Most psychotherapeutic approaches are, to a greater or lesser extent, rooted in the theories and principles of scientific psychology. Nevertheless, in-session psychotherapeutic interaction between a therapist and a client is, at its core, a folk-psychological practice. As such, it is based on folk-psychological skills and competencies. But which ones exactly? This chapter argues that, while we may initially be inclined to perceive the practice of psychotherapy as primarily involving sophisticated mindreading on the part of both the therapist and the client/patient, (...) a complete characterization of psychotherapy must give at least the same amount of attention to different forms of therapeutic mindshaping. Using examples drawn from multiple therapeutic traditions, I illustrate how therapeutic mindreading and mindshaping interact. I conclude by highlighting some of the consequences of this perspective for the ethics and politics of psychotherapy. (shrink)

Several authors have recently argued that psychotherapy, as it is commonly practiced, is deceptive and undermines patients’ ability to give informed consent to treatment. This ‘deception’ claim is based on the findings that some, and possibly most, of the ameliorative effects in psychotherapeutic interventions are mediated by therapeutic common factors shared by successful treatments, rather than because of theory-specific techniques. These findings have led to claims that psychotherapy is, at least partly, likely a placebo, and that practitioners of psychotherapy have (...) a duty to ‘go open’ to patients about the role of common factors in therapy ; to not ‘go open’ is supposed to unjustly restrict patients’ autonomy. This paper makes two related arguments against the ‘go open’ claim. While therapies ought to provide patients with sufficient information to make informed treatment decisions, informed consent does not require that practitioners ‘go open’ about therapeutic common factors in psychotherapy, and clarity about the mechanisms of change in psychotherapy shows us that the common-factors findings are consistent with, rather than undermining of, the truth of many theory-specific forms of psychotherapy; psychotherapy, as it is commonly practiced, is not deceptive and is not a placebo. The call to ‘go open’ should be resisted and may have serious detrimental effects on patients via the dissemination of a false view about how therapy works. (shrink)

Explicates the mutually fundamental commonalities between the methods and practices of Western psychotherapies, especially those whose bases are social, interpersonal, and communicational, and the disciplines of Buddhism, Vedanta, Yoga, and Taoism.

Cultivating trusting psychotherapy bonds is complex, challenging, and a critically important topic. In Trusting in Psychotherapy, the author posits that trusting cannot be understood apart from trustworthiness and that therapists should give equal attention to the task of becoming trustworthy to their patients. Blending developmental science and ethical thought, the author elucidates such topics as what it means to trust in the practice of psychotherapy; the many facets of trusting and trustworthiness; attachment relationships; the central role of hope in trust; (...) and the ethical-moral basis of trusting and trustworthiness. (shrink)

Summary The article substantiates the possibility and meaningfulness of a coherent theoretical system for psychotherapy, as it is strived for in Gestalt Theoretical Psychotherapy and presented in several articles in this issue of the journal "Gestalt Theory". The necessity of consistency in the theoretical assumptions and concepts of a psychotherapy method is not derived from scientific considerations alone, but already arises from the elementary role of consistency in human life. This also results in the requirements for the consistency of theoretical (...) foundations of psychotherapy. It is not fulfilled in a mere internal, logical consistency of its models, but only in the actual fitting together with the critical-phenomenal and naive-phenomenal worlds of the therapists and their clients in the reality test of life. (shrink)

The psychotherapeutic theories of Descartes and Spinoza are heavily influenced by Stoicism. Stoic psychotherapy has two central features. First, we have a remarkable degree of voluntary control over our passions, and we can and should exercise this control to keep ourselves from having any irrational passions at all. Second, the universe is determined by the providential divine will, and in any situation we can and should align ourselves with this divine will in order to achieve equanimity. Whereas Descartes largely endorses (...) the Stoic picture, Spinoza develops a distinctive, intellectualized version of this view. (shrink)

This article will briefly explore some of the ways in which the past has been used as a means to talk about psychotherapy as a practice and as a profession, its impact on individuals and society, and the ethical debates at stake. It will show how, despite the multiple and competing claims about psychotherapy’s history and its meanings, historians themselves have, to a large degree, not attended to the intellectual and cultural development of many therapeutic approaches. This absence has the (...) potential consequence of implying that therapies have emerged as value-free techniques, outside of a social, economic and political context. The relative neglect of psychotherapy, by contrast with the attention historians have paid to other professions, particularly psychiatry, has also underplayed its societal impact. This article will foreground some of the instances where psychotherapy has become an object of emerging historical interest, including the new research that forms the substance of this special issue of History of the Human Sciences. (shrink)

This paper traces the manner in which the word ‘psychotherapy’ was invented and how it became taken up and disseminated in the English-, French- and German-speaking medical worlds at the end of the 19th century. It explores how it was used as an appellation for a variety of practices, and then increasingly became perceived as a distinct entity in its own right. Finally it shows how the fate of the word ‘psychotherapy’ enables Freud’s invention of ‘psychoanalysis’ to be located.

