‘Implicit relational knowing’, ‘engagement and the charged other’ and ‘being moved’: Key emotion processes in both shorter-term and longer-term relational psychodynamic psychotherapy (and other forms of therapy).

“The essence of psychotherapy is the experience of the therapeutic relationship and using that to alleviate suffering. Descriptions on the written page do not convey the emotional intensity, the connection between patient and therapist and the dynamic flow of psychotherapy.” (Eppel 2018)

In the preface to his instructive book, Short-Term Psychodynamic Psychotherapy, Alan Eppel offers a bold one-line description to the inevitably impossible question, ‘What is psychotherapy?’ In the very next line, he then explains why this simple proposition might miss the mark. Intensity, connection, and flow are lived here-and-now unfolding emotional experiences, difficult to track. His appeal to the need for what I will describe as short-term relational psychodynamic psychotherapy is not an old fashion exclusivist claim for modality superiority. Indeed, he acknowledges the well-established place of Cognitive Behavioural Therapy in pioneering short term therapy but wants to suggest that some clients may also require something different. (Plurality suggests such arguments may also work in both directions.)

From the outset of psychoanalysis, when Freud and others engaged various approaches to talk therapy, the processing of emotion within a therapeutic relationship served as a central feature for the field. However, much has changed over the past 130 years in the world of psychoanalytic/psychodynamic psychotherapy. At least two shifts relevant for the theme of emotion processes might be noted in this evolution. First, since the early 1990s, many theorist/practitioners have identified a relational turn —including notions of two-person psychology, intersubjectivity, mentalisation—as one of the key historical expansions of psychoanalysis, resulting in a range of innovative clinical applications. Second, and even more recently, these relational interests would also contribute to the increasing introduction of more innovative shorter-term psychodynamic therapies, often centred upon what Alexander & French termed in 1946 as ‘corrective emotional experiences.’

This presentation will explore three overlapping relational psychodynamic emotion processes explored first by the Boston Change Process Study Group (BCPSG) (1) beginning in 2010, ‘implicit relational knowing’, then from 2018, (2) ‘engagement and a charged other’ and (3) ‘being moved’. The first has emerged as a fruitful application of caregiver-infant interactions (mutually regulatory ones) to adult psychotherapy suggesting a causal role for the therapeutic relationship in adult treatment. The second process, ‘engagement with a charged other’ represents an explicit deepening of the first concept and clarifies three contributions: 1) a core positive affective investment; 2) prioritization; and 3) continuity. In the last of the three, ‘moving through and being moved by’, the BCPSG expands previous work by identifying a shared emotional process depicted as ‘body-based interaffectivity.’ Noteworthy here is how embodiment and meaning making are brought together as part of a single relational emotion process.

Lastly, these key processes will be identified within and tracked across a few fictionalised case vignettes, built upon the presenter’s experiences in working relationally in a range of contexts, especially time/resource limited shorter-term settings. A key question posed in this clinical discussion asks to what degree can processes first depicted across long-term psychodynamic contexts be applied to less traditional contexts.