Bioenergetic Analysis

1. Definition Bioenergetic Analysis (BA) is a psychotherapeutic method the roots of which go back to Freud, e.g. to psychoanalysis. In contrast to psychoanalysis, however, which focuses mostly on fantasies, thoughts and dreams as the main expressions of the unconscious, BA in addition pays close attention to the bodily expression of the patient as manifested in gestures, mimics, voice and breathing patterns. Rather than splitting body, mind and soul BA understands them as an indivisible unity whereby each influences the others and where therapeutic interventions on one modality can have an effect on the others. BA originally was developed by Wilhelm Reich, student and later associate of Freud and finally an ardent critic of Freud. He introduced the concept of character armouring meaning that certain emotionally traumatic experiences, often stemming from early childhood, can cause a substantial tightening of certain muscular regions and with it a deadening of the affective state as a protection of the soul. “Character analysis”, Reich’s most famous piece of writing (Reich 1945) thus describes and explains physical and expressive structures in terms of certain neuroses and introduces the reader to a number of body-oriented psychotherapeutic techniques. Two of his students (and patients), John Pierrakos and Alexander Lowen took the ideas of Reich further. While Pierrakos developed a body psychotherapy form known as “Core Energetics”, Alexander Lowen developed BA as it is known today. Bioenergetics actually means dealing with the “energy of life”; somatic, psychic and affective expressions are controlled by a common biological energy-dependent mechanism.

2. Enquiry Alexander Lowen (1958, 1975), basing himself on his own experiences with Wilhelm Reich and by studying his patients very carefully from the point of view of physical structure, appearance and motility, of their limbs, their chest and pelvic region, their breathing pattern, their facial mimics, eye expression and gestures, he concluded that human beings can be divided in five basic personality structures: the schizoid, the oral, the masochistic, the narcissistic and the rigid character. These expressions have their basis in Freud’s concept of developmental phases; they were further explained and inquired into by Keleman (1981) and also Johnson (1985), Keleman paying more attention to the anatomy of a person and Johnson trying to reconcile with Freud. Depending when during development certain deficits or traumata occurred, in coping attempts one or the other character feature would emerge, be rehearsed and would find its form also in the physical structure of the person. BA as psychotherapy would then be to analyse the deficit, trauma or unresolved conflict, find some verbal and physical interaction to bring them out and help the patient find a means to heal. Lowen has described in many vignettes how he goes about; in fact he has also developed what is known as “body reading”, whereby he practically can read the character structure of a person by analysing the body structure and muscular tension pattern. His theoretical and practical concepts are all entirely based on personal observations and are in need of scientific proofs. The section on research will show that the bioenergetic community has been actively engaged since a few years to fill this gap.

3. Applications From the above it is clear that BA is a form of body psychotherapy useful for adults suffering from neurotic and psychosomatic disorders. How useful it is for psychotics is unknown at the present time, as we have no publications yet referring to the treatment of these disorders. Also the application of BA to children and their disorders (Ventling 2001) is still in the beginning, but publications begin to appear. From inquiries and research data (for more details see 1.4. on Research) we know that most our adult patients can be classified according to the ICD-10 as belonging to the class F4 e.g. suffering from neurotic disorders, such as phobic and panic disorders, anxieties, compulsive disorders, adjustment problems, depressions with and without psychosomatic complications etc. A smaller fraction suffers from personality and behaviour disorders, and are classified as F6; about the same proportion suffering from affective disorders we can classify as F3. (Gudat 1997; Ventling & Gerhard 2000; Bertschi 2003).

4. Therapy Bioenergetic therapy is preceded by intensive work on diagnosis. The present life situation, the personal history of development including prenatal, natal and postnatal period are explored, as well as the medical history, the experiences in relationships and their qualities. Body expression, posture, muscular tension, blockades in different body sections, degree of liveliness and body awareness are carefully observed and - hypothetically - related to the character structure which seems closest to the person. Thus the therapist gets an idea of the client's life topics, his fundamental problems and his characteristic strategies of solution. Even if this idea needs continued re-examination in the course of therapy, it still offers a practical orientation to structure verbal and non-verbal information as well as body signals. These first impressions teach the therapist what to expect from a client in terms of reactions, resistances etc.

Bioenergetic Analysis is a form of psychotherapy where two approaches are combined: the verbal and the bodily approach. Both approaches take part in the therapeutic process. - The verbal approach starts from the client's reports, paying attention not only to the words but also to the emotional nuances and the bodily reactions involved. The focus is then put on the latter kind of communication so that the client becomes clearly aware of it and can better express himself. Verbal interventions and interpretations on the part of the therapist aim at fostering the therapeutic process through an understanding of the current experience of the client in the therapeutic setting and its relation to his past experiences. - The bodily approach first attempts to deepen breathing and to improve body perception and awareness. This can be done choosing from a wide range of exercises in stress positions, in a state of relaxation or in different forms of movement. One aim is to foster the spontaneous emotional expression of the client - or even make it possible again - and lead him to conscious reflection. (Lowen 1980, 1981, Dietrich 2004, Steinmann 2002) We distinguish between so-called “exercises” and bodily interventions. Lowen (Lowen & Lowen 1979) and several followers (Sollmann 1988; Dietrich & Pechtl 1991) have described physical “exercises” the purpose of which is to gain a better consciousness of one’s body and its parts, especially those parts which are tense, but also to feel more alive, as Lowen called it, more vibrant. Some exercises are intended to bring a person more to his feet, to feel the ground, others to help him to feel freer. Ultimately the effect is that the patient is also more sensitive and open to feelings like sadness, anger, fear, despair etc. and dares to show them. These exercises can be offered to a patient during a therapeutic session or as some therapist colleagues do it, they offer exercise classes. A bodily intervention is different: here we may mirror a certain gesture or facial expression or suggest taking up a stress position or even a cathartic movement, this with the idea to bring out the hidden feeling that we therapists noticed. There exist many case vignettes reporting such interventions (see the books by Lowen) and also a number of complete case histories with explicit details of such interventions (Ventling 2001, 2002).

5. Research
5.1.Theoretical inquiries: Differentiation and elaboration of basic concepts, their specific applications and possible links to other scientific disciplines
The literature of Wilhelm Reich (e.g. 1933; 1942; 1948; 1961), founding father and predecessor of most contemporary body-psychotherapies, and that of Alexander Lowen (e.g. 1958; 1967; 1975), founder of Bioenergetic Analysis (BA) and initiator of the International Institute of Bioenergetic Analysis (IIBA) provided us with concepts which continuously stimulate reflecting, criticism and further discussions and inquiries into their validity and possibility of practical applications. Thus many members of the IIBA have felt a need or desire to express their views or practical experiences in form of publications. Such publications can be found first of all in journals published by local societies such as the “Forum der Bioenergetischen Analyse” (German Societies), or “Körper und Seele” (Swiss Society) and the equivalents “Le corps et l’analyse” or “Anima e Corpo” (Francophone and Italian Societies respectively). For an international audience we have the following platforms available: the IIBA journal “Bioenergetic Analysis”, “Energy and Character”, the “USA Body Psychotherapy Journal”, not to mention the possibility of publishing in established journals of various psychological or psychiatric societies. To list all would go beyond the scope of this chapter. Each volume of “Körper und Seele” of the Swiss Society for Bioenergetic Analysis and Therapy (SGBAT) is devoted to a specific theme, one of these volumes defining basic concepts of Bioenergetic Analysis (Ed. Koemeda-Lutz 2002). Here an attempt is made to link BA to current concepts and results of psychological, neurobiological, sociological, linguistic and medical theory and research. Recent book publications have explored extended realms for specific applications of Bioenergetic Analysis (Ventling 2001; 2002). Severals authors have tried to connect neurobiological findings to body-psychotherapeutic concepts and techniques (Resneck-Sannes 2003; Klopstech 2004; in press; Lewis 2004; Koemeda-Lutz and Steinmann 2004; Koemeda-Lutz 2004; in press; Ventling 2004). Finally attempts to connect the bioenergetic concept of energy to concepts and models of modern physics have been undertaken by Mahr (1997; 2001), Carle (2002) and Madert (2004). During the past few years theoretical (elaboration of basic concepts) and clinical inquiries (single case studies – see separate list; development of new techniques, e.g. Lowen & Lowen 1977; Dietrich & Pechtl 1990) were supplemented by quantitative empirical studies.