This book takes the discursive and postmodern turn in psychotherapy a significant step forward and will be of interest to all those working in mental health who want to work wiht clients in ways that will facilitate challenges to oppression and processes of emancipation. It achieves this by: · reflecting on the role of psychotherapy in contemporary culture · developing critiques of language in psychotherapy that unravel its claims to personal truth · the reworking of a place in the transforative (...) therapeutic practice Deconstruction is brought to bear on the key conceptual and pragmatic issues that therapists and clinical psychologists face, and the project of therapy is opened up to critical attention and reconstruction. The book provides clear reviews of different viewpoints and will help readers to orient themselves on the complex terrain of debates. (shrink)

Argues that psychotherapy's claim to be a universal scientific practice that objectively treats ahistorical illnesses is untenable. PT is a cultural product, so it both reflects and reproduces its cultural context. Because cultural context is in part composed of moral traditions embedded in political structures, PT is unavoidably a moral practice with political consequences. Implicit moralities in current practices are discussed. Philosophical hermeneutics in PT practice are offered as an alternative. In a discussion of intersecting traditions, it is suggested that (...) a hermeneutic perspective can portray the keeping of family secrets as a commitment to a particular moral code, rather than the products of a "dysfunctional family." If PT theories can be changed so that they are more historically situated, and if PT practices can be changed to use hermeneutics, then a different moral frame can be put forth. 2012 APA, all rights reserved). (shrink)

Psychotherapy style is conceptualized as the therapeutic method that a therapist employs while working with clients during treatment. It influences both the therapeutic process and results of therapeutic actions. The present study developed and validated the Psychotherapy Style Scale. By following a systematic psychometric development process, a three-factor structure of the PSS was identified. Exploratory factor analysis and confirmatory factor analysis provided evidence of multidimensional structure and validity of the PSS. Cronbach’s α suggested that the resulting scale was highly reliable. (...) Criterion validity was also satisfactory, demonstrated by correlations between the scale and criterion validity measures. The PSS has the potential to help better understand therapists’ behavioral characteristics and select the most appropriate therapists for clients who undergo psychotherapy. (shrink)

Psychotherapy was an invention of European modernity, but as the 20th century unfolded, and we trace how it crossed national and continental borders, its goals and the particular techniques by which it operated become harder to pin down. This introduction briefly draws together the historical literature on psychotherapy in Europe, asking comparative questions about the role of location and culture, and networks of transmission and transformation. It introduces the six articles in this special issue on Greece, Hungary, Yugoslavia, Russia, Britain (...) and Sweden as well as its parallel special issue of History of Psychology on ‘Psychotherapy in the Americas’. It traces what these articles tell us about how therapeutic developments were entangled with the dramatic, and often traumatic, political events across the continent: in the wake of the Second World War, the emergence of Communist and authoritarian regimes, the establishment of welfare states and the advance of neoliberalism. (shrink)

Psychotherapy holds out the promise of help for people who are hurting and in need. It can save lives and change lives. In therapy, clients can find their strengths and sense of hope. They can change course toward a more meaningful and healthy life. They can confront loss, tragedy, hopelessness, and the end of life in ways that do not leave them numb or paralyzed. They can discover what brings them joy and what sustains them through hard times. They can (...) begin to trust, or to trust more wisely. They can learn new behaviors in therapy and how to teach themselves new behaviors after therapy ends. They can question what they always believed was a given. They can find out what matters most to them, and how to stop wasting time. They can become happier, or at least less miserable. They can become better able, as Freud noted, to love and to work. They can learn how to accept and love themselves just as they are and accept others who are different from them. Our ethics acknowledge and affirm our profession's responsibilities. This book was written to help strengthen, deepen, and inform ethical awareness and the sense of personal ethical responsibility. Its job is to help you hold onto the ideals-including ethical ideals-that called you into the profession to begin with, to help you develop and fulfill those ideals. There will be so much-trust us on this-that tends to dull ethical awareness, to make ethics drift out of focus, to create barriers between you and your ideals, to replace ethics with pseudo-ethics and ethics placebos. Fatigue, endless paperwork, unrealistic expectations, illness, family crises, not being able to make ends meet, burn out, threats of job loss, insurance coverage that doesn't come close to meeting the needs of our clients, biases that have not been addressed, and so many other forces can pressure us into cutting ethical corners. This book is intended to help you develop a strong and healthy resistance to such forces, to help you weather them without losing your ethical awareness and ideals. (shrink)

