Interpersonal Reconstructive Therapy

Interpersonal reconstructive therapy (IRT) is a psychotherapy for treating people with personality disorders, especially those not helped by other therapies or medication, developed by Lorna Smith Benjamin, a retired professor at the University of Utah. It is based on the understanding that early attachment patterns shape a patient's later behavior: when infant care is "good enough," the infant forms a secure attachment that serves as a base for interacting with the world, but when early care is less than optimal, the infant must still attach to caregivers, and the resulting patterns, formed as the infant internalizes its interactions with caregivers by acting as the caregiver did, acting as if the caregiver is still in control, or treating themselves as the caregiver did, can become maladaptive in later life and produce personality disorders. IRT seeks to recognize and analyze these maladaptive patterns, which cause a patient to repeatedly engage in self-destructive behavior, and guide the patient toward healthier patterns, formulating the case according to Benjamin's own Structural Analysis of Social Behavior; therapy proceeds through five stages, collaboration between patient and therapist, learning about the old patterns and their origin, blocking the old patterns, enabling the will to change, and learning new patterns, and is rarely completed in less than a year, with most courses requiring multiple years.