5.2.Quantitative Research Studies.

5.2.1. Evaluation of the effectiveness of Bioenergetic Analysis
Four studies have been carried out to evaluate the effectiveness of Bioenergetic Analytic Therapy. Three of these studies were retrospective (Gudat 1997; 2002; Ventling and Gerhard 2000; Bertschi et al. 2003), one is prospective (Koemeda-Lutz et al. 2003 a + b). All studies yielded clearly positive results. Presently the Swiss Charta for Psychotherapy (currently comprising 22 institutes teaching psychotherapy and representing different methods) is planning another prospective study, naturalistic in its design for evaluating outpatient psychotherapies in Switzerland, comparing different methods of treatment. Bioenergetic therapists will participate in this study. In addition to this general question of overall effectiveness of the method, several areas have been investigated in more detail:

5.2.2. Evidence for “Character Styles” – a psychosomatically based model of personality
Quantitative empirical studies have been carried out by Fehr (1998 a; 2000), inquiring into the validity of the bioenergetic theory of character structures. Fehr (1998 b) developed a questionnaire (Bioenergetische Prozessanalyse BPA) in order to assess characterological profiles of patients and how they change during therapy. By factor analytical computations Fehr (2000) explored the interrelatedness between bioenergetic characterological and other well established personality dimensions, namely the Big Five (Goldberg 1990).

5.2.3. Investigating the Validity of “Body Reading” as a Diagnostic Tool
Body reading has been an important diagnostic tool in Bioenergetic Analysis (Lowen 1958; Bäurle 1988; Kurtz & Prestera 1976; Rank 1994; Sollmann 1999). One study was carried out to test whether trained therapists can reliably gain valid information from their patients’ bodily appearance. They can (Koemeda-Lutz and Peter 2001; 2002). A second study was designed to derive a screening skid for “Body Reading” from therapists’ verbal accounts of what criteria they base their judgments on (Koemeda-Lutz et al. 2003 c). © European Federation for Bioenergetic Analysis – Psychotherapy, 2005

For additional information please visit the web page of the European Federation for Bioenergetic Analysis-Psychotherapy (EFBA-P) at www.bioenergeticanalysis.net

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Biosynthesis

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Body Psychotherapy

Body-Psychotherapy is a distinct “mainstream” branch of psychotherapy within the field of psychotherapy, which has a long history and a large body of literature and knowledge based upon a sound theoretical position. It involves a different and explicit theory of mind-body functioning which takes into account the complexity of the intersections and interactions between the body and the mind. The common underlying assumption is that the body is the whole person and there is a functional unity between the mind and the body. The body does not merely mean the “soma” and that this is, in some way, separate from the mind, the “psyche”. Many other approaches in psychotherapy touch on this area (e.g psycho-somatics). Body-Psychotherapy is different in that it considers this unity as paramount and fundamental. Any approach to the mind therefore involves the body as well, de facto; and every aspect of the body, affects and is affected by the mind, and not just the brain.

Body-Psychotherapy involves a developmental model; a theory of personality; hypotheses as to the origins of disturbances and alterations; as well as a rich variety of diagnostic and therapeutic techniques used within the framework of the therapeutic relationship. There are many different and sometimes quite separate approaches within Body-Psychotherapy, as indeed there are within the other mainstreams of psychotherapy.

Body-Psychotherapy is also a natural science, having developed over the last seventy years from the results of research in biology, anthropology, proxemics, ethology, neuro-physiology, developmental psychology, neonathology, perinatal studies and many more disciplines. There are many research projects within Body-Psychotherapy, and many more which also inform it.

It also exists as a specific therapeutic approach with a rich scientific basis on an explicit theory. Body-Psychotherapy is also an approach which demands a high level of knowledge, skill and awareness of non-verbal communication, subtle body signals, diagnostics & processes, emotional ergonomics, psychosomatics, and so forth.

There are also a wide variety of techniques used within Body-Psychotherapy and some of these are techniques used on the body involving touch, movement and breathing. There is therefore a link with some body therapies, somatic techniques, and some complementary medical disciplines, but whilst these may also involve touch and movement, and may well be very psychotherapeutic, they are also very distinct from Body-Psychotherapy, as they do not fit within the scope, depth and training requirements of the field of psychotherapy.

Body-Psychotherapy recognises the continuity and the deep connections in which all psycho-corporal processes contribute, in equal fashion, to the organisation of the person. There is not a hierarchical relationship between mind and body, between psyche and soma. They are both functioning and interactive aspects of the whole.

Historically Body-Psychotherapy has been somewhat marginalised by some of the more traditionally accepted branches of psychotherapy; possibly because of historical and societal anathemas about touch. However this position is now itself more marginalised and Body-Psychotherapy, its long and rich history, its body of knowledge and its particular perspectives are increasingly being accepted, validated, and sought after by other branches of psychotherapy. Body-Psychotherapy has been scientifically validated by the E.A.P. as have a number of the various modalities within this mainstream branch of psychotherapy.
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Bonding Psychotherapy


Bonding Psychotherapy was developed in the 1960s and 70s by the American Psychiatrist and Psychoanalyst Dr. Daniel Casriel (d. 1983). It is an experiential learning process based on mobilizing and expressing deep feelings, developing positive attitudes toward self and others, and on learning and practicing new behaviors. A central observation of Dr. Casriel is the importance of a biologically anchored basic human need for emotional and physical closeness to others. Casriel labeled this basic need as the need for “bonding”. The theory of Bonding Psychotherapy has recently been further developed by Dr. Konrad Stauss based on
an integration of attachment theory, the theory of consistency (Grawe), modern neurological research, and the process experiential methods of Greenberg and Elliot. Casriel’s basic need for bonding was enlarged to include further psychosocial basic needs: attachment, autonomy, self-esteem, identity, physiological comfort and pleasure, and meaning and spirituality.
 