The Great Psychotherapy Debate: Models, Methods, and Findings comprehensively reviews the research on psychotherapy to dispute the commonly held view that the benefits of psychotherapy are derived from the specific ingredients contained in a given treatment (medical model). The author reviews the literature related to the absolute efficacy of psychotherapy, the relative efficacy of various treatments, the specificity of ingredients contained in established therapies, effects due to common factors, such as the working alliance, adherence and allegiance to the therapeutic protocol, (...) and effects that are produced by different therapists. In each case, the evidence convincingly corroborates the contextual model and disconfirms the prevailing medical model. (shrink)

Through a warm and passionate investigation of the most fundamental properties of human behaviour, Psychotherapy and Science shows how a scientific foundation for psychotherapy is both necessary and feasible. Addressing psychotherapy's need for a coherent theoretical grounding, the book argues that there are striking parallels between the emotion-processing mind and phenomena that have been scientifically observed and charted in the areas of evolution, the immune system and the brain. The idea that scientific theories might be applied to psychotherapy is thoroughly (...) explored in a surprisingly accessible manner. Throughout the book, the ways in which science has a bearing on the clinical techniques and practice of psychotherapy are emphasized, and priority is given to the needs of psychotherapists to focus their theoretical and clinical efforts on understanding the deep, evolved factors behind human suffering, deception, self-limitations and death anxiety. This rare and engaging insight into a scientific quest for better psychotherapeutic knowledge offers a truly original way through the current impasse of ever-divergent theories, and is one of the most cogent challenges to psychotherapy in recent times. It is essential reading for all training and practising psychotherapists, and for those involved in related research. (shrink)

Before he became a counterculture hero, Alan Watts was known as an incisive scholar of Eastern and Western psychology and philosophy. In this 1961 classic, Watts demonstrates his deep understanding of both Western psychotherapy and the Eastern spiritual philosophies of Buddhism, Taoism, Vedanta, and Yoga. He examined the problem of humans in a seemingly hostile universe in ways that questioned the social norms and illusions that bind and constrict modern humans. Marking a groundbreaking synthesis, Watts asserted that the powerful insights (...) of Freud and Jung, which had, indeed, brought psychiatry close to the edge of liberation, could, if melded with the hitherto secret wisdom of the Eastern traditions, free people from their battles with the self. When psychotherapy merely helps us adjust to social norms, Watts argued, it falls short of true liberation, while Eastern philosophy seeks our natural relation to the cosmos. (shrink)

Paying careful attention to the multiple meanings the word ‘institution’ has in French, this article traces the development of institutional psychotherapy’s clinical practice. Through a close reading of Jean Oury’s seminars and clinical writing alongside other key members of the GTPSI (Groupe de travail de psychothérapie et de sociothérapie institutionnelles or Working Group on Institutional Psychotherapy and Socio- therapy), this article argues that institutional psychotherapy’s specificity is in the way in which the clinical and the political are able to connect (...) their praxis. (shrink)

This book is a scholarly mongraph on Sigmund Freud's understanding of the basics of psychotherapy theory and practice from the perspective of phenomenology.

This book explores the ethics around everything connected with setting up and running a therapy private practice. Offering a hands-on approach to realistic ethical dilemmas encountered by the private practitioner, the book examines the everyday management of practice, and the context of ethical issues in contemporary private practice. Chapters explore the fundamentals of some of the most common ethical considerations in private practice, providing space for the reader to think creatively about how they use their preferred ethical framework, and how (...) that may be translated into an individually tailored approach for each client, and for each private practice. The book provides exercises, examples, and vignettes, in addition to the author's own unique working model, to help the reader bring theoretical reflections into their own everyday practice. Relational Ethics in Psychotherapy and Counselling Private Practice will help private practitioners feel more confident and grounded in their private practice and up-to-date with developing thoughts. It will also appeal to training institutes, supervisors, and students. (shrink)

Despite a wealth of findings that psychotherapy is an effective psychological intervention the principal mechanisms of psychotherapy change are still in debate. It has been suggested that all forms of psychotherapy provide a context which enables clients to transform the meaning of their experiences and symptoms in such a way as to help clients to feel better, and function more adaptively. However, psychotherapy is not the only healthcare intervention that has been associated with ‘meaning’: the reason why placebo have effects (...) has also been proposed to be a ‘meaning response’. Thus, it has been argued that the meaning of treatments has a central impact on beneficial (and by extension, negative) health-related responses. In light of the strong empirical support of a contextual understanding of psychotherapy and its effects, the aim of this conceptual analysis is to examine the role of meaning and its transformation in psychotherapy – in general – and within three different, commonly-used psychotherapy modalities. (shrink)

