THE THREE-LEVEL MODEL: History, Mandate, Rationale, and an Extened Case study Exploring Change in a Patient in Psychoanalysis with the Three-Level Model (3-LM)

Abstract

This chapter outlines the initiation and development of the Three-Level-Model by the IPA Committee on Clinical Observation. Using an extended psychoanalytic case, the study of Ms. C, explored by 3LM groups, the chapter describes the model’s three approaches to detailed clinical material. In a phenomenological approach, sessions from the opening, middle, and end phases of an analysis are explored and discussed in ordinary language to observe presenting difficulties (“anchor points”) and changes in them over the course of an analysis. At Level Two, the group participants refer again to the line-numbered verbatim sessions to conceptualize the patient’s difficulties and the changes and lack of changes in specific dimensions of the analysis, guided by questions based on the OPD=2 and PDM=2. In a third approach, the group returns to the session material to study links between the analyst’s interpretations and the observed changes in the analytic couple and process. The superordinate aim is to demonstrate with a “bottom-up” method, both to the outside world and to the mental health communities, that our psychoanalytic method can bring about significant change in patients suffering from psychic pain.