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Existential Analysis

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Gestalt Therapy

Gestalt therapy was founded in the socio-cultural context of humanistic psychotherapies. It was Friederich Perls, a German Jewish psychoanalist, whose intuition gave rise to this form of therapy: together with his wife, Laura Polsner, he had emigrated in the Forties, because of his race, first to South Africa and subsequently to the United States, where his insight was further developed by a group of American intellectuals with a deep knowledge of psychoanalysis. Of these the most outstanding were Paul Goodman, Isadore From, Paul Weisz, Lotte Weisz, Elliot Shapiro, Alison Montague and Sylvester Eastman. The birth of Gestalt therapy can be placed with the publication of the book "Gestalt Therapy. Excitement and Growth in the Human Personality" by F. Perls, R. Hefferline and P. Goodman, in 1951. It expressed the creative synthesis of various philosophical, psychological and cultural tendencies of the post-war period (Gestalt psychology, of course Psychoanalysis, Wilhelm Reich's, Karen Horney's, and Otto Rank's theories, Holism, Existentialism and Phenomenology, and finally Oriental philosophies, especially Zen), in a perspective on human nature which is still unique and fascinating. Friedrich Perls had been Kurt Goldstein's laboratory assistant in Germany, and was thus intimately involved in the enthusiastic studies of the perception of Gestalt psychology. His dissatisfaction with the Freudian theory of the Ego led him to realize that introjection completes its fundamental evolutionary task much earlier than Freud had theorized. For Perls, teeth development (the dental phase) is the physiological proof of all this. If the newborn child's sucking its mother's milk creates or sustains the human capacity - at a physiological as well as a psychological level - to introject, teeth development must likewise create (or maintain) a physiological or psychological capacity on the part of the child, namely the capacity to deconstruct both food and reality, to attack them in order to be able to assimilate them, if they are nourishing, or reject them if they are harmful or non-nourishing. Perls saw aggressiveness itself in the positive terms of the survival and of physical and existential growth of the organism: the drive to self-fulfillment is thus spontaneously attained. Goldstein's positive perspective of the impulse to self-fulfillment was a fundamental influence on Perls's thinking, which was offered as a way of overcoming the dualism present in Freudian metapsychology between the individual's impulses and the need for social organization. Indeed, since the individual is the subject who deconstructs and reconstructs, this means that s/he has a real possibility of living fully in her/his own world. Every experience comes about at the contact boundary between a human animal organism and her/his environment. It is precisely what happens at this boundary that is open to observation and to a possible therapeutic intervention. The contact boundary is the place where the Self unfolds - the Self being that function of the human organism which expresses its ability to make contact with its environment and to withdraw from it. The process of contact between the human organism and its environment, explained in Gestalt therapy on the basis of the dynamic concept of function - instead of instances - allows the individual to orient her/himself in the world, and to act on it for the self-preserving purpose of assimilating what is new - what is different from the self - and growing. Thus the contact boundary is the place where creativity (which expresses the uniqueness of the individual) can be combined with adjustment (which expresses reciprocity necessary to social living). There is not a unique model of health in Gestalt therapy, since every individual will create his/her own adjustment coping with the novelty offered by the other. On the clinical level, certain substantial differences of psychotherapeutic practice follow from Perls's ideas: we may think, for instance, of the positive redefinition of the patient's aggression, of the value given to the capacity to concentrate (which Perls substituted for free association) as recovery of spontaneity of the organism, and of the brilliant replacement of the cause-and-effect concept with the concept of function. Gestalt therapy holistic perspective brings us to think to the relationship between the individual and the social group no longer as separate entities but as parts of a single unity in reciprocal interaction, so that the tension which there may be between them is not to be regarded as the expression of an indissoluble conflict but as the necessary movement within a field which tends towards integration and growth. Finally, the perspective of the contact boundary makes us possible to understand human behavior in terms of intentionality for contact: every experience finds its meaning in the relationship and in the time within which it is inserted. This restores concreteness to the exigencies of the individual and of social living: every conflict is to be faced in the here and now of the situation, because it is only in the details of a context that we can find real solutions. Gestalt therapy entrusts the regulation of need to the relationship itself, because it is in full recognition of the self and the other that the needs of the interacting partners find healthy expression and creative resolution.   This is a brief and partial description of Gestalt therapy's birth and main principles. The history and development of this approach has been so creative that any description can just tell one perspective, neglecting others.
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Hypno Psychotherapy

Unlike the majority of comparable therapies, hypno psychotherapy measures its history not in years or decades but centuries. Therefore, if the provenance of a therapy is to be determined by its longevity, hypno psychotherapy has stood the test of time.

Throughout much of that history, the discipline has been hampered by the absence of a single theory to explain the medium through which it works - hypnosis. The usually acknowledged forerunner of modern hypno psychotherapy, Franz Anton Mesmer (1734-1815), believed in the existence of a universal fluid - animal magnetism - an imbalance of which in the human body caused illness. He, and others trained by him, sought to control the distribution of this fluid, restoring balance, and health, to those who sought his help. Mesmer was careful to confirm whether any given presenting problem were organic or functional, and worked with the latter, functional psychosomatic illnesses. (This same caution is observed by competent practitioners today.) Mesmer was convinced that a cure might only be achieved when a patient experienced a crisis, typified by convulsions and related phenomena. In 1784, a Royal Commission in France, where Mesmer was then resident, decided against the existence of magnetic fluid. The Commission attributed Mesmer's undoubted successes to his manipulation of a patient's imagination; that is, by suggestion.

In an age not familiar with the power of suggestion alone, outside of a religious context, the significance of the Commission's findings was overlooked. But if there were no universal fluid, with nothing physical being transmitted between Mesmerist and subject, related phenomena must be psychological in origin. The blind regained their sight, for instance, through the power of imagination and suggestion, rather than animal magnetism. Since Mesmer would not allow his theory to be displaced by such a concept, and the Commission discounted it, the emergence of modern psychology and hypno psychotherapy was postponed. Discredited by the findings of the Commission and other enquiries, and the bizarre nature in which he chose to conduct therapy sessions, Mesmer eventually returned to his native Austria.

These events, along with the convulsions of the French Revolution, Napoleonic and post-Napoleonic Europe, scattered Mesmer's followers throughout Europe and abroad. Attempts to carry forward Mesmer's medical applications met with considerable opposition. British doctors who advocated the use of Mesmerism, for instance, made little progress because of the attitude of the medical and scientific establishments. John Elliotson (1791-1868) was obliged to resign his post as Professor of Surgery at University College, London. James Braid (1795-1860), who substituted the word "Hypnotism" * for Mesmerism, was refused permission to read a paper on the subject to the British Association for the Advancement of Science. James Esdaile (1808-1859), who performed over 300 major surgical operations in India using hypnosis as the anaesthetic, was denied access to the medical press to publish his findings. (* From Hypnos, Ancient Greek god of sleep, since Braid thought a form of sleep was involved. The name persists, though the sleep theory has been discarded.)

The often legitimate suspicions aroused by the extravagant claims and behaviour of mesmerists and hypnotists - some of whom exploited, and exploit, related phenomena for "entertainment" - relegated the legitimate applications of hypnosis to the fringe of respectability. The advent of chemical anaesthetics and growth of the drugs industry impeded the study and use of hypnosis in medicine. In much the same way as chemical agents had served to displace hypnosis in the practice of medicine, so Freudian psychoanalysis tended to displace it in psychotherapy. Despite sporadic revivals of interest, such as after and during the First and Second World Wars when short term psychotherapy was needed, its present popularity is comparatively recent. Mesmer's student, de Puysegur (1751-1825), had quietly relegated the importance of the crisis in favour of the trance-like state typical of his therapeutic practice. Modern therapy, too, recognises the significance of the trance and, when we speak of somebody being "mesmerised", we do not suppose that person to be convulsed. Although emotion may be released - most particularly when the technique of hypno-analysis is used, based on the Freudian view that repressed material may be recovered from the unconscious mind - it is a sense of calm detachment, rather than crisis, which typifies the great majority of hypnotherapy sessions.

A typical modern hypno psychotherapy session, influenced by research and refinement in numerous countries since Mesmer's day, comprises induction, treatment strategy, and termination. In the induction, the therapist may, for example, speak slowly to the subject about the subject's becoming imaginatively involved in an experience of focussed awareness, whilst peripheral distractions fade - hence the subject may, with eyes closed, concentrate upon the progressive relaxation of his/her muscles to the exclusion of external events and stimuli. A good subject, well-motivated, optimistic about the therapy and confident in the therapist (criteria in which he/she may be educated in and out of hypnosis) is then ready to engage in any therapy intended to change inappropriate behaviour, thought or feeling. This means that virtually all, if not all, psychological techniques may be delivered via the medium of hypnosis. Because imaginative involvement, selective attention, and suspension of the critical process are all characteristic of the hypnotic state, hypno psychotherapy may often be the treatment of choice. The subject may move forward or backward in time, rehearse coping techniques, learn to correct types of thinking and feeling prejudicial to emotional well-being, and behaviour prejudicial to physical health, confront, but not exaggerate, life's problems whilst reappraising its potential, develop the ability to use self-hypnosis and perform "homework" tasks emphasising modern hypno psychotherapy's stress upon a subject's active involvement in the desired therapeutic outcome. At the termination, cues for subsequent positive thoughts, feelings or behaviour (post-hypnotic suggestions) may be introduced or re-iterated. Finally, the subject is gently returned from what has been described as an altered state of consciousness - the hypnotic state - to the everyday state of consciousness with its diffuse and distracting stimuli. Now discussion takes place (possibly an extension of dialogue whilst the subject was in hypnosis) and the hypnotic experience is examined in order to inform and enhance future therapy sessions i.e. the therapist defers to the source of expertise and control which lies not with the therapist, but with the subject.

Given a comfortable environment, a sympathetic and empathetic therapist who inspires confidence, and the subject's optimism about a realistic outcome, that outcome may be achieved. Because hypnosis is so fundamental, and universal, even if not recognised as such, it should not be withdrawn from the public domain, either in terms of training or availability as therapy. Rather, we should be aiming to widen such training and availability. Whilst hypnosis can stand alone as a form of therapy or form an adjunct to any other profession, it should become the property of no single profession.

