Glossary

Behaving for a period as though one already possessed the desired quality — a direct ancestor of behavioural rehearsal.

Active constructive responding

Responding to another person’s good news with enthusiasm and elaboration; Gable’s research finds this predicts relationship quality more than support during difficulty.

Active imagination

Deliberate, waking engagement with unconscious contents: dialoguing with a figure, painting, or writing. Powerful, and contraindicated where reality testing is fragile.

Actualising tendency

The single motivational construct: an inherent directional tendency toward maintenance and enhancement of the organism.

Adaptive Information Processing

The model’s theoretical frame: an innate processing system that metabolises experience and is overwhelmed by trauma.

ADDRESSING

Hays’ framework for systematic cultural inquiry: Age, Developmental and acquired Disability, Religion, Ethnicity, Socioeconomic status, Sexual orientation, Indigenous heritage, National origin, Gender.

Affirmative practice

Practice that treats a client’s gender identity or sexual orientation as valid and not as the problem, while addressing the real consequences of living in a hostile environment.

Agenda setting

The collaborative construction of what this session will cover, in the first few minutes. Not bureaucracy: it is the structural device that makes brief therapy possible and prevents drift.

Allegiance effect

The tendency for a treatment to perform better in trials conducted by researchers who favour it. One of the largest confounds in comparative psychotherapy research, and not a matter of dishonesty.

Alliance (working alliance)

Bordin’s three components: agreement on goals, agreement on tasks, and the affective bond. The most robust process predictor of outcome in psychotherapy research, at roughly r = 0.28.

Amplification

Enriching a dream image by placing it alongside mythological, religious and cultural parallels — as distinct from free association, which moves away from the image.

Analyst self-disclosure

A technical question rather than a prohibition: what to disclose, when, and whose needs it serves.

Anxiety pathways

Striated muscle, smooth muscle, and cognitive-perceptual disruption — the three routes of unconscious anxiety discharge, and the real-time guide to how much pressure is safe.

Asocial response

Deliberately declining the complementary pull, so that the self-confirming cycle is interrupted.

Assimilative integration

A single home theory that absorbs techniques from elsewhere while retaining its own organising logic. Probably how most experienced clinicians actually work.

Attachment protest

Criticism and pursuit understood as distress signals from a partner who cannot reach the other.

Attention Training Technique (ATT)

A structured 12-minute auditory attention exercise: selective attention, rapid switching, divided attention. Practised daily.

Attrition

Loss of participants from a study or patients from a treatment. Completer-only analyses inflate apparent effects.

Authenticity / bad faith

Living in acknowledgement of one’s freedom and finitude, versus Sartre’s mauvaise foi — pretending one has no choice.

Automatic thought

The rapid, involuntary appraisal running alongside experience. Accessible to attention once trained, and the entry point of the whole therapy.

Autopilot

Acting without awareness. The programme’s opening theme, and the state in which relapse gathers unnoticed.

Awareness continuum

Tracking the flow of present experience — "now I am aware of…" — across sensory, emotional, cognitive and relational channels.

Awfulising

Evaluating an event as worse than it could possibly be.

Base rate

The frequency of a condition in a population. Low base rates destroy the positive predictive value of screening instruments — the central problem in suicide risk prediction.

Basic anxiety

Horney’s term for the pervasive insecurity of a child in an environment experienced as hostile; the engine of the three neurotic trends.

Basic assumption group

Bion’s unconscious group-level defences — dependency, fight-flight, pairing — that displace the work task.

BASIC ID

Lazarus’ multimodal assessment: Behaviour, Affect, Sensation, Imagery, Cognition, Interpersonal, Drugs/biology. Assess all seven; treat the ones that are loaded.

Behavioural activation

Scheduling activity by plan rather than by mood, to restore response-contingent reinforcement.

Behavioural experiment

A planned activity designed to test a specific belief by gathering direct experiential evidence. Requires a falsifiable prediction stated in advance, with a specified observable outcome.

Behavioural rehearsal

Practising a behaviour in session with feedback, before attempting it in life. Modelling, rehearsal, feedback, repeat.

Bids for connection

Small everyday attempts to gain attention or affection. Gottman found turning toward bids in ordinary moments predicts stability better than conflict behaviour does.

Bilateral stimulation

Eye movements, alternating taps or tones. The distinctive feature, and the contested one.

Bipolar self

The self as spanning ambitions (from mirroring) and ideals (from idealisation), with talents and skills between them.

Blended care

Combining face-to-face sessions with digital modules, typically reducing the number of sessions required.

Body scan

Sustained systematic attention through the body; the first formal practice taught, and the one that establishes non-striving.

Bona fide treatment

A treatment delivered by trained therapists, based on established psychological principles, intended to be therapeutic. The comparator that makes the dodo bird verdict meaningful.

Broaden-and-build

Fredrickson’s theory that positive emotions widen thought-action repertoires and accumulate durable resources.

CAPS-5

The Clinician-Administered PTSD Scale, the primary outcome measure in the phase 3 trials.

Central dynamic sequence

The structured progression from inquiry through pressure and challenge to breakthrough and consolidation.

Central relational paradox

Keeping parts of oneself out of relationships in order to preserve them, and thereby becoming isolated inside them.

Chain analysis

Detailed link-by-link reconstruction of a problem episode, followed by solution analysis. The workhorse of individual DBT.

Challenging experience

The preferred term for a difficult session. Common, usually manageable with support, and not by itself predictive of poor outcome.

Change talk / sustain talk

The client’s own language for and against change. The therapist evokes the former and rolls with the latter.

Character strengths (VIA)

A classification of 24 strengths across six virtues; used clinically to shift from deficit to capacity.

Circular causality

Mutual influence in a loop, with no non-arbitrary starting point.

Circular questioning

Asking one member about the relationship between two others. Generates information and, by itself, changes the system.

Clinically significant change

Movement from the clinical population’s range into the functional population’s range, as distinct from change that merely exceeds measurement error.

