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Integrating Time-Limited Dynamic Psychotherapy and a Buddhism-Inspired Aversion/Attachment Model of Client Suffering: The Cases of "Beth" and "Amy"

Jason Samlin


In recent times, Buddhist psychological concepts have become appealing to many psychotherapy theorists and practitioners. Included are such notions as mindfulness, the "acceptance" of experience, the nature and causes of suffering, and the use of "skillful means" behaviors and thoughts that are intentionally undertaken to reduce suffering both for oneself and others. While there are a number of cognitive-behavioral therapy treatments that incorporate such Buddhist psychological concepts, little research and practice has been done examining the integration of such concepts and short-term dynamic psychotherapy.  As one effort to fill this gap in research, the purpose of this study was to develop and pilot test in two cases—"Beth" and "Amy"—a model (a) that was based on such Buddhist concepts and (b) that would assimilatively integrate with the "home theory" of an established form of modern, relational, short-term psychodynamic psychotherapy, namely, Levenson's (1995, 2010) Time-Limited Dynamic Psychotherapy (TLDP). The new model is called the "Aversion/Attachment Model of Client Suffering" (A/AMCS).  The A/AMCS model was conceptually incorporated into Beth's and Amy's case formulations through an expansion of TLDP’s case formulation method. Also, the A/AMCS model was technically integrated into TLDP treatment in two ways. First, formal mindfulness meditation practices were implemented with each client by conducting eight half-hour practices before sessions 6-13, in the context of therapy that lasted 23 and 20 sessions, respectively. Second, the treatment sessions included the incorporation of acceptance practices and skillful means strategies. Following the Pragmatic Case Study Method (Fishman, 2005), Beth and Amy’s cases are examined both quantitatively and qualitatively. This study concludes with a discussion of the possible reasons for Beth's dramatically positive outcome compared with Amy's only moderately successful outcome, together with a broader discussion of how future research could further examine the integration of Buddhist psychological concepts and short-term psychodynamic psychotherapy.

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