formulations, interpreting client free associations served the function of abreacting strangulated affect. Over time, modifications were made to psychoanalysis, but the centrality of interpretation remained. In general, an interpretation refers to client content that is out of awareness, and it serves to make the unconscious material conscious. Within the psychodynamic therapies, interpretations are divided between transference and extratransference interpretations, with the former believed to be more potent. Transference is the enactment of the patient's intimate past relationships, which distort current relationships, especially with the therapist. Interpretation of this transference promotes client awareness and resolution of the conflictual relationships. Although there are various conceptualizations within the psychodynamic approaches, interpretations are believed to be most effective when used sparingly, focused on client material that is close to consciousness, and delivered at an appropriate time during the course of treatment. Research also supports tentatively delivered interpretations over those stated in directive, absolute terms. Greater progress results when therapists accurately focus on interpersonal aspects of client material (wishes toward others and their expected or actual responses) rather that simply focusing on feeling states (response of self).

Interpretation in Nondynamic Therapies

Although therapist interpretation is a historically important intervention that is consistently judged as helpful by clients, therapists, and objective raters, it is also among the more controversial techniques. Opponents of interpretation are critical of its use, arguing that it reduces client autonomy and implies a therapist agenda. This position argues that the use of interpretation is a manifestation of the medical model and that the interpretive therapist assumes a position of expert. Correct timing, depth, and accuracy of interpretation are responsibilities of the therapist, and client readiness to accept an interpretation is judged by the therapist. In addition, interpretation targets unconscious material (such as defenses or transference), suggesting that the therapist “knows” before the client. Furthermore, interpretations are often external, explanatory, and causal, pointing out etiological underpinnings of current behaviors. This position is rejected on philosophical grounds by some schools of therapy.

Future Directions

Therapist interpretation has been the focus of much research and debate within and across schools of therapy. Some authors consider interpretation as a common element across therapies, but different therapeutic vocabularies make comparisons difficult. With the traditionally rigid boundaries between therapeutic modalities becoming increasingly permeable, and with the therapeutic relationship and client factors accounting for the majority of the outcome variance, techniques such as interpretation may be de-emphasized and balanced with a relational emphasis in psychodynamic schools of therapy. In other therapeutic schools, interpretations may become more tolerated if applied in a manner that de-emphasizes therapist expertness and accentuates client agency.

  • clients
NicolaGazzola
http://dx.doi.org/10.4135/9781412963978.n289
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