Why do some people relate to others in dysfunctional ways even though this leads to disappointments and distress? In my current research, I am addressing this issue based on a model I have developed about "interpersonal defense." My approach to defense shifts the focus away from the traditional emphasis on intrapsychic mechanisms regulating a person’s inner state. Instead, it calls for (1) viewing defense primarily as interpersonal behavior, (2) conceptualizing and operationalizing defensive interpersonal behavior as a special type of problematic interaction pattern characterized by breaches in how discourse is organized over time, that is, failures in what I call "coordination" (e.g., unmarked shifts of topic, rejecting accurate paraphrases), and (3) focusing on the role defensive interpersonal behavior plays in social interactions as a way of impacting subsequent interaction events.
The last point is probably the most important. People behave defensively because in some respects this leads to desired outcomes. Unfortunately, it is also true that the "feed forward effects” of interpersonal defense include unintended negative consequences. Among other things, the part of the theory that concerns these feed forward effects includes a novel formulation of the self-fulfilling prophesy idea.
My current work on the theory focuses on patients with personality disorders treated as part of the Brief Psychotherapy Research Program at Beth Israel Medical Center. I am employing a case formulation approach based on the theory to carefully examine defensive interpersonal behavior and its consequences in the context of therapy sessions.
My work on interpersonal defense grows out of an ongoing line of psychotherapy process research I have been pursuing for some time. In that line of research, I have developed an approach to studying patients’ contribution to the alliance based on my interests in coordination. I have found that assessments of patient interpersonal behavior in terms of processes of coordination are essentially orthogonal to the types of processes investigated in most other studies in this area and that coordination measures predict a large percentage of variance in treatment outcome over and above more commonly studied variables. This work has also led to interesting findings about the mechanisms of therapeutic change.
My research on interpersonal defense extends this work on patient coordination. It may provide answers to key questions raised by the research on patient coordination such as why patients behave in noncoordinating ways (with a therapist and in other relationships as well) and just how these problematic processes work against successful outcome. I hope to be able to build upon my research on coordination and interpersonal defense with studies aimed at discovering especially helpful ways for therapists to intervene when patients take a defensive stance in the treatment context.