Supportive Psychotherapy: Other Supportive Mechanisms

Nature of the Concept

Ever since it was advanced by Alexander and French (1946), the concept of the “corrective emotional experience” has been a central, or almost the central, explanatory construct invoked in the psychodynamic literature to elucidate the mechanism of the supportive psychotherapeutic approaches (plural); as such, it has been used to explain almost all therapeutic change other than that resting, in the expressive approach, on the operation of interpretations leading to mutative insights. It should be clear by now that I am using the concept here in a far more sharply circumscribed manner: I consider it as one of the possible supportive technical mechanisms operating (usually) within the broader framework of the more encompassing positive dependent transference attachment, with its transference gratifications. It may be less clear that I am not using the concept in the sense adumbrated by Alexander and French (1946)—that of attempting to alter or resolve expectations and behaviors of the patient by a planned counteraction within the transference situation, in which the patient is directly confronted with attitudes or behaviors of the therapist that are deliberately contrary to the patient's transference expectation. I am, rather, using it in the more classically psychoanalytic sense advanced by Gill (1954)—that of providing a steadfastly concerned therapeutic stance, equidistant from (and therefore neutral in relation to) the conflicting intrapsychic forces within the patient, and corrective in precisely the sense of not being drawn to respond in counteraction to the patient's transference expectations and pulls.

Within this usage, though the concept of the corrective emotional experience could probably be invoked, to some extent or other, in relation to the change process in a fair number of the PRP patients treated with the more supportive therapeutic approaches, it stood out most particularly in relation to three of