Winnicott and Sullivan in the Brief Psychotherapy Clinic, Part II—The Necessity for New Theory and Practice

SULLIVAN (SULLIVAN, 1956) WINNICOTT (WINNICOTT, 1971), AND DAVANLOO (DAVANLOO, 1978), (1980) offer theories of interaction, which attempt to explain their kinds of engagement in psychotherapy. However, all of these must be partial theories, since they explain only a part of the continuum of interaction. A general theory of brief psychotherapy, to be adequate to our practical needs in selection of patients would have to explain how we are to conduct the trial therapy with different kinds of patients. In this paper we will propose such a new general theory.

Let us suppose that we begin, with the customary, "What brought you to the Clinic?" Usually, the patient will offer some details, perhaps some generalizations to explain these details. And usually, the details and the generalizations are inadequate.

We usually ask the patient to be more specific, to tell us more, but more often than not at this point the relationship remains superficial; the story is at the surface. Now, to decide upon our next course of action, we must have some grasp of the possible sources of this situation.

At one extreme, the patient may experience himself as controlling the situation, and perhaps the doctor. He may get away with being