Revisiting Empathy, Motivational Systems, and a Theory of Cure

Lichtenberg’s chapter on “Empathy, Motivational Systems, and a Theory of Cure” was a brilliant effort to integrate his new paradigm of multimotivational systems with Kohut’s empathic approach to psychotherapy. Lichtenberg shows how the clinical dialogue with patients can be monitored by using empathic perception to track shifts in motivational systems. At any given moment, a particular motivational system may become dominant. Successfully identifying the dominant motivation through empathic perception creates in patients a feeling of being understood without judgment. This ambience of safety allows for a shift that activates an exploratory motivation with patients and a spirit of inquiry. An observational platform is created where experience from the past with attachment figures and interaction in the here and now in therapy can be explored from new perspectives. Recent research in psychotherapy that uses monitoring the clinical dialogue with patients by tracking shifts in motivational systems supports the view of its positive effects. Lichtenberg’s “theory of cure” is based on the premise that an empathic perception that monitors shifts in motivational systems will mobilize intrinsic self-righting capacities in patients. I note that there is controversy about what mutative factors in psychotherapy are most important: building an ambience of safety and trust or creating new insights into personal and internal conflicts through the use of language and symbolic representations. Both factors are crucial for positive changes in psychotherapy, and their importance will vary from patient to patient and from one patient–therapist relation to another. I note that Wilma Bucci’s multiple code theory that sees experience coded at subsymbolic and verbal symbolic levels supports this view. I close by proposing that we can build on Lichtenberg’s multimotivational system by adding a trans-survival need to give meaning to our lives.