The current paradigm of mental health has fallen short in its promises to deliver better care and quality of life for those who lives with mental illness. Recent works have expressed the need for more comprehensive frameworks of research, in which phenomenology emerges as a fundamental tool for a new wave interdisciplinary studies with the humanities. In line with this project, this article hopes to explore the relation between education and phenomenologically oriented psychotherapy, through the work of Brazilian educator Paulo (...) Freire. First, we will briefly expose Freire’s biography and main ideas (such as the “banking model of education” and the creation of “culture circles”), showing how they can be useful during the clinical encounter. We will also highlight the importance of dialogical psychotherapy during situations of injustice and oppression. Finally, we will provide some insights that can help build a new paradigm of mental health that is based on a “praxis of freedom”, whether in research or clinical practice. We call this proposal a “Psychotherapy of the Oppressed”. (shrink)

The Oxford Handbook of Psychotherapy Ethics explores a whole range of ethical issues in the heterogenous field of psychotherapy. It will be an essential book for psychotherapists in clinical practice and valuable for those professionals providing mental health services beyond psychology and medicine, including counsellors and social workers.

_Aims:_ Italy was one of the first countries to be significantly affected by the coronavirus disease 2019 (COVID-19) pandemic, determining a unique scenario for Italian psychotherapists to consider changing the modality in which they deliver treatment. The present study aimed at studying which factors related to psychotherapists and their clinical practice had a major role in predicting two main outcomes: (1) the rate of interrupted treatments during lockdown and (2) psychotherapists’ satisfaction with the telepsychotherapy modality. _Methods:_ An online survey was (...) administered to licensed psychotherapists ( n = 306), who worked mainly as private practitioners, between April 5 and May 10, 2020 (i.e., the peak of the pandemic in Italy). _Results:_ Psychotherapists reported that 42.1% (SD = 28.9) of their treatments had been interrupted, suggesting that Italy faced an important undersupply of psychotherapy during the lockdown. Using the Akaike information criterion (AIC) model selection, we identified three predictors of the rate of interrupted treatments: (1) psychotherapists’ lack of experience with telepsychotherapy prior to the lockdown, (2) their theoretical orientation (with cognitive behavioral psychotherapists reporting a higher rate of interrupted treatments), and (3) patients’ lack of privacy at home, as reported to the psychotherapists. Furthermore, we found four predictors of psychotherapists’ satisfaction with the telepsychotherapy modality: (1) the rate of interrupted treatments, (2) psychotherapists’ previous experience with telepsychotherapy, (3) their beliefs about the compatibility of telepsychotherapy with their theoretical orientation, and (4) their use of a video-conferencing modality, rather than telephone. _Conclusion:_ The following recommendations can help policy makers, professional associations, and practitioners in promoting the continuity of psychotherapy treatments during the COVID-19 outbreak and in future emergencies: (i) disseminating training programs for practitioners on telepsychotherapy, (ii) supporting patients to pragmatically access a private space at home, (iii) encouraging practitioners to use video-conferencing (instead of telephone) to deliver remote therapy, and (iv) increasing the acceptance of telepsychotherapy among both clinicians and the general public. (shrink)

The second edition of The Great Psychotherapy Debate has been updated and revised to include a history of healing practices, medicine, and psychotherapy, an expanded theoretical presentation of the contextual model, an examination of therapist effects, and a thorough review of the research on common factors such as the alliance, expectations, and empathy.

Ethics and Values in Psychotherapy examines the ways in which the ethical convictions of both therapist and client contribute to the practical process of psychotherapy. Practitioners are increasingly focusing on the issue of their extensive--and often problematic--ethical influence on clients as they attempt to agree on guidelines and standards for professional practice. Alan C. Tjeltveit argues that any discussion of ethical practice in psychotherapy must be carried out in connection with traditional ethical theories. The author draws on scientific, clinical, and (...) philosophical approaches to address issues such as: the role of therapy in society; the goals and outcomes of psychotherapy; techniques and practices; the existence and operation of values; and the intellectual and social context in which therapy takes place. This comprehensive study is a significant contribution to the debate on the ethical character of psychotherapy. (shrink)

I propose to demonstrate the clinical plausibility of the ‘psychotherapy scene’ of the Bacchae, which is subjected here to a purely psychiatric analysis: all my interpretations and conjectures are based on clinical data and psychiatric theory only. Euripides' objective and rational treatment of the irrational, the accuracy of his descriptions of abnormal behaviour, which are compatible, down to the last detail, with descriptions found in modern psychiatric texts, and his capacity to present not simply a partial list of symptoms, but (...) a coherent clinical picture are taken for granted and will not be discussed further in the present context. The focus of my enquiry is exclusively the psychiatric plausibility of Euripides' description of the psychotherapeutic process.It goes without saying that, since ‘instant cures’ are impossible, Euripides condensed a normally fairly long procedure into a single scene, selectively high-lighting only what would be the crucial moments of a real psychotherapy. His summary of the psychotherapy is as satisfactory as that of a modern psychiatrist. In fact, Euripides' masterly selectivity actually facilitates the understanding of the psychodynamics of Agave's recovery. This enables me to comment on the Euripidean text in exactly the same way as I commented on the verbatim transcript of the psychotherapy of one of my Plains Indian patients. (shrink)

Psychotherapy, Meditation and Health: A Cognitive-Behavioural Perspective. Edited by Maurits G. T. Kwee. East-West Publications, The Hague 1990. 319 pp. £18.95.

