Resolution of assimilation setbacks in the case of Alicia: the dance of strands

ABSTRACT

Objective

According to assimilation theory, in successful therapy, the usual self, composed of dominant voices (DVs) comes to terms (establishes meaning bridges) with traces of problematic experiences, or nondominant voices (NDVs).  Voices are composed of multiple strands, that is, traces of interrelated experiences. Setbacks typically involve a shift from a more-assimilated pre-setback strand of a problem to a less-assimilated setback strand. This qualitative theory-building case study investigated participants’ responsive processes as they resolved such setbacks.

Methods

Alicia was diagnosed with depression and treated with a cognitive therapy for 26 sessions. Setback episodes (N = 70) resolved to at least level 4 (Insight) on the 0 to 7 assimilation scale were identified, and the therapist's and client’s responsive actions were described as the different strands appeared and evolved during the post-setback resolution.

Results

Resolutions involved a dance of strands of the NDVs and DVs, facilitated by the introduction of therapeutic strands by the therapist. This entailed joint, mutually responsive work by client and therapist. This required tempering strands of the DV (responsively moderating their dominance) and opening the DV to strands of NDVs, which were reframed in ways that seemed to make them more understandable and less painful.

Conclusion

If both participants elicit and pursue many strands of conflicting voices--the dance of strands – their positions become mutually comprehended, facilitating assimilation and the resolution of setbacks. As clients resolve setbacks in this way, DV and NDV come to understand each other, establishing a meaning bridge.

KEYWORDS:

• Responsiveness
• assimilation setbacks
• switch of strands
• resolution of setbacks
• therapeutic zone of proximal development
• balance strategy

Disclosure statement

No potential conflict of interest was reported by the author(s).

Practical implications

• For the resolution of setbacks clients and therapists engage in a dance of strands, that is, a mutually responsive exchange involving varied aspects of a problem.

• Resolution of setbacks and building meaning bridges often proceeds from introducing new therapeutic strands.

• The dance of strands involves external and internal dialogue among therapist and client voices through which clients can come to terms with (assimilate) their problematic experiences.