How Psychotherapy Works : Process and Technique book cover
1st Edition

How Psychotherapy Works
Process and Technique

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ISBN 9780898625486
Published November 18, 1993 by Guilford Press
224 Pages

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Book Description

In the landmark volume, THE PSYCHOANALYTIC PROCESS, Joseph Weiss presented a bold, original theory of the therapeutic process. Now, in HOW PSYCHOTHERAPY WORKS, Weiss extends his powerful theory and focuses on its clinical applications, often challenging many familiar ideas about the psychotherapeutic process.

Weiss' theory, which is supported by formal, empirical research, assumes that psychopathology stems from unconscious, pathogenic beliefs that the patient acquires by inference from early traumatic experiences. He suffers unconsciously from these beliefs and the feelings of guilt, shame, and remorse that they engender, and he is powerfully motivated unconsciously to change them. According to Weiss's theory, the patient exerts considerable control over unconscious mental life, and he makes and carries out plans for working with the therapist to change his pathogenic beliefs. He works to disprove these beliefs by testing them with the therapist. The theory derives its clinical power not only from its empirical origin and closeness to observation, and also from Weiss's cogent exposition of how to infer, from the patient's history and behavior in treatment, what the patient is trying to accomplish and how the therapist may help. By focusing on fundamental processes, Weiss's observations challenge several current therapeutic dichotomies--supportive versus uncovering, interactive versus interpretive, and relational versus analytic.

Written in simple, direct language, Weiss demonstrates how to uncover the patient's unconscious plan and how the therapist can help the patient to carry out his plans by passing the patient's tests. He includes many examples of actual treatment sessions, which serve to make his theory clear and usable. The chapters include highly original views about the patient's motivations, the role of affect in the patient's mental life, and the therapist's basic task. The book also contains chapters on how to pass the patient's tests, and how to use interpretation with the patient. Dr. Weiss also provides a powerful theory of dreams and demonstrates how dreams can be utilized in clinical practice.

This distinguished volume is a major contribution that will profoundly affect the way one conceptualizes and practices therapy. Theoreticians, investigators, and clinicians alike will find it enlightening reading.

Table of Contents

The Technique of Psychotherapy: Theory and Practice. Introduction. Affective Motivation and Adaption. The Therapist's Task. Inferring the Patient's Plan from the First Few Sessions of Therapy. Testing. Interpretation. The Therapist's Use of Dreams. Part II: Research and a Comparison of Theories. The Empirical Basis of the Theory. A Comparison of the Present Theory with Freud's 1911?1915 Theory and with His Late Theories. A Comparison of the Present Theory with Other Current Theories. Appendix: List of Case References. References. Index.

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Joseph Weiss is a training analyst at the San Francisco Psychoanalytic Institute, Clinical Professor of Psychiatry at the University of California Medical Center in San Francisco, and Co-director (with Harold Sampson) of the San Francisco Psychotherapy Research Group. He received his baccalaureate degree from Harvard, his medical degree from the University of Cincinnati Medical School, and was trained in psychoanalysis at the San Francisco Psychoanalytic Institute, where he became a training analyst in 1962. He is also currently in private practice in San Francisco.


Patients come to psychotherapy hoping to get better and look to therapists to help them feel safe by disconfirming conscious pathogenic beliefs. Here we have what seems like a remarkably simple idea. But what is revolutionary and most startling, Weiss's theory has been empirically tested and validated. Weiss ranges from his broad conceptualization of motivation and pathogenesis to the microanalysis of the clinical exchange. He demonstrates the impact of psychotherapy is in the effect of interventions, not on the intent or purity of technique. Reading HOW PSYCHOTHERAPY WORKS is a corrective educational experience. --Joseph Lichtenberg, M.D., Washington, D.C.

This exciting and original book is a veritable treasure-house of practical understanding and clinical wisdom gained from Dr. Weiss's decades of psychoanalytic experience and amply supported by an impressive body of systematic research on the theories he has advanced. The lucidity and readability of this work is outstanding and should make this an excellent basic text for beginners in the field, as well as seasoned mental health practitioners.

According to Weiss's therapy, psychopathology stems from pathogenic beliefs formed mainly in childhood from traumatic relationships. Weiss's theory of therapy and technique follows directly from his concept of psychopathology. He views psychotherapy as a process in which the patient works to disconfirm his pathogenic beliefs with the help of the therapist. Patients are powerfully motivated to disconfirm these beliefs because they are maladaptive and grim, and they produce much mental pain. Weiss conceptualizes the therapist's basic task as being one of helping patients to disprove their pathogenic beliefs, particularly their unconscious pathogenic beliefs, and to help patients pursue the goals that have been blocked by these overwhelmingly disturbing ideas. --Theo. L. Dorpat, M.D., F.A.P.A., Seattle, Washington

In HOW PSYCHOTHERAPY WORKS, Joseph Weiss offers an experience-near, relational, and rational approach to psychoanalytic therapy that is based on empirical research into the therapeutic process. A breath of fresh air in a field dominated by unsupported doctrine, this excellent text will serve as an invaluable guide to all students of psychotherapy. --Robert D. Stolorow, Ph.D., Training and Supervising Analyst, Institute of Contemporary Psychoanalysis

....This highly original book is recommended reading for mental health professionals at all levels of training. --Theo L. Dorpat in The Psychoanalytic Quarterly

This book is recommended for educators and practitioners wanting to understand and make use of a psychoanalytic approach with clients. --David A. Jenkins, Ph.D., The American Journal of Family Therapy

This book summarizes decades of clinical teaching, research, and study in a form that is readily accessible to the working psychoanalyst....The body of work presented is important and should be taken seriously. --Stephen F. Bauer, M.D., in Psychoanalytic Books

This original and exciting book on psychotherapy process and technique should become, in a short time, the most outstanding book in the field of psychoanalytical technique and process....The readability of this eminently practical volume makes it required reading for mental health professionals at all levels of training and experience. --Theo L. Dorpat, M.D., in The Psychoanalytic Psychotherapy Review
...original and exciting....The most outstanding book in the field of psychoanalytical technique and process....Required reading for mental health professionals at all levels of training and experience.
--Psychoanalytic Psychotherapy Review, 8/22/1993ƒƒ
....This highly original book is recommended reading for mental health professionals at all levels of training.
--The Psychoanalytic Quarterly, 8/22/1993ƒƒ
Attractive and logically organized. It includes a feature rarely seen in texts discussing psychotherapy technique: empirical data supportive of the author's theories and technical prescriptions....An excellent book that meets its objectives and that will be quite useful both to therapists in training and experienced clinicians.
--Doody's Annual Health Sciences Book Review, 8/22/1993