Four forces in psychotherapy

Fight disease or restore health? Pay attention to behavior or emotions? There are different approaches in psychotherapy that focus on different aspects of the work. What exactly, said the psychotherapist Viktor Kagan in the framework of the project “Department of Psychologyin Novaya Gazeta.

It all started with medicine…

“Psychology has a long past and a short history,” said the German psychologist Hermann Ebbinghaus. This fully applies to psychotherapy. The emergence of psychotherapy is usually counted from the last quarter of the XNUMXth century. At this time, psychological laboratories began to open, they are also physiological, they studied conditioned reflexes. But it is interesting that philosophers also worked there. Psychotherapy was fueled by what physiological laboratories gave.

1. Psychoanalysis

From medicine grew the first force of psychotherapy — psychoanalysis. And he brought something new — the psychoanalyst began to listen to the patient. Sigmund Freud studied under the French psychiatrist Jean Charcot. The analysis of the cases proceeded as follows: the patient was brought to the auditorium, where the professors and students gathered. The patient answered the questions he was asked. And he was not allowed to say anything other than that. It was not a conversation, but a medical investigation, an interrogation. Psychoanalysis introduced the patient into the circle of human psychology.

With psychoanalysis came the concept of psychological defenses — this is something without which modern psychotherapy would not exist. And all other therapies have grown out of psychoanalysis.

2. Cognitive-behavioral therapy

The second force came much later, although it could have appeared earlier. This is what today is called cognitive behavioral therapy. It focuses on behavior. She does not want to talk about the soul, because the practical meaning of this term is not clear.

The therapist recognizes the patient’s conditions and applies certain techniques to them. If there is fear, then depending on what kind of fear it is, this or that technique will be chosen. This is the basis of part of the methods of cognitive-behavioral therapy, when a person is immersed in a frightening environment and gradually he gets used to it and begins to be less afraid.

There is no person as such, an integral indivisible personality.

Today, various types of cognitive behavioral therapy are included in the insurance program in many countries. It is short-term and gives a clear result that can be measured.

3. Existential and humanistic approach

The third force began to mature in the post-war period. And almost immediately, humanistic psychology went hand in hand with existential psychology, so we will combine them into one. Existential deals with a person as he is, with the whole, with a personality, and not with a disease, a reflex, a state. Each person is unique, so each patient needs his own therapy, because no two patients are the same.

The emergence of the third force is connected with the free development of culture. In the guarded pens of totalitarian cultures, existential humanistic therapy cannot grow.

• existential therapy

4. Transpersonal approach

Transcultural or transpersonal psychology. It is rooted in world spiritual practices, primarily esoteric ones, such as Hinduism, Buddhism, the religion of the tribes of South America… It addresses the metaphysical man. There are nine books by Carlos Castaneda about this, and even if they are fictional, they are brilliantly fictional. This direction stands a little apart. There is a lot of metaphysics in it, and it is not translated into the language of physics.

These are the four major players in the psychotherapy arena. All therapies can be placed with greater or lesser certainty in a package of one of the four forces.

Integrative approach

But today psychotherapy is becoming more and more integrative. Theories or belonging to a certain school rather indicate a way of philosophizing, the formation of a worldview, than the actual action. Designate a frame in which the picture of psychotherapy is placed. Each psychotherapist has his own framework.

The psychotherapy space is like a building. It has many doors. You can enter through any door, climb in through a window or chimney. It’s how you feel comfortable. But psychotherapy is something that happens inside and it is important what you do when you get into the house, and not through which door you entered.

The full lecture by Viktor Kagan can be viewed here.