Motivational Monitoring: How to Identify Ruptures and Impasses and Enhance Interpersonal Attunement

摘要

Attachment theory is useful, but per se it may not be sufficient to understand the complexity of human relationships. For this reason, we believe that there is the need to refer to a broader (evolutionary theory of motivation; Liotti, Psychoanal Inquiry 37(5):319-331, 2017) that considers normal functioning as the result of the harmonious activation of various motivational systems, each aimed at achieving an objective of high evolutionary value (adaptive for the individual, the social group, and the species). In this approach, pathology results from the disharmonious and dysfunctional activation of one or more motivational systems. This leads to a theory of care aimed at modulating the maladaptive activation of motivational systems by recognizing each patient's dysfunctional interpersonal schemas and restoring his ability to function in more flexible ways. Motivational monitoring allows us to recognize impasses/ruptures within the therapeutic alliance and effectively use interventions to restore it. It may enhance patients' emotional regulation and the interpersonal attunement between patient and therapist, reducing the risk of dropouts and leading to better therapeutic outcomes.