Closure

Bringing the patient back to stability at the end of every session regardless of whether processing is complete. Non-negotiable.

Co-therapist dyad

Two therapists present for all dosing sessions, for safety, containment and transference reasons.

Cognitive Attentional Syndrome (CAS)

Perseverative thinking, attentional threat monitoring, and unhelpful coping. The transdiagnostic maintaining mechanism.

Cognitive conceptualisation diagram

The one-page case formulation linking early experience → core beliefs → conditional assumptions → compensatory strategies → three current situations with their automatic thoughts, emotions and behaviours.

Cognitive fusion

Behaviour dominated by verbal content rather than by direct experience; the thought is looked *from* rather than *at*.

Collaborative empiricism

The defining stance: therapist and patient as co-investigators examining the patient’s beliefs as testable hypotheses. Neither the therapist as expert who corrects, nor the therapist as mirror who reflects.

"Let’s treat that as a prediction and find out. What exactly do you think will happen, and how would we know?"

Committed action

Building larger patterns of values-consistent behaviour, including the willingness to have whatever shows up while doing so.

Common factors

The ingredients shared across effective therapies — alliance, expectation, rationale, ritual, therapist qualities.

Communication analysis

Detailed reconstruction of a specific conversation to identify how the exchange broke down and what could have been said instead.

Comorbidity

The presence of more than one diagnosable condition. The norm rather than the exception in clinical populations, and frequently an exclusion criterion in trials.

Compassionate self

A deliberately cultivated identity with wisdom, strength, warmth and commitment, developed through imagery and method-acting.

Complementarity

The principle that interpersonal behaviour pulls for a predictable response: correspondence on affiliation, reciprocity on control.

Completion of defensive response

Enacting, slowly and partially, the protective movement that could not be executed at the time.

Complex reflection

A reflection that adds meaning or emphasis rather than repeating. The main tool for shaping change talk.

Compliments and the bridge

The end-of-session structure: genuine compliments, a rationale linking them to the task, and a small task.

Conditions of worth

Internalised contingencies on acceptability, absorbed when positive regard was made conditional. The tradition’s account of the origin of psychopathology.

"I am only worth something when I am useful to other people."

Configurations of self

Mearns and Thorne’s account of the self as plural — several partially autonomous configurations, each with its own conditions of worth.

Congruence / genuineness

The therapist being what they actually are in the relationship — aware of their own experience and not hiding behind a professional facade.

Contact / contact-boundary

The meeting between organism and environment, and the site at which self is constituted.

Container / contained

Bion’s model: the caregiver or analyst receives unbearable states, metabolises them, and returns them tolerable and thinkable.

Contingency management

Systematic reinforcement of a target behaviour, usually with vouchers or privileges. The most effective single intervention for stimulant use disorder.

Coping questions

For clients at the bottom of the scale: "how have you managed to keep going at all?" Finds agency where there appears to be none.

Coping styles

Surrender, avoidance and overcompensation — the three ways schemas are perpetuated.

Copy processes

Identification, recapitulation and introjection — the three routes by which early relationships persist.

Core Conflictual Relationship Theme (CCRT)

Luborsky’s operationalisation of transference into three coded components - Wish, Response of Other, Response of Self - extracted from relationship episodes the patient narrates. The concept that made transference empirically tractable.

W: to be seen as competent. RO: they criticise / withdraw. RS: I shut down and hide my work.

Countertransference

The therapist’s total emotional response to the patient. Historically an error to be eliminated; now understood as an instrument, provided it is noticed rather than enacted.

Creative hopelessness

Experiential contact with the unworkability of the control agenda, arrived at by the client rather than asserted by the therapist.

Credulous approach

Taking the client’s account at face value as a valid construction, rather than as material to be decoded.

Cultural formulation interview

A structured set of questions covering the client’s definition of the problem, its perceived causes and context, coping and help-seeking, and factors affecting the clinical relationship.

Cultural humility

An other-oriented stance of openness and lack of superiority regarding the client’s cultural identity, including willingness to be told you got it wrong.

Cultural mistrust

Wariness toward institutions with a documented history of harm — an accurate appraisal, not a symptom.

Cultural opportunity

A moment when the client offers identity-relevant material. Taking it up is associated with better outcomes; the common failure is politely changing the subject.

Customer / complainant / visitor

De Shazer’s typology of the client’s relationship to change; intervention is matched to it rather than assumed.

Cyclical psychodynamics

Wachtel’s account of internal patterns and external consequences continuously generating each other.

Decentring

Observing thoughts and feelings as transient mental events rather than as accurate reflections of reality or of the self. The proposed mechanism, and a measurable one.

Decision analysis

Generating and evaluating options for an interpersonal problem, then rehearsing the chosen one.

Decisional balance

The pros and cons of changing and of not changing; the shift in their ratio predicts movement between stages.

Deepened extinction

Combining two separately extinguished cues to strengthen the new learning.

Definitional ceremony

A structured practice in which outsider witnesses respond to the person’s story, and the person responds to their responses.

Defusion

Changing the relationship to a thought rather than its content — noticing it as a thought, so that it loses some of its behavioural pull.

Demandingness

The absolutistic must, from which all other irrational beliefs derive.

Dereflection

Frankl’s redirection of attention away from self-monitoring and toward something meaningful outside the self — anticipating the attentional interventions of modern social-anxiety protocols.

Detached mindfulness

Awareness of a thought as a mental event, with no attempt to engage, analyse, suppress or respond. Distinct from meditative mindfulness, and requiring no practice discipline.

Dialectical abstinence

The synthesis for addictive behaviour: absolute commitment to abstinence, plus a fully worked plan for what to do after a lapse.

Dialectics

The philosophical stance that reality is composed of opposing forces, that synthesis is always possible, and that the therapist’s job is to find the truth in both positions.

Dialogic relationship

The contemporary relational turn, drawing on Buber: inclusion, presence, and commitment to dialogue rather than the therapist as director of experiments.

