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Reflections on epistemic trust and its role in psychotherapy
Author/s: George Silberschatz 
Year:  2020 Issue: Language: Italian 
Pages:  5 Pg. 54-58 FullText PDF:  76 KB
DOI:  10.3280/PU2020-001005
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Fonagy and his colleagues have recently proposed that deficits in epistemic trust are a centerpiece of severe personality disorder and that therapists’ efforts to build epistemic trust are central to the psychotherapeutic process. Their model builds on solid developmental research but lacks clarity and precision in delineating the process of building trust. This is a unidirectional process whereby the therapist provides "ostensive cues that enable the patient to temporarily suspend hypervigi-lance or epistemic mistrust. A bidirectional model that takes into account the patient’s ostensive cues or tests of the therapist would provide greater precision, clinical rigor, and empirical validity to the model.
Keywords: Psychotherapy process; Personality disorder; Epistemic trust; Control-Mastery Theory; Patients’ tests of the therapist

  1. Alexander F., French T.M. et al. (1946). Psychoanalytic Therapy: Principles and Applications. New York: Ronald Press (trad. it. dei capitoli 2, 4 e 17: La esperienza emozionale correttiva. Psicoterapia e Scienze Umane, 1993, XXVII, 2: 85-101. Edizione su Internet:
  2. Allison E. & Fonagy P. (2016). When is truth relevant? Psychoanalytic Quarterly, 85, 2: 275-303.
  3. Bugas J. & Silberschatz G. (2005). How patients coach their therapists in psychotherapy. In: Silberschatz, 2005, pp. 153- 167.
  4. Csibra G. & Gergely G. (2009). Natural pedagogy. Trends in Cognitive Science, 13, 4: 148-153.
  5. Curtis J.T. & Silberschatz G. (2005). The assessment of pathogenic beliefs. In: Silberschatz, 2005, pp. 69-91.
  6. Curtis J.T. & Silberschatz G. (2007). Plan formulation method. In: Eells T.D, editor, Handbook of Psychotherapy Case Formulation. 2nd Edition. New York: Guilford, 2007, pp. 198-220.
  7. Curtis J.T., Silberschatz G., Sampson H. & Weiss J. (1994). The plan formulation method. Psychotherapy Research, 4, 3/4: 197-207., DOI: 10.1080/10503309412331334032
  8. Fonagy P. & Allison E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, 51, 3: 372-380.
  9. Fonagy P., Luyten P. & Allison E. (2015). Epistemic petrification and the restoration of epistemic trust: A new conceptualization of borderline personality disorder and its psychosocial treatment. Journal of Personality Disorders, 29, 5: 575-609.
  10. Fonagy P., Luyten P., Allison E. & Campbell C. (2017). What we have changed our minds about: Part 2. Borderline personality disorder, epistemic trust and the developmental significance of social communication. Borderline Personality Disorder and Emotion Dysregulation, 4, 1.
  11. Gazzillo F. (2016). Fidarsi dei pazienti. Introduzione alla Control-Mastery Theory. Milano: Raffaello Cortina.
  12. Gazzillo F., Genova F., Fedeli F., Curtis J.T., Silberschatz G., Bush M. & Dazzi N. (2019). Patients’ unconscious testing activity in psychotherapy: A theoretical and empirical overview. Psychoanalytic Psychology, 36, 2: 173-183.
  13. Gazzillo F., Dimaggio G. & Curtis J.T. (2019). Case formulation and treatment planning: How to take care of relationship and symptoms together. Journal of Psychotherapy Integration. Advance online publication. --
  14. Migone P. & Liotti G. (1998). Psychoanalysis and cognitive-evolutionary psychology: An attempt at integration. International Journal of Psychoanalysis, 79, 6: 1071-1095 (trad. it., con una Nota introduttiva di Paolo Migone: Psicoanalisi e psicologia cognitivo-evoluzionista: un tentativo di integrazione. Psicoterapia e Scienze Umane, 2018, 52, 2: 251-290). P. Williams, “Riassunto dell’articolo e della discussione avvenuta tra il dicembre 1998 e il gennaio 1999”: International Journal of Psychoanalysis, 1999, 80, 2: 415-423.
  15. Rogers C.R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 2: 95-103.
