Core Conflictual Relationship Theme (CCRT) - Luborsky

Question 1

Wish (W) - Response from Other (RO) - Response from the Self (RS)

Answer 1

The first was what the patient wished for, wanted, or desired in this relationship with the person about whom he/she was speaking. Luborsky went on to describe this item as the Wish, shorthanded as W. The second item was how the patient believed this other person would respond if the patient were to articulate or act on his/her Wish. This item was referred to as the Response from the Other, shorthanded to RO. Given this belief of other person’s response (the RO), the third item was how the patient then did actually react. This was referred to as the Response from the Self, shorthanded to RS. The RS described how the speaker behaved and what he/she felt.

Question 2

Relationship Episodes (REs)

Answer 2

Luborsky noted that most of the inferences he made occurred when he was paying attention to the patient’s narratives about interactions that he/she had with other people.

to develop a CCRT the therapist listens for and immediately transcribes Relationship Episodes (REs).

Question 3

Patient’s perspective

Answer 3

A second guiding principle is that the RO is always from the patient’s perspective.

Question 4

Expected v Actual (RO-expected or RO-actual) & (RO-behaviour or RO-affect)

Answer 4

The CCRT contains the three components previously described: a Wish (W) that occurs in the context of a relationship, a Response from the Other that may be either expected (RO-expected) or actual (RO-actual), and a Response from the Self that has behavioural and affective arms (RO-behaviour and RO-affect). These three components do not exist in isolation but are linked to each other in a cascading manner. The Response from the Other (RO) is what the patient expects would happen if he/she acted on the Wish. Or, less frequently, the RO is what actually happens when the patient does act on the Wish.

asking the question: “What did you want to do?” the therapist encouraged Steven to flesh out and articulate his Wish. When he goes on to enquire: “If you had spoken up what might have happened?” he is gently directing this patient to put into words how he expected his boss to respond—the RO.

Question 5

The goal?

Answer 5

The goal during the beginning phase of psychotherapy is focused on helping the patient become more aware of how frequently the CCRT is activated and rules his/her life (Book, 1998).

to make a repetitive, unconscious behaviour conscious, so that Steven would have more of an opportunity to see the price he pays for such automatic, maladaptive behaviour. Simultaneously, the therapist encourages him to attempt new and more successful ways of behaving. The major technique the therapist uses is one of confrontation: bringing the patient’s awareness to an external or internal reality to which he/she is oblivious.

Question 6

Second Phase: Working Through the RO

Answer 6

This phase is crucial to the promotion of personality growth that liberates the patient from those unconscious forces that constituted his/her RO, so that he/she is free to actualize his/her Wish. In particular, the focus in this phase is helping the patient understand that the RO—the expectation is related to early childhood experiences with his or her caretakers more than it is the reality of his current situation.