Diary card

Daily self-monitoring of urges, behaviours, emotions and skills use. It sets the agenda for the individual session and is non-negotiable.

Differential activation

Teasdale’s hypothesis that mild dysphoria reactivates the full depressogenic processing pattern in people with a history of episodes.

Differentiation of self

Bowen’s capacity to hold one’s own position while staying emotionally connected; low differentiation produces fusion or cutoff.

Digital divide

The systematic exclusion of people without devices, data, digital literacy or privacy from digitally delivered care.

Discord

Interpersonal friction between client and clinician. Reframed from client "resistance" to a signal about the relationship — a genuine conceptual advance.

Disintegration anxiety

The dread of the self coming apart — for Kohut the deepest anxiety, deeper than castration anxiety.

Dissociation

A common acute effect, distinct from the therapeutic action; correlated with response in some analyses, which complicates blinding here as elsewhere.

Dodo bird verdict

The finding that bona fide psychotherapies produce broadly equivalent outcomes. Robust in aggregate for common presentations, and routinely over-read in both directions.

Doing vs. being mode

The discrepancy-based problem-solving mode versus the allowing, present-centred mode. Applying doing mode to mood produces rumination.

Dominant object relation

The self–object–affect configuration currently active in the room.

Dose–response

The relationship between number of sessions and improvement. Typically negatively accelerated: most gain occurs early, with diminishing returns.

Downward arrow

A technique for moving from automatic thought to core belief by repeatedly asking what it would mean if the thought were true.

"Suppose you did get it wrong in the meeting - what would that mean about you?" … repeated to bedrock.

Dropout (premature termination)

Unilateral ending by the patient. Around 20% of adult therapies; predicted better by alliance and unmet expectations than by symptom severity.

Earliest recollections

The first specific memories, treated as projective material that reveals the current style of life rather than as history.

Early maladaptive schema

A pervasive theme about oneself and one’s relationships, formed in childhood, elaborated throughout life, and dysfunctional to a significant degree.

Effect size

A standardised measure of difference, usually Cohen’s d or Hedges’ g. Meaningless without knowing the comparator.

Ego-strengthening

Generalised suggestions for confidence, calm and coping — a standard component of most protocols.

Elicit–Provide–Elicit

The way to give information without triggering reactance: ask what they know, offer information with permission, ask what they make of it.

Emotion exposure

Exposure to the emotional experience itself rather than to a specific feared situation.

Emotion schemes

Internal structures integrating emotion, bodily sensation, meaning and action tendency; activated as a whole rather than assembled.

Emotion transformation

Changing a maladaptive emotion by accessing an adaptive one in its presence, rather than by regulation or extinction.

Emotion-driven behaviour

Any action driven by the urge an emotion carries, which reduces distress in the short term and maintains it in the long term.

Empathic confrontation

Naming the schema-driven behaviour and its cost, from within an empathic understanding of why it developed.

Empathic understanding

Sensing the client’s private world as if it were one’s own, without ever losing the "as if". Rogers is emphatic about the qualifier.

Empathy / vicarious introspection

Kohut’s definition of the psychoanalytic method: sustained immersion in another’s subjective experience. A mode of observation, not a virtue.

Empirically supported treatment

A specific protocol with randomised evidence for a specific disorder, meeting defined methodological criteria.

Empty-chair dialogue

For unfinished business with a significant other; the best-researched experiential task.

Enactment

A jointly created episode in which analyst and patient live out a relational scenario before either can think about it. Contemporary technique treats enactments as inevitable and as prime therapeutic opportunities - the pattern arrives in the room rather than in a report about it.

Enactment (couple)

Directing partners to speak the new emotional content to each other in session — the mechanism of change in EFT, not a rehearsal for it.

Encounter

A moment of genuine meeting between two people, without role or technique. The tradition’s proposed active ingredient.

Entactogen

A compound producing feelings of emotional openness, warmth and connection; distinguished from classic psychedelics by the absence of major perceptual change.

Entropic brain hypothesis

Carhart-Harris’s proposal that psychedelics increase the entropy of brain activity, moving the system away from over-ordered states associated with rigidity.

Epistemic trust

Openness to learning from another person; damaged by early misattunement and restored by being accurately understood. Fonagy’s proposal for what all effective therapies actually restore.

Esketamine

The S-enantiomer, marketed as a nasal spray and approved in the US and EU for treatment-resistant depression and for depression with acute suicidal ideation, with mandated in-clinic monitoring.

Evidence-based practice

The integration of best available research, clinical expertise, and patient characteristics, culture and preferences. A decision process, not a list.

Exceptions

Times when the problem does not occur or is less severe. Always present, and systematically unnoticed.

Existential anxiety

Anxiety proportionate to the actual conditions of being alive. Not a disorder, and not to be treated as one.

Existential guilt

The sense of having failed one’s own possibilities — guilt about a life not lived rather than about wrongdoing.

Expectancy violation

The mismatch between what the person predicted and what occurred. The currently favoured active ingredient.

Experiencing / felt sense

Gendlin’s term for the bodily, pre-conceptual sense of a situation. Depth of experiencing predicts outcome better than most therapist variables.

Experiential avoidance

Unwillingness to remain in contact with unwanted private experiences, and the actions taken to alter their form or frequency.

Experiment

An action proposed in session to make something implicit explicit. Gestalt’s distinctive method, always co-created and always optional.

Explanatory model

Kleinman’s term for the client’s own account of what is wrong, why it happened, what course it will take and what should be done. Eliciting it is the single most useful cross-cultural intervention.

Exposure

Systematic, planned contact with a feared stimulus, without escape or safety behaviours, until the prediction attached to it has been tested.

Externalising

Linguistic separation of person and problem, so the problem becomes something to be in relationship with rather than something one is.

Extinction burst

The temporary increase in a behaviour when reinforcement stops. Predicting it out loud prevents the parent, partner or patient from concluding the plan has failed.

