If deep and enduring psychodynamic change is the ultimate goal of treatment, then periodically juxtaposing seemingly contradictory “forces” (Hegel’s thesis and antithesis) will eventually jump-start the patient’s “adaptive recovery” by creating optimally stressful, growth-incentivizing “mismatch experiences.”
Dr. Stark will be proposing use of something to which she refers as a “conflict statement” – a clinically useful and almost universally applicable therapeutic intervention strategically designed to target the patient’s internal conflictedness between anxiety-provoking (but ultimately growth-promoting) forces pressing “yes” and anxiety-relieving (but growth-impeding) resistant counterforces defending “no.”
The stress and strain of the “destabilizing dissonance” thereby created will provide the “therapeutic leverage” needed for the patient gradually, over time, to relinquish the tenacity of her attachment to rigid defenses in favor of more flexible adaptations – “compromise positions” that will “reconcile common truths” (Hegel’s synthesis) and transform conflict into collaboration.
The strategic construction of conflict statements requires of the therapist that she be able both to support the patient’s defense by “being with the patient where she is” (Salman Akhtar’s (20212) “homeostatic attunement”) and to challenge the patient’s defense by “directing the patient’s attention to where the therapist would want her to go” (Salman Akhtar’s (2012) “disruptive attunement”).
Dr. Stark will be offering specific clinical examples to demonstrate these powerfully impactful, optimally stressful psychotherapeutic interventions that juxtapose anxiety-provoking challenge with anxiety-relieving support. After all, no pain, no gain…