Orne, M. T., & Wender, P. H. Anticipatory socialization for psychotherapy: Method and
rationale. American Journal of Psychiatry, 1968, 124, 1202-1212.
Anticipatory Socialization for Psychotherapy: Method and Rationale
BY MARTIN T. ORNE, M.D., PH.D., AND PAUL H. WENDER, M.D.
There is a strong positive relationship between a patient's perception of psychotherapy
and its ultimate success. Some patients who appear to lack motivation for treatment may
be capable of profiting from psychotherapy if they are taught what to expect--if they
understand the "rules of the game." A clinical procedure for introducing such patients to
psychotherapy is outlined by the authors, who also present excerpts from a hypothetical
PSYCHOTHERAPY WILL BE VIEWED here as a special form of social interaction.1
The transactions which take place in psychotherapy, like those of any other social
enterprise, can run their normal course only if the participants are familiar with certain
ground rules, including the purpose of the enterprise and the roles to be played by the
participants. Only if this requirement is met can the psychiatrist judge his patient's
aptness for treatment, capacity for insight, etc.; only then can the patient benefit from the
opportunity offered him. A therapist whose patients do not have the requisite
understanding of the assumptions underlying psychotherapy will encounter serious
difficulties, especially if he is not fully aware of this deficit.
The purpose of this paper will be to argue that an important determinant of success and
failure in psychotherapy is the degree to which the patient understands the rules of the
game. Further, several techniques of training will be proposed which may facilitate
psychotherapy in patients who may lack the necessary understanding, and evidence will
be presented to show that one of these techniques has the desired effect.
The Enterprise of Psychotherapy
In this century, the writings of Freud and the dynamic psychologists who followed him
have had such a major impact that the basic assumptions of depth psychology are widely
available, although in an admittedly crude form. Psychotherapy is sought by a relatively
high proportion of individuals in some social groups, so that virtually all members of the
group have acquired considerable sophistication. It is not unlikely
Dr. Orne is professor of psychiatry, University of Pennsylvania, and director of the unit
for experimental psychiatry, Institute of the Pennsylvania Hospital, 111 N. 49th St.,
Philadelphia, Pa. 19139. Dr. Wender is medical officer in research, laboratory of clinical
science, National Institute of Mental Health, and instructor, department of child
psychiatry, Johns Hopkins University, Baltimore, Md. 21205.
This manuscript was originally prepared as part of a research proposal while the authors