Meaning and development in the interpersonal treatment of severe psychopathology

As a result of increasing empirical evidence for biological etiologies and economic pressures for rapid symptom relief, treatments for patients with severe psychopathology have become more directive, behavioral, and biomedical. Since a more comprehensive understanding of severe mental disorders is gained through both empirical causal explantation and the discovery of meaning (Carpenter, 1987), clinicians are currently under a greater challenge to help patients cultivate more phenomenologically meaningful change experiences. An interpersonal treatment approach based upon narrative, intersubjective, developmental, and relational principles of understanding severe psychopathology that is complementary to behavioral and biomedical intervention is presented. Four universal maturational processes (interpersonal self, boundary formation, symbolization, response differentiation) are then described and used to illustrate how life-story repair, adjustment, and elaboration can create more meaningful treatment experiences.