The process of therapeutic change involving implicit knowledge: Some implications of developmental observations for adult psychotherapy

Several aspects of developmental change that are dependent on interactions between parent and infant are examined for their value in casting light on the processes of change in adult psychotherapies. First, the domain of implicit knowledge (where changes necessarily occur in nonverbal infants) is identified. The vast majority of therapeutic change is found to occur in this domain. We then examine the improvised, largely unpredictable, nonlinear movements toward mutual goals that characterize the processes of parent–infant and therapist–patient interactions. Finally, we provide a microdescription of these processes and provide a terminology for the “moments” that make up their flow. Of particular importance is the “moment of meeting,” in which the participants interact in a way that creates a new implicit, intersubjective understanding of their relationship and permits a new “way-of-being-with-the-other.” We view “moments of meeting” as the key element in bringing about change in implicit knowledge, just as interpretations are thought to be the key element in bringing about change in explicit knowledge.