DIT formulation

Question 1

What is DIT?

Answer 1

DIT is a brief (16 sessions) psychodynamic and interpersonally oriented intervention - Addresses a non-conscious realm of experience

Question 2

Why is DIT interpersonal?

Answer 2

because a central focus is on the service user’s relationships, internal and external, as they relate to the problem(s) in the service user’s current life

Question 3

Why is DIT considered as dynamic?

Answer 3

Dynamic as it is concerned with helping the service user to understand the interplay between external and internal reality as it relates to a problematic relational pattern

Question 4

What is one of the key assumptions in DIT treatments for depression & anxiety?

Answer 4

A common clinical observation is that service users who present as depressed (and / or anxious) almost invariably present with difficulties / distress in their relationships. Symptoms are therefore seen as a manifestation of a relational disturbance

Symptoms of anxiety and depression are understood to be a response to interpersonal difficulties / perceived threats to attachments (loss and separation) and therefore also threats to the self

These perceived threats can both result from, and cause, difficulties in thinking clearly and realistically about the internal and external world, one’s own thoughts and feelings and experiences of the self with others

Question 5

How does DIT aim to bring about change?

Answer 5

Helping the service user to understand the connection between presenting problems and what is happening in his/her relationships by identifying a core, unconscious repetitive pattern of relating
Encouraging the service user’s capacity to reflect on his/her own (and others’) states of mind to enhance her/his ability to manage interpersonal difficulties (mentalisation)

Question 6

Key components of DIT formulation?

Answer 6

Dominant self-representation
Dominant representation of the other
Key affects aroused by this self-other constellation: both conscious and less conscious
Defensive strategies to manage psychic pain
Elements of positive and negative transference already in play

Question 7

What are some of the key question to ask yourself during assessment?

Answer 7

What kind of relationship(s) does the service user typically create (including the one with you)?

How does this relate to the presenting symptoms?

The early IPAF (formulation) is co-developed with the service user during the assessment phase

Question 8

What are some of the key elements to try and understanding during the assessment phase of DIT?

Answer 8

Key part of the assessment phase is mapping out the service user’s characteristic interpersonal style

Closely exploring significant relationships (past & present). Genograms are very helpful here

Obtain detailed accounts (at least one) of some important current interpersonal interactions (conflict situations often give rich information)

Listening out for (and be emotionally attuned to) common communication difficulties, intense affect, assumptions that the service user is making about other’s thoughts and feelings

Therapist curiosity about the service user’s subjective experience of their interpersonal world

Teasing out recurrent relational and affective patterns typically structured around self and other representations

Question 9

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