Psychoanalytic focal therapy

Abstract

This essay depicts briefly the historical antecedents of Michael Balint’s focal psychotherapy, developed with his co-workers at the Tavistock Clinic and first presented in his book, co-authored with Paul H. Ornstein and Enid Balint. Balintian focal psychotherapy serves here as a background for the authors’ presentation of their revision of focal psychotherapy based on Heinz Kohut’s psychoanalytic self psychology and the process nature of psychoanalytic psychotherapy. The essay highlights the essential elements that distinguish the Ornsteins’ approach from Balint’s original conceptions as well as from the best kno'^n contemporary brief psychotherapies in the United States, which are sketched in passing. The distinction rests on several factors. Among them are the following: (1) the Ornsteins view psychoanalysis, intensive psychoanalytic psychotherapy and focal psychotherapy on a continuum - as long as the therapist uses the same basic treatment approach (acceptance, understanding and explaining), the same theory of psychopathology and the same theory of cure. (2) The Ornsteins differentiate between a technique-oriented and a process-oriented form of treatment, postulating that each therapeutic encounter will initiate a set of inner experiences (how patientexperiences therapist and how therapist experiences patient), which is here called “the process.” (3) It is the nature of this process that determines the therapist’s responses, rather than a “set technique.” In fact, the Ornsteins speak of the therapist’s “responsiveness ” and not of his “technique. ” Their approach is illustrated here with a treatment sample, detailing the process of this form of focal psychotherapy.

Keywords:
Psychoanalyticfocal therapy, self psychology