In this chapter, we explore how themes of existential philosophy have been used to develop a formal orientation of psychotherapy, and we discuss the main principles of existential psychotherapy and their application in practice. We also draw upon case examples to specifically illustrate how the approach of existential psychotherapy is utilized in clinical practice. In the case examples, each patient's identify has been disguised to maintain confidentiality. The new science of meaning, represented by the chapters in this volume, not only (...) offers therapists a deep conceptual framework within which to practice older, more established techniques but should also suggest new approaches. By recognizing the centrality of meaning as sense making and acknowledging the distinction between the what and the why of sense making, therapists should be armed with a variety of epistemic and teleological tools with which to fashion therapy strategies that are unique for each individual. (shrink)

‘Institution’ as a concept has a particular resonance in the collaborative work of Deleuze and Guattari. Looking at institutional psychotherapy and the way in which it traverses the works of Deleuze and Guattari, this article will attempt to offer some ways that the concept of institution can be put to work. To do so, it will begin with two statements about institutional psychotherapy made by the psychiatrist Jean Oury: ‘Institutional psychotherapy is perhaps the putting in place of all kinds of (...) means to struggle, each day, against all that might make the whole of the “collective” topple over towards a segregative or concentrationary structure’, and ‘The establishment is a building and a contract agreed with the State, a price per day. The institution, when it exists, is a labour, a strategy to avoid a whole load of people fermenting, like a jar of jam with a poorly closed lid.’ These statements will open the door to a deeper exploration of what an institution can do and how it was activated in Guattari’s clinical practice and in the collaborative philosophy developed with Deleuze. (shrink)

Dans cet article, l’auteur, psychologue exerçant en Institut thérapeutique, éducatif et pédagogique (itep) et en point-rencontre, traite la question de l’articulation entre la place du secret autour des maltraitances intrafamiliales en psychothérapie de l’enfant et la distorsion du rapport à la dette symbolique chez ce dernier, au regard de son vécu. Le sujet est abordé à partir d’une réflexion théorique associée à des apports cliniques issus de rencontres thérapeutiques. L’objectif est d’amener le lecteur à porter un regard plus nuancé sur (...) les situations de révélations de maltraitances par l’enfant, en considérant avec plus d’attention la perte de la place qu’il occupe au sein de son système familial. En parallèle à la question du positionnement de l’enfant, l’auteur interroge également le positionnement du thérapeute et rappelle l’importance de l’investissement affectif dans la relation thérapeutique, aussi anxiogène qu’il puisse être parfois pour les deux partenaires du dispositif. (shrink)

Precision medicine impacts virtually all medical specializations, including psychiatry. Though precision psychiatry, in general, is a flourishing area of research and debate, psychotherapy as one pillar of psychiatry has received little attention. Theoretical discussions about precision psychotherapy are rare; research on precision in psychotherapy is just evolving. In this paper we provide a conceptualization of precision psychotherapy providing a common idea of what should be understood as precision in the context of psychotherapy and what kind of psychotherapy research can be (...) considered to contribute to the aims of precision psychotherapy. (shrink)

The aim of the article was to develop the thesis that patient’s decisions about truth and responsibility are central to the process of psychotherapy and yet they are rarely explicitly articulated. In the first part of the text, I outlined the anthropological context of the thesis, according to which human intentionality and psychological mechanisms have the status of domains of objective reality that are ontologically separate, although in the patient’s experience they combine with one another. Next, with reference to the (...) classical opinions of psychotherapy, I identified two aspects of patient decisions related to her/his psychopathology: adaptive (more pronounced in childhood) and moral (more pronounced in adulthood). I went on to isolate groups of psychological operating mechanisms involved in both truth- and responsibility-avoidance choices and, using clinical illustration, showed how the therapist can support alternative decisions. Finally, I further clarified the understanding of the proposed working model by indicating the different therapeutic consequences of revealing psychological mechanisms vs. decision-making based on the type of patient disorder and the anthropological-moral character of his/her choices. (shrink)