Fear of compassion

Active resistance to receiving or giving warmth, common in highly self-critical people and requiring assessment before compassion work.

Felt sense

Gendlin’s term, used here for the bodily quality of an experience prior to words.

Fixed-role therapy

Kelly’s signature technique: the client enacts a deliberately different character for two weeks as an experiment, discovering that identity is more revisable than assumed.

Flight instructions

The agreed guidance given in preparation for how to respond to difficulty during dosing — typically to turn toward rather than away from what arises.

Flooding

Immediate exposure to the most feared stimulus without gradation. Effective but poorly tolerated; graded approaches have better retention.

Focal conflict

The single dynamic theme a brief therapy commits to. Stating it aloud in the first sessions and holding to it is what distinguishes brief dynamic therapy from short open-ended therapy.

Focusing

For an unclear felt sense; Gendlin’s method incorporated as a task.

Formula first session task

"Notice what happens in your life that you want to continue" — assigned regardless of the presenting problem.

Formulation (case conceptualisation)

A hypothesis about what is maintaining this person’s difficulties and what would change them, from which the treatment plan follows.

Four dimensions

Van Deurzen’s physical, social, personal and spiritual worlds; a map for locating where a person’s difficulty actually lies.

Free association

The fundamental rule: say whatever comes to mind, without selecting for relevance, logic, or decency. It is not a technique for producing material so much as a device for making resistance visible - the moments when it fails are the data.

"I want you to try to say whatever comes to mind, even if it seems trivial, irrelevant, or embarrassing - especially then."

Functional analysis

Identifying the antecedents and consequences maintaining a behaviour. The most portable assessment method in the field.

Functional unblinding

The methodological problem that participants and therapists can nearly always tell whether an active drug was given, which compromises blinding in every trial in the field.

Gender role analysis

Systematic examination of the messages a client received about what their gender permits and requires, and the cost of complying with them.

Gender role conflict

O’Neil’s construct: distress arising when rigid gender roles restrict a person or cause harm to themselves or others.

Genogram

A structured three-generation family diagram recording relationships, events, patterns and cutoffs.

Gift of love

Benjamin’s account of symptom persistence: the pattern is maintained out of loyalty to an internalised figure and the hope of finally being loved by them.

Graded format

The contemporary modification: anxiety regulation and capacity building before pressure, for patients with fragile tolerance.

Group cohesiveness

The group analogue of the therapeutic alliance; the strongest process predictor of group outcome.

Group matrix

Foulkes’ term for the shared communicational network of the group, within which individual symptoms become intelligible.

Guided discovery

Questioning that leads the patient to information outside their current awareness, without leading them to a predetermined answer. Distinguished sharply from rhetorical questioning aimed at extracting a concession.

Guided self-help

Structured materials plus brief regular support from a person. The best-evidenced low-intensity format.

Gut-directed hypnotherapy

The specific protocol for irritable bowel syndrome, and the best-evidenced application in the field.

Habit reversal training

Awareness training plus a competing response, for tics, trichotillomania and body-focused repetitive behaviours.

Habituation

Decline in response with repeated presentation. Real, but no longer regarded as the mechanism of change.

Head-on collision

A sustained, direct confrontation with the resistance and its cost to the patient’s life. Powerful and easily misapplied.

Healthy adult mode

The mode that nurtures, sets limits and moderates the others. Building it is the goal of treatment.

Healthy vs. unhealthy negative emotions

Concern rather than anxiety; sadness rather than depression; annoyance rather than rage; remorse rather than guilt.

Here and now

The insistence that the material is what is happening in this room in this minute, including the past when it arrives in the present tense.

Here-and-now focus

Attending to what is happening between members in the room rather than to reported outside events.

Holding & containment

Winnicott’s holding environment and Bion’s container-contained: the therapist metabolises what the patient cannot yet bear, returning it in a form that can be thought about. The theoretical basis for why simply being with a patient in distress is an intervention.

Homeostasis

The system’s tendency to restore its previous equilibrium; the account of why individual improvement so often destabilises a family.

Iatrogenic

Caused by the treatment. Applies to psychotherapy as much as to medicine, and is under-studied here.

Identified patient

The family member who carries the symptom, and whom the family presents as the problem. Systemic therapy treats this designation as a piece of information about the system, not as a diagnosis.

Idiographic vs. nomothetic

Knowledge about this individual versus knowledge about people in general. Formulation is idiographic; diagnosis is nomothetic; both are needed.

Imagery rescripting

Re-entering a childhood memory in imagery and altering what happens, with the therapist or the healthy adult intervening on behalf of the child.

Imaginal exposure

Repeated, detailed, present-tense recounting of a feared memory or scenario, used where in vivo exposure is impossible or unsafe.

Impact message

Kiesler’s term for the covert pull a person exerts on others; measurable, and the therapist’s most direct sample of the patient’s relational world.

Incongruence

The gap between experience and self-concept. The single dimension along which this theory measures disturbance.

Individuation

The lifelong process of becoming a differentiated, whole person through integration of conscious and unconscious.

Induction

The procedure for focusing attention and producing the hypnotic state. Less important than commonly assumed; the suggestions are the active ingredient.

Informed consent

An ongoing process, not a signature: capacity, adequate information including risks and alternatives, and voluntariness.

Inner-directed approach

The MAPS stance: the patient’s own process leads, the therapists support. Contrasts sharply with the therapist-directed structure of prolonged exposure.

Inquiry

The group facilitation method: exploring participants’ direct experience of practice without interpreting or teaching at them. The hardest skill for the teacher.

Integration

The therapeutic work of converting the experience into durable changes in belief and behaviour. Widely agreed to be where the treatment happens, and widely under-resourced.

Intention-to-treat analysis

Analysing all randomised participants regardless of whether they completed. The conservative and generally correct approach.

Internal object

A mental representation of a relationship, not of a person: self, other, and the affect linking them.