Virtually any book on the subject deals with the numerous theories of hypnosis. Essentially, the debate centres upon whether or not hypnosis is a special state. "State" theorists might argue that the subject's appearance and subjective reports of the hypnotic experience alone would support their theory. "Non-state" theorists might argue that hypnotic behaviour is the result of motivation, attitude and expectancy resulting in the subject's willingness to follow the therapist's suggestions. Perhaps the outcome will be some sort of compromise: 'Hypnosis is an altered state of consciousness, the achievement of which is greatly influenced by factors such as the subject's motivation, attitude and expectancy promoting a willingness to follow the therapist's suggestions'.
 

Related Links: www.hypnotherapyuk.net

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Integrative Psychotherapy

Integrative psychotherapy embraces first and foremost a particular attitude towards the practice of psychotherapy which affirms the importance of a unifying approach to persons. Thus a major focus is on responding appropriately and effectively to the person at the emotional, spiritual, cognitive, behavioural and physiological levels. The aim of this is to facilitate integration such that the quality of the person¹s being and functioning in the intrapsychic, interpersonal and socio-political space is maximised with due regard for each individual¹s own personal limits and external constraints. Within this framework it is recognised that integration is a process to which therapists also need to commit themselves. Thus there is a focus on the personal integration of therapists. However, it is recognised that while a focus on personal growth in the therapist is essential there needs also to be a commitment to the pursuit of knowledge in the area of psychotherapy and its related fields. Therefore the EAIP defines as ³integrative² any methodology and integrative orientation in psychotherapy which exemplifies or is developing towards, a conceptually coherent, principled, theoretical combination of two or more specific approaches, and/or represents a model of integration in its own right. In this regard there is a particular ethical obligation on integrative psychotherapists to dialogue with colleagues of diverse orientations and to remain informed of developments in the field. A central tenet of integrative psychotherapy is that no single form of therapy is best or even adequate in all situations. Integrative psychotherapy therefore promotes flexibility in its approach to problems but also subscribes to the maintenance of a standard of excellence in service to clients, in supervision and in training. Thus when integrative therapists draw on different strategies, techniques and theoretical constructs when dealing with particular situations, this is not done haphazardly but in a manner informed both by clinical intuition and a sound knowledge and understanding of the problems at hand and the interventions to be applied. In the final analysis Integrative Psychotherapy, while affirming the importance of foregrounding particular approaches or combinations of approaches in regard to specific problems, nevertheless places the highest priority on those factors which are common to all psychotherapies, especially the therapeutic relationship in all its modalities. In regard to the therapeutic relationship however, particular emphasis is placed on the maintenance of an attitude of respect, kindness, honesty and equality in regard to the personhood of the client in a manner which affirms the integrity and humanity both of the self and the other. Integrative psychotherapy affirms the importance of providing a holding environment in which growth and healing can take place in an intersubjective space which has been co-created by both the client and the therapist.² EAIP 1997. For further information please contact: The President, EAIP P.O. Box 2512, Ealing London W5 2QG United Kingdom.
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Logotherapy

Logotherapy and Existential Analysis are two sides of the same coin of psychotherapy.

Logotherapy is helping to search for a possible, personal meaning in relation to a situation or condition, and others. Logotherapy is integrative since it is integral reality based, actual meaning - person centred psychotherapy. The search for meaning which Logotherapy initiates, is the search for the last resort of personal freedom to exist and live for a loved one and/or for a humane cause. It may be a goal very close by and practical to do or to live for , but it may also be an existential and ethical source of strength helping a person to face fate, physical and psychological illness, deprivation, loss, and eventually dying.

Existential Analysis is a twofold process of exploring the client's past and present action, experience and attitude in relation to the question of being, or of having been responsible as a person on the one hand, and of finding intrinsic, unconsciously operant values related to dignity. The other side of Existential Analysis is the phenomenological scientific approach to questions concerning the human condition, the so-called meta-clinical issues.
As such, Logotherapy and Existential Analysis is the foundation of 'noodynamic psychotherapy'. The school of Logotherapy and Existential Analysis was founded by the late Austrian Prof. Dr. Dr. h.c. multi Viktor E. Frankl (1905 - 1997). Logotherapy was 'invented' in the years 1925 - 1945, as a school is also known as ‚the third Viennese school', the school of psychotherapy which emerged on the one hand from Sigmund Freud's Psychoanalysis and on the other hand from the Individual - Psychology from Alfred Adler. Initially it was meant to be additional, to fill out lacunas in existing schools like the first two Viennese schools, and later on to emerging schools like the behavioural and Rogerian, and other 'existential therapies'. At the same time however, Logotherapy itself developed into a powerful separate approach, with its specific terminology, analysis, diagnose, range, interventions and treatment. Many other schools have benefited from Logotherapy and Existential Analysis over the years, and new methods have been developed from Logotherapy in many adjacent fields.
Professor Frankl taught at Stanford (Palo Alto) and San Diego and at many other US and Canadian university colleges, he taught in the Eastern European states, as well as in Western Europe, in South Africa, in South America and in Japan. His last lecturing visit before he passed, was to China. Viktor Frankl's books have been translated into 28 languages. He was awarded 31 international doctorates.

Logotherapy and Existential Analysis is supported by a vast group of internationally respected scholars and researchers. It is recognised by the American Psychiatric Association, the American Psychological Association, the American Medical Association and by the WHO of the UN. In Europe, the European Association for Psychotherapy in Vienna affirmed the scientific and therapeutic validity of Logotherapy and Existential Analysis, by awarding EALEA the accrediting status concerning the European Certificate for Psychotherapy.

Info and bibliography:
Contact the Viktor Frankl Institute in Vienna and/or visit:
www.logotherapy.univie.ac.at

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Multimodal Approach

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Neuro-Linguistic Psychotherapy

Neuro-Linguistic Psychotherapy (NLPt) is a systemic imaginative method of psychotherapy with an integrative-cognitive approach.
The principal idea of Neuro-Linguistic Psychotherapy (NLPt) is the goal-orientated work with a person paying particular regard to his/her representation systems, metaphors and relation matrices.
In the course of the therapeutical work in NLPt the verbal and analogue shaping and the integration of the expressions of one's life and digital information processes is given an equal share of attention.
The aim of the method consists in accompanying and giving support to human beings so that they can obtain ecologically compatible goals. Further the method helps to position the subjectively good intentions underlying the symptoms of illness and/or dysfunction so that old fixations about inner and outer unproductive behaviour and beliefs can be dissociated and new subjectively and intersubjectively sound behaviours and beliefs can be established and integrated.
Neuro-Linguistic Psychotherapy (NLPt) as a method of personal development and communication training (NLP) is of course to be found in many other fields: education, counselling, supervision, coaching, management training, sport and health psychology. But as a method of psychotherapy it has a clearly distinguished, theoretically and methodologically elaborated core and wide application scope even though it originally was established in an "anti-psychotherapeutic subculture".

In this context it is linked to a single, pair or group therapeutical setting. Within the framework of the psychotherapeutic contract, a protective frame, and professional discretion, the focus is turned to the achievement of goals in health and well being.
NLPt developed independently with reference to the basic elements created by Milton Erickson, Virginia Satir and Fritz Perls in the 60s and 70s. Because of the acceptance of NLP and NLPt concepts by other psychotherapy schools in the 90s as well as of the creation of a holographically integrative NLPt theory, an average well educated and specialized public often happens to forget - due to an understandable political positioning of the established associations' interests in the face of younger schools - that NLPt was successfully passed on over three generations of psychotherapists, and that the theory of this method - compared to other schools - has an even longer tradition which is now well established and practiced whole over Europe.

The formation of the Neuro-Linguistic Psychotherapy (NLPt) is based on five traditional theories that were created at different historical moments, which are complementary to each other, and it is based on an assumption resulting from the modelling process:

1. The Cybernetics of the Theory of the Mind by Gregory Bateson, in particular of the logical levels of Learning and of the Unified Field Theory as a further development by Robert Dilts.