Psychoanalysis, in Freud’s day and our own, has met with and continues to meet with staunch opposition from critics. The most ruinous criticism comes from philosophers, with a special interest in science, who claim psychoanalysis does not measure up to the above-board canons of acceptable scientific practices and, thus, is not scientific. It is common today to direct such criticisms to all metempirical forms of psychotherapy—i.e., psychotherapies that in no way concern themselves with grounding their claims with empirical research. The (...) most common defense is to cold-shoulder the criticism and counter that psychoanalysis, whether or not Freud recognized it, is a hermeneutical, not an etiological, method of therapy. In that regard, its measure of success is not symptom-removal or redirection of drive-energy in socially condoned or acceptable ways, but broadened understanding through a commonly created myth, effected by therapist and patient, for the patient’s wellbeing. In this undertaking, I argue that the hermeneutical apologia of psychoanalysis is a dodge, not a defense—an impenetrable asylum in which therapists can find refuge by buffering themselves from the possibility of criticism of the scientificity of their discipline. Because hermeneuticism disavows the possibility of knowledge in any meaningful sense—and, with that, scientific knowledge gained through observation or experimentation—it levels the epistemological playing field. With knowledge impossible and science annulled, no “investigative” inquiry or discipline can claim a status superior to any other and, hence, psychotherapy is an investigative discipline as legitimate as any other. The literature on the hermeneutic defence of psychotherapy is vast—too vast for anything but a representative sample of it in this critique. I focus merely on some of the most recent literature. (shrink)

`Erwin′s argumentative skills and knowledge of the literature are remarkable and most of his original claims are persuasive....The merit of the analysis Erwin offers is to provide a well-informed and accessible account of the current state of psychotherapy, its history and its philosophical grounds′ - Metapsychology Online `For those readers who favour an empirical-scientific approach to counselling and therapy, and who view therapy, at least potentially or in principle, as an objective science, this will no doubt be a very useful (...) and informative book... We should be grateful that Erwin has set out more fully than anyone to date the specifically philosophical case for a "science of therapy"; and those of a New Paradigm persuasion at least now know the nature of the arguments they will have to refute in order to sustain their position. I look forward with eager anticipation to their efforts, and to an emerging and fruitful engagement between philosophy and therapy - for both have a great deal to learn from each other′ - Counselling, The Journal of the British Association for Counselling and Psychotherapy This pioneering book analyzes the interface between philosophy and psychotherapy. The first authoritative work to apply rigorous philosophical discipline to therapeutic claims and counter-claims, it will encourage psychotherapists, counsellors and applied psychologists to examine their practice and clarify their thinking. Edward Erwin discusses some of the key philosophical issues that have a particular relevance to psychotherapeutic theory - autonomy and free choice, the nature of the self, epistemology, and values and morals - as well as examining specific interdisciplinary issues that cut across the boundaries between philosophy and psychotherapy. Finally, he looks at the `crisis′ in psychotherapy today, offering a valuable philosophical insight into the debate about the proliferation and efficacy of therapeutic approaches. (shrink)

The article outlines the Multiple-Field-Approach ("Mehr-Felder-Ansatz") in Gestalt Theoretical Psychotherapy and in psychotherapy in general. This Gestalt theory based approach deals 1) with the conditions under which a secondary phenomenal field (containing a secondary phenomenal ego and a secondary phenomenal environment) segregates within the primary phenomenal field, 2) with the dynamic field interaction between primary and secondary field and their role in psychotherapy, 3) with psychotherapeutic techniques favouring the segregation and favouring the dissolution of a secondary field . Some of (...) these phenomena have been discussed as mind-wandering, daydreaming, or - in a pathological context - as dissociation. But it seems that the Gestalt psychological approach presented in this paper has to offer a more promising framework for these phenomena and their dynamics. (shrink)

I discuss varieties of depth psychology that both emphasize the unconscious in particular ways and simultaneously accentuate human freedom and the underdetermination of the future. They recognize the soul as vital to the work of psychotherapy. Some even speak of a “mythopoetic” imagination. The soulful depth psychologists to be considered here include Frederic Myers, Theodore Flournoy, Carl G. Jung, Vera von der Heydt, Victor White, Otto Rank, Evangelos Christou, Richard Schwartz, and James Hillman. I will contend that these approaches align (...) with a Catholic anthropology. (shrink)

Psychotherapy is a professional activity because the therapist focuses his attention on a certain aspect of his patient’s problem and by this restriction attempts to achieve a deeper insight. A to-be-feared secularization of psychotherapy can be averted if the therapist continues to be aware of the abstract nature of theory, and realizes that one’s affective experience and religious life are intertwined. Dooyeweerd’s philosophical anthropology can be used to clarify this intertwinement. When treating patients with a Christian outlook on life the (...) therapist will attempt to link his patients affective experience to their religious life by strengthening and restructuring those moments in the emotional domain that anticipate faith. This is an extremely professional and at the same time extremely normative enterprise. (shrink)

