How Meaning Is Made: Ambiguity Tolerance as a Central, Operationalizable Concept for Psychotherapy Integration

Ambiguity tolerance has been defined as the ability and skill to hold multiple interpretations and meanings of experience in mind simultaneously. Whereas many effective psychotherapy theoretical approaches appear conflicting and disparate in their focus (e.g., unconscious processes, cognitive distortions, reinforcement, radical acceptance, narratives, emotion regulation, etc.), all work to help individuals expand their understanding of their experiences, that is, to not rely on simplistic, overly personalized interpretations of meaning. This article asserts that successful therapeutic approaches essentially work to increase clients' tolerance of ambiguity (albeit from different perspectives), thereby encouraging them to see the complexity and nuance of their situation rather viewing it as simple, black and white, either/or, or easily understood. Thus, all theoretically grounded forms of psychotherapy increase clients' ability to avoid harm and increase connectedness and growth by helping them broaden their understanding of their past experiences and their current stressors. In spite of this overlap in theoretical models of psychotherapy, it can be difficult to know how to operationalize these similarities in approaches. The authors argue that ambiguity tolerance is a common mechanism in psychotherapy and can be easily operationalized through existing (and user-created) measures. The literature on ambiguity tolerance and related constructs is reviewed, and the authors suggest that greater attention to ambiguity tolerance (as a predictor of individual success and a broader mechanism of change in psychotherapy) will allow for more powerful and effective approaches to psychotherapy as well as greater theoretical integration.