Form and forming a focus: In brief dynamic therapy

Abstract

The author draws upon the work of Kenneth Wright, outlining the function of the therapist in giving shape to the inarticulate felt experience of the patient. Through processes of mirroring, attunement and identifying narrative patterns, and as an alternative to the making of interpretations, the therapist brings the experience of the patient within the jurisdiction of form, and in so doing contains and holds this experience. The author then turns more specifically to the role of the therapist in brief therapy in establishing a focus for the work, and how this can be seen as a way of containing the patient's inarticulate felt experience. Whether it arises as a crystallization of the focus, a flash, or as a central maladaptive pattern, establishing a focus can be seen as a way of lending shape to the narrative pattern and of making a fundamental connection to the patient's idiom. It can therefore be seen as a containing structure for the work and as a way of bringing the experience of the patient within the jurisdiction of form. The importance of the non-verbal utterances of the therapist in mirroring the patient's feelings is noted and links are made to Osimo's concept of emotional maieutics in which the therapist acts as a midwife to the patient, enabling him or her to give birth to their hidden feelings. The significance of non-verbal experience in the therapeutic relationship is also linked to Balint's notion of a new beginning and Levenson's conceptualization of new experiences in brief work. The paper concludes with a case example that illustrates these themes; in it, the author is perceived as a Sherpa guiding the patient on her journey to explore the unfamiliar terrain of her feelings and their freer expression, within the jurisdiction of form provided by the focus.