Shift in representation and symbolisation of affective experience: a paradoxical outcome in therapy

Lars Henrik Kaasen Thoresen, Hans Hella Thørnquist, Erik Stänicke*, John McLeod

*Corresponding author for this work

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Defining outcome represents a key challenge for psychotherapy theory, research and practice. The present paper uses a case study of a client with anorexia nervosa to contribute to the development of conceptual understanding of the nature of paradoxical outcome. In this case, different sources of outcome data offered different answers to the question of whether or not the therapy had been successful. Qualitative thematic analysis of therapy transcriptions was carried out, using Interpretative Phenomenological Analysis (IPA). Both the process of change that occurred in this case, and the conflicting outcome indicators, could be explained in terms of a model of affect elaboration. These findings are discussed in terms of the need for caution when interpreting results from outcome measures in psychotherapy research and practice.
Original languageEnglish
Pages (from-to)177-200
Number of pages24
JournalEuropean Journal of Psychotherapy & Counselling
Issue number2
Early online date9 Jul 2021
Publication statusE-pub ahead of print - 9 Jul 2021


  • Illusion of mental health
  • Anorexia nervosa
  • Mentalization
  • Psychotherapy
  • Outcome
  • Paradoxical outcome
  • Affect elaboration Ergebnis

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