Re: APA exchange and romanticism
Sat, 10 Feb 1996 20:03:39 -0500

Bob Neimeyer stated,"...the extent of sustainable change is defined on
the one hand by the level of threat we can tolerate, and on the other by the
level of anxiety we can manage (in the Kellian senses of these "emotion"
terms). The attempt to find and work within these limits while introducing
moderate novelty into a problem system is essential to psychotherapy."
I am pleased that this topic has come up because I have been grappling
with it in supervision as a clinical psychology graduate student, having had
the privilege of studying with Bob Neimeyer in the past. One of my current
therapy supervisors continues to challenge me with an observation that he and
a number of his colleagues have made- the majority of patients which have
been terminated from psychotherapy at their practices, seemingly having had
"moderate novelty" introduced into their problematic construct systems,
return to therapy within months or a few years having "forgotten" their
revised construct system and drifted back into the prior problematic state of
their construct system. After a session or two of being reminded of the
novelty which has previously been introduced, the patients magically seem to
return to the more functional construct system. However, they continue to
return to therapy indefinitely, never seeming to be able to hold onto the
revised construct system.
My supervisor uses these observations to support his view that an
individual's constructs are not his or her own to revise and maintain but are
co-created with others in one's environment. It was my belief, which I think
is at least somewhat like that of Jim Mancuso's, that the patient is revising
his or her construct system within the environment in question and,
therefore, the constructions of others are taken into account, making the
patient's revised construct system compatible and maintainable. I also
thought that as a therapist is encouraging exploration and revision of the
construct system, he or she would also help the patient to develop anchor
points in the environment (others who support the revised construct system).
My supervisor said, again based on his experience and that of his
colleagues, that this seldom happens, though there is more chance of success
when a couple or the whole family participates in therapy together. He does
indeed, as Bob Neimeyer suggested imply that my view of an individual's
construct system and the potential for agency therein is romantic.
Can any PCP therapists speak to the challenges he raises? Do you have
the same experience that patients nearly always return, needing reminders of
the new constructs or revised construct system they took with them at
termination? I will share this thread with my supervisor and may have more
thoughts and questions in the future.

Laura E. Holcomb
University of Tennessee, Knoxville