Dialectically Integrated Psychotherapy: Unconscious Internal Models and Unifying Processes of Change

This paper presents a theoretically unifying meta-theoretical framework, Dialectically Integrated Psychotherapy, supporting single-model and integrative practice. Current perspectives on integration and unification tend to side-step the relevance of therapy specific theory. In contrast this work pays close dialectical attention to the theoretical contributions of five major perspectives: attachment, psychodynamic, cognitive, behavioural and humanistic. It systematically identifies significant overlaps between them, and draws on their compatible differences. Five trans-theoretical core constructs are defined on an integrative basis, synthesizing theory across epistemologies. One of these, unconscious internal models of self, others, relationships and the outside world integrates the theoretical constructs of schemas, the inner world of object relations, internal working models and complex learning histories, and sits at the heart of a unifying dialectical model of human psychological functioning. All effective therapies are deemed to facilitate constructive change within these models, and a meta-framework connects the unifying model with the impacts of different approaches to therapy. The paper introduces the literature on psychotherapy integration and the principles underlying this work. It describes the methodology used to identify overlaps; the trans-theoretical core constructs; the unifying model of psychological functioning; the meta-framework and the processes that help unhelpful unconscious internal models to change for the better. Implications for practice and empirical research are discussed, and current limitations are addressed. In conclusion, the work provides a dialectical rationale for the complementary value of different theories in routine practice and offers a basis for greater consensus within the profession.