Abstract
Since historical times, human beings have been on a quest to finding a remedy or cure to mental disorders that affect them. For instance, some traditional methods of therapy were highly based on cultural rituals of healing that have now been phased out by modernization. Also, different religions had devised their means of treating mental conditions through methods such as meditation, religious lectures, philosophical lectures, and resting among others. Nonetheless, some of these methods, for instance, meditation, are still highly valued, even though they lack a supportive scientific basis.
However, under the current practice, patients who suffer from mental disorders are expected to contact a professional therapist to help them in treating their mental condition. Therefore, psychotherapy can be defined as the treatment offered to persons who suffer from mental disorders. A key aspect of psychotherapy is to teach people or provide people with tools to help them in tackling their unhealthy thoughts. Therapists are trained to work with the affected individuals to help them in devising a viable solution to the existing core problem.
Psychotherapy is done via various approaches. However, no single approach has been shown to provide perfect results. At times, therapists are forced to include elements of different therapeutic approaches into their patient’s clinical process or strategy.
Additionally, the approach used on a patient is highly dependent on the underlying needs. The paper provides an overview of three types of psychotherapies, namely, patient-centered treatment, existential psychoanalysis, and gestalt therapy. The psychotherapies are commonly used in practice today. The paper compares them based on their assumptions, models of personality, clinical process and strategies, targeted areas of therapeutic change, and limitations and/or weaknesses exhibited by each of these psychotherapeutic approaches.
Person-centered Therapy
Person-centered therapy is a humanistic approach that focuses on an individual’s self-perception, rather than a therapist’s interpretation of a person’s unconscious ideas and/or thoughts. The theory was first formulated by Carl Rogers, an American psychologist whose interest was centered on the conscious attitudes of a child towards self-idealization. Therefore, the theory was instituted on the principal concepts of attitudes based on three elementary conditions, namely, correspondence, categorical positive regard, and compassion. The approach is not concerned about the source of the problem but rather focuses on finding the best possible solution.
The approach is humanistic in the sense that it is designed to foster an open and truthful client-therapist relationship through the empowerment of the client in taking control of his or her palliation. Therefore, Rogers’ approach sees the user as the core source of his or her healing, rather than originating from the therapist himself. The therapist is simply a facilitator who develops constructive companionship with the client.
The approach proposes that the existence of every individual is not static, but dynamic. Such existence is dependent on experiences. Therefore, the reaction of every organism or individual is purely about his or her experiences or perceptions of reality. Moreover, this reaction is wholly manifested. The theory also assumes that the propensity of every creature involves fighting to realize, safeguard, and intensify its experiences.
Behavior is considered the basic goal of the organism. The conduct is aimed at satiating an organism’s pending needs from experiences and a self-perceived point of view. The sensation is also very critical in the sense that it facilitates the result-focused deeds of the organism. According to the concept, an internal frame would be the best viewpoint for comprehending behavior.
Due to the interaction of the self-perceptual field and the environment, the structure of the self becomes modified into an organized conceptual pattern that is consistent with the relationships and/or characteristics that relate to oneself and the values linked to these concepts. Therefore, values are based on individual experiences. They form part of the structure of the self. Moreover, these values can result from direct experiences by an individual or they can be derived from others but discerned in a distorted manner.
As a person continues to have experienced, the incidents are superficial, represented, and structured to form an affiliation with the personality. However, besides being ignored due to the absence of a perceived relationship, the experiences are denied figuration or distorted due to the presence of discrepancies between the self-structure and the occurrences. However, most of the experiences in an individual are consistent with the self-structure. Nonetheless, in some instances, the behavior may result from inconsistencies or non-symbolized personal experiences.
Roger also highlights the concept of psychological adjustments by asserting that its existence arises from the assimilation of both the visceral and sensory experiences of the individual. He further accentuates that such experiences can only be perceived as threats. Additionally, the more the inconsistent experiences, the more rigid the perceptions when it comes to the maintenance of the self-structure. However, in certain conditions, some inconsistent experiences may be self-revised to include and assimilate the experiences. According to the theory, an organism whose perception incorporates both the visceral and the sensory experiences into one integral and consistent system is more capable of understanding other persons while accepting others as individuals who are separate from it.
