Intervention modes in psychoanalysis and in psychoanalytic psychotherapies: A revised classification (Reprinted)

Psychoanalytic psychotherapy evolved here in America almost exactly a half-century ago, out of the psychoanalysis innovated by Freud a half-century earlier in Vienna. From the start it was framed along two distinct lines that were called expressive (interpretive, insight-aiming, uncovering) and supportive (ego-maintaining, suppressive), both directions being solidly anchored in psychoanalytic understanding, but differing in techniques and in goals in relation to the differing clinical exigencies of patients across the entire psychopathological spectrum. Because of its greater closeness to the techniques and goals of psychoanalysis proper, expressive therapy has from the start been better articulated with greater (seeming) consensus on its modes of action and the mechanisms of the changes that it achieves. In this paper we trace out in detail the granual elaboration of our understanding of the various techniques that can be specified in the originally more amorphous and ambiguous conceptions of supportive intervention modes. We offer in conclusion an amplified scheme for categorizing both expressive and supportive intervention modes.