Defenses in Interpersonal Interaction: Using a Theory-Building Case Study to Develop and Validate the Theory of Interpersonal Defense

I investigated interpersonal defense theory, an interpersonal reconceptualization of defense processes, using the theory-building case study approach. Close examination of patient-therapist interaction during a psychotherapy session provided support for tenets of the theory. The analyses of the clinical material also elucidate some of the key concepts of interpersonal defense theory. Those concepts include a new way of conceptualizing the nature of problematic interpersonal behavior, which offers a novel approach to understanding patients’ contributions to the alliance and transference phenomena. The analyses also clarify ideas from the theory about how defensive behavior on the part of one individual affects how the other person in a relationship behaves. These ideas lead to a new approach to countertransference, point away from common formulations of the self-fulfilling prophecy concept, and offer a novel response to the question of why dysfunctional processes persist. In addition to considering these substantive matters related to interpersonal defense theory, I also consider methodological issues related to the theory-building case study approach. The analyses presented illustrate the process of simultaneously examining whether multiple tenets from a theory are supported by observations on a single case, a crucial part of the theory-building case study approach that can make unique contributions to validating theories. I also discuss the role played by case formulations in the process of determining whether observations conform to theoretical tenets, which is an aspect of the logic of theory validation that has not been considered previously in the literature on the theory-building case study approach.