https://doi.org/10.4081/ripppo.2021.577

When and for whom do psychodynamic therapists use guided imagery? Explicating practitioners’ tacit knowledge

Vol. 24 No. 3 (2021)
Submitted: July 15, 2021
Accepted: November 30, 2021
Published: December 20, 2021
Guided affective imagery, guided imagery psychotherapy, differential indication, psychodynamic therapy, tacit knowledge.
Abstract Views: 2225
PDF: 711
HTML: 52
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Jule Bauckhage
Department of Psychology, University of Kassel, Germany.
Christian Sell
csell@uni-kassel.de
https://orcid.org/0000-0002-8460-3946
Department of Psychology, University of Kassel, Germany.

Guided imagery psychotherapy (GIP) is an established therapeutic method using creative mental imagery within a psychodynamic frame of reference. Although there is evidence for the method’s general effectiveness, it is yet unclear under which conditions and for which patients it should be used. The aim of this study was therefore to empirically identify indication criteria for the use of guided affective imagery (GAI) as part of psychodynamic therapies. We conducted semi-structured interviews with N=15 psychodynamic therapists also qualified as GAI training therapists. We asked them to recollect cases in which they had decided either for or against the use of imagery. The therapists described a complex interplay of different factors. Using grounded theory coding supplemented by elements of Consensual Qualitative Research we reconstructed from their accounts a sequential model of their indicative decisions. First, there is a consideration of clear contraindications related to reality testing and destructiveness. Second, there are aspects requiring a modified application of GAI such as emotional instability and post-traumatic stress disorder symptoms. In a final step, there are a number of characteristics of the patient, the therapist, the therapeutic relationship, the patients’ initial imagery and different therapeutic goals and foci which are weighed relatively to each other in order for therapists to reach an indication decision. We end by discussing ways in which the indicative decision model may be used to improve GAI training as well as the method’s differential efficacy and effectiveness.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Argelander, H. (1974). Die psychoanalytische Situation einer Gruppe im Vergleich zur Einzeltherapie. Psyche, 28(4), 310-327.
Bahrke, U., & Nohr, K. (2018). Katathym Imaginative Psychotherapie: Lehrbuch der Arbeit mit Imaginationen in psychodynamischen Psychotherapien. Berlin: Springer-Verlag. DOI: https://doi.org/10.1007/978-3-662-56546-9
Beutler, L. E., Forrester, B., Gallagher-Thompson, D., Thompson, L., & Tomlins, J. B. (2012). Common, specific, and treatment fit variables in psychotherapy outcome. Journal of Psychotherapy Integration, 22(3), 255-281. doi:10.1037/a0029695. DOI: https://doi.org/10.1037/a0029695
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252-260. doi:10.1037/h0085885. DOI: https://doi.org/10.1037/h0085885
Bryant, A., & Charmaz, K. (2019). The SAGE Handbook of Current Developments in Grounded Theory. London: SAGE. DOI: https://doi.org/10.4135/9781526485656
Caspar, F. (1997). What goes on in a psychotherapist’s mind? Psychotherapy Research, 7(2), 105-125. doi:10.1080/10503309712331331913. DOI: https://doi.org/10.1080/10503309712331331913
Charmaz, K. (2014). Constructing Grounded Theory. London: SAGE.
Corbin, J., & Strauss, A. (2014). Basics of qualitative research: Techniques and procedures for developing grounded theory. London: SAGE.
Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches. London: SAGE.
Cronbach, L. J., & Snow, R. E. (1977). Aptitudes and instructional methods: A handbook for research on interactions. Irvington, New York: Irvington Publishers.
Delgadillo, J., & Gonzalez Salas Duhne, P. (2019). Targeted prescription of cognitive-behavioural therapy versus person-centered counseling for depression using a machine learning approach. Journal of Consulting and Clinical Psychology. doi:10.1037/ccp0000476. DOI: https://doi.org/10.1037/ccp0000476
Dieckmann, M., Becker, M., & Neher, M. (2020). Faber/Haarstrick. Kommentar Psychotherapie-Richtlinien. Amsterdam: Elsevier Health Sciences.
Dieter, W. (2000). Katathym-imaginative Psychotherapie bei Borderlinestörungen. Psychotherapeut, 45(2), 90-98. DOI: https://doi.org/10.1007/s002780050206
Dieter, W. (2001). Die Katathym Imaginative Psychotherapie - Eine tiefenpsychologische Behandlungsmethode. Imagination, 23(3), 5-41.