2. The social-cognitive Theory of Learning by Albert Bandura together with the Modelling Approach, improved in practice by Richard Bandler and John Grinder.

3. The Transformational Grammar established by Noam Chomsky and the postulates advanced by Alfred Korzybski's concept of time binding, and Glasersfeld's, which served as a basis and influenced the linguistic models developed by Bandler and Grinder.

4. The assumption of a fundamental orientation of human action towards goals (Pribram, Galanter, Miller, TOTE, 1960)

5. The theoretical writings of William James emphasizing the inherent sensory representation systems as basic elements of information processing and of subjective experience.

6. The assumption of the existence of functional and independent parts of one's identity encompassing conscious and unconscious process elements, resulting from the practice of modelling the works of Fritz Perls, Virginia Satir and Milton Erickson.

On the basis of these theories and assumptions as well as of the generatively designed modelling processes the NLPt range is laid out as an open architecture that may becomes wider because of new developments from ongoing practical work.

Similarities to and differences from other methods:

First, from a pragmatic point of view it has to be said, that the phenomenon of an intensive exchange of psychotherapists, representatives of the various psychotherapeutical orientations, can be observed at present in part also due to presentations/trainings of NLPt in Central and Western Europe.

Secondly, the actual, practical work of well trained psychotherapists relying on traditionally opposed theory concepts moves closer and closer.

In this context it should be clearly stated that the qualified psychotherapeutical work, performed in all psychotherapeutical associations in Central Europe is highly appreciated.

A detailed comparison between NLPt an other schools and a research biblographiy can be found at www.eanlpt.org

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Personcentered Psychotherapy

The Personcentred Approach as foundation for Theory and Practice within the PCA-Psychotherapy The PCA-Psychotherapy, in Germany also know as Clientcentred Psychotherapy, is one of the most important modalities in Germany besides Psychoanalysis and Behaviour Therapy. It differs from these other modalities through its special setting of the therapeutic relationship and through different goals for the therapy. The aim of the Personcentred approach and of psychotherapy in general is healing, alleviation and prevention of psychic and psychosomatic illnesses. The core of the psychotherapeutic work is:

  •  Empathy and selfexploration
  •  Unconditional positive attention
  •  Congruence, genuineness and trust.

Empathy and selfexploration
The therapist tries to notice in detail the inner relationships of the clients or patients and to connect them with their emotional components and the meaning they experienced. The therapist tells the clients about his feelings regarding the situation the client is in (empathy). This enables the clients to review their selfperception and improves the capability of the clients to explore themselves and their problems (selfexploration).

Unconditional positive attention
The therapist is facing the clients/patients with unconditional positive attention. He enters the world of the client without prejudice and judgement (unconditional positive attention). This enables the clients to express their emotions more freely and with less fear.

Congruence, genuineness and trust
The therapist is honest to himself and can fully observe his own experiences and integrate these experiences into the therapeutic process, if indicated. There is no discrepancy between feelings and expression of these feelings (congruence/genuineness). The congruence of the therapist is highly important for building and maintaining a trusting relationship with the client.  

PCA-Psychotherapy is based on Clientcentred Psychotherapy and Counselling. This method has its origin in the work of the american psychologist Carl R. Rogers (1902-1987). Rogers developed this method in the fourties and fifties of the last century in regard to his own personal experiences as a psychotherapist and relying on throughout scientific research (which was unique for that time period). The psychologist Reinhard Tausch from Hamburg introduced the clientcentred psychotherapy during the 60-ies of the last century in german speaking countries. The PCA-Psychotherapy has established itself in universities and trainings at an college-level and in social professions. Many academic studies have also integrated this method in their additional trainings, especially psychology, medicine, social paedagogics. This method is a solid part of clinical-psychological work and medical and psychosomatic basic care and psychotherapy. In recent days the evolution of PCA-Psychotherapy has been developed, particularly regarding pathology. Therefore PCA-Psychotherapy can be used with more preciseness and offers a wider range of purpose oriented therapeutic help, especially when it comes to take into account the different individual requirements. The personencentered approach also finds a huge number of activities in non therapeutic fields: social work, social paedagogics, in schools, foster homes, offices and organisations.

The philosophic-anthropologic foundation of the personcentred concept is:

  • trust in the positive self-structuring power of humans
  • life as permanent process of changing
  • selfresponsibility of humans
  • acceptance of individual life-plans
  • trust in personal experience as the source for knowledge.

The image of man in the personcentered concept is gaining importance beyond the clinical-scientific field. It is acting as a social movement in the political area.  

GwG Gesellschaft für wissenschaftliche Gesprächspsychotherapie e.V. Fachverband für Psychotherapie und Beratung

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Positive Psychotherapy (Peseschkian, since 1968)

Positive Psychotherapy is a short-term psychotherapeutic method, with a psychodynamic model, a humanistic world-view, and a transcultural approach. It has been developed since 1968 by Prof. Dr. Nossrat Peseschkian, MD., PhD., and his co-workers in Germany, and is today an officially accepted method in the field of postgraduate training in many countries.

The method of Positive Psychotherapy based on transcultural researches in over 20 cultures, and based on three main principles:

  1. The principle of hope, symbol of global identity: The world-view is based on the concept that "every human-being is good by nature" and "endowed with a lot of capabilities and a great potential." This positive image of man - that everybody has the two basic capabilities "to love" and "to know" - has led to the concept that illnesses and disorders are some kind of capability, and are therefore interpreted in a positive way. E.g. depression regarded as "the capability to react with deep emotions on conflicts". Through the further use of stories, anecdotes and examples from other cultures the patient is encouraged to play a more active role in his own healing process. Positive Psychotherapy believes that every human-being is an entity of body, mind, emotions and soul, and the aim of the therapeutic process is to help the client to develop his capabilities and find the balance in his or her life.
  2. The principle of moderation, symbol of social identity: The Conflict Contents and Conflict Dynamics: A main model of Positive Psychotherapy is the Balance Model, and the patient is encouraged to develop all sphere of life and to distribute his daily energy equally in the four spheres of body, work/achievement, contacts/relationships, and future/fantasy.
  3. The principle of consultation, symbol of everyday-life-identity: The Five-Stage-Therapy and self-help: With the help of a structured five-stage-procedure, the patient and client is led from his symptoms to the solution of his conflict. In the aspect of self-help, he is also encouraged to become a therapist for his own family and environment. Here, elements of other methods are applied in order to secure a flexible approach to the unique needs of every client. This interdisciplinary approach of Positive Psychotherapy presents a framework in which different methods can work and cooperate together.

Since 1968, Positive Psychotherapy is applied mainly in the following areas: psychotherapy, counselling, education, prevention and management training. In Germany, the Wiesbaden Academy of Psychotherapy is licensed by the State Medical Chamber in Hessen for the postgraduate training of physicians in psychotherapy, and by the State Ministry for Health Professions for the training of psychologists. Since 1971, more than 38,000 doctors have been trained in Germany, Switzerland and Austria with this method, and since the late 1980s several thousand colleagues in Eastern European countries. Today, Positive Psychotherapy has been established in more than 24 countries, and introduced in more than 60 countries worldwide. Its affairs are coordinated by the International Center of Positive Psychotherapy, which has its headquarters in Wiesbaden, Germany, with 45 trainers and lecturers. It has organized already four World Congresses for Positive Psychotherapy - in St. Petersburg, Russia (1997), in Wiesbaden, Germany (in 2000), Bulgaria (in 2003) and in Cyprus (in 2007). Besides training, teaching and practical psychotherapy, a main emphasis has been transcultural research. In 1997, a quality assurance and effectiveness study was undertaken in Germany, and the results show the high effectivity of this short-term method. The study was awarded with the Richard-Merten-Prize 1997. Prof. Dr. Nossrat Peseschkian was in 2006 distinguished with the Order of Merit – Distinguished Service Cross of the Federal Republic of Germany and in 2007 with the International Avicenna-Prize from the Association of Iranian Physicians and Dentists in Germany and in Geneva. Today there are more than 25 major books on Positive Psychotherapy, of which some have been published in more than 26 languages. About 20 Ph.D. dissertations have been prepared with topics related to this new concept.