Internal vs. external locus of evaluation

Whether a person judges their experience by their own lights or by others’. Movement toward the internal is the tradition’s measure of progress.

Internal working model

Bowlby’s term for the expectation, built from early caregiving, about whether needs will be met and what one must be to be cared for.

Interoceptive exposure

Deliberate induction of feared bodily sensations — hyperventilation, spinning, straw breathing, stair running — central in panic disorder.

Interpersonal formulation

The explicit statement, given aloud to the patient, linking symptoms to one problem area and proposing it as the focus. The patient must agree.

Interpersonal inventory

A systematic review of current close relationships conducted in the first sessions, from which the focus is chosen.

Interpretation

A statement that makes a connection the patient has not made, between present and past, or between feeling and defense. The full sequence runs confrontation (noticing) → clarification (specifying) → interpretation (explaining) → working through.

"I notice you laughed just as you said your father left. I wonder whether the laugh comes in exactly where the grief would be."

Intersectionality

Crenshaw’s framework: forms of disadvantage compound and interact rather than adding up, and cannot be analysed one axis at a time.

Irreverent communication

Deliberately off-balance, matter-of-fact or unexpected responses used to break rigid positions. Balanced against reciprocal communication, and requiring a solid relationship.

Laddering

Asking repeatedly which pole is preferred and why, to move from peripheral constructs to core ones.

Landscape of action / landscape of identity

Questions about what happened, and questions about what it says about the person’s values, hopes and commitments. Both are needed.

Life tasks

Work, friendship and love — later expanded to self and spirituality. Health is engagement with all of them.

Limited reparenting

The therapist meeting unmet core needs within professional boundaries.

Low frustration tolerance

"I can’t stand it" — usually false, and the engine of avoidance.

Manualisation

Specifying a treatment in sufficient detail to be delivered consistently and tested. Makes trials possible; arguably distorts what gets studied.

Marker

An observable in-session statement or behaviour indicating that the client is ready for a specific task. EFT’s organising technical idea: intervention follows marker.

Mediator

A variable through which a treatment produces its effect. Mediation evidence is much weaker than efficacy evidence for nearly every psychotherapy.

Mentalization

The capacity to understand behaviour — one’s own and others’ — in terms of mental states. Its collapse under attachment stress is the target in MBT.

Mentalizing

Understanding behaviour in terms of mental states; implicitly and explicitly, about self and other.

Metacognitive beliefs

Beliefs about thinking itself, positive and negative, which drive and sustain the CAS.

Microaggression

Brief, commonplace verbal or behavioural slights communicating hostility or invalidation, often unintended by the person delivering them and cumulative in effect.

Minority stress

Meyer’s model of the excess stress faced by stigmatised groups: distal stressors (discrimination, violence) and proximal processes (expected rejection, concealment, internalised stigma).

Miracle question

The signature intervention: a hypothetical in which the problem is solved overnight without the client knowing, followed by minute description of what would be different.

Mode

The moment-to-moment emotional state and coping response currently active. The unit of intervention in contemporary schema therapy.

Moderator

A variable that changes the size or direction of a treatment effect — for example, number of prior episodes moderating MBCT’s benefit.

Multiple self-states

Bromberg’s account of the self as a coalition of states, with ordinary dissociation as the mechanism holding them apart.

Multiple selves exercise

Separating the angry, anxious and sad parts of a reaction and then bringing the compassionate self to each.

Mutuality and asymmetry

Aron’s formulation: the relationship is mutual in influence and asymmetrical in role, responsibility and power. Both halves matter.

Mystical-type experience

A measurable class of experience — unity, transcendence of time and space, noetic quality, ineffability, positive mood — correlated with outcome and central to the field’s theorising.

Narcissistic rage

Implacable fury in response to an injury to self-cohesion; distinguished from ordinary anger by its demand for undoing rather than redress.

Natural and logical consequences

Dreikurs’ alternative to punishment: let reality teach, or arrange a consequence that fits the behaviour.

Negative and positive cognition

The self-referential belief held with the memory, and its adaptive replacement.

Negative cognitive triad

Beck’s account of depressive content: negative views of the self, of the world and current experience, and of the future. Hopelessness about the future is the component most associated with suicide risk.

Negative cycle

The self-reinforcing pattern of protective behaviours that both partners contribute to and neither controls. Externalising it as the enemy is the first move in EFT.

Neuroception

Porges’ term for unconscious appraisal of safety or threat, determining autonomic state.

Neuroticism

The shared temperamental substrate of the emotional disorders, and the UP’s ultimate target.

Neutrality & abstinence

Neutrality is equidistance from id, ego, superego and reality - not coldness. Abstinence means not gratifying transference wishes so that they can be examined rather than enacted. Both have been substantially revised: relational analysts argue that total neutrality is impossible and its pretense is itself an enactment.

Non-striving

The paradoxical stance that practice has no goal — which is difficult precisely because participants come wanting a result.

Normative male alexithymia

Levant’s term for the socialised difficulty many men have identifying and articulating emotional states — a learned deficit rather than a constitutional one.

Not-knowing stance

The therapist’s active, curious, humble position: minds are opaque, including the therapist’s own, and the patient is the expert on theirs.

Number needed to treat

How many patients must receive a treatment for one additional good outcome. Often more intuitive than an effect size.

OARS

Open questions, Affirmations, Reflections, Summaries — the core micro-skills.

Opposite action

Acting contrary to the action urge of an emotion when the emotion does not fit the facts or is not effective.

Optimal frustration

A failure of attunement small enough to be tolerated and understood, which builds internal structure.

Organismic valuing process

Direct, pre-verbal evaluation of experience by its actual value to the organism. Distorted by conditions of worth and, in this theory, recoverable.

Paradoxical intention

Frankl’s technique of asking the patient to try deliberately to produce the feared symptom, which breaks anticipatory anxiety. A direct ancestor of exposure and of ACT defusion.

