Private theories of patients and therapists in comparison: A multiple-case study in the preliminary phases of the psychoanalytic treatment

Background: Literature has widely demonstrated that the so-called "private theories" (PT) have a predictive role at multiple levels: in the evolution of the working alliance, in the construction-deconstruction of treatment resistances, and, more generally, in terms of the treatment process and outcome effects (Philips et al., 2007). Aims: The current study aims to explore the PTs of patients and therapists in the initial phases of the psychoanalytic treatment, in terms of their convergence, divergence, and interrelation. In this regard, patients and therapists deal with the early stages of the treatment according to theories that could be considered 'unconscious' or 'naïve'. How these theories concern the nature and course of pathogenesis, as well as the cure process will be explored. Methods: Data were collected from 18 semi-structured PTI interviews uniformly administered to patients and therapists, matched for couples (9 and 9). Through full transcription of the 18 interviews, textual analyses (algorithmic, cluster, and factor analysis) were performed via the T-LAB mixed-methods software. Interviews were also coded using some additional dimensions (e.g., timing, problem's nature and location, speech form). Results: The emerging theoretical model identifies four main clusters of PT, focused on: (1) a diagnostic-experiential perspective, (2) a crisis-impasse standpoint, (3) the gratification-frustration of the desire, and (4) the relational-contextual framework. Preliminary results indicate specific oppositions (clusters 1 and 2 vs. clusters 3 and 4), along with a high level of convergence between patients and therapists regarding cluster (1) and cluster (3). Discussion: The implications of these findings will be discussed with particular reference to clinical intervention and its possible "targeted" adjustments.