Transdiagnostic Potential of Person-Centered (Reconstructive) Psychotherapy: Focus on Comorbid Depressive and Anxiety Disorders On the 95th Anniversary of Boris D. Karvasarsky

On the occasion of the 95th anniversary of the birth of the outstanding psychotherapist B.D. Karvasarsky, this article explores the transdiagnostic potential of person-oriented (reconstructive) psychotherapy (PORP) in treating comorbid depressive and anxiety disorders. Developed within the Leningrad–St. Petersburg school of psychotherapy, PORP is based on V.N. Myasishchev’s psychological theory of relationships and views the patient’s disrupted relational system as the primary pathogenetic factor in neurotic disorders. Unlike the mononozological approach focused on ICD-10 diagnoses, the transdiagnostic potential of PORP emphasizes deep personality mechanisms that underlie various clinical manifestations. PORP consists of several sequential stages: diagnosis and establishment of contact, insight and confrontation, reconstruction of the relational system, and consolidation of new attitudes in everyday practice. PORP demonstrates particular effectiveness in comorbid conditions, as it interprets depression and anxiety as complementary responses to disturbed relationships. The advantages of PORP include a holistic approach to personality, work with deep structural layers, a high degree of individualization, and the ability to achieve not only symptomatic relief but also sustained changes in personality functioning, significantly reducing the risk of relapse. The article emphasizes the importance of developing transdiagnostic approaches in psychotherapy to overcome the limitations of current diagnostic practices and achieve stable remission in complex clinical cases.