Operationalizing the gift of love (GOL) in Interpersonal Reconstructive Therapy (IRT): An examination of the role of meaning reconstruction in therapeutic change.

Interpersonal Reconstructive Therapy (IRT) (Benjamin, 2003/2006) is an integrative, principles-based treatment approach and theory of psychopathology that conceptualizes the motivating factor that underlies personality psychopathology as the gift of love (GOL). That is, copy processes are learned and maintained to achieve psychic proximity to the important people and their internalized representations (IPIRs) that were the original teachers. Relinquishing this gift of love allows a person to re-orient their life towards uncovering and living by their own individually held meanings that will then define how they relate to themselves and their world. Spirituality and religion have historically helped individuals make meaning of and endure some of life’s most trying events (Canada et al., 2016; Hawthorne et al., 2015; Lichtenthal et al., 2010; Johnson & Zitzmann, 2020). Furthermore, Park and Folkman (1997) and others have studied how spirituality can play a large role in a person’s meaning-making processes. The ability to make meaning out of a stressful situation has been shown to promote adaptation and well-being. This study asserts that the process of understanding and learning to let go of the gift of love is inherently a spiritual task. Studies involving IRT have not yet considered explicitly spiritual coping and its connections to the gift of love. This study created a coding system based on existing theory that reliably detects the gift of love as well as spiritual coping in an archived IRT dataset. Results indicated that the presence of spiritual coping, particularly positive spiritual coping, was significantly associated with higher levels of adherence to IRT. In addition, this study revealed that GOL is associated with personal and social spiritual coping and is positively associated with therapeutic change, as measured by GOL stages of change. Keywords: Interpersonal Reconstructive Therapy, interpersonal theory, personality disorders, religious coping, spiritual coping, therapeutic chang

The Case of Sharon Considered from the Vantage Point of Interpersonal Reconstructive Therapy

In Interpersonal Reconstructive Therapy (IRT: Benjamin, 2003/2006; 2018) a case formulation is used to tailor interventions to each patient’s unique patterns. Using the IRT lens, psychopathology is understood as reflecting attempts to adapt to current environments using maladaptive rules and values that were learned and internalized in the context of close attachment relationships. IRT identifies precise ways in which early learning shapes present experience. Additionally, the "gift of love" (GOL) hypothesis posits that motivation to repeat maladaptive ways is linked to the wish to receive love and acceptance from specific internalized attachment figures by repeating their ways and values for the patient. The IRT case formulation has been shown to be reliable and valid (Critchfield, Benjamin, & Levenick, 2015). The therapy adherence measure is also reliable (Critchfield, Davis, Gunn, & Benjamin, 2008) and correlates well with retention as well as reduced symptoms and rehospitalization rates (Karpiak, Critchfield, & Benjamin, 2011) among "difficult to treat" patients characterized as having high levels of personality disorder, chronic and severe problems, and prior failed treatment attempts. To illustrate the case formulation process, an IRT formulation is applied to the case of a 28-year-old female patient for whom a poor outcome was documented

Interpersonal Wishes and Fears with Regard to Internalized Attachment Figures: Differing Focus of Two Case Formulation Methods that use SASB

This commentary is organized in parallel with Westerman’s (2021b) comparison to include focus on (1) the formulation methods used by IRT and Interpersonal Defense Theory, and then (2) their treatment implications. In each major section, comments center first on comparison of the approaches in general, and then turn to a focus on the details of Sharon’s case. In sum, we wish to underscore the need for continued empirical work in both IRT and Interpersonal Defense Theory traditions as ways to advance our field. We see each method as offering a different scope and focal areas of concern. With a mind toward the advancement of research and application along both lines of thought, our commentary provides an overview of how we see areas of alignment, divergence, and their potential meaning for theory and practice. The two methods share a great deal in terms of assumptive worldviews, prioritization of relational material, and even specific measurement methodology (SASB). Where the methods diverge, we believe it is primarily because they seek answers to different kinds of questions