Samenvatting
summary Current Psychotherapies of Danny Wedding & Raymond J. Corsini
summary of current psychotherapies. Most parts are written in English, some small parts in Dutch
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SAMENVATTING PSYCHOTHERAPIEWEEK 1: INTRODUCTION TO 21ST- CENTURY PSYCHOTHERAPIES
Many contemporary therapies have a foundation in the past. Since the beginning of history, people
tried to find remedy to mental disorders. In the beginning it were rituals and not scientific. But
Hippocrates already did some research about mental health a long time ago. But the real
psychotherapy did emerge at the 18 th century. Unconscious plays an important role in this book.
Leibniz was the first to research this phenomenon. Herbart thought that ideas struggled with each
other to get access to the consciousness and express themselves. This was typical for the 18 th
century. Two influential thinkers of the 19 th century were Mesmer and Schopenhauer. Their impact is
seen in psychiatric literature of Freud, Adler and Jung. Mesmer can be seen as the pioneers of
hypnotherapy. Although many things have changed since then, you can still trace principles back to
Mesmer. Such as the importance of the therapist, selective memory, importance of confidence of the
patients in the therapy.
Psychotherapy-related science in the 19 th century
The natural science empiricists
Fechner began with the distinction between sleeping and waking state- the dream state. He tried to
measure the intensity of psychic stimulation needed for ideas to cross the threshold from the
unconsciousness to the awareness. Helmholz discovered unconscious inference, an unconscious
process about what our past taught us about a object. The approach of these lab based scientists
became known as the organicist tradition. Kraepelin is the founder for the DSM.
The psychologist-philosophers
philosophers had a great influence on psychotherapies. They thought about the unconsciousness.
This is the basic of many modern therapies. Scopenhauers argument was that we know things that
we are unaware that we know and that we are largely driven by blind, irrational forces. Carus
developed an early sophisticated schema for unconscious, he speculated that there are several levels
The consciousness of the therapist and a client speaks to each others consciousness and
unconsciousness. There is transference and countertransference.
The clinician-researcher
in the 19th century a lot of clinicians made discoveries and innovations. A lot of clinicians use
techniques they learned in school and do not change their approach to a problem.
The impact of the biological sciences on psychotherapy
when you learn there are alterations in the brain. Every encounter with our environment changes
our neural functioning. Biological science plays an important role in psychotherapy. Lesions for
example have an influence on the behaviour of people. The plasticity of the human can help to
improve well-being. Epigenetica: genes can turn on or off depending on the environment. Also the
culture can play an role on our central nervous system. Epigenetic effects can operate for better or
worse. A lot of factors play an role, and it is important to look at all of them. You have to look at the
organic and environmental variables. For example it is important to look at the medication history of
a patient. Nurture plays also an important role, and plays also a role in choosing in which
environment you are going to live. It also influences the genes. Evolutionary psychology also played
an role in developing psychotherapy. It shines a light on the human genome, genes and traits. All
humans share an unique nature, the mutations make us all different but in essence we were the
same. Clinicians have to find out how those traits influence the personal life and help them further.
,CULTURAL FACTORS AND PSYCHOTHERAPY
cultural factors play an important role in psychotherapy. Couseling of multicultural is complex, it is
easier when all members of the therapeutic dyad are from the same culture. When the therapist and
patients have different backgrounds. It matters if the authority figure is a member of a minority
culture of a major, dominant culture. When you give marital couseling to people of two different
cultures, and you also identify with one, it could give a wrong relation. You are never completely
aware of the fact that your culture influence the way you treat people. Every culture has its own
problems of giving psychotherapy. Language, behavioural manners, myth and metaphor shape the
structures of our mind. These things together shape personality. When you are not familiar with
these aspects of the client culture it is difficult to treat. All therapists have made the mistake of using
metaphors, or using a taboo of the clinets culture. So you can’t make one general psychotherapy for
the whole world. In China you need to have a different sort of therapy with their culture. Even within
the same society there are differences in culture.
NEGOTIATING FAULT LINES IN THE EBT TERRAIN
it important to have empirically based treatments, EBT. There is a lot of research to different
therapies. This is always a struggle. Because most patients have 1 session pre week, but are also
influenced by other things happening that week. There are so much variables involved, so it is hard
to say if a intervention is empirically effective. Patients are often difficult to read, because there is
often anxiety, coping skills and emotions. Beforehand you don’t know what the effect is of an
intervention. You have to make many decisions on how you are going to treat someone. Clients also
learn many things by watching the therapist, these are called throw-ins. These things don’t seem
important, but for the client it can make a lot of difference.