Paradoxical theory of change

Beisser’s principle: change follows full contact with what is, not from effort to be otherwise.

Participant observation

Sullivan’s replacement for analytic neutrality: the clinician cannot observe without affecting, so the effect must be included in the data.

Pendulation

Deliberate movement between activation and resource, building capacity to return.

PERMA

Seligman’s five components of well-being: positive emotion, engagement, relationships, meaning, accomplishment.

Perpetual problem

A conflict rooted in stable differences that will not be resolved. The goal is dialogue rather than solution.

Personality organisation

Neurotic, borderline or psychotic level, defined by identity integration, defensive level and reality testing.

Placebo / expectancy

Improvement attributable to the expectation of benefit. In psychotherapy this cannot be separated out, and on the contextual model it is part of the mechanism rather than a nuisance.

Plasticity window

The period of heightened synaptic plasticity following ketamine administration, proposed as the optimal time for therapeutic learning.

Positive connotation

The Milan practice of attributing benign intent to every family member’s behaviour, including the symptom, to reduce defensiveness and reveal the system’s logic.

Post-hypnotic suggestion

A suggestion linked to a future cue, taking effect outside the session.

Potential space

The intermediate area between inner and outer reality where play, symbol and culture live.

Practice-based evidence

Data generated from routine clinical work rather than from trials; addresses external validity at the cost of causal inference.

Pre-session change

Improvement between booking and attending, which occurs in a substantial minority of cases and is asked about routinely.

Preparation and integration

Borrowed from the psychedelic protocols; less standardised and much less studied in this context.

Preparation, dosing, integration

The three-phase structure of every credible protocol. Dosing without the other two is drug administration, not therapy.

Pretend mode

Talk about mental states disconnected from actual experience.

Primary maladaptive emotion

A core emotional response — usually shame or fear — that was adaptive in its original context and is not now.

Prognosis

The expected course of a condition with and without treatment. Frequently omitted from consent conversations, and part of what a patient needs in order to decide.

Projective identification

Klein’s concept: a part of the self is not merely attributed to another but induced in them, so the other actually begins to feel and behave accordingly. Explains why therapists working with certain patients feel uncharacteristically helpless, or cruel.

Psychic equivalence

Inner experience taken as an exact map of outer reality.

Psychological flexibility

Contacting the present moment fully and, depending on what the situation affords, persisting in or changing behaviour in the service of chosen values. The single outcome ACT targets.

Psychological wellbeing practitioner

The English model: a role trained specifically to deliver low-intensity interventions under supervision.

Punctuation

Where a participant begins the story of a sequence. Arguments about who started it are arguments about punctuation.

Radical acceptance

Complete acceptance of reality as it is, on the grounds that rejecting reality does not change it and adds suffering to pain.

Re-authoring

The collaborative development of an alternative story, thickened with detail, history and witnesses.

REBUS

Relaxed Beliefs Under Psychedelics: the proposal that psychedelics reduce the precision of high-level priors, allowing revision.

Recognition

Benjamin’s term for apprehending the other as a separate subject; its failure produces the doer/done-to complementarity.

Reframing

Offering a different meaning for the same behaviour, usually one that makes change possible. "He is not lazy; he is protecting you from having to face the empty house."

Relapse prevention / therapy blueprint

The end-of-treatment document the patient writes: what I learned, what my warning signs are, what I do about them. A defining feature of the model and a plausible source of its durability advantage over medication.

Relational depth

Mearns and Cooper’s term for moments of profound mutual contact and recognition. The contemporary British extension of Rogers’ encounter.

Relational Frame Theory

The behavioural account of language and cognition on which ACT rests: arbitrarily applicable relational responding, and the transformation of stimulus functions.

Relational-cultural theory

Miller’s account of growth through connection; disconnection as the primary source of suffering.

Reliable change index

Whether an individual’s change exceeds what measurement error alone would produce.

Renewal / reinstatement / spontaneous recovery

The three ways extinguished fear returns — in a new context, after a stressor, or with time. The empirical basis for varying context deliberately.

Repair attempt

Any move to de-escalate during conflict. Gottman found that whether repair attempts are received, rather than whether conflict occurs, distinguishes stable from unstable couples.

Repertory grid

Kelly’s assessment method: elicit constructs by comparing triads of significant people or elements, then rate all elements on all constructs, producing an analysable map of the person’s meaning system.

Resistance

Everything in the patient that opposes the work - lateness, silence, compliance, charm, intellectualising, sudden improvement. Resistance is not obstruction to be defeated; it is defense observed in motion, and it is the most reliable indicator of where the anxiety is.

The patient who has been late three weeks running, all since the session in which he cried.

Resourcing

Establishing embodied experiences of safety, strength or competence before approaching difficult material.

Response prevention

Blocking the compulsive or neutralising response that would otherwise terminate the exposure. Essential in OCD; ERP without the RP is not a treatment.

Responsiveness

Adjusting what one does to what this patient needs at this moment. Confounds attempts to measure technique effects, because good therapists give more of what is needed to those who need it.

Retroflection

Turning against oneself what was directed at another. The core mechanism in self-criticism and much somatic tension.

Reverie

The analyst’s receptive, associative state, in which the patient’s projected material can be registered.

Righting reflex

The clinician’s impulse to fix and to argue for the healthy choice. The single most damaging thing a helper does with an ambivalent person.

Role dispute stages

Renegotiation (both still talking), impasse (talking has stopped, resentment continues), dissolution (the relationship is ending). Each requires a different intervention.

Role reversal

The rapid exchange of positions within a configuration; the patient becomes the persecutor and the therapist the victim, or vice versa.

Rupture (alliance rupture)

A strain or breakdown in the alliance. Withdrawal ruptures move away and feel like good sessions; confrontation ruptures move against and feel like bad ones. The repair, not the absence, is the therapeutic event.

Ryff’s six dimensions

Self-acceptance, positive relations, autonomy, environmental mastery, purpose in life, personal growth.

