The power of the therapeutic relationship

This interview (unfortunately only in Italian) deals with a  topic – the therapeutic relationship – which has recently been increasingly debated, especially by the line of research on psychotherapy. Do you agree that systemic therapists have been less concerned with the therapeutic relationship than psychoanalysts and cognitivists? And why? What new ideas have systemic therapists introduced about the therapeutic relationship? Does your family semantic polarities theory bring into play any new ideas on this topic? Is there a systemic thinking about the therapeutic alliance? These and others are the questions that Luca Mazzucchelli asks me and on which we discuss
This is not an interview, it is a video promoted by La Repubblica - L’Espresso (one of the main Italian newspapers) with which it was released on DVD on a Sunday in December 2012. It is part of a collection of 16 videos dedicated to psychology. Here I deal with many topics on the family and the relational dynamics that characterize it. Among this variety of topics are the following: the isolated mind, the functions of interaction, the double bind, complex family structures, parenting between social construction and instinct, triadic interactions, types of families, meaning and identity, family and gender identity , the family as a composition of differences, family and psychopathology, the building of bonds, the resources of the family.
This is the first interview that I gave to Luca Mazzucchelli, when he was not yet one of the protagonists of the Italian psychology and psychotherapy and their dissemination in the digital world. The quality of the video is not excellent - the interview was done with a mobile - but the questions that Luca asked me are stimulating and the discussion that ensued seems to me interesting . We addressed many issues at the heart of the systemic psychotherapies. We pass from psychopathology to change during the therapeutic process, to the therapeutic relationship, to the specific systemic techniques. Some suggestions to young psychologists close the interview.
This long interview is part of a series of interviews conducted by State of Mind with Italian clinicians. The aim is to provide an overview of the state of the art of psychotherapy in Italy. The interview starts from the theoretical-clinical principles which are fundamental for systemic therapists and in particular for me, to then move on to psychotherapeutic practice. How and when do I involve family members? Do they always have to be present at the sessions? How do individual systemic therapies differ from those conducted with other models? What is their specificity? What kind of change do systemic therapies pursue? And with what tools and techniques? How is therapeutic change assessed? What indicators do I consider? Who decides the end of the therapy? The patient or the therapist? How do systemic therapists work with "difficult patients"? And what is the influence of cognitivism, and in particular of Guidano's post-rationalistic perspective, on my model of semantic polarities?
This title that Luca Mazzucchelli and I have chosen for this interview seems incongruous. Depression is a devastating experience. But it is precisely the great depression, with the block of motor skills that characterizes it, inhibits suicidal and violent behaviors and, as you will see, also other behaviors that can be harmful. There are many questions to which this interview answers. Why is depression cyclical? And why precisely the depressed people who - according to Beck's well-known statement - have a negative conception of themselves, of the world and of the future, contribute so decisively to sciences and the arts? But does it make sense to talk about depression or are there very different forms of depression? Is serotonin, as biological psychiatry heralded for many years, really so important in the development of the depressive disorders? And are serotonergic drugs (SSRIs) really useful? What are the warning signs of depression?
What are the reasons for a girl to refuse food? What family experiences favor the development of anorexia? Why on earth does the onset of anorexia occur so frequently in adolescence? Is the role of the mother really so crucial? Does the experience of anorexia, beyond the many problems it creates, contain any resource aspects? How to deal with anorexia in therapy? These and others are the questions I answer in this conversation with Luca Mazzucchelli in which we focused much more on anorexia than on other eating disorders.
Is there a fundamental problem shared by people suffering from disorders of phobic spectrum? And which is it? Does the couple dynamics play a fundamental role in the development of panic attacks? And the family of origin? Is it possible to identify resources in people prone to developing a phobic disorders? What risks and difficulties does psychotherapy working with these people? Do you recover from panic attacks, agoraphobia and other phobic troubles? These are the main questions I answer in this interview with Luca Mazzucchelli
In this conversation with Luca Mazzucchelli we talk about the disenchantment in the couple, a topic that, like all psychotherapists, I often find myself facing, but also about the enchantment that sometimes (not always) gives life to the couple. I have focused my attention only relatively recently on this magical phase that we hardly see in therapy. And, as strange as it may seem to you, it was precisely psychopathology and the differences that can be found in this regard between different disorders that sparked my interest in this topic. Suffice it to say, that falling in love can cause symptomatic onset in phobic organizations. On the contrary, people with depressions, that can be placed in the semantics of belonging, as cyclical depressions and bipolar II disorders, generally recover if they fall in love, at least as long as the spell remains. Much of the interview is dedicated to the innovations introduced by the theory of semantic polarities that I have developed in the understanding of couple dynamics and to the profound differences in the love registers that we find in people with different semantics. I also introduce many clinical examples and Luca Mazzucchelli prompts me with several intriguing questions. An example? Do couples that belong to the same semantic get along better than those with little semantic cohesion? And what about intercultural couples?
La psicoanalisi non ha già detto tutto o quasi su questa psicopatologia? Cosa introduce di nuovo sui disturbi ossessivo-compulsivi il modello che hai elaborato?  Qual è il dramma degli ossessivo-compulsivi? Che significati hanno ossessioni e compulsioni? E i rituali?  Oltre ad ossessioni e compulsioni, ci sono altri sintomi e problemi che travagliano la vita degli ossessivi? La terapia familiare è utile con questa psicopatologia? Rispondo a queste  e ad altre domande  in questa intervista con Luca Mazzucchelli