Supervision and therapy are isomorphic processes. What supervision teaches is the process of creating change in people, and the very teaching of this process is itself an attempt to create change in the supervisee. Like families, therapists tend to confine themselves to selected segments of their possible repertory. Thus a major goal of supervision can be the expansion of the therapist's use of self.
Existential psychotherapy is more properly viewed as a therapy informed by a sensibiity to existential issues, rather than as a discrete, self-contained school of therapy. It addresses the anxiety embedded in our consciousness of the parameters of existence, especially in our confrontation with death, meaninglessness, freedom, and isolation. I shall discuss these concerns, particularly those with the greatest relevance to everyday therapy practice. I shall discuss the implications of the existential sensibility for the conduct of therapy and the therapeutic relationship. Genuineness and authenticity are necessary.
Focusing is bodily attention, not to mere sensations but to an at first unclear, implicitly complex bodily sense-of a situation, problem, or aspect of life. Therapy deepens immediately with many clients if asked what physical sense comes in the middle of the body in relation to what is being worked on. With half a minute of repeated direct attention, clients can assign a "quality-word," e.g., "heavy," "fluttery," or "tight." Then small steps come to say the crux of the problem. Each brings a slight (later large) "shift" and release, a direct sense of validity, although further steps may again change the whole problem.
Methods for training therapists customarily are directed to developing cognitive abilities. Using Milton Erickson as a model, an alternate, experiential approach is offered. The "evoking style" of the therapist determines the outcome of the treatment more than the theoretical and clinical methods to which the therapist ascribes.
The evolution of psychotherapeutic methods over the past 200 years from Mesmer through the psychoanalytic schools, behaviorism and current cognitive psychology tells a fascinating tale of our evolving understanding of human nature. In this address we will trace the development of fundamental techniques such as suggestion, free association, active imagination, gestalt dialogue, focusing, Erickson's indirect approaches and what I now call "The Basic Accessing Question."
Anyone can perform brief or short-term therapy, but unless pivotal issues are addressed, the treatment will, at best, be too narrow and restricted. It is essential to employ empirically established methods whenever possible, but also to have a framework and rationale for on-the-spot inventiveness. This Invited Address will explain how to be precise and targeted while also ensuring that interactive healing processes are put into effect.
The author traces the evolution of psychodynamic theory over the past fifty years and demonstrates how various individuals and schools of thought have contributed to increasing conceptual clarity despite significant continuing differences. Along with these theoretical advances, there have been important changes in analytically-oriented therapeutic techniques.
Cognitive therapy was originally developed for the treatment of Depression and Anxiety. Since its early beginnings various clinicians and investigators have extended its use to a wide variety of disorders and populations. Systematic outcome studies have demonstrated its efficacy not only in the garden variety of disorders such as Depression, Anxiety and Panic but also in medical disorders such a low back pain, diabetes, chronic fatigue syndrome and chronic hypertension.
In the early decades of the 20th century Freud's mastery of the craft of presenting a case enthroned a belief that anxiety disorders were caused by repressed emotional complexes and that recovery required the restitution of repressed ideas. This belief dominated psychotherapeutic practice, and even though little was to be seen in the way of success, any alternative was treated with scorn. Mid-century studies of experimental neuroses showed that these disturbances were the consequence of the learning of maladaptive anxiety and could be overcome by systematic counteraction by other emotions.
My own physical disabilities as well as my performance anxiety during my childhood and adolescence impelled me to read many ancient and modern philosophers who had worked on the philosophy of human happiness and unhappiness. Thinking about their views and adapting them to my own life, I made myself distinctly less disturbed as well as less disturbable.