Psychoanalytically Oriented Supportive Therapy: Literature Review and Techniques

There has been an upsurge of interest in supportive psychotherapy in the past several years, perhaps best exemplified by the publication in 1984 of Werman's The Practice of Supportive Psychotherapy. A number of authors (Buckley, 1986; Dewald, 1971; Winston et al., 1986) have argued for more teaching and supervision of supportive therapy in residency training programs, and against its being regarded as a second class “Cinderella of psychotherapies” (Sullivan, 1971). These writers also discussed supportive strategies and tactics in general terms.

However, there is no generally accepted list of supportive interventions in the literature; such a list is a prerequisite to any attempt to standardize the treatment. In addition, there does not exist a systematic review of the psychoanalytic literature relevant to supportive psychotherapy, although both Kernberg (1984) and Winston et al. (1986) quote the literature extensively.

This paper reviews the core psychoanalytic literature relevant to supportive psychotherapy, and then utilizes the literature to construct a list of techniques appropriate for a psychoanalytically oriented supportive therapy. It does not discuss behavior therapies or cognitive therapies, both of which can be considered “supportive” psychotherapies in the broadest sense. Nor does it discuss supportive techniques in other than the therapeutic dyad, for example, in families or groups, although the same techniques would be generally applicable.

Several major trends in modern psychiatry contribute to the present interest in supportive psychotherapy. Formal psychoanalytic treatment has lost much of its former charisma. The difficulty in demonstrating that long-term exploratory treatment leads to better outcomes than either brief or supportive treatments has led to increased interest in the latter modalities. Psychotherapists are tending to treat a more disturbed group of patients, for whom