HISTORY OF ANTI-EXPECTATION PSYCHOTHERAP TECHNIQUES

Roger P. says, ” My interest in these techniques grew out of  a number  of encounters with resistant patients who stated that they were seeking change while at the same time they clung tenaciously to the symptoms   and discomforts that brought them in. Such patients tended to externalize problems and emphasize that the world was beyond  their  control while demonstrating the ability to control the therapy  situation by fending off therapist attempts at exploration, interpretation, or direction. These patients often took the role of the help rejecting complainer, first identified by Jerome Frank and later described by other clinicians. Thus,they continually attempted to pull  advice from the therapist only to reject any suggestions that might be  offered. They made their problems seem insoluble and appeared to take a special delight and pride in the insurmountability of  their  difficulties.

Perhaps the key to this type of patient’s control  of the therapy  situation is his expectation that no matter what he does, the therapist  will try to be therapeutic.The patient remains relatively confident that his negative view of himself will  be matched by therapeutic interventions aimed at getting him to see the “causes” of his views, the  alternatives he is overlooking, the positive assets he has, or the resistive nature of  his communications.  Typically, a static balance          soon evolves  in which the patient’s negative statements are repeatedly counterbalanced  by therapist intervention.While this kind of patient  behavior may get attention and possibly preserve some  inappropriate truths for the patient — such as,even the therapist can’t help me solve my problems —  it can prove extremely frustrating to therapists  and potentially destructive of the therapeutic relationship.It eventually becomes imperative that the therapist somehow disturb the nonproductive stability of the resistant behavior. The use of Anti-Expectation Techniques allows the therapist to regain control over        this impasse to therapeutic progress.”

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