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Agoraphobia |
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Although, within
personal construct
theory, psychological disorders are not classified in terms of
psychiatric
nosological categories (see diagnosis),
several
personal construct research studies have explored the features of
construing
of people who have received particular psychiatric diagnoses. One such
diagnosis,
agoraphobia, can be considered to represent a clear behavioural
expression
of the strategy which George Kelly termed constriction,
in which a person narrows their perceptual field in order to minimise
apparent
incompatibilities. There is consistent research evidence, from
investigations
of the personal construct systems, approaches to conflict situations,
and
marital relationships of individuals diagnosed as agoraphobic, that
they
and their partners tend to construe people in a uniformly positive
light
and may have a low level
of awareness in relation
to the construing of interpersonal conflict
(e.g. Winter and Gournay,
1987;
Winter, 1989). Conflict situations may therefore tend to be beyond the range
of convenience of the construct systems of such individuals, for
whom agoraphobia may allow them to avoid these situations and to
constrict their interpersonal world to a partner who
is a constant source of validation.
There are some indications
that
such a pattern may have a basis in a family background in which
exploratory
behaviour was inhibited and the child was protected from invalidation
(Lorenzini
and Sassaroli, 1988). Amongst the other features found in some of the
studies of the construct systems of agoraphobics and their partners is
a tendency to differentiate highly between people in terms of whether
they are likely to be unfaithful.
A treatment approach has been developed for people diagnosed as
agoraphobic in which exposure therapy is supplemented with Interpersonal
Transaction Groups (see group
psychotherapy) focusing on reconstruction in areas central to the
personal construct theory model of agoraphobia (e.g. elaboration of the
construing of conflict). Clients receiving this approach have been
found to show significantly greater improvement than while they were on
a waiting list, although evidence that the personal construct
psychotherapy sessions are more effective than supportive therapy is
less clear (Winter et al., 1999). |
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References
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- Lorenzini,
R. and Sassaroli, S. (1988). The construction of change
in agoraphobia. In F. Fransella and L. Thomas (eds.), Experimenting
with
Personal Construct Psychology. London: Routledge and Kegan Paul.
- Winter,
D.A. (1989). An alternative construction of agoraphobia. In K. Gournay
(ed.), Agoraphobia: Current Perspectives on Theory and Treatment.
London: Routledge.
- Winter,
D. and Gournay, K. (1987). Constriction and construction in
agoraphobia. British Journal of Medical Psychology, 60, 233-44.
- Winter,
D., Gournay, K., and Metcalfe, C. (1999). An investigation of the
effectiveness of a personal construct psychotherapy intervention. In
J.M. Fisher and D.J. Savage (eds.), Beyond Experimentation into
Meaning. Farnborough: EPCA Publications.
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David A. Winter
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