Deconstructive and Constructive Dynamics in the Clinical Process: A Step Further in the Validation of the Two-Stage Semiotic Model

Abstract

The two-stage semiotic model (TSSM) suggests that the basic dynamics of a psychotherapy process could be described in terms of alternation of two different processes aimed respectively at constraining patients’ meanings regulating experience and action (deconstructive process) and at supporting the elaboration of innovative meanings (constructive process). The present case study tests the specificity of each of these processes in terms of clinically relevant features detected at interpersonal, intrapsychical, and clinical levels. A 76-session good-outcome psychodynamic treatment was studied. The results enable constructive and deconstructive sessions to be differentiated in terms of interaction modalities and the patient's modalities of thinking. This is consistent with the TSSM hypothesis that the constructive and deconstructive sessions are composed of qualitatively different clinical processes.