  16. Sampson H. (1976). A critique of certain traditional concepts in the psychoanalytic theory of therapy. Bulletin of the Menninger Clinic, 40, 3: 255-262.
  17. Sampson H. (1992). The role of “real” experience in psychopathology and treatment. Psychoanalytic Dialogues, 2, 4: 509-528., DOI: 10.1080/10481889209538948
  18. Sampson H. (2005). Treatment by attitudes. In: Silberschatz, 2005, pp. 111-119.
  19. Silberschatz G. (1986). Testing pathogenic beliefs. In: Weiss, Sampson & the Mount Zion Psychotherapy Research Group, 1986, pp. 256-266.
  20. Silberschatz G., editor (2005). Transformative Relationships: The Control-mastery Theory of Psychotherapy. New York: Routledge.
  21. Silberschatz G. (2007). Comments on “The necessary and sufficient conditions for therapeutic personality change”. Psychotherapy: Theory, Research, Practice, Training, 44, 3: 265-267., DOI: 10.1037/0033-3204.44.3.265
  22. Silberschatz G. (2008). How patients work on their plans and test their therapists in psychotherapy. Smith College Studies in Social Work, 78, 2/3: 275-286., DOI: 10.1080/00377310802114528
  23. Silberschatz G. (2017). Improving the yield of psychotherapy research. Psychotherapy Research, 27, 1: 1-13., DOI: 10.1080/10503307.2015.1076202
  24. Silberschatz G. (2020). Responsiveness in Control-Mastery Theory. In: Watson J. & Weisman H., editors, Attuning to Enhance Therapist Responsiveness. Washington, D.C.: American Psychological Association, 2020, in press.
  25. Silberschatz G. & Curtis J.T., (1993). Measuring the therapist’s impact on the patient’s therapeutic progress. Journal of Consulting and Clinical Psychology, 61, 3: 403-411., DOI: 10.1037/0022-006X.61.3.403
  26. Silberschatz G., Curtis J.T., Sampson H. & Weiss, J. (1991). Research on the process of change in psychotherapy: The approach of the Mount Zion Psychotherapy Research Group. In: Beutler L. & Crago M., editors, Psychotherapy Research: An International Review of Programmatic Studies. Washington, D.C.: American Psychological Association, 1991, pp. 56-64 (trad. it.: La ricerca sul processo del cambiamento in psicoterapia: l’approccio del Gruppo di Ricerca in Psicoterapia di San Francisco. In: Zabonati A., Migone P. & Maschietto G., a cura di, La validazione scientifica delle psicoterapie psicoanalitiche [Venezia, 18-19 maggio 1991]. Mestre [VE]: IPAR, 1994, pp. 61-78).
  27. Silberschatz G., Fretter P.B. & Curtis J.T. (1986). How do interpretations influence the process of psychotherapy? Journal of Consulting and Clinical Psychology, 54, 5: 646-652., DOI: 10.1037/0022-006X.54.5.646
  28. Silberschatz G. & Sampson H. (1991). Affects in psychopathology and psychotherapy. In: Safran J. & Greenberg L., editors, Emotion, Psychotherapy, and Change. New York: Guilford, 1991, pp. 113-129.
  29. Wampold B.E. & Imel Z.E. (2015). The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work. Second Edition (First Edition: 2001). New York: Routledge (trad. it.: Il grande dibattito in psicoterapia. L’evidenza della ricerca scientifica avanzata applicata alla clinica. Presentazione di Nino Dazzi. Roma: Sovera, 2017).
  30. Weiss J. (1986). Theory and clinical observations. In: Weiss, Sampson & the Mount Zion Psychotherapy Research Group, 1986, pp. 3-138 (trad. it. di pp. 3-31: Weiss J., Introduzione al lavoro del “San Francisco Psychotherapy Research Group”. Psicoterapia e Scienze Umane, 1993, XXVII, 2: 47-65).
  31. Weiss J. (1993). How Psychotherapy Works. Process and Technique. New York: Guilford (trad. it.: Come funziona la psicoterapia. Presentazione di Paolo Migone e Giovani Liotti. Torino: Bollati Boringhieri, 1999).
  32. Weiss J., Sampson H. & the Mount Zion Psychotherapy Research Group (1986). The Psychoanalytic Process: Theory, Clinical Observation, and Empirical Research. New York: Guilford (trad. it. del cap. 1: Weiss J., Introduzione al lavoro del “San Francisco Psychotherapy Research Group”. Psicoterapia e Scienze Umane, 1993, XXVII, 2: 47-65).

George Silberschatz, Reflections on epistemic trust and its role in psychotherapy in "PSICOTERAPIA E SCIENZE UMANE" 1/2020, pp. 54-58, DOI:10.3280/PU2020-001005


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