How can talking cure? On language in psychotherapy

摘要

Psychotherapy is traditionally considered as a talking cure, i.e. a healing method that operates through language; however, the implications of this view are unclear as the therapeutic effects of verbal processes have been spelled out in various ways. Against this background the present study discusses central approaches to the talking cure in terms of 1) catharsis, 2) symbolization, 3) metaphors, 4) verbal interventions and 5) narratives with reference to findings of psychotherapy research. As a result, a complex pattern of disparate theoretical approaches arises which converge in the basic assumption that the therapeutic potential of language is due to its ability to explicate or modify pathological or maladaptive experiential constellations. Empirical findings regarding these approaches are heterogeneous: Most types of verbal activity show equivocal associations with therapy outcome. More consistent findings are reported regarding associations with process variables, which imply that specific processes can be effectuated by different types of verbal activity (e.g. understanding by transference interpretations, self-disclosure, metaphors, or narratives). Moreover, it was demonstrated that most verbal activities can have detrimental effects. Altogether, empirical findings suggest an integrative view on the therapeutic effects of language, i.e., that language contributes to effectuate therapeutic change due to a set of basic processes that need to be considered within the framework of relational interaction and which depend on complex boundary conditions that need to be clarified and systematized in subsequent psychotherapy research.