The significant other history: an interpersonal-emotional history procedure used with the early-onset chronically depressed patient

Am J Psychother. 2011;65(3):225-48. doi: 10.1176/appi.psychotherapy.2011.65.3.225.


An interpersonal-emotional history procedure, the Significant Other History, is administered to the early-onset chronically depressed patient during the second therapy session in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). Patients are asked to name up to six significant others and answer two questions: (1) What was it like growing up with or being around this person? (2) What is the emotional "stamp" you take from this relationship that informs who you are today? An interpersonal-emotional theme reflecting the early learning history of the patient is derived from these "stamps" or causal theory conclusions. One transference hypothesis (TH) is derived from the Significant Other History (SOH) and is formulated in one sentence, such as "If I do this, then the therapist will likely do that" (e.g., "If I make a mistake around Dr. E, then Dr. E will label me 'stupid' or 'incompetent"). The transference hypothesis highlights the interpersonal content that most likely informs the patient's expectancy of the therapist's reactions toward him or her. Throughout the therapy process, the therapist will proactively employ the transference hypothesis in a technique known as the Interpersonal Discrimination Exercise to help patients cognitively and emotionally discriminate the practitioner from hurtful significant others. The goal here is to increase the patient's felt safety within the therapeutic dyad and eventually to generalize the felt safety to the patient's other relationships.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Age Factors
  • Child
  • Child Abuse / psychology
  • Chronic Disease
  • Cognitive Behavioral Therapy / methods*
  • Depressive Disorder / psychology*
  • Depressive Disorder / therapy*
  • Emotions*
  • Family / psychology
  • Fear / psychology
  • Female
  • Humans
  • Interpersonal Relations*
  • Medical History Taking / methods*
  • Professional-Patient Relations
  • Transference, Psychology