Shift in representation and symbolisation of affective experience: A paradoxical outcome in therapy

• Published in: European Journal of Psychotherapy & Counselling Vol. 23; no. 2; pp. 177 - 200
• Main Authors: Thoresen, Lars Henrik Kaasen, Thørnquist, Hans Hella, Stänicke, Erik, Mcleod, John
• Format: Journal Article
• Language: English
• Published: Abingdon Routledge 03.04.2021; Taylor & Francis Ltd
• Subjects: Affect elaborationErgebnis; Affektausarbeitung; anoressia nervosa; Anorexia; Anorexia nerviosa; Anorexia nervosa; Anorexie mentale; Caracterización de la elaboración; Clinical outcomes; elaborazione affettiva; Ergebnis; esito; esito paradossale; Illusion de santé mentale; Illusion der psychischen Gesundheit; Illusion of mental health; illusione di salute mentale; Ilusión de salud mental; Mental health; mentalisation; Mentalisierung; Mentalización; Mentalization; mentalizzazione; outcome; paradoxes Ergebnis; Paradoxical outcome; Psicoterapia; Psychotherapie; Psychotherapy; Psychothérapie; Resultado; Resultado paradójico; resultats; resultats Paradoxaux; élaboration de l'affect; έκβαση; επεξεργασία συναισθήματος; παράδοξο αποτέλεσμα; Ψευδαίσθηση ψυχικής υγείας; ψυχικοποίηση; ψυχογενής ανορεξία; ψυχοθεραπεία
• ISSN: 1364-2537; 1469-5901
• DOI: 10.1080/13642537.2021.1923048

Defining outcome represents a key challenge for psychotherapy theory, research and practice. The present paper uses a case study of a client with anorexia nervosa to contribute to the development of conceptual understanding of the nature of paradoxical outcome. In this case, different sources of outcome data offered different answers to the question of whether or not the therapy had been successful. Qualitative thematic analysis of therapy transcriptions was carried out, using Interpretative Phenomenological Analysis (IPA). Both the process of change that occurred in this case, and the conflicting outcome indicators, could be explained in terms of a model of affect elaboration. These findings are discussed in terms of the need for caution when interpreting results from outcome measures in psychotherapy research and practice.