The Expressive Psychotherapeutic Mode

Psychotherapy conceptualized within the framework of the psychoanalytic theory of mental functioning—usually called “psychoanalytically oriented” or “psycho-dynamic” psychotherapy—has been traditionally divided into the expressive psychotherapeutic mode (also called “uncovering” or “insight-aiming” psychotherapy) and the supportive psychotherapeutic mode (also called “suppressive” or “ego-strengthening” psychotherapy). The traditional distinction has been between the therapy (called “expressive”) that is basically geared toward analyzing defenses and resistances in order to uncover conflict (i.e., to make unconscious conflict conscious, as a step toward an eventual reintegration)—albeit, in distinction from psychoanalysis proper, within limited and prescribed sectors of personality functioning—and the therapy (called “supportive”) that is basically geared toward strengthening defenses and resistances in order to make the repression of conflict more effective (i.e., to reduce the inner conflict pressures that have led to the eruption of symptoms and behavior disturbances). Our own original PRP conceptualizations of this distinction in psychotherapeutic approaches as providing the basis for our treatment planning and prognostication, as well as the framework within which the subsequent treatment course and outcome would then be assessed, were set forth in our initial PRP publication (Wallerstein & Robbins, 1956, pp. 252-257). A much more detailed spelling out of these counterposed approaches along all the relevant dimensions of the psychotherapeutic process has been offered in Section III (pp. 93-302) of Paul Dewald's Psychotherapy: A Dynamic Approach (1964).

In the introduction to his book, Dewald says of his approach: “In Section III on psychotherapy, the material is deliberately presented in the form of a somewhat artificial dichotomy of supportive versus insight-directed psychotherapy. This is being done for peda