I am a great fan of Peter Fonagy, partly because he has a brilliant mind but also because he gave such a great lecture (or rather whole day of lectures) that I still remember much of what he said 7 years later….I’ve just read an interview with him in the Psychotherapist magazine (generally not a gripping read it has to be said – the UKCP‘s quarterly journal).

He summarises what ‘integrative’ therapy means to him, and as I like the way he has put things, I wanted to reproduce them here. Not being a ‘purist’ (eg Gestalt therapist or CBT therapist) means I generally have to make great effort to convey what I do. There’s no neat ‘treatment’ that, say, analysts describe. Fonagy thinks there are three main ingredients to a successful psychotherapy: attachment, mentalising and compassion.

‘Attachment’ here refers to the trust any client must have in her therapist, which is clearly a difficult and counter-intuitive experience as she won’t know her/him from the off. This trust is sometimes described as the ‘therapeutic alliance’ or ‘collaborative stance’. Fonagy puts it in these terms: the therapist and client co-create this attachment relationship (which has infantile origins) via a number of subtle and important behaviours, that are mostly immeasurable by scientific standards. These include the therapist being emotionally ‘contingent’ in response to the client’s story and point of view. If you (therapist) take an interest in me, this creates, biologically, an attachment relationship between the two of us. I look to you to soothe my distress and this will elicit care from you (just as a mother responds to her child).

‘Mentalising’ is an ugly word but a sophisticated concept that Fonagy has written loads on. It involves a therapist being able to create in her mind some image of her client’s mind and is crucial for therapy. She must also communicate in such a way that the client is facilitated in organising her mental world. Experiencing anyone making sense of my thoughts and feelings help me organise myself – in distress I may even ask someone to think for me.

Lastly, but by no means least is compassion. This is another big and favourite topic of mine, written about here.

I agree with something else he says ‘I am totally signed up to psychotherapy regardless of modality’.