Commentary by an Interpersonal Psychotherapist

Before Christmas, I visited the David Hockney Exhibition at the Tate Gallery. His photo-collages caught my imagination. In Dinner at the British Embassy in Tokyo and Conversation with Christopher Isherwood, both place and time are captured. Overlapping images of the same person in interaction convey a much greater sense of what it was like to be present than a static image. Yet what I saw was what the artist had selected for me to see. However, my curiosity was aroused, there was no way in which I could see portions of the room that were not depicted or people who were present but had been edited out. It is much the same with this account of a group therapy session. The author presents what he sees and follows what he is interested in. In fairness, the account is full of interest.

What of my interest as an interpersonal psychotherapist? My special concern is with recurrent, interpersonal patterns that are limiting and self-defeating. How does a person interact? What are the points of correspondence between these patterns and ways of coping learnt in that person's personal past? What reactions does the person prompt or draw from others and with what consequences for self-esteem and selfimage? How do people, each with their own characteristic repertoire of interpersonal patterns, combine and with what consequences? How can the therapist and patient or, in this instance, the group and a member develop greater awareness of these sequences and intervene with therapeutic effect? Lifting one's sights from within group interaction, what are the interactions between the group and the larger group of the therapeutic community of which they are a constituent part and, beyond that, the institution as a whole?

Another dimension to the interpersonal approach, particularly as it has developed in North America, is the drive towards increasing clarity and precision in formulating the problematic patterns. One formula is that devised by Luborsky et al in the Core Conflictual Relations