Alexithymia and change process: Contributions of a phase model

• Published in: Counselling and psychotherapy research Vol. 20; no. 4; pp. 703 - 714
• Main Authors: Silva, Ana Nunes, Branco Vasco, António, Watson, Jeanne C.
• Format: Journal Article
• Language: English
• Published: Abingdon Blackwell Publishing Ltd 01.12.2020
• Subjects: Alexithymia; case study; change process; emotional processing; integrative approach; Psychotherapy; Therapists
• ISSN: 1473-3145; 1746-1405
• DOI: 10.1002/capr.12303

The research literature shows patients with alexithymia have poorer outcomes in psychotherapy. We reflect upon psychotherapy with alexithymic patients presenting one case study, from a larger research project, throughout 12 sessions. This study used a mixed‐methods design with qualitative and quantitative methods exploring both client's and therapist's perspectives. From the client's perspective, different dimensions were explored: emotional process components, symptom severity, therapeutic alliance and the processing capacity regarding the phase‐specific general strategies as postulated in the Paradigmatic Complementarity Metamodel (PCM). Regarding the therapist's perspective, we investigated the PCM phase‐specific strategic goals promoted throughout the process and the perception of the therapeutic alliance. Quantitative and qualitative data are presented. The client presented a significant change in both alexithymia and symptom severity regarding the reliable change index, being considered a good outcome. The sequencing of general strategies as a phase‐by‐phase map of the therapeutic process is used to describe the development of client's and therapist's variables. We discuss that considering alexithymia in case conceptualisation may help overcome its impact on the therapeutic process, especially regarding emotional processing and the therapeutic alliance. The implications for psychotherapy intervention are highlighted.