Dimidjian, S. (2019). Evidence-based practice in action: bridging clinical science and intervention. New York, NY: Guilford Publications.
Dresing, T., & Pehl, T. (2012). Praxisbuch Interview, Transkription & Analyse Anleitungen und Regelsysteme für qualitativ Forschende. Marburg: Dr. Dresing & Pehl GmbH.
Esplen, M. J., Garfinkel, P. E., Olmsted, M., Gallop, R. M., & Kennedy, S. (1998). A randomized controlled trial of guided imagery in bulimia nervosa. Psychological Medicine, 28(6), 1347-1357. doi:10.1017/S0033291798007405. DOI: https://doi.org/10.1017/S0033291798007405
Evers, O., Schröder-Pfeifer, P., Möller, H., & Taubner, S. (2019). How do personal and professional characteristics influence the development of psychotherapists in training: Results from a longitudinal study. Research in Psychotherapy: Psychopathology, Process and Outcome, 22(3), 389-401. doi:10.4081/ripppo.2019.424. DOI: https://doi.org/10.4081/ripppo.2019.424
Federal Ministry of Social Affairs, Health, Care and Consumer Protection. (2019). Psychotherapie. Gesundheitsportal. Available from: https://www.gesundheit.gv.at/leben/psyche-seele/krisenintervention/psychotherapie
Freud, S. (1900). Die Traumdeutung: Vol. Gesammelte Werke 2/3. Fischer.
Hall, E., Hall, C., Stradling, P., & Young, D. (2006). Guided imagery: creative interventions in counselling & psychotherapy. London: SAGE.
Hill, C. E., & Knox, S. (2021). Essentials of consensual qualitative research. American Psychological Association. DOI: https://doi.org/10.1037/0000215-000
Huppert, J. D., Bufka, L. F., Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2001). Therapists, therapist variables, and cognitive-behavioural therapy outcome in a multicenter trial for panic disorder. Journal of Consulting and Clinical Psychology, 69(5), 747-755. doi:10.1037//0022-006X.69.5.747. DOI: https://doi.org/10.1037/0022-006X.69.5.747
Kernberg, O. F. (1993). Severe personality disorders: psychotherapeutic strategies. London: Yale University Press.
Kirn, T., Echelmeyer, L., & Engberding, M. (2009). Imagination im Anwendungsfeld der Klinischen Psychologie und Psychotherapie. In T. Kirn, L. Echelmeyer, & M. Engberding (Eds.), Imagination in der Verhaltenstherapie (pp. 3-24). Springer. doi:10.1007/978-3-642-01058-3_1. DOI: https://doi.org/10.1007/978-3-642-01058-3_1
Koddebusch, C., & Hermann, C. (2018). A proposed conceptualization of therapeutic competence: the three level model. Research in Psychotherapy: Psychopathology, Process and Outcome, 21(1), 12-23. doi:10.4081/ripppo.2018.286. DOI: https://doi.org/10.4081/ripppo.2018.286
Kottje-Birnbacher, L. (1992). Strukturierende Faktoren des Katathymen Bilderlebens. Praxis Der Psychotherapie Und Psychosomatik, 37(3), 164-173.
Kvale, S., & Brinkmann, S. (2009). InterViews: learning the craft of qualitative research interviewing. London: SAGE.
Leichsenring, F., & Leibing, E. (2003). The effectiveness of psychodynamic therapy and cognitive behaviour therapy in the treatment of personality disorders: A meta-analysis. American Journal of Psychiatry, 160(7), 1223-1232. doi:10.1176/appi.ajp.160.7.1223. DOI: https://doi.org/10.1176/appi.ajp.160.7.1223
Lempert, L. B. (2007). Asking questions of the data: memo writing in the grounded theory tradition. In A. Bryant & K. Charmaz (Eds.), The SAGE handbook of grounded theory: paperback edition (pp. 245-264). London: SAGE. DOI: https://doi.org/10.4135/9781848607941.n12
Leuner, H., & Wilke, E. (2005). Katathym-imaginative Psychotherapie (KIP). Georg Thieme Verlag. DOI: https://doi.org/10.1055/b-002-44944
Luborsky, L. (1998). The relationship anecdotes paradigm (RAP) interview as a versatile source of narratives. In L. Luborsky & P. Crits-Christoph (Eds.), Understanding transference: the core conflictual relationship theme method (pp. 109-120). American Psychological Association. DOI: https://doi.org/10.1037/10250-007
Lutz, W., Clausen, S. A., & Deisenhofer, A.-K. (2019). Perspektiven einer evidenzbasierten und personalisierten Psychotherapie. Zeitschrift Für Klinische Psychologie Und Psychotherapie, 48(2), 79-89. doi:10.1026/1616-3443/a000518. DOI: https://doi.org/10.1026/1616-3443/a000518
Morgan, D. L. (2007). Paradigms lost and pragmatism regained: methodological implications of combining qualitative and quantitative methods. Journal of Mixed Methods Research, 1(1), 48-76. doi:10.1177/2345678906292462. DOI: https://doi.org/10.1177/2345678906292462
Nilsson, T., Svensson, M., Sandell, R., & Clinton, D. (2007). Patients’ experiences of change in cognitive-behavioural therapy and psychodynamic therapy: a qualitative comparative study. Psychotherapy Research, 17(5), 553-566. doi:10.1080/10503300601139988. DOI: https://doi.org/10.1080/10503300601139988