Safe / calm place

A resourcing exercise installed during preparation, used for closure and for managing between-session distress.

Safety behaviour

An action taken to prevent a feared catastrophe which, by preventing disconfirmation, maintains the belief. Salkovskis’s insight: the patient concludes they survived *because* of the behaviour.

Gripping the trolley in a supermarket to avoid fainting; the fainting never occurs, and the belief that it would is preserved intact.

SASB

Structural Analysis of Social Behavior: a three-surface model coding behaviour toward others, reactions to others, and treatment of the self.

Scaling questions

Rating on 0–10 to make change visible and incremental — where are you now, what would one point higher look like, how did you get to where you are rather than lower.

Scapegoating

The group’s displacement of unwanted material onto one member. The leader’s job is to interrupt it and to make it thinkable.

Selective inattention

Automatic non-noticing of anxiety-provoking material — the everyday, demonstrable version of repression.

Self-as-context

The observing perspective — the "I" that has been continuous through every experience. Distinguished from the conceptualised self, which is a story.

Self-efficacy

Bandura’s domain-specific belief in one’s capability, built primarily through mastery experience.

Self-system

The anxiety-avoiding structure that organises what can be experienced. Its cost is a narrowed life.

Selfobject

Kohut’s term for another person experienced as performing a function for one’s own self-cohesion - mirroring, idealising, twinship. Failure of these functions, rather than forbidden wishes, is what produces the disorders of the self.

Selfobject transference

Kohut’s mirroring, idealising and twinship transferences; the patient uses the therapist to perform a function they cannot yet perform alone.

Sensitivity / specificity

True positive and true negative rates of a test at a given cut-point. Both shift with the population, so a cut-point is not a fixed property of an instrument.

Set and setting

The person’s mindset and expectations, and the physical and interpersonal environment. The most robust determinant of the character of a psychedelic experience.

Shame-attacking exercise

Deliberately doing something mildly embarrassing in public to discover that the consequences are survivable.

Shaping

Reinforcing successive approximations to a target behaviour, rather than waiting for the finished product.

Sick role

Parsons’ concept used therapeutically: a temporary legitimate status that relieves the patient of the expectation of normal functioning and reduces self-blame.

Signature strengths

The handful of strengths a person finds most authentic and energising; deploying them in new ways is the core PPT exercise.

Social microcosm

The principle that members recreate their external relational world inside the group.

Socratic questioning

The four-stage sequence: informational questions, empathic listening, summarising, and analytical/synthesising questions that apply the new information to the original belief.

Softening

The resolution marker in two-chair work: the critic becomes vulnerable and the internal relationship changes.

Soothing rhythm breathing

Slowed breathing used specifically to activate the parasympathetic soothing system, not as relaxation.

Spitting in the soup

Naming the hidden payoff of a behaviour so that it can no longer be enjoyed unexamined.

Splitting

Keeping good and bad experiences of the same object entirely separate, so that ambivalence never arises.

Stages of change

Precontemplation, contemplation, preparation, action, maintenance — with relapse as an expected part of the cycle rather than a failure.

Stepped care

Offering the least intensive appropriate intervention first, with defined criteria for stepping up. Only works if stepping up actually happens.

Stimulus control

Arranging the environment so that cues for desired behaviour are present and cues for problem behaviour are not. The basis of CBT-I and of most habit change.

Stop and rewind

The core technique: halt the session at the point of mentalizing failure and reconstruct the preceding moments.

Structural interview

Kernberg’s assessment method, using confrontation of contradictions to reveal the level of organisation.

Sudden gains

Large between-session symptom improvements. Occur in around a third of cognitive therapy cases for depression and predict better final outcome.

SUDS

Subjective Units of Distress, 0–100. Useful for tracking and for building hierarchies; under inhibitory learning it is no longer the criterion for ending an exposure.

Suggestibility

A stable, measurable individual difference; the strongest moderator of hypnotic response.

Supportive–expressive continuum

Technique varies from uncovering and interpretive to ego-supporting and advisory, positioned according to structural level, current stress and ego strength — and moved within a treatment as needed.

Synchronicity

Meaningful coincidence without causal connection. Jung’s most contested proposal and not scientifically supported.

Systematic evocative unfolding

Rice’s task for problematic reaction points — "I don’t know why I reacted like that" — reconstructing the moment in slow motion.

Task

A specific intervention sequence matched to a marker, with a researched path of resolution.

Technical eclecticism

Selecting techniques by evidence and fit without merging the theories behind them. Lazarus’ position.

Technical neutrality

Equidistance from the patient’s conflicting internal forces; deviated from deliberately when safety requires, and then restored explicitly.

Teleological mode

Mental states inferred only from physical actions.

Teleology

Explanation by purpose rather than by cause; the "final fiction" toward which a person moves.

The daimonic

May’s term for any natural function with the power to take over the whole person — sex, anger, ambition. Health integrates it; disowning it makes it destructive.

The personal is political

Private distress frequently has structural causes; recognising this is therapeutic in itself because it relieves the self-blame of treating a social problem as a personal failure.

The Question

"What would be different in your life if you no longer had this problem?" The answer often reveals what the symptom is protecting the person from attempting.

The spirit of MI

Partnership, acceptance, compassion and evocation. Without the spirit, the techniques become manipulation and clients detect it.

The third

Benjamin’s "moral third": a shared space that transcends the doer/done-to collapse and allows both parties to be subjects.

Theoretical integration

Merging two or more theories into a new framework with its own concepts. Wachtel’s cyclical psychodynamics is the exemplar.

Therapeutic documents

Letters, certificates and written summaries that make the alternative story durable and portable.

Therapeutic factors

The eleven mechanisms Yalom identified through which groups produce change.

Therapist effects

The proportion of outcome variance attributable to who delivers the treatment: 5–8%, against roughly 1% for treatment differences.

