MEANING AND DEVELOPMENT IN THE INTERPERSONAL TREATMENT OF SEVERE PSYCHOPATHOLOGY

As a result of increasing empirical evidence for biological etiologies and economic pressures for rapid symptom relief, treatments for patie nts with severe psychopathology have become more directive behavioral, and biomedical. Since a more comprehensive understanding of severe me ntal disorders is gained through both empirical causal explanation and the discovery of meaning (Carpenter, 1987), clinicians are currently under a greater challenge to help patients cultivate more phenomenolog ically meaningful change experiences. An interpersonal treatment appro ach based upon narrative, intersubjective, developmental, and relation al principles of understanding severe psychopathology that is compleme ntary to behavioral and biomedical intervention is presented. Four uni versal maturational processes (interpersonal self, boundary formation, symbolization, response differentiation) are then described and used to illustrate how life-story repair, adjustment, and elaboration can c reate more meaningful treatment experiences.