Compared with mainstream medicine and complementary and alternative therapies, the practice of psychotherapy has enjoyed a relative pass when it comes to ethical evaluation. Therefore, contributions to the, although slowly growing, body of literature on psychotherapy ethics are to be welcomed. In his paper ‘Psychotherapy, placebos, and informed consent’, Garson Leder takes issue with what he calls the ‘go open’ project in psychotherapy ethics—the idea that the so-called ‘common factors’ in therapy should be disclosed to prospective patients. Although Leder does (...) not give a detailed list, the common factors include therapist characteristics, patient characteristics, and the working alliance. He argues that the project advocating disclosure of these factors is flawed on two grounds: that information about common factors is not necessary for informed consent; and clarity about specific mechanisms of change in therapy is consistent with ‘many theory-specific forms of psychotherapy’. There are multiple serious problems with Leder’s critique of the recent literature, including how he represents the contours of the debate, which I list, and address in this response. (shrink)

Currently there are several psychotherapy modalities utilising theory and research from neuroscience in treatment frameworks for mental health and recovery from trauma. In Australia this includes: the Conversational Model of Psychodynamic Psychotherapy, a contemporary psychodynamic approach used for treating Borderline Personality Disorder and other trauma-related disorders; Electroencephalogram Neurofeedback, a brain training therapy which has been used as an adjunct to counselling/psychotherapy in traumatic stress and developmental trauma; and Somatic Experiencing, an integrative mind-body approach based on body responses to threat and (...) fear, especially thwarted attempts to enact fight or flight in the face of threat. These modalities have a promising but still-limited evidence base. This paper explores the role of different types of evidence to frame a descriptive review of the current evidence base available for clinicians practicing in these three modalities. While large clinical trials can provide evidence of comparative effectiveness, case studies, observational, qualitative and practice-based enquiry can assist in discovering other aspects of therapy important for individual clients and practitioners. Existing frameworks of evidence- and ethics-informed health and clinical decision-making suggest an ethical approach can incorporate new, developing and evidence-building therapies. Recommendations include careful consideration of informed consent for therapy including disclosure of efficacy and safety, and specific to psychotherapies incorporating neuroscience, a need for practitioners to reflectively assess their own knowledge, competence, heuristic approaches and biases. (shrink)

Psychotherapy is a well-established, efficacious, and fully accepted treatment for mental disorders and psychological problems. Psychotherapy is an interpersonal practice engaging patient values, interests, and personal meanings at every step. Thereby, psychotherapy abounds with moral issues. In psychotherapy ethics, numerous moral issues converge, including self-determination or autonomy, decision-making capacity and freedom of choice, coercion and constraint, medical paternalism, boundaries between health and illness, insight into illness and the need for therapy, dignity, under- and overtreatment, and much more. The Oxford Handbook (...) of Psychotherapy Ethics covers the whole range of ethical issues in the heterogenous field of psychotherapy, closing a commonly perceived gap between ethical sensitivity, technical language, and knowledge among psychotherapists. The primary audience is psychotherapists in clinical practice. Furthermore, the Oxford Handbook of Psychotherapy Ethics addresses the whole range of professionals providing mental health services beyond psychology and medicine including counselors, social workers, nurses, or ministers. The Oxford Handbook of Psychotherapy Ethics is not only intended for a clinical audience but also for a philosophical/ethical audience. The goal of the is to explicitly link the two disciplines by fostering a productive dialogue between them, enriching both the psychotherapeutic encounter and the ethical analysis and sensitivity within and outside the clinic. (shrink)

