page_title: David H. Malan
section_title: Brief Psychotherapy
hierarchical_section_title: David H. Malan / Brief Psychotherapy
caption_attribution_description: English: Triangle of Conflict
context_page_description: David Huntingford Malan is a British psychoanalytic psychotherapy practitioner and researcher recognized for his contribution to the development of psychotherapy. He promoted scientific spirit of inquiry, openness, and simplicity within the field. He is also noted for his development of the Malan triangles, which became a rubric in which therapists can reflect upon what they are doing and where they are in relational space at any given moment.
context_section_description: Although trained as an analyst, initially using analysis in therapy, and recognising the validity of analytic insights, Malan has always been concerned that analysis takes too long and too few patients can be treated.
  His research and writing therefore focussed on finding the most effective treatment that can help more patients in the shortest possible time.
  Balint's Brief Therapy Research Group.
  In 1956, after becoming a psychotherapist at the Tavistock Clinic, Malan was invited by Balint to join his Brief Psychotherapy research group investigating whether brief focal therapy was effective. Patients were treated using a radical interpretive approach and the results were evaluated against specified criteria and, in general, they were extremely good. Malan analysed the results in his Oxford DM thesis and subsequently developed the ideas in A Study of Brief Psychotherapy : Tavistock publications 1963. Other publications analysing aspects of the results were The Frontier of Brief Psychotherapy  and Toward the Validation of Dynamic Psychotherapy  - both published by Plenum in 1976.
  Brief Psychotherapy Workshop
  Following his appointment as a Consultant in the Adult dept., Malan introduced a Brief Psychotherapy workshop which all trainees were required to attend. They presented cases where they had used the principles of Brief Psychotherapy under his supervision. The aim was to achieve effective therapeutic results in the fewest sessions and to research the factors that made this possible.
  In the workshop the technique was actively interpretive. The work was initially focussed on the presenting problems but became more wide-ranging with responsive patients and demonstrated deep and lasting changes.
  An account of twenty-four therapies completed by trainees as part of the Brief Psychotherapy Workshop is summarised in ‘Psychodynamics, Training and Outcome’ by Malan and Osimo, pub. Butterworth –Heinemann 1992. It is based not only on the sessions but on the follow-up of a series of patients, and shows that good therapeutic results can be achieved by trainees under supervision.
  The Two Triangles
  A key element of therapy is the linking of the Two Triangles - the Triangle of Conflict (Defence, Anxiety and Hidden Feeling) and the Triangle of Persons (Current, Transference/Present and Past). The Triangle of Conflict illustrates the relation between anxiety, defences and the underlying impulses or feelings. The Triangle of Persons shows the links between the relationship with the therapist, with current people in the patient's life, and with people from their past.
  Malan always acknowledges that each Triangle was independently devised by Ezriel (1952) and Menninger (1958) respectively, but he showed how, when put together, the relation between them for the patient at any given moment in therapy, can form a reliable basis for many of the interventions that the therapist makes. Ref: Individual Psychotherapy and the Science of Psychodynamics (p. 80)
  As early as 1963 in his analysis of cases in Balint's workshop, Malan had identified that good outcome correlated with a high frequency of interpretations making a link between the transference and childhood, but the full significance and usefulness of the concept of linking the Triangles came later.
  The Myth of Superficiality
  Research from the workshop exploded the ‘myth of superficiality’ whereby critics maintain that Brief Psychotherapy is a superficial treatment that can only be effective with superficially ill patients, bringing about superficial results. Malan maintains that the aim of every session is to ‘put the patient in touch with as much of their true feelings as they can bear and that the long-term outcome should demonstrate deep and lasting changes.’ The work does not have to be focal and limited to specific problems and should lead to therapeutic changes that are wide-ranging, deep-seated and permanent. This has been shown in many of Malan's follow-up studies where Brief Therapy and Intensive Short-term Dynamic Psychotherapy have been used.
  Collaboration with Habib Davanloo
  In 19
caption: Triangle Of Conflict
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