Rita Teodoru, Talking about the Psychic Change in Terms of Need, Desire and Capacity

Abstract: Attempts to measure the “moti¬vation for change” as a predictor of success or failure in psychotherapy are not warranted. The concept of motivation is useful if one looks in detail at the hierarchy of motives, from conscious to unconscious, from conflict-free to primitive, drive-determined for¬ces, at any given stage of psycho¬therapy. Doing so will help distin¬guish wishesto continue experiencing the real and fantasied satisfactions of psycho¬therapy from wishes to bring about change in oneself. When careful diagnosis makes it possible to calibrate treatment goals to an accurate assessment of the patient’s capacity to change, failure to meet those goals can then be explained in terms of treatment methods and techniques, instead of blaming the patient for a supposed lack of motivation to recover.