Tuesday, October 23, 2012

The Four Theaters of Psychotherapy

     No one will ever agree 100% with anyone else about the validity of psychotherapeutic orientations.  Obviously a Rational Emotive Behavior therapist will disagree fundamentally with a psychoanalyst.  But, as we have seen time and time again, even those who study or partake of the same theory have different views on how to apply it.  With all this in mind, I will now try to do the impossible:  to create a unified theory for psychotherapy.  This is ultimately self-defeating, but it's at least a fun thought exercise.
     I think, at this point, that there are four theaters of psychotherapeutic application.  These include the world, the immediate environment, interpersonal, and intrapersonal.  The world, in my definition, would be analogous to the macrosystem in Bronfenbrenner's Systems model.  This include fundamental ideas and archetypes in a person's (indeed, in each person's) life.  Immediate environment refers to the room in which the therapist and client(s) find themselves.  The interpersonal theater is an idea that there is a certain mode or fashion to how a therapist and client interact.  The last theater is intrapersonal.  Whereas there is a dialogue between people, I think that there is also a dialogue in a person's hand.
     But the real question here is how to use specific theories in each one of these areas.  What is appropriate?  I will be using more popular and basic theories because they are easier to obtain and study than more obscure theories.

    Starting from the outside and moving toward the inner theatres, we come to the world.  Understanding the world is a difficult thing.  Obviously every theory in psychotherapy is attempting to answer some/many/all (though the audacity of that last type would be staggering) questions about what is "out there."  So my goal here is not to do that.  The goal is to be able to come to terms with large ideas.  I can't think of a better orientation in this realm than existential psychotherapy.  This theory leads to thoughts and ideas about some of the larger issues in life.  The real issue is how to help the client prepare for (or help them prepare themselves for) the large issues in life.  I think that techniques and a deep understanding of existentialism can help these issues to be addressed.
     The environmental theater of things is an amazingly simple ideas as all the tenets have been exampled, tested, and applied through Rogers.  Everything he says about genuineness, unconditional-self and -other acceptance, and empathy pertains to this idea.  Perhaps, at this point, I should make a more detailed distinction between environment and interpersonal.  I do this because genuineness etc. can be communicated verbally.  But I think that these can be communicated through body language and the set-up of the room as well.  As I write this, I realize that the difference is tenuous at best.  Something to come back to later.
     How we talk to a client and what method we use with our words is very important.  How do we get a therapeutic relationship started and keep it sustained?  At this point in my limited career, I think that an author by the name of Kottler,  who wrote On Becoming a Therapist said it amazingly well.  He said that (paraphrasing) we learn to counsel through the power of our personality.  I love that statement.  I know that that has absolutely no theory, evidence, or respectable orientation behind it.  Honestly, I think that the interpersonal part of therapy is really what the inter-theory scuffle is about.  At this point, I haven't found one that satisfies me yet.  This will have to do for now . . .
     The last theatre is intrapersonal.  This one is fairly straightforward.  The question is: How does one better himself when the counselor is not around?  Better said, how does the client counsel themselves when the counselor is away and all they have is the voice of their conscience in their head?  Albert Ellis found a pretty good answer to that.  REBT teaches a person to keep their thoughts/emotions/actions in control by understanding how each of them are interconnected.  It's something that someone can do by themselves.
     Perhaps the Unified Theory isn't really about the specific theories used in the different theatres, but rather the model of theatres itself.  This is, of course, a little more difficult to change in the World and the Environment.  Again, this whole thing needs to be discussed more when I have more time to think about it.

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