Page 164 - EMCAPP-Journal No. 7

The Work and Thinking of David Benner

“The Incarnation or restructuring dysfunctional cognitions. Ho-

as a Metaphor for wever, these theory-laden descriptions tell us
much more about the therapists‘ conceptuali-
Psychotherapy” in zations than about their interventions. When
the actual interventions are observed from a
“Journal of Psychology more theoretically neutral vantage point, they

and Theology” 11, 1983 1 often turn out to be very similar to those used
by therapists working with supposedly very dif-
ferent treatment approaches. These similarities
The incarnation of Christ is considered as a me- in actual therapist behavior increase as therapy
taphor for the role of the psychotherapist. The effectiveness increases, with the most effective
tendency of children to attempt to purge paren- therapists showing more similarities among
tal badness by taking it upon themselves, as no- themselves than differences (Bergin & Lambert,
ted by object relations theorists, is considered as 1978).
a reflection of the imago Dei. Ways in which a
similar process may occur in psychotherapy are Another reason for our limited understanding
then considered. It is concluded that the incar- of how therapy works is that attempts to iden-
national element of psychotherapy may be one tify and label the curative factors have usually
of the basic curative factors present in any suc- been within the framework of one of the com-
cessful therapy. peting theoretical models. Thus, psychoanalysts
have tended to rely on the concept of insight,
The question of how therapy works has largely behaviorists on the concept of learning, and
been obscured by the more primary questions cognitive therapists on the concept of cognitive
of whether it works. As more and more consen- restructuring as they attempt to explain thera-
sus develops that at least under some circum- peutic gains. The general difficulty in demon-
stances psychotherapy can produce significant strating differential effectiveness of one type of
changes. Garfield (1983) has argued that it is therapy over another has, however, been dis-
now time to turn our attention to the question couraging for those arguing for such concepts.
of how these changes occur. Yalom’s (1970) list One would expect that if one of these were the
of the curative factors operative in group psy- major curative factor in psychotherapy, then a
chotherapy seems to have been well received by treatment approach based specifically on this
practitioners of many different styles of group factor should maximize its role in treatment
therapy. No such list, however, exists for indivi- and, therefore, be demonstrably superior in ef-
dual therapy. In fact it appears that although we fectiveness. However, in general, this has not
have an abundance of theories of psychothera- proven to be the case. Rather, we find most the-
py, we seem to possess very little understanding rapies studied to be approximately equal in ef-
of the way in which talking with someone about fectiveness, the exceptions being rare and with
personal problems produces change. specific disorders.

The Search for Curative Factors This difficulty in demonstrating differential ef-
One reason for the uncertainty as to how thera- fectiveness of various types of therapy has, ho-
py works relates to the difference between what wever, also made a positive contribution to the
therapists say they do in therapy and what they search for the illusive curative factors. Frank
actually do. It has become clear that labels of (I961) is one who has called our attention to
theoretical orientation do very little to describe the on-specific factors in therapy such as faith,
actual therapeutic operations. Thus, one might hope, and other expectation variables. Such fac-
describe himself or herself as analyzing and tors, sometimes referred to as placebo factors,
working through a transference reaction, get- are general to all therapies and may therefore
ting the patient in touch with his or her body, be the common active ingredient. Frank‘s de-
monstration of the role of such factors in both
1 Thank you for the copy rights to Rosemead School of
Psychology, Biola University
163