Psychotherapy as a Polyphonic and Playful Conversation

Cátia Guerra,Eva Osório,Joana Rebelo,Raquel Pedrosa,Patrícia Nunes,António Roma-Torres

doi:10.3390/psych4010008

Abstract

Since the emergence of hypnosis, we have witnessed a multiplication of psychotherapies, which have different backgrounds and aims. The omnipresence of psychotherapy leads us to an inevitable question: what is psychotherapy? In this article, we analyse the concept of mental disorder and how psychotherapy works, underlining three mechanisms: influence, polyphonic dialogue and play. Focusing on the therapeutic dialogue, we explore what is told during therapy and how, what is done while telling, and how dialogue can create new narratives and new meanings, highlighting the importance of influencing the patient on changing the symptomatic behaviour. We also consider how the multiple voices of the patient, therapist and others can generate an alternative to the monologic discourse of the disease. While the psychiatric illness may indicate a sterile dialogue which often expands the pathology, communicating in a different and active way can create new and healthier meanings. Therefore, one of the therapy’s aims is to influence the patient, throughout a dialogic and playful conversation, to gain freedom from disease.

Highlights

The relationships between guidance, mastery, examination of conscience, meditation and counselling have been present since Antiquity, for instance in the relation between the shepherd and his flock, the master and his pupil, and the doctor and his patient [1].Psychiatry has incorporated some of these practices and, since its inception, words and the relationship between the patient and the therapist have played an important part in treatment, which gained autonomy under the concept of psychotherapy
Afterwards, we focus on how psychotherapy works, highlighting three mechanisms that we consider essential to it: influence, polyphonic dialogue and play
We analysed therapy as a conversational practice that occurs in a therapeutic setting and that addresses significant factors of mental disorder: vicious communication and lack of freedom

Summary

Introduction

Psychiatry has incorporated some of these practices and, since its inception, words and the relationship between the patient and the therapist have played an important part in treatment, which gained autonomy under the concept of psychotherapy. In response to the question of what psychotherapy is, Jay Haley [5] argued that “in the last few decades we have seen the social impact of therapy developing everywhere in communities, and we can no longer think of therapy as the interchange between two people. It is a business, a calling, and the agent of many forces”

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