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0300 Integrative in a nutshell (E)

 

How does the integrative approach to the human growth process differ from the classical psychotherapies, which follow a single therapeutic model or modality, which we call mono-modal?

The Background

The approach is based on certain more contemporary visions of human mental functioning. None of the earlier insights since Freud are rejected, but there are also many other things which have been discovered since by other schools of thought.

Firstly there is the growth model.  The medical doctor and neurologist Freud assumed, that like with bodily health, human beings psychologically function normally and well spontaneously. Should this not be the case, then this points to a serious disturbance in this spontaneous development somewhere in the past and this he called a psychological trauma. This trauma, sometimes in the unconscious, had to be sought out and exposed (psychoanalysis), and processed and worked through (catharsis) with the help of a healer (psychotherapist). Once this healing work, which can last years, is complete, the person in question will again function normally and spontaneously. This vision is called the illness model. 

Since Rogers, Maslow and other greats of the “humanist” psychology, we find ourselves in a life-long growth process. Some people have experienced many impediments to growth: they display pathologies, the most frequent of which are: depression, neurosis and schizophrenia. On the other hand there are people who function “optimally”: they have developed their latent potential to the full and feel themselves objectively and subjectively “happy”. The largest group falls between these two groups: they are full of underdeveloped possibilities, but not to the extent that they exhibit abnormal moods, thoughts or behavioural patterns: they are the “normal ones”, rather not unhappy than really deeply happy. Thus not two groups, as the illness model suggests, but three. The humanist approach does not exclude in-born or traumatic mental elements, but regards these rather as factors which have inhibited growth. Even if you succeed in neutralising the disturbing factors with medication, the person can generally still grow much more as a person. Alongside the term psychological trauma, we speak as much, or even more about anarkema, psychological short-comings, unfulfilled needs and the experience of insufficient signals indispensable for fundamental self confidence (Freud’s primary narcissism, the corner stone of mental health) and instead of blockages, one speaks of latent possibilities, underdeveloped or “sub-functional” skills.

The helping professional is thus someone who also promotes upward growth (psycho-anagogue), and not just someone who fights illness (psychotherapist). And the intention is that the growth process proceeds far beyond the level of the “normal”, modal, banal or average. Experience has shown that such growth inducing methods are also active in pathologies, and not just with normal people who want to optimalise themselves. Hence the term “psycho-anagogy” (growth induction) in stead of psychotherapy (illness healing). This vision we call the growth model. It was introduced in the nineteen sixties by people like Rogers and Maslow. 

A further consequence of the substitution of the illness  model by the growth induction model, is that the client has a fundamentally different view of his problems and growth crisis. Beside the fact that he no longer has to accept the humiliating label “psychiatric patient”, but sees his life-problems as the result of a series of attitudes and skills which can be trained-up separately, the psycho-anagogic client works more consciously and soberly on his growth process, and immediately avoids all paralysing guilt projections towards parents, early undesired sexual experiences, in-born causes and the inevitable transference and countertransference. Understanding (also emotional) and re-experiencing causes, seldom means that the sub-functional skills suddenly improve of themselves. Phenomena such as neurosis forming and gains of illness are also greatly limited. On the other hand, the psycho-anagogue is more free is his movements and contacts, in a way that music teachers, GP’s and sport teachers are. Normal personal sympathy and friendship are possible. The magical transference and countertransference myths don’t get a chance. On the other hand, the psycho-anagogue carries another heavy responsibility on his shoulders: he must also behave in his private life according to the principles of integration, optimal communication, etc.

A second big difference is that the integrative psycho-anagogue neither does apply a single, one-sided method such as for example psychoanalysis, behavioural therapy, family therapy, Gestalt therapy, medication, meditation, training etc., all methods which undoubtedly bear fruit in certain situations. Nor is he an eclectic, who has learnt different methods, and chooses to apply a particular approach according to the situation. A psycho-anagogue does not mix different mono-methods together, but the effective elements from these treatment approaches. He does not practice different methods which he has learnt from diverse “schools”, but one method: the integrative. For example, if he uses systematic desensitisation from behavioural therapy, to work away phobic reactions, his approach is very different from that of a pure behavioural therapist.

The Method

In integrative treatment (or growth induction, psycho-anagogy), we don’t just look at “disordered” thinking and behaviour in the DSM sense, but also, and especially, at the underdeveloped (sub-functional) skills in thinking, feeling and doing, which must be further developed to improve the chances of success in life. Thus rather a functional analysis than a diagnosis. In the course of the psycho-anagogy, this analysis might be updated in mutual consultation, based on the experience gained in the meantime.

A second characteristic is that, where possible, use is made of two major approaches: the mental, which works directly on the feelings, behaviour and insights, and often (but not always) proceeds via verbal interaction, both conscious (talking therapy) and sub-conscious (hypnosis, relaxation, trance, as intense experiences of emotions), and the cerebral-organic, which rests on the brain’s biochemical and electrical processes, supporting and strengthening the mental processes. We consider medication (mainly antidepressants), meditation, neurotherapy (such as neurofeedback, rTMS, EMDR, ECT) as psychological interventions. It has been shown time and again that the combination of both elements works the best, the whole being greater than the sum of the two approaches apart, particularly regarding long term effectiveness and prevention.

A third characteristic is that the client, through optimising his feeling, thinking and doing, evolves from the “superficial” (concrete behaviour) to deeper mechanisms. By “deeper” we mean that the client can with ever more independence self-regulate his own functioning. By re-experiencing mental processes and emotions at a certain level, one tries to descend to greater command over oneself. Of course, once the original complaints have disappeared, the motivation of the client can fall off such that not all people go through all the growth stages possible.

A fourth characteristic is that one tries to help the clients understand as quickly as possible the worth of the phenomenon integration, and tries to teach them the associated skills. Integration is not just a theoretical tool for a rapprochement of different theories and schools of thought, but more especially a method by which to function as an individual, with a daily life more free from conflict. For this we look to integrate different needs, rather than to make painful choices. One also learns to integrate in relations and co-operation: communication is, after all, nothing else than searching together for an integration of diverging positions.