Brief dynamic psychotherapy: toward a more comprehensive model.

Previous schools of brief dynamic psychotherapy, however valuable, have rejected the majority of potential patients. When the brief therapy method was experimentally extended to include most who applied, a new, more comprehensive model emerged. I discovered that many patients arrive in therapy not simply with a focal issue but, beneath that, with a pathogenic belief, i.e., a negative conviction about self engendered by unconscious guilt toward primary objects. I have found this pathogenic belief to be a most economic subject for brief therapy. Moreover, unverbalized but specific relationship interventions often represent a more effective treatment strategy to combat pathogenic belief than does interpretation alone. Critical review of previous work and a case illustration demonstrate that the new model speaks to important controversies in the theory and the practice of brief psychotherapy.