Brief dynamic psychotherapy: characterologic intervention and the physical position of the patient

BRIEF dynamic psychotherapy has achieved widespread acceptance in the past 20 years but as yet has formed no satisfactory approach to effecting character change. The most frequently chosen path has been to select for treatment only those who readily demonstrate the capacity to investigate focal conflict, thus bypassing character armor. The strategy here flows in the opposite direction. Within brief dynamic treatment, what technical alterations might more effectively engage characterologic difficulty? I report on one such innovation. When patients are asked to sit close to but turned at 180 degrees from the therapist, those with character disorders--particularly patients suffering from mid-level disorders--can often suspend their defenses sufficiently to permit specific types of new material into the treatment. This alteration in process appears, in turn, to abet outcome.