Head Office: European Federation of Centers for Positive Psychotherapy
Luisenstraße 28, D-65185 Wiesbaden, Germany
Tel. +49-611-34109903
Fax: +49-611-39990
email: wapp@positum.org
Website: www.positum.org

Secondary office: International Academy for Positive and Transcultural Psychotherapy
Langgasse 38-40, D-65183 Wiesbaden, Germany
Tel. +49-611-3411674
Fax: +49-611-3411676
email: foundation@peseschkian.com
Website: www.peseschkian-stiftung.de

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Psychoanalysis

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Psychodynamic/Psychoanalytical Psychotherapy

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Psychodrama

Psychodrama was the inspritaion of Jacob L. Moreno, MD, Psychodrama is an action method of psychotherapy drawing on aspects of drama and theatre to aid the exploration of issues raised by an individual. Psychodrama is based on the concept of role theory . Insight can be gained into how and why we act, thus offering the opportunity to increase our role repertoire leading to personal growth and integration. Psychodrama is practiced as both group and Individual therapy.


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Psychosynthesis

Manifestations of the human psyche, such as creative imagination, intuition, aspiration, genius, are facts which are as real and important as are the conditioned reflexes,........ spiritual drives or spiritual urges are as real, basic and fundamental as sexual and aggressive drives; they should not be reduced to sublimation or pathological distortion of the sexual and aggressive components of the personality - although in many neurotic cases such elements are, of course, also present. (Assagioli, 1965) Roberto Assagioli, the founder of Psychosynthesis and one of the first psychoanalysts in Italy, was a visionary who sowed the seeds of many current ideas and methods in Transpersonal Psychotherapy. If the dialectic between Freud and Jung can be characterised as that of a tension between ego and soul, then Assagioli's vision was to bring into psychotherapy a third element, that of the spirit. The spiritual domain offers a meta-level frame from within which to understand phenomena which are experienced psychologically, yet which seem to transcend psychological explanation. It is from within this frame that Assagioli suggested a 'Higher' or transcendent Self which was a source of inspiration beyond the personal self. Psychosynthesis brings together different orientations in psychotherapy - Psychoanalysis, Humanistic Psychology and Transpersonal Psychology. In broad terms we can say that these concern themselves with the past, the present and the future and are reflected in Assagioli's core model which differentiates human consciousness into the Lower, Middle and Higher Unconscious. The Lower which links with psychoanalysis, leads to an analysis of origins, the Middle which links with Humanistic Psychology focuses on the here-and-now and the Higher, linked with Transpersonal Psychology, leads to exploring future potentials. This tripartite differentiation forms the structural basis of Psychosynthesis Psychotherapy. Psychosynthesis is an inclusive psychology rather than a reductive one. Assagioli's root metaphor was the idea of synthesis, which begins from the premise that we are essentially whole in our nature - not good or perfect but whole. Whatever fragmentation, alienation and splitting we have suffered in order to psychologically survive, the spiritual self is calling us towards our healing. Holding two opposite sides until a synthesis at a higher level emerges, is a dialectical process known since the times of Aristotle. Psychosynthesis applies it as a tool for transformation of the personality. The growing awareness in the psychotherapeutic field that there is no one right answer or method leads us to the need for flexibility on the part of the psychotherapist. The beauty of Psychosynthesis Psychotherapy is that it is inclusive of and honouring of difference. There are a wide variety of methods employed to meet the diversity of needs presented by different people whether they be suffering from early wounding, neurotic conflicts or existential questions about who they are and where their life is going. The imagination is the medium through which many processes in Psychosynthesis Psychotherapy happen. We emphasises the exploration of the symbolic process through the use of creative visualization and mental imagery. In complement to expanding awareness, there is the development of the capacity to Will. Assagioli set much store by people learning to face the challenges that life set them - the blessings of obstacles he called them.
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Psycho-Organic Analysis

With elements of the Freudian and Jungian Analysis, the theories of Reich as far as they refer to the body …formed method of psychotherapy. Paul C. Boyesen has integrated these since 1970 into a complete theory with the derivation of a therapeutic technique." (Prof. Dr. Uwe Henrik Peters; Dictionary of Psychiatry, Psychotherapy and Medical Psychology; 5th ed. 1999, 1st ed. 1974; Wörterbuch der Psychiatrie, Psychotherapie und medizinischen Psychologie; 5. Aufl.; München, Wien: Urban und Schwarzenberg, 1999; 1. Aufl. 1974)

As a specific method in psychotherapy Psycho Organic Analysis (POA) has been developed since the early 1970s as a synthesis of psychoanalysis and bodypsychotherapy. The originator Paul C. Boyesen based this approach to psychotherapy on the work of S. Freud, C.G. Jung and W. Reich as far as Reich understood the significance of the body for psychotherapy. From his practice being part of the reichian and neoreichian bodypsychotherapies in the early 1970s Paul C. Boyesen started to integrate experiences with and concepts of psychoanalysis into his work e.g. transference, counter-transference, symbolic, imaginary, real, impulses, primary and secondary. POA formulates a specific ethic of intervention, specific theories and methods of intervention e.g. Situation, Expression and Feeling; Primaryimpuls; The unconscious Familycontracts; The Psycho Organic Cycle; Active Relaxation; Breathing and Emotions; Residual and Consequential Energy; Choice of Experience; The Body of the Word; Sense and Sensation. Adding specific new aspects and enlarging the understanding of common basic concepts of psychotherapy POA integrates the unconscious, projection and transference in a client centered depth therapy process taking into account the bodily felt sensations and experience. Today, due to this development, colleagues have added their theoretical conclusions derived from their clinical practice to the field of POA. In consequence the basic principles of POA find their application in many countries and in various fields like psychotherapy as well as counselling, coaching, changemanagement, managementtraining, coupletherapy, prevention and rehabilitation.

Basic Concepts of POA
This presentation is going to mention very briefly some basic concepts of POA.

The Ethic of Intervention

Psycho Organic Analysts listen to the sense that the client wants to realise in life and meet these choices with absolute respect.

The Unconscious

Working with the articulations of the unconscious belongs to the basic aspects of the analysis e.g. in dreams, imaginations, movements, actions and the spoken words.

The Residual and the Consequential Energy
The clinical practice of POA shows the ability of the unconscious to create these two kinds of energies ( movement, activity ).

The Psycho Organic Cycle

It was not by chance that Paul C. Boyesen developed the concept Psycho Organic Cycle in the 1970s as a generalisation and differentiation of the Reichian formula: tension - charge - discharge - relaxation.

The Body of the Word
Words and thoughts are embodied in specific ways. They are psycho-organic representations of certain levels of energy (movement, activity). On different levels of the psyche (conscious, preconscious, unconscious) words and thoughts are forms or preforms of embodiment.

Sense and Sensation
Actions, Interactions and life experiences can be seen in the light of sense and sensation. Sense is understood to be related to the choice of a certain experience, a certain direction in life. Sensation is the felt quality of the chosen experience (feelings). Psycho Organic Analysts give attention to the articulations of the unconscious, to the sense the client wants to give to his or her life, to the integrations he or she seeks to achieve and thus wants to realize in his or her personal and social actualisation. It is fundamental to meet these choices with absolute respect.

Training Institutes and Professional Association
Within the framework of the Boyesen Institute and the Boyesen Foundation, Paul Boyesen has established trainingprogrammes in several countries since 1975. During the 1980s he initiated the foundation of traininginstitutes for Psycho Organic Analysis and national professional associations as separate social entities in reciprocal relation.
The European Association for Psycho Organic Analysis (EAPOA)

National association had been founded in 1984 in France and 1985 in Germany. Since its foundation in 1986 the European Association for Psycho Organic Analysis (EAPOA) has been working on different levels for social representation and identity of professional psychotherapy. Today EAPOA is a network of individual members, national associations and training institutes in various European countries like Belgium, Luxembourg, Switzerland, Latvia, Spain, Germany and France
The Training Institutes EFAPO and IIPOA
Main training institutes in Europe are EFAPO, EIPOA, and IIPOA. In addition they are running, partly in cooperation, training programmes in Brazil, Canada, Lebanon and Russia.