Norcross, J. C., & Wampold, B. E. (2018). A new therapy for each patient: evidence-based relationships and responsiveness. Journal of Clinical Psychology, 74(11), 1889-1906. https://doi.org/10.1002/jclp.22678 DOI: https://doi.org/10.1002/jclp.22678
Oddli, H. W., & Halvorsen, M. S. (2014). Experienced psychotherapists’ reports of their assessments, predictions, and decision making in the early phase of psychotherapy. Psychotherapy, 51(2), 295-307. doi:10.1037/a0029843. DOI: https://doi.org/10.1037/a0029843
Patton, M. Q. (2015). Qualitative research & evaluation methods: integrating theory and practice. London: SAGE.
Polanyi, M. (1962). Personal knowledge: Towards a post-critical philosophy, revised edition. Chicago, IL: University of Chicago.
Reddemann, L. (2014). Psychodynamisch Imaginative Traumatherapie: PITT®-Das Manual. Ein resilienzorientierter Ansatz in der Psychotraumatologie. Klett-Cotta. DOI: https://doi.org/10.1007/978-3-642-35068-9_15
Reyno, S. M., Simmons, M., & Kinley, J. (2020). A meta-analytic study examining the relationship between alexithymia and dissociation in psychiatric and non-clinical populations. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(1), 99-107. doi:10.4081/ripppo.2020.439. DOI: https://doi.org/10.4081/ripppo.2020.439
Rohde-Dachser, C. (2004). Das Borderline-Syndrom. Hans Huber Verlag.
Sachsse, U. (1989). ‘Das Bildern macht alles nur schlimmer’. Grenzen einer Therapie mit dem katathymen Bilderleben bei Patienten mit strukturellen Ich-Störungen. In G. Bartl & F. Pesendorfer (Eds.), Strukturbildung im therapeutischen Prozess (pp. 169-182). Literas Universitätsverlag.
Schultze-Lutter, F., Schmidt, S. J., & Theodoridou, A. (2018). Psychopathology - A precision tool in need of re-sharpening. Frontiers in Psychiatry, 9, 446. doi:10.3389/fpsyt.2018.00446. DOI: https://doi.org/10.3389/fpsyt.2018.00446
Sell, C., Möller, H., & Taubner, S. (2017). Effectiveness of integrative imagery- and trance-based psychodynamic therapies: guided imagery psychotherapy and hypnopsychotherapy. Journal of Psychotherapy Integration, 28(1), 90-113. doi:10.1037/int0000073. DOI: https://doi.org/10.1037/int0000073
Silberschatz, G. (2017). Improving the yield of psychotherapy research. Psychotherapy Research, 27(1), 1-13. doi:10.1080/10503307.2015.1076202. DOI: https://doi.org/10.1080/10503307.2015.1076202
Sternberg, R. J., & Horvath, J. A. (1999). Tacit knowledge in professional practice: researcher and practitioner perspectives. Hove: Psychology Press. DOI: https://doi.org/10.4324/9781410603098
Stigler, M., & Pokorny, D. (2012). Eine Dekade der KIP-Prozessforschung im Überblick. In H. Ullmann & E. Wilke (Eds.), Handbuch Katathym Imaginative Psychotherapie (pp. 122-145). Huber.
Tanzilli, A., Majorana, M., Fonzi, L., Pallagrosi, M., Picardi, A., de’ Fornari, M. A. C., Biondi, M., & Lingiardi, V. (2018). Relational variables in short-term psychodynamic psychotherapy: An effectiveness study. Research in Psychotherapy: Psychopathology, Process and Outcome, 21(3), 190-200. doi:10.4081/ripppo.2018.327. DOI: https://doi.org/10.4081/ripppo.2018.327
Thomas, V. (2015). Using mental imagery in counselling and psychotherapy: A guide to more inclusive theory and practice. London: Routledge. DOI: https://doi.org/10.4324/9781315673233
Ullmann, H., & Wilke, E. (Eds.). (2012). Handbuch Katathym Imaginative Psychotherapie (KIP). Mannheim: Huber Verlag.
VERBI Software. (2019). MAXQDA 2020 [computer software]. VERBI Software. Available from maxqda.com
von Wietersheim, J., Wilke, E., Röser, M., & Meder, G. (2003). Ergebnisse der Katathymimaginativen Psychotherapie. Psychotherapeut, 48(3), 173-178. doi:10.1007/s00278-003-0298-1. DOI: https://doi.org/10.1007/s00278-003-0298-1
Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: the evidence for what makes psychotherapy work. London: Routledge. DOI: https://doi.org/10.4324/9780203582015
Zilcha-Mano, S. (2017). Is the alliance really therapeutic? Revisiting this question in light of recent methodological advances. American Psychologist, 72(4), 311-325. doi:10.1037/a0040435. DOI: https://doi.org/10.1037/a0040435

How to Cite

Bauckhage, J., & Sell, C. (2021). When and for whom do psychodynamic therapists use guided imagery? Explicating practitioners’ tacit knowledge. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(3). https://doi.org/10.4081/ripppo.2021.577
Copyright (c) 2021 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.