Psychotherapy Orientation and Therapist Persona

Psychotherapy orientations at the moment are generally seen as distinct units of expertise and information that may be chosen from a metaphorical toolbox and utilized at will. Like the final surgeon, the eclectic psychotherapist is claimed to have the ability to choose from quite a lot of methods and ship the simplest remedy for a given affected person, impartial of the private traits of the therapist. I argue that this declare is fake, particularly as a result of it fails to acknowledge that psychotherapy orientations movement from the character of the therapist and can’t be thought of distinct from it.

Many years in the past, within the mid-Twentieth century, it was usually accepted that the psychotherapist (who was most probably a psychiatrist) had a set therapeutic type and more-or-less utilized it to all of his sufferers. If he felt that he couldn’t assist a specific affected person, he referred the affected person to a specialist in a unique therapeutic method, who is perhaps extra possible to assist the affected person.

For example, if the psychoanalyst discovered a depressed affected person unlikely to learn from psychodynamic remedy, he referred the affected person to a psychopharmacologist, or to a supportive psychotherapist, or each. Psychotherapy orientation was seen as being particular to the person therapist; it couldn’t be chosen at will as if chosen from a toolbox.

Within the latter half of the Twentieth century and persevering with into the twenty first century, a unique thought emerged. This concept holds that the therapist should attempt to adapt his type to every specific affected person, choose from plenty of approaches by which he deems himself competent, and apply methods from that method to work with the affected person. Thus, in the midst of an 8-hour workday, the therapist could say that he practices cognitive remedy within the morning, interpersonal remedy after lunch, and psychoanalytic remedy within the late afternoon.

The emergence of this “eclectic” method displays the concept that psychotherapy orientation has nothing in any respect to do with the individual training it; it’s only a talent to be realized and utilized, the way in which one learns algebra and makes use of it to unravel polynomial equations. Makes an attempt at “psychotherapy integration” view psychotherapy orientation equally, although these makes an attempt purpose to create a single, unified psychotherapy method that may be utilized by any therapist impartial of the therapist’s private traits. I see these concepts as reflecting a misunderstanding of the connection between psychotherapy orientation and therapist character.

Why do I say that psychotherapy orientation can’t be separated from the character of the therapist? It’s as a result of the assorted psychotherapeutic orientations are based mostly on differing moral techniques and philosophies, and therapists who worth specific moral philosophies will discover themselves naturally inclined to observe specific psychotherapies in keeping with their very own moral-ethical beliefs. To submit that psychotherapy orientation may be adopted at will—impartial of the therapist’s personal beliefs and character—is to disregard this fundamental premise.

Directive and Non-Directive Therapies

Whereas there isn’t a scarcity of particular psychotherapies—certainly, new ones appear to be developed each few months—it may be argued that there are two fundamental approaches to remedy: directive and non-directive. In directive therapies, comparable to cognitive-behavioral remedy, the therapist adopts an lively function in instructing the affected person new expertise, methods, or methods. In some types of directive remedy, the therapist could give recommendation.

In non-directive remedy, comparable to psychoanalytic remedy, the therapist seeks to not immediately affect the habits of the affected person however moderately to assist him come to a greater understanding of himself and what ails him. Szasz (1965) made an identical distinction between sorts of therapies, and Langs (1973) later described these variations as elementary to understanding psychotherapy principle.

Psychotherapy Orientation Flows from Persona

I contend that the orientation of the psychotherapist flows immediately from the character of the therapist and can’t be thought of distinct from it. On this respect, the psychotherapist differs considerably from the physicist, who could apply an unlimited array of theories, and from the final surgeon, who’s expert in quite a lot of methods.

Certainly, the historical past of psychotherapy is replete with examples of therapists cultivating methods finest suited to their particular person psychologies. Freud, as an illustration, deserted hypnosis as a result of he realized his character was ill-suited for the authoritarian-intrusive function of the hypnotist. He went on to develop psychoanalysis and the strategy of free affiliation not solely as a result of he felt it to be a more practical method but in addition as a result of it meshed extra naturally together with his character.

When Sullivan launched his personal number of psychoanalytic remedy, this was reflective of his want for closeness within the psychotherapy relationship; he was a lonelier man than Freud. And when Albert Ellis launched rational emotive remedy, this, too, mirrored his personal character, which was rather more direct and confrontational than lots of his psychoanalytic friends.

That is to say that the variations between the 2 sorts of therapies described above—directive and non-directive—are representations of variations between two sorts of people who observe these therapies, and never simply variations between kinds or methods. Whereas my purpose right here is to not describe intimately the character variations between these two sorts of therapists (however merely to level out that such variations exist), it appears potential that the directive therapist is in higher want of construction and maybe management, whereas the non-directive therapist is pushed extra by his introspective qualities and wish for understanding.

Ramifications for Schooling and Remedy

Whether it is true {that a} therapist’s theoretical orientation flows from his character and can’t be thought of individually from it, this may have important ramifications for the coaching of psychotherapists and the remedy of sufferers. When it comes to coaching and training, the younger therapist should very fastidiously discover the assorted modalities of remedy to see which one feels most genuine.

Definitely, a private evaluation or psychotherapy is an effective place to begin, although the introspective work shouldn’t finish there. The trainee ought to immerse himself within the literature, focusing significantly on the philosophical tenets underlying every theoretical orientation. He ought to have a look at his life and see how he lives it in relation to others and to himself. Solely then will he be capable to choose an genuine therapeutic method.

With regards to remedy, the therapist could be sensible to restrict himself to working with sufferers with whom he feels he may be most genuine, since it is just when the therapist is genuine that he may be efficient. Importantly, such selections about who to deal with and who to not deal with shouldn’t be made solely on the idea of analysis, because the private traits of sufferers with a given psychiatric dysfunction could also be simply as different as the private traits of individuals within the normal inhabitants. I argue that the therapist should put on just one hat within the consulting room, and if he feels {that a} completely different therapeutic method is more likely to be extra useful for a specific affected person, then he shouldn’t placed on a unique hat however refer the affected person accordingly.

Conclusion

On this article, I’ve argued that psychotherapy orientation is a mirrored image of who the therapist is as an individual, and that it shouldn’t be thought of one thing that may merely be adopted or utilized at will. Consequently, I’ve additionally argued that the “eclectic” therapist is a fable. For the reason that eclectic therapist can have just one genuine theoretical orientation, for my part, he could be sensible to refer poorly matched sufferers to different therapists moderately than making an attempt to use a remedy that runs counter to his character. Such concepts have important ramifications each for the coaching of psychotherapists and for the remedy of sufferers.