ABSTRACT

The formulation stage was, in fact, imbued with operations aiming to introduce change at early sessions: improving metacognition. This gives patients the opportunity to learn how to better describe and communicate their inner world to others, therefore reaching for and accomplishing deeper human connections. Dynamic assessment is based on behavioural, imagery, body, or drama exercises, which a clinician would propose not with the purpose of producing structural personality improvement, but rather in order to engage patients in activities aimed at improving metacognition. The core element of this approach is encouraging patients to abstain from coping strategies they usually resort to and to devote themselves to their exploration motive. A good narrative is a memory of something happening, not what a patient imagines could have happened. An imagined scene can help a therapist begin to reconstruct the patient’s schema structure, but after initial reconstruction, the therapist needs to ask for memories where the patient recalls having to confront a feared situation.