The common perception that good people have fewer flaws is wrong. It is not a matter of more or fewer flaws. It is the willingness to change them that counts.
Dr. Louis Tartaglia
Series Parts:
Part 1 – The Human Condition – A Perspective
Part 2 – A Theoretical Approach to the Human Condition
Part 3 – A Synthesis of Three Theories
Table of Contents
- Technical Eclecticism
- Step #1: RELOOK: Making the unconscious conscious, Awareness
- Step #2: REVIEW: Challenging the Maladaptive Belief System
- Step 3#: RECONSTRUCT: Creating Positive Change
- Conclusion
The Client “Johnny” mentioned in this article is Hypothetical and does not exist.
Technical Eclecticism
When Johnny comes in for therapy, he shares that he seeks both understanding of himself and change, for the better. In order to facilitate this outcome, we would look at his human condition – his story, his experiences, his personality, his functionality. A therapeutic integrative strategy would present theories of personality, psychopathology and change processes. Psychotherapy integration is best characterised by attempts to look beyond and across confines of single-school approaches to see what can be learned from other perspectives. (Messer, 1992) [4] It allows versatility in treatment and opens up different options in which a therapist may find useful when working with a client. Technical eclecticism refers to selecting the best treatment techniques for the individual and the problem. (Corey, 2009) [1] Theoretical integration is defined by conceptual or theoretical creation beyond a mere blending of techniques. (Miller et al., 2011) [5] In this essay, I shall attempt technical eclecticism.
Three theories which could integrate to form a treatment plan for Johnny would include Psychodynamic Psychotherapy, Redecision Therapy and Constructive Psychotherapy. I shall attempt to map out a step-by-step plan below:
Step #1: RELOOK: Making the unconscious conscious, Awareness
Corey (2009) [1] writes that psychoanalysis seeks the growth of the ego through analysis of resistance and transference, allowing the ego to solve the unconscious conflict. Many times, clients walk into the room not aware of where their anxiety and distress stems from, they are a floating iceberg. The goal of therapy is to first make the unconscious conscious. Psychodynamic Psychotherapy focuses on how present behaviour is rooted in early repressed childhood conflicts which remain unresolved. It sheds light on the dynamics of transference and counter transference, illuminating the source of resistance, anxiety and mechanisms of ego defense.
For Johnny, it is important to understand the painful, unresolved conflicts of his father’s physical abuse. The techniques of Psychodynamic Psychotherapy are geared towards increasing awareness, gaining intellectual insight, and beginning a working-through process what will lead to a reorganization of the personality.
Client: Relies more on therapist as guide.
Step #2: REVIEW: Challenging the Maladaptive Belief System
Redecision Therapy emphasizes childhood development or early decisions made via different ego states of a person. These early decisions, uncovered perhaps in Step #1, prove maladaptive in Adult life. Redecision Therapy postulates that these maladaptive decisions, contaminated beliefs, can be re-decided, rewritten by going back to the scene of early decision making, clarify the impasse, addressing injunctions and the racket system, and then consciously making a new decision. This sets the stage for implementing new changes in the client’s life. He would need to use the sound values of a Parent, the rationality of the Adult and the creativity and feelings of the Child (Steiner & Perry, 1999). [7]
Client: Therapist assists in past recollections however, client makes the redecision.
Step 3#: RECONSTRUCT: Creating Positive Change
Steps #1 and #2 focus much on the client, in relation to self and how early childhood decisions affect life in adulthood. Constructive Psychotherapy provides a larger perspective – the individual and the social – and addresses the process of change. The self is a fluid coherence of perspective from which one experiences life. But the sense of self emerges and changes in relationship to others. Mahoney (2003) [3] wrote that each human being is formulated differently with five basic themes – human experience involves continuous active agency, there is a core ordering process of the self influenced by social-symbolic processes within a complex flow of tensions.
For change to take place, Mahoney proposed reconstructing life with 3 Rs – Relationship (between the client and the therapist), Rational and Rituals, emphasizing the client’s strength and abilities.
Client: Client takes ownership of change and the therapist is the facilitator.
All three therapies provide beneficial contributions to a therapeutic treatment strategy for a client. Psychodynamic Psychotherapy reduces resistance and anxiety by working on transference, uncovering conflicts and gaining insight by talking and sharing, interpretations and dreams analysis. Redecision Therapy works provides a collaborative element to the therapeutic relationship. The onus is on the client to make a redecision, with assistance from the therapist only when going back to an early traumatic scene. By the time the client reaches Step #3, the therapist becomes a facilitator and has fewer directives. The client is empowered to make changes in his life. The client is the active agent. The therapist provides affirmations of hope and strength in the client.
By drawing on the strengths of each theory, we are able to create a strategy in which a client’s past is examined, his maladaptive belief system and coping mechanisms are challenged and the client is able to implement new, positive changes in his life by constructing new rituals based on a renewed belief system.
Conclusion
In his book entitled Choices That Change Lives, Hal Urban (2006) [8] cites a relevant quote by psychiatrist Dr. Louis Tartaglia, “The common perception that good people have fewer flaws is wrong. It is not a matter of more or fewer flaws. It is the willingness to change them that counts”. The human condition of each individual is dynamic, in process, continuous. It is not sufficient to draw just one conclusion on a life’s story. It is “the result of a host of errors and fantasies which have arisen in the course of the total evolution of organic change” (Nietzsche et al., 2009). [6] From a therapeutic perspective, perhaps what is essential is to grow and cope with change.
The human condition of each individual is dynamic, in process, continuous. “Clients who do not say goodbye keep a part of their energy locked in the yesterday.” (Goulding & Goulding, 1997) [2] With Johnny, we work towards unlocking this energy and using it positively in the here-and-now.
References:
[1] Corey, G. (2009). Theory & Practice of Counseling and Psychotherapy. Belmont, CA: Thomson Brooks/Cole.
[2] Goulding, M. M., & Goulding, R. L. (1997). Changing Lives Through Redecision Therapy. New York: Grove Press.
[3] Mahoney, M. (2003). Constructive Psychotherapy. New York: The Guilford Press.
[4] Messer, S. B. (1992). “A critical examination of belief structures in interpretive and eclectic psychotherapy.” In Handbook of Psychotherapy Integration. New York: Basic Books, 130-165.
[5] Miller, A. M., Sward, J. M., Nielsen, R. C., & Robertson, S. N. (2011). Theoretical integration of humanistic and cognitive/behavioral approaches in counseling. Retrieved from http://counselingoutfitters.com/ vistas/vistas11/Article_51.pdf
[6] Nietzsche, F. W., Zimmern, H., & Cohn, P. V. (2009). Human, All-too-human. Prometheus.
[7] Steiner, C., & Perry, P. (1999). Achieving Emotional Literacy. New York: Bloomsbury.
[8] Urban, H. (2006). Choices That Change Lives. New York: Fireside.
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