The development of cognitive-behavior therapy parallels major developments in how to conceptualize the role of cognition in psychopathology and behavior change. Dr. Meichenbaum will trace his "personal journey" as a clinician and researcher, noting the altering views of cognition from a behavioral, information processing and constructive narrative perspective. He will examine the therapeutic and research implications of this shift.
The split in the modern personality is between the head and the body, between the rational mind and irrational gut feelings. It reflects the split in this culture between science and the natural forces in life and nature which science attempts to control. The modern individual lives largely in his head and is out of touch with his body because he had deadened it to suppress the fear, the pain and the despair which he experienced in childhood.
In the ancient world, the philosopher was a physician of the soul who, employing the healing word (iatroi /ogoi), offered counsel to persons perplexed by problems in living. After the triumph of Christianity, the priest as confessor-counselor replaced the philosopher as rhetorician of consolation. With the birth of psychiatry, and especially since the Freudian revolution, we call helping persons with words "psychotherapy." I shall try to show that without a decisive separation of rhetorical healing from medical healing, psychotherapy as the secular cure of souls is doomed to extinction.
Madanes will present guidelines for the positive use of shame in couples and families. Stories from therapy will be told to reveal complicated problems in which shame, sex, power and love are interconnected. Looking at extreme cases of violence will throw light on when it is appropriate to experience shame and how to recover from the pain that shame represents.
In the 1990's all factors of therapy are changing. The way of financing therapy is changing, there are new types of clientele, there are striking differences in ideology and the training of therapists is becoming a new kind of enterprise.
Epicurus, Kierkegaard, and Nietzsche are forefathers of contemporary psychotherapy. Freud was aware of these wellsprings of modern therapy, and Jung brings them specifically into his writing and his methods. We not only get hints from these forefathers, but we also find a lasting base in them, such as Bubar's "l-thou" construct or Kierkegaard's emphasis on the ultimate relationship of the self to life. These ideas are assumed in Freud, Jung, Adler, Rank, Fromm and other leading therapists in our day. It is these latter therapists who have given us the web of ideas which underlie contemporary psychotherapy.
Human experience and human action center in and derive from human subjectivity. Our preoccupation with objectivity results displaces identity from inner living to external. Life-changing psychotherapy requires centered awareness and self-direction. Three therapeutic elements are prime: Full presence, major commitment, and exploring client's self-and-world constructs.
The importance of therapeutic alliance is described. Therapeutic alliance, transference, and transference acting-out are defined and distinguished from each other and the therapeutic task of helping the patient to convert transference acting-out to therapeutic alliance and transference is outlined. The differences in the form and content of the intrapsychic structure are described to show why different therapeutic techniques are necessary to establish the therapeutic alliance: Confrontation with the borderline and mirroring interpretation of narcissistic vulnerability with the Narcissistic Personality Disorder. A brief case illustrates each.
The emphasis in Dynamic Psychotherapy over the past few decades has shifted from a focus on insight and the recovery of early memories to a recognition that the quality of the patient-therapist relationship is the quintessential factor upon which the success of therapy depends. This involves both the real relationship and transference-countertransference elements, all within a systems-theory orientation.
This address includes a brief history of Reality Therapy, and explains that it is based on control theory and that it is applied to both counseling and managing clients. Case examples are used to show that it is composed of two major components: Creating the counseling environment and the procedures that lead to change.