Psychotherapy as a Process of Transformation: Analysis of Posttherapeutic Autobiographic Narrations

Abstract

Psychotherapy research is still dominated by the drug metaphor, based—in analogy to medical treatment—on the natural science paradigm. Yet this scientific metamodel has its limitations in explaining the complex developments occurring within and after the therapeutic process. Once psychotherapy is understood as a social interaction conveying different aspects of knowledge (concerning behavior as well as self-related experiences and interpretations), you must shift to models and research questions based on the social sciences. In this article, I present the results of a study based on autobiographical narratives of discharged clients of the same psychotherapy ward. We show that new experiences from psychotherapy are integrated, and thereby assimilated, into the previous person schemas. The potential for this integration contributes decisively to the long-term effect of psychotherapy. By using the methods of “social scientific hermeneutics” and ideal typification, we reconstructed the transformation of psychotherapeutic knowledge into four typical structures. These types differ in several respects: (a) their systems of autobiographical construction, i.e., complex metaschemas which develop during a lifetime, (b) their subjective concepts about emotional disorders and about psychotherapy, and (c) their future orientations.