A Prospective Interpretation of Unconscious Processes During Psychoanalytic Psychotherapy

In recent years, an increasing number of adults have entered psychotherapy because of flashbacks involving childhood sexual abuse. Although traditional techniques have proven useful for interpreting the latent content of these patients' narratives and dreams, a new technique labeled the prospective approach has been applied more recently. This model proposes that intrapsychic conflict impairs the patients' predictive abilities. The prospective approach may be implemented during all phases of the treatment to examine whether the patient is able to predict the interpersonal outcomes of imminent events. During the initial alliance phase, patients use the therapists' responses to predict upcoming change. During the working-through phase, patients rely on their own perceptions to assess future outcomes. Last, during the termination phase, patients predict outcomes from the responses of significant others. In the case study described, the prospective approach was applied to resolve intrapsychic conflict in an adult female who complained of incestuous flashbacks about events that had occurred during her childhood.