Understanding Experience: Psychotherapy and Postmodernism is a collection of innovative interdisciplinary essays that explore the way we experience and interact with each other and the world around us. The authors address the postmodern debate in psychotherapy and psychoanalysis through clinical and theoretical discussion and offer a view of the person that is unique and relevant today. The clinical work of Binswanger, Boss, Fromm, Fromm-Reichmann, Laing, and Lacan is considered alongside the theories of Buber, Heidegger, Husserl, Merleau-Ponty, Sartre and others. Combining (...) clinical data from psychotherapy and psychoanalysis with insights from European philosophy, this book seeks to fill a major gap in the debate over postmodernism and bridges the paradigmatic divide between the behavioural sciences and the human sciences. It will be of great interest to clinicians and students of psychotherapy and psychoanalysis who wish to come to terms with postmodernism, as well as those interested in theinteraction of psychoanalysis, philosophy and social theory. experience. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Psychodramatic Psychotherapy for Schizophrenic IndividualsJohn Nolte, MD, PhD (bio)As a long-time student, practitioner, trainer, author and advocate of J. L. Moreno, MD,’s works and specifically the psychodramatic method, I am always appreciative of efforts, like Chapy’s, to commend and advocate for psychodrama. This is especially so because for a time, Moreno and psychodrama were heavily criticized, even maligned in the mental health professions. At the same time, considering how (...) poorly Moreno and his methods have been understood as well as the difficulty of accessing his original material, I feel an obligation to set the record straight when confronted with incomplete, inadequate, or sometimes incompetent expositions of Moreno’s psychodrama.Chapy’s article recommends psychodrama as a treatment method for schizophrenic people by calling upon existentialist and phenomenological concepts. Psychodrama, he proposes, opens up existence by allowing “schizophrenic patients to incorporate the experience of an ‘absolutely other.’”There are major flaws in Chapy’s presentation. His “clinical illustration,” the presentation of a psychodrama with a schizophrenic patient, while it may be considered psychodrama under the broadest definition of the term, hardly fulfills the requirements of a psychotherapeutic psychodrama. We must question the competence of the psychodramatist in Chapy’s example. Chapy’s description of the drama itself falls short of being an adequate account of a psychodrama, failing to convey the emotional intensity and realness which a well directed and reported psychodrama achieves. We do not learn, for example, if Damien’s perception of his father is introduced through role reversal with the father, a standard psychodramatic technique which is done in order to give the auxiliary ego taking that role an understanding how Damien experiences his father. We do not know if role reversals are made throughout the drama so that Damien can experience how he is perceived by father, can feel the force of his confrontation in the role of father, and is required to reply as his father to his confrontation. We are given little information about the psychodramatic techniques employed by the director other than the scene setting of the studio in which the psychodramatic [End Page 227] encounter takes place, and the soliloquy in which Damien expresses his worry and hopes for the outcome of the confrontation. It should be clear in the description of the drama whether the father’s statements in the drama were produced by Damien in role reversal, or by the auxiliary ego playing the role. There is a difference and it is significant. Although we are told that Damien “evokes a systematic relationship between him and his father” during the psychodrama, we do not see how this happens. Every psychodrama is an existential experience and its description should fully communicate its meaning and emotion.A more serious problem, however, is that this drama does not deal with Damien’s psychosis. Although Damien may be diagnosed as schizophrenic, his disorder is obviously in remission or controlled by psychotropic drugs. The drama reveals none of the hallucinations, delusions, or disorder characteristic of schizophrenic disorders. It could be psychodrama of any young man with a complaint about his father.The notion that people with schizophrenia can be successfully treated by psychodrama is not new. Moreno began developing psychodramatic psychotherapy at his Beacon Hill Sanitarium, established in 1936. He and psychodrama gained some fame because of his success in treating schizophrenic patients at a time when schizophrenic individuals were considered incapable of benefitting from psychotherapy. Moreno’s approach to the treatment of schizophrenic patients was much more robust than the psychodrama described by Chapy. During a psychotic attack, the individual’s perception of the world and self are distorted in ways that made action and interaction in the world of conventional reality impossible. Additionally, the psychotic episode makes the psychotic person incapable of being comprehended by anyone else, including the psychiatrist. Moreno’s solution was to make the chaotic, bewildering, sometimes violent and always terrifying inner world visible and tangible in the surplus reality of the psychodramatic stage. In moments of lucidity following the psychotic episode, he asked his schizophrenic patients to reenact their psychotic experiences. The result was that, “In this imaginary reality on the psychodramatic stage, the... (shrink)

During psychotherapy, patient and therapist tend to spontaneously synchronize their vocal pitch, bodily movements, and even their physiological processes. In the present article, we consider how this pervasive phenomenon may shed new light on the therapeutic relationship– or alliance– and its role within psychotherapy. We first review clinical research on the alliance and the multidisciplinary area of interpersonal synchrony. We then integrate both literatures in the Interpersonal Synchrony (In-Sync) model of psychotherapy. According to the model, the alliance is grounded in (...) the coupling of patient and therapist’s brains. Because brains do not interact directly, movement synchrony may help to establish inter-brain coupling. Inter-brain coupling may provide patient and therapist with access to another’s internal states, which facilitates common understanding and emotional sharing. Over time, these interpersonal exchanges may improve patients’ emotion-regulatory capacities and related therapeutic outcomes. We discuss the empirical assessment of interpersonal synchrony and review preliminary research on synchrony in psychotherapy. Finally, we summarize our main conclusions and consider the broader implications of viewing psychotherapy as the product of two interacting brains. (shrink)

Although the term psychotherapy evokes the idea of an incisive intervention, psychotherapy is fundamentally different from any procedure found in medicine or surgery aimed at curing a disrupted body. Psychotherapy does not aim to cure the body or even the brain; it aims to persuade a person in distress to think and behave differently. It is a method common in some form to all cultures. The late Jerome Frank, a psychiatrist and esteemed scientific investigator of psychotherapy, used the study of (...) therapies that succeeded and failed to define several characteristics common to all successful therapies (Frank and Frank 1991). In addition, he found that patients seek psychotherapy for reassurance, hope, and support .. (shrink)