European Association for Psycho Organic Analysis (EAPOA) www.eapoa.com
École Francais d’Analyse Psycho Organique (EFAPO) www.efapo.fr
International Institute for Psycho Organic Analysis (IIPOA) www.iipoa.org

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Systemic Familytherapy

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Transactional Analysis

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Rational-Emotive and Cognitive-Behavior Therapy

• For more details see the European Association of Behavioural and Cognitive Therapies (EABCT - http//www.eabct.com)

DEFINITION: Cognitive and behavioral psychotherapies (commonly referred to as cognitive behavior therapy - CBT) are psychological interventions focused on (1) human development/optimization; (2) mental health promotion and prevention of clinical psychological problems; and (3) treatment of life problems and subclinical and clinical conditions that involve psychological mechanisms/factors. In order to reach these goals, CBT uses cognitive and behavioral learning theories and principles, to help the clients change their irrational/distorted cognitions/beliefs, maladaptive behaviors, and dysfunctional feelings, in order to make them feel, get, and stay better.
BRIEF HISTORY: The fundamental and paradigmatic aspects of the modern CBT were set by Albert Ellis and Aaron T. Beck. Indeed, Ellis’ Rational Emotive Behavior Therapy (REBT) and Beck’s Cognitive Therapy (CT) (mentioned here in historical order) were the foundational forms (i.e., the original CBT strategies) of CBT that, although slightly different in the type of cognitions they emphasize, set the common fundamentals of theory, research, practice, and even training in the modern CBT field. In order to illustrate this historical aspect, sometimes the name used for this form of psychotherapy is not simply cognitive-behavior therapy (CBT), but rational-emotive & cognitive-behavior therapy (REBT/CBT). However, the simpler CBT name is now more and more common and widespread, while REBT and CT are typically considered as the two initial foundational CBT strategies that constitute the architecture of modern CBT.
THEORY: Arguably, the cognitive ABC model (i.e., A-Activating events prime B-explicit and implicit Beliefs/cognitions that contribute to C-emotional and behavioral Consequences) is the general framework of modern CBT. This general framework of modern CBT incorporated those previous rigorous developments of behavioral therapy (BT) strategies that were supported by experimental and clinical research [e.g., the behavioral ABC model (A-antecedents; B-behavior; and C: consequences in the form of reinforcements), conditioning theories etc.]. Moreover, the CBT framework was further (1) developed in new CBT strategies (e.g., including new concepts/techniques like mindfulness in Mindfulness-Based Cognitive Therapy, Dialectic Behavior Therapy, Metacognitive Therapy etc., acceptance in Acceptance and Commitment Therapy, Compassion-Focused Therapy etc.) and/or (2) adapted in various CBT strategies (e.g., Glasser’s Reality and Choice Therapy; Lazarus’ Multimodal Therapy; Maultsby’s Rational Behavior Therapy; Meichenbaum’s Cognitive-Behavioral Modifications etc.). For a comprehensive list of the most important CBT strategies see Dobson (2009) and Kuehlwein & Rosen (1993). Thus, various CBT strategies vary in the type of components of the cognitive and behavioral ABC models they emphasize and target. For example, in the cognitive ABC model some CBT strategies (mainly behaviorally oriented) emphasize and directly target A (e.g., by using problem solving techniques) and C (e.g., by behavioral modifications, relaxation) components, while others are more cognitively oriented (B), focusing and using cognitive restructuring techniques (and here the focus could be on various types of cognitions). Based on the new developments in psychology (i.e., cognitive sciences, behavioral genetics and cognitive neurosciences, behavioral learning theories etc.) and based on its own basic/fundamental research, CBT theory is updated continuously, thus being a progressive research program in science.
PRACTICE: The main components of the CBT practice are: (1) clinical diagnosis/evidence-based psychological assessment; (2) CBT conceptualization (the key distinctive aspect of CBT); (3) CBT strategies (including the above mentioned techniques); and (4) a sound therapeutical relationship (e.g., active collaboration, empathy, unconditional acceptance of the client, congruence). CBT can be practiced individually, in groups, and for couples/families, for a large range of clinical and non-clinical conditions and ages (e.g., children/adolescents, adults, aging population). The main CBT techniques - reunited in CBT strategies - include cognitive restructuring techniques (e.g., empirical, logical, pragmatical, metaphorical, cognitive hypnotherapy etc.), behavioral techniques (e.g., exposure, desensitization, social skill training/assertiveness training, relaxation, biofeedback, behavioral hypnosis etc.), coping strategies (e.g., self-instructional training, relaxation, breath control, socio-cognitive hypnotherapy etc.), problems solving techniques (e.g., problem solving, solution focus, decision making, negotiation and conflict resolution etc.), mindfulness/acceptance techniques etc. Some of these techniques can be used in the context of the new technologies (e.g., computer/online-based CBT, virtual reality-based CBT etc.). Based on theoretical developments in psychology and basic/fundamental, translational, and applied CBT research, new CBT strategies and techniques are developing continuously, thus making the field a very dynamic one.
TRAINING: While all CBT psychotherapists share the fundamentals of the CBT (i.e., cognitive and/or behavioral learning theories) they

“…may call themselves Cognitive Psychotherapists, Behavioural Psychotherapists, Cognitive Behavioural Psychotherapists or Rational Emotive Behaviour Therapists. These different titles often reflect the preference and training of individual therapists for specific techniques which address problematic thoughts, assumptions and beliefs directly (Cognitive Psychotherapists), address behaviour directly (Behavioural Psychotherapists) or a combination of techniques aimed at addressing thoughts and behaviour (Cognitive Behavioural Psychotherapists, Rational Emotive Behaviour Therapists). Whatever title they use, the approach is commonly referred to as CBT. Most importantly, all therapists aim to help clients achieve desired change in the way they think, feel and behave…” (EABCT: http://www.eabct.com, retrieved 18 July, 2013).

The CBT training components typically include (for details please see the EABCT standards): (1) personal therapy/development (especially when it is regulated in the country of interest); (2) CBT theoretical training (focused on the general architecture and fundamentals of CBT – including various cognitive and behavioral models and strategies –, rather than focused only on a specific CBT strategy); (3) CBT clinical practice (it can be more focused on preferred CBT strategies/psychological treatments); and (4) CBT clinical supervision. The minimal training is 5 years, including professional (i.e., in a mental health profession) and post-professional (i.e., CBT) training. Due to the continuing theoretical and practical developments in the CBT field, the training programs are dynamically evolving and thus, the continuing education is a fundamental aspect for any already trained CBT psychotherapist.

RESEARCH AND CLINICAL EVIDENCE: Starting from the fundamentals of the CBT paradigm, various specific CBT psychological treatments (often flexibly manualized and including particular CBT strategies) are continuously elaborated and tested in clinical trials for a large spectrum of clinical (e.g., CBT for major psychiatric/psychological and medical disorders that involve psychological mechanisms/factors) and non-clinical (e.g., rational-emotive education) conditions (for details see the NICE Guidelines and the APA’s Research Supported Psychological Treatments). Thus, CBT is the spearhead of psychotherapy in the evidence-based movement in the health field. Hundreds of studies supporting the efficacy and/or (cost)effectiveness of various CBT psychological treatments also tentatively support CBT’s overall efficacy and/or (cost)effectiveness and clearly argue for its evidence-based oriented profile and its evidence-based status (e.g., one of the golden standard psychotherapy treatments for a large variety of clinical conditions). For more details and for specific evidence-based CBT psychological treatments refer to the Key Resources in CBT section.
SELECTIVE REFERENCES:
• Dobson, K. (2009, ed.). Handbook of cognitive-behavioral therapies (third edition). The Guilford Press: New York.
• EABCT (2013). What is CBT? (http://www.eabct.com; retrieved 18 July, 2013)
• Kuehlwein, K.T., & Rosen, H. (1993, eds). Cognitive Therapies in action. Evolving innovative practice. Jossey-Bass Publishers: San Francisco.

