Recently I have been thinking about the different perspectives of depth psychotherapies, some of which hold a two person model and some of which hold a one person model. Much of recent psychotherapy focuses on the intersubjectivity of the therapist and the patient or on the relationship process between the two. In this view, the patient develops a relationship with the therapist and this provides a stability and context within which the patient can grow and develop. As the patient internalizes the experience of the relationship with the therapist, the patient becomes autonomously self regulating because the internalized relationship continues to give the patient reflections of him or herself that are organizing and accurate. In other words, “I know who I am and I know I have value because one other person set aside his or her personal agenda to pay close attention to me and to give me accurate reflections of who I am.”
The one person model provides a focus on the internal dynamic of the patient in order for him or her to move from an inaccurate assumption that he or she is causing all of his or her experience to a more accurate picture of his or her separateness from the motives and actions of other people. The focus remains on the patient’s inner life and the therapist is a medium, observer, and encourager, but remains a separate entity. It is not the relationship that is the focus of the analysis, but the subjective experience of the patient. This movement toward a deep comprehension of separateness, while frightening, allows the patient to have a truly autonomous experience of his or her own subjective inner life and thus to have a separated and more accurate view of the agency and motives of other people. In short, it allows a true relationship experience because the patient discovers that other people are separate from him or herself. In other words, “Because I have come to know my own motives accurately, I can know you accurately. I understand that you are a separate person from me, and your motives and actions are generated from your own personal subjective experience just as my motives and actions are generated from my own personal subjective experience.”
While these distinctions are subtle, they affect the way the therapist and patient focus on the process of what is happening for the patient. Either perspective can have value, and either can leave gaps in the development of the patient’s subjective sense of well-being. With the two person model, it can become difficult to keep in mind that the patient has a life outside of the office that is the purpose of his motive to continue his development. With the one person model, the therapist can forget his or her personal, subjective view and its impact on the patient’s development. It is the therapist’s responsibility to hold in mind simultaneously different perspectives on the work that is unfolding in the therapy process.