Thought-fusion beliefs

Thought-action, thought-event and thought-object fusion, central in OCD.

Three channels of communication

What the patient says, how they behave, and what the therapist feels. All three are data, and they frequently contradict each other.

Three good things

Recording three things that went well each day, with a causal account of why. The most-tested single positive intervention.

Three systems model

Threat, drive and soothing — the evolutionary account of affect regulation and the basis of the whole approach.

Three-minute breathing space

The core portable practice: awareness of current experience, gathering attention to the breath, expanding to the body. Used both routinely and responsively.

Three-pronged protocol

Past memories, present triggers, and future template — all three are targeted.

Thrownness

Heidegger’s Geworfenheit: we did not choose the situation into which we were born, and freedom is always situated freedom.

Tight and loose construing

Constructs that make unvarying predictions versus those that make varying ones. Health requires the capacity to move between them.

Time limit

The agreed number of sessions, stated at the outset and used as a mobilising force rather than an administrative constraint.

Time-limited dynamic psychotherapy

Strupp and Binder’s model organised around the Cyclical Maladaptive Pattern: acts of self, expectations of others, acts of others toward self, and acts of self toward self.

TIPP

Temperature, Intense exercise, Paced breathing, Paired muscle relaxation — physiological crisis skills that change body chemistry fast enough to compete with self-harm.

Titration

Contacting a small, tolerable amount of activation rather than the whole of it.

Top dog / underdog

The demanding, moralising part and the evasive, sabotaging part — locked in a game neither can win.

Topography vs. function

What a behaviour looks like versus what it does. Two people who both self-harm may be doing entirely different things, requiring different interventions.

Transcendent function

The emergence of a third position from holding two opposites in tension without resolving either prematurely.

Transdiagnostic

Targeting a mechanism shared across disorders rather than the features of one. A response to comorbidity and to protocol proliferation.

Transference

The displacement onto the therapist of feelings and expectations belonging to earlier relationships. Not a distortion to be corrected but material made available.

Transmuting internalisation

The incremental taking-in of a function the selfobject performed, converting it into the patient’s own capacity.

Treatment contract

The detailed, negotiated frame that makes the treatment possible and against which deviations become interpretable.

Treatment fidelity / adherence

The extent to which a treatment was delivered as specified. Distinguished from competence, which is how well it was delivered.

Trial therapy

An extended initial session, often two to three hours, which is simultaneously assessment and treatment and establishes whether the patient can use the method.

Triangle

The three-person configuration that stabilises a two-person system under stress; the basic molecule of family emotional process.

Triangle of insight

Linking a pattern across three contexts: the therapy relationship, current relationships, and the past. The core interpretive structure in dynamic work.

Tricky brain

The de-shaming frame: our brains combine old emotional systems with new cognitive capacities, producing loops we did not design.

Triple vulnerability model

Generalised biological, generalised psychological, and specific psychological vulnerabilities.

Two triangles

Malan’s conflict (defense–anxiety–feeling) and person (past–current–transference) triangles; used together they generate most brief dynamic interventions.

Two-chair dialogue

For self-critical or self-interruptive splits; adapted from Gestalt and subjected to task-analytic research.

Two-continua model

Keyes’ finding that mental illness and mental health are related but distinct dimensions; absence of illness does not entail presence of health.

Two-person psychology

The field is constituted by both participants; there is no view from outside it.

Tyranny of the should

Horney’s account of the idealised self-image and the relentless internal demands it generates — the dynamic ancestor of the cognitive "should statement".

Ultimate concerns

Death, freedom, isolation and meaninglessness — the four givens of existence that generate anxiety and, when evaded, generate symptoms.

Unconditional positive regard

Non-possessive warmth that does not vary with what the client discloses. Not approval, and not the absence of a viewpoint.

Unconditional self-acceptance

Refusing to rate the self at all, while continuing to evaluate behaviour.

Unfinished business

An incomplete gestalt that continues to organise present experience until it can close.

Unified detachment

IBCT’s technique of describing the pattern in neutral, almost anthropological terms so the couple can look at it together rather than at each other.

Unique outcome / exception

An event inconsistent with the dominant story; the entry point to re-authoring.

Unlocking the unconscious

The breakthrough moment in which warded-off feeling is experienced directly, with somatic and imagery components.

Use of an object

Winnicott’s account of how the other becomes real: by surviving the patient’s destructiveness without retaliation or collapse.

Utilisation

Erickson’s principle: use whatever the client brings, including their resistance, rather than opposing it.

Validation

Communicating that a response makes sense given the person’s history and current context. Six levels, from staying awake through to radical genuineness.

Values

Freely chosen, ongoing directions for living. Not goals: a goal can be achieved and crossed off, a value can only be lived toward.

VoC and SUD

Validity of Cognition (1–7) and Subjective Units of Distress (0–10); the two tracking measures.

WEIRD samples

Western, Educated, Industrialised, Rich, Democratic — the narrow base from which most psychological findings are generalised.

Well-Being Therapy

Fava’s structured, sequential treatment based on Ryff’s six dimensions, delivered after acute treatment to prevent relapse.

Will to meaning

Frankl’s claim that the primary human motivation is the search for meaning, ahead of pleasure or power.

Window of tolerance

The zone of autonomic arousal within which a person can think, feel and relate at the same time. Above it, hyperarousal; below it, shutdown.

Wise mind

The synthesis of emotion mind and reasonable mind — knowing something in a way that is neither purely felt nor purely reasoned.

Word association test

Jung’s empirical demonstration of complexes through reaction-time delays. His most methodologically respectable work and a forerunner of implicit measures.

Workability

The criterion that replaces truth. Not "is this thought accurate?" but "is acting on it moving you toward what matters?"

Working alliance

Greenson’s term for the rational, collaborating part of the relationship, distinguished from transference. Bordin later generalised it - agreement on goals, agreement on tasks, and the affective bond - into the most robust process variable in all of psychotherapy research.

Worry postponement