Molnos, A. (1998): A psychotherapist's harvest

(7) FOUR TRIANGLES, THE

The diagram of the four triangles (Molnos, 1984, 1986a) represents in an abstract form the content and process of any dynamic psychotherapy, starting with the usual sequence of an assessment interview. This is as follows: The patient comes with his difficulty. No matter how he presents it soon turns out that the core of the problem is some disturbance in his relationships with others. As the therapist takes his history and looks for patterns, she discovers similar patterns in his past. Finally, sooner or later she sees the same pattern appearing in the here-and-now. In the course of therapy they keep on working on this repetitive pattern.

The three corners of the large triangle in the diagram refer to the patient's current (C) problem, to his problems in the past, mostly with his parents (P) and to the same problem as it is bound to arise in the therapeutic situation, here-and-now with the therapist (T). As all these problems occur in relationships with other persons close to the patient, the name given to the large triangle is "triangle of person". Each of the crucial, problematic relationships signifies psychic conflict for the patient, which is represented by the three smaller triangles inside the triangle of person. Their name is "triangle of conflict". Each represents the patient's internal conflict between his true feeling (X), his anxiety (A) about it and his defences (D) towards both, his true feeling (X) which is repressed and the anxiety (A) caused by the latter.

By lucky coincidence P is the initial letter of "past" as well as "parents". Moreover, the terms "therapeutic situation", "therapist" as well as "transference" all start with a T.

When the therapist takes the patient's history she is looking for patterns. By doing so, knowingly or not, she is using the four triangles. She keeps on using it during the course of the whole therapy: the conflict now, out there; the problem in the past, there and then, and, finally, the problem here-and-now.

I devised this graphic design was as a visual aid for teaching purposes in 1983. It is a further development of the "two triangles" (Malan, 1979, p.80). The notation is also different. The most important difference is that the patient's true feelings are symbolised by an X, the independent unknown variable at the start of the therapy.

See also index: ASSESSMENT, CONFLICT, CURRENT RELATIONSHIPS, DIAGRAM OF THE FOUR TRIANGLES, HERE-AND-NOW, PAST RELATIONSHIPS, PRESENTING PROBLEM, TRANSFERENCE, TRUE FEELING. The next pathfinder entry is (8) PRECIPITATING EVENT.