Experiential Short-Term Dynamic Psychotherapy, by Ferruccio Osimo. AnchorHouse, 2003.
Reviewed by Ronald J. Frederick, PhD, LP
With Experiential Short-Term Dynamic Psychotherapy: A Manual, Ferruccio Osimo, MD, makes a substantial contribution to the field of Experiential Dynamic Therapy (EDT) detailing with refreshing clarity and humanity the theory and technique of his particular model of psychotherapy: E-STDP.
Dr. Osimo begins by introducing the reader to the basics of the experiential-dynamic paradigm with an illustration of Malan’s Two Triangles followed by a brief history and theory of the acceleration of the therapeutic process. He then goes on to delineate in detail an array of clinical interventions for dealing with each of the three corners of the triangles with a particular emphasis on therapeutic activity, that is, what the therapist does or can do to affect change. Grounded in the quest for deep emotional experiencing and working through common to the different EDTs, the clinical methods essential to E-STDP focus on the active management of defenses, affects and anxiety, and constitute what Osimo refers to as the Dynamic Activities: Defense Restructuring, Emotional Maieutics, and Anxiety Regulation.
Of the three dynamic activities set forth, it is in his conceptualization and discussion of “emotional maieutics” where Dr. Osimo makes what may be his most significant contribution. He astutely finds a way to delineate and articulate therapeutic activities that heretofore had not been adequately given their due. “Maieutic Activity” applies the concept of maieutics (derived from the ancient Greek for midwife) to E-STD and the experiencing of emotions. Here, the therapist acts as a midwife of sorts, helping the person to fully bare and give birth to emotions present in him/herself. Through a “maieutic attitude” the therapist (1) makes himself emotionally available to the patient providing a sense of being connected and not alone, (2) actively attunes to the experiencing of emotion, and (3) supports the verbal and bodily expression of such emotion. Above all, the main purpose in this activity is to attenuate an “intense, primordial” fear of emotional expression so that feelings can coalesce and then be expressed.
All of the three main activities rely on the accurate mirroring of defenses and can flexibly be adapted to the therapist’s own personality, the individual patient, and the specific issue being addressed. Never dogmatic, Osimo emphasizes being realistic about the influence of the therapist’s personality, gender, culture, life experience and training on the work with clients and encourages an individualistic approach that honors the clinician’s strengths as well as his/her authenticity. He contends that the best results will occur when the therapist makes use of the dynamic activities that are most aligned with his or her personality saying, “a therapist’s effectiveness primarily descends from coherence with his/her own way of being, and willingness to make oneself emotionally available to the patient” (p. 140). Osimo highlights the essential interpersonal nature of the therapy relationship, in which both the therapist and client come together as real, as the “basis on which cure can be built” (p. 165). The challenge to doing transformational work lies in not only being able to master and apply these approaches, but to do so in a manner that honors both the uniqueness of both the client and the therapist. Osimo illustrates the different approaches of E-STDP and demonstrates his own flexibility in applying relevant interventions in two lengthy case descriptions of two very different clients. The reader is thus afforded two wonderfully detailed examples of the application of this model and the remarkable therapeutic that are possible.