KEY RESOURCES IN CBT:
• European Association for Behavioural and Cognitive Therapies (http://www.eabct.com)
• Association for Behavioral and Cognitive Therapies (http://www.abct.org)
• Beck Institute for Cognitive Behavior Therapy (http://www.beckinstitute.org)
• Academy of Cognitive Therapy (http://www.academyofct.org)
• International Association of Cognitive Psychotherapy (www.the-iacp.com/)
• Albert Ellis Institute (http://www.albertellis.org)
• Association for Rational Emotive Behaviour Therapy (http://www.arebt.net)
• APA’s Research Supported Psychological Treatments (http://www.div12.org/PsychologicalTreatments/index.html) – American Psychological Association (APA - http://www.apa.org)
• NICE Guidelines - National Institute for Health and Clinical Excellence (NICE - http://nice.org.uk)
• International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health (http://www.psychotherapy.ro)
 

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Reality Therapy

WHAT IS REALITY THERAPY?

Reality Therapy was developed in the mid-sixties by William Glasser MD, an American Psychiatrist and psychologist and its techniques, theory and wider applications continue to evolve at his hands.   Reality Therapy is a method of therapy which teaches people to understand the needs that have developed through the evolution of our species and that drive all human beings; to make more effective choices to meet those needs; to take control of their own lives; and to develop the strength to handle the stresses and problems of life.

Choice Theory Psychology is the theoretical base for Reality Therapy. Modern cybernetic research supports the Choice Theory idea that all behaviours – conscious or non-conscious, efficient or non-efficient, normal or abnormal – are chosen as the best option we have at the time in the attempt to control external and internal variables (circumstances) to meet our needs.  Choice Theory suggests that the only person I can control is myself and assumptions that I can control others or that they can control me tend to be counter-productive and ineffective. Learning the principles of Choice Theory and applying them to make a more need-satisfying life is a key task of the Reality Therapy process. This is an optimistic, transformative process for the client where s/he becomes aware that almost all behaviour is chosen and so there are possibilities to choose less suffering and more effective behaviour.

The Reality Therapy model places unsatisfactory or non-existent relationships at the source of almost all human problems.  The goal of Reality Therapy is to help people reconnect with the important people in their lives.

WHAT YOU CAN EXPECT FROM A REALITY THERAPY PSYCHOTHERAPIST

The Reality Therapy Psychotherapist will work to build a trusting, empathic, deep relationship with the client from the start. The relationship will be characterised by understanding and by honesty, and may include supportive involvement outside the counselling office.

• There will be a clear focus on the present. What happened in the past that was painful has a great deal to do with who we are today, but continuously revisiting this painful past can contribute little or nothing to what we need to do now: improve an important, present relationship. Therefore, the past will not be discussed too much, because the Reality Therapy model suggests that almost all human problems are caused by unsatisfying relationships in the present.  It is true, of course, that there are times when the past is manifest in present experience, which can  cause the past to have new meaning, and where this is important it will be explored in therapy

• Symptoms and complaints will not be focused on very much either, since these are understood as the ways that clients choose to deal with unsatisfying relationships.

• Accepting that the behaviour of every person is chosen to satisfy her/his needs, the client realizes that the only person whose behaviour s/he can control is her/his self; it means s/he has to give up the attempts to control the behaviour of others; therefore, the focus is away from blaming, or criticising or complaining about others, and towards making changes in our own behaviours that will get us closer to a need-satisfying life.

•  The therapist will help clients understand the holistic nature of their behaviour, how their actions and thoughts, their feelings and their body physiology all work together as they try to live a need-satisfying life.   This means bringing the focus on what they can control directly in the present to improve their relationships and their life – that is, their actions and thoughts. Less time is spent on what they cannot control directly; that is, changes to feelings and physiology. Feelings and physiology can be changed, but only as part of changes in acting and thinking.

• The therapist will remain non-judgmental and non-coercive, but will encourage clients to judge all you are doing by the choice theory principle of self-evaluation: “Is what I am doing getting me closer to the people I need? Is it getting me what I want?”  If the choice of behaviours is not working in the client’s view, then the therapist helps the client to find new behaviours that lead to a better connection with the important people in his/her life.

• To teach the client Choice Theory and to give her/him the experience of connectedness and care the therapist will always be patient and supportive but will keep focusing on the source of the problem - the disconnectedness. Counselees who have been disconnected for a long time will find it especially difficult to reconnect. They are often so involved in the symptom they are choosing that they have lost sight of the fact that they need to reconnect.

Description written by Arthur Dunne: artd@eircom.net 

Contact EART President: 
Danko Butorac - danko.rt@hi.t-com.hr

EART website: http://www.realitytherapy-europe.org/  EAPTI e-mail: irt@siol.net


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Transactional Analysis

 

Transactional Analysis (TA) is an approach to psychotherapy, which offers a coherent model of intrapsychic and interpersonal dynamics and a corresponding methodology. It draws on a variety of psychological theories – including both psychoanalytic and cognitive behavioural - which are integrated into humanistic philosophy and grounded in the therapeutic relationship.

Eric Berne, TA’s founder, was an innovative and creative thinker who brought together some of the most effective ideas in counselling and psychotherapy (analytic, cognitive behavioural, social, phenomenological) into a powerful body of theory and practice. Although trained in psychoanalysis, Berne espoused the values of the humanistic movement, believing that change is possible and that human beings have a natural aspiration to take responsibility for themselves and live in harmony with themselves and others. Perhaps his most significant contribution was that he sought to de-mystify psychotherapy. He therefore employed concepts, language and methods, which were understandable to everyone, developing theories which have both simple immediacy and subtle depth.

Some of TA’s theories and models clearly have echoes in the psychoanalytic traditions. Its central concept, ego states, emerged from the work of Federn and Weiss. It proposes a tri-partite model of personality that has, in a broad sense, three aspects – a ‘parent part’ that is the manifestation of environmental and parental ‘introjects’ or learned ways of being, a ‘child part’ comprising feelings, attitudes and corresponding behaviour that is the result of patterns of childhood experience, and an ‘adult part’ which represents ‘here and now’ feelings, thoughts and behaviour. Each of these ‘parts’ corresponds to one type of ego-state.

Other concepts, such as strokes, are influenced by the behavioural approach, which was gaining strength in the U.S. when Berne was developing his ideas. Indeed, ground-breaking concepts such as rackets, script beliefs and so on, (Berne, 1961, 1963, 1964; Erskine and Zalcman, 1979) were forerunners of many cognitive behavioural ideas. Despite this, TA is generally known as a humanistic approach to psychotherapy because of its philosophy of human beings – that we aspire to and are capable of taking charge of our lives, making changes and living in harmony with ourselves and others.

One of Berne’s most revolutionary innovations was the treatment contract by which he invited his clients to choose their own goals and agree with him a plan for their therapy. Research has since shown that this agreement of goals is one of the vital factors in effective psychotherapy. Indeed, research into psychotherapy outcome and also into brain function, directly supports many of the core TA concepts.

TA is thus an integrative approach and its strength is its versatility: it can be used as a brief-term, cognitive behavioural intervention that helps to adjust social functioning, and it is also a depth psychotherapy, that can lead to transformational change.

In recent years, transactional analysts have developed and expanded the approach, and new trends such as constructionist TA and relational TA have emerged as creative and effective approaches to working with individuals, couples, groups and communities.
 

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Description of Modalities

 

Bioenergetic Analysis

Biosynthesis

Body Psychotherapy

Bonding Psychotherapy

Existential Analysis

Gestalt Therapy

Hypno Psychotherapy

Integrative Psychotherapy

Logotherapy

Multimodal Approach

Neuro-Linguistic Psychotherapy

Personcentered Psychotherapy

Positive Psychotherapy (Peseschkian)

Psychoanalysis

Psychodynamic/Psychoanalytical Psychotherapy

Psychodrama

Psychosynthesis

Psycho-Organic Analysis

Reality Therapy

Systemic Familytherapy

Transactional Analysis

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