MANUALIZATION OF TREATMENT
Spontaneous throw-ins are not a basis for science of psychotherapy. It makes doing psychotherapy
more something like an intuition. When the outcome is good, it does not explain how the variables
have caused the outcomes. The link is not yet fully understood, this will only be possible when we
have neurobiology that that can describe the organism’s interaction with its environment. There are
advantages of manualizing psychotherapy. It wil be a methodical, stepwise fashion.
OBSTACLES TO SCIENCE OF PSYCHOTHERAPY
There are many variables that must be considered. Also the person itself who is the therapist is very
influencal. Also the combination between therapist and client is very important. Also personality and
genes are important variables which makes it hard for psychotherapy.
SOURCES OF HOPE
what works in psychotherapy is more important than why it works. Some therapies such as CBT are
more amenable to manualization than other, such as psychotherapy. But there must not be a
preference for this reason. The variables are also an opportunity to make adjustments and
compromise.
INDUSTRIALIZING PSYCHOTHERAPY
as psychotherapy has gained recognition as a health discipline, there are more people wanting it to
be insureaned. Creating health care teams, with all kinds of professionals are also very helpful.
WHO CAN DO PSYCHOTHERAPY
psychotherapy is a general term for many clinical procedures that are intended to improve cleints
well being. Well trained, educated professionals can practice psychotherapy. But the standards have
to be high. All different kinds of professionals can do psychotherapy. It is important that they never
overstep the limits of their competencies. The use of positive psychotherapy is becoming more
,popular. This has affected the practice of a range of psychotherapies. Positivity is growingly
important in mental health care.
CONCLUSION
there are three critical issues about psychotherapy: treatment efficacy, therapist aptitudes and
diagnosis and diagnostic coding.
1. Efficacy the best possible treatment should be chosen, not what the therapist likes best.
2. Some therapists are better in treating one disorder and not another one. It is not sure if this is due
to the discomfort of the therapist. Also their personality and competencies play a role.
3. Before giving a correct treatment there needs to be a treatment.
, WEEK 2: PSYCHOANALYTIC PSYCHOTHERAPIES
Freud is the founding father of psychoanalysis. There are many theories about psychoanalysis, most
was developed by Freud bit also Adler, Carl Jung enz. Later psychoanalysis were influenced by the
founding fathers theories. There are important similarities between all of these traditions, but also
important differences. Despite the lack of a unified perspective, there are certain basic principles
1. All humans are motivated by wishes, fantasies that are outside of awareness.
2. Interest in facilitating awareness of unconscious motivations, thereby increasing choice.
3. Emphasis on how we avoid painful or threatening feelings, fantasies and thoughts.
4. We are ambivalent about changing and emphasis on exploring this ambivalence.
5. Emphasis on using the therapeutic relationship for changing
6. Using the therapeutic relationship to explore self-defeating psychological processes and actions.
7. Emphasis on helping clients to understand their own construction of their past and present plays a
role in their self defeating patterns.
BASIC CONCEPTS
The unconscious
one of Freud’s most important insights was that we don’t have a reational understanding of the
factors that motivate our actions. Unconscious is an area with impulses, wishes, memories which are
splitt of the awareness. This occurs because the associated affects are too threatening or the content
of the impulses and whishes are learned by the individual to be unacceptable through cultural
conditioning. Contemporary psychoanalysts see the unconscious a little bit different. Some also see
as Freud an ego which keeps aspects of experiences driving from the id out of the awareness. Others
say that you can’t speculate about hypothetical psychic agencies. Some say that you need to
conceptualize an experience as a reflection of a particular type of compromise between an
underlying wish versus a fear. Others say it is just the lack of attention.
Fantasy
people’s fantasies play an important role and the way they relate to their relationships with other
people. These fantasies vary to the extent to which they are part of the awareness, some are
daydreams, others are more unconscious. In Freud’s early thinking these fantasies were linked to
sexuality or aggression. Later he said that it served a number of psychic functions such as regulation
of self-esteem, feeling of safety and mastering trauma. Because fantasies are viewed as motivating
our behaviour and shaping our experience exploring and interpreting is an important part of
psychoanalysis.
Primary and secondary processes
primary: a raw and primitive form of psychic functioning begins at birth, is unconsciously. There is no
distict between past, present and future. Different feelings can be condensed into one image or
symbol. Can be seen in dreams, fantasies and psychosis.
secondary: psychic functioning associated with consciousness. Ordenly, rational, reflective thinking.
Defences
is an intrapsychic process that functions to avoid emotional pain by pushing thoughts, wishes,
feelings or fantasies out of awareness. There was a attempt to conceptualize different defensis. Such
as intellectualization: talinking about something threating while keeping an emotional distance.
Projecting: attributing a threating feeling to another person. Reaction formation: denies a
threatening feeling and proclaims the opposite. Splitting: attemps to avoid the perception of the
other as goed from being contaminated by negative feelings, he may split the representation in twho
different images. Is commonly used by infants so they are able to feel safe with their mother. Rather
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