Existential Therapy
Existential therapy is a philosophy-based psychotherapy approach that was founded by Karl Jaspers. According to Wedding and Corsini (2013), there exist two basic patterns of being, namely, inauthentic and authentic mode patterns. The inauthentic mode is modeled by someone who fails or refuses to take control of oneself and instead seeks refuge by externally deriving definitions of oneself and the world.
Therefore, the individual succumbs to a state of false security through divergence from the reality regarding the approved habits and the current life conventions. On the other hand, the authentic mode is typified by the acknowledgment of one’s life responsibilities, despite the anxiety that sets in when doing so. Instead of seeking to lose one’s identity in the crowd, the person discovers his or her self-uniqueness. Thus, he or she strives to become ones’ inherent person. Therefore, existential therapy can be regarded as a dynamic and diverse approach to psychotherapy that is aimed at addressing concerns that are deeply rooted in individual existence or being.
Existential therapy has evolved into a diversified form of psychotherapy. This evolvement has oriented therapists to caption the aspects of experimental reflection, freedom, and responsibility using different degrees of intensities and priorities. Nonetheless, the acknowledgment that things can never remain constant is the hallmark of existentialism. The current design of the approach bears in mind the complementarity and integration through a holistic and holographic point of reference.
Existential therapists cannot only detect the inner psychological processes in an individual but also connect insights derived to their works’ cultural and social implications. Hence, contemporary existential therapy confronts biological and pragmatic means of intervention to the extent of their situational and/or contextual relevance. According to today’s existentialists such as Wedding and Corsini (2013), existential therapy is open to the world in which diverse persons and/or groups dwell.
This approach emphasizes providing a means of examining, confronting, clarifying, and reassessing a person’s understanding of life, including the problems one encounters and the limits imposed during one’s existence in the world.
Regarding the role of the therapist, the psychoanalyst helps the client to confront his or her anxieties that he or she faces during his or her daily existence through the creation of meaning to his or her experiences. Therefore, an existential therapist should understand the personal experiences and anxieties of the clients to guide them through the struggle of defining their existence. To facilitate this process, the therapist has to forge a relationship with the clients.
One of the tactics employed by existential therapists is to provide hope to the clients by instilling a sense of quest in them. Failure to do so, the users may relapse to their desperate condition. Besides the guiding role, the existential therapist also plays a symbolic role. In this regard, the psychoanalyst is perceived to have undergone his or her existential ordeal and emerged victoriously. By this virtue, clients can derive comfort in the possibility of recovery from their condition before renouncing their daily existence patterns. Therefore, the therapist plays an important role in a supportive framework in the client’s healing process.
Gestalt Therapy
Gestalt therapy is a phenomenological approach that was founded by Fredrick Fitz and Laura Perl. The approach teaches both patients and therapists how to be aware of their feelings, perceptions, and actions, including distinguishing them from the interpretation of their pre-existing attitudes. This form of therapy aids people to move away from their usual way of thinking. It helps them to distinguish between their perceptions of the current and past situations.
Some of the fundamental tenets of this approach include an emphasis on the holistic person and self-sense, emphasis on the thought process, rather than the results, an emphasis on objectivity, subjectivity, and affection, and regard on the effects of life events such as abuse on the development of personality. Other tenets include the conviction that growth and development are key ingredients of life’s motivation, and the conviction that all individuals are born with an inner sense of motivation and a capacity for interacting with oneself.
Gestalt therapy also emphasizes satisfaction and attachment, the belief that the self cannot exist without the influence of other people, and the belief that the organizational structure and content contained in the mind are mainly shaped through interactions of the self with others. Therefore, the model emphasizes the importance of others in defining one’s perspective of life.
The goal of Gestalt therapy is to help an individual to explore his or her awareness and insight. Notably, the aspect of awareness is unremitting, rather than sporadic. Hence, during the therapy, an individual should own what he or she is doing, instead of just knowing. Nonetheless, knowing alone marks a passage between being fully unaware and being in a state of focal awareness. For instance, when a person reports that he or she is aware of something, yet he or she claims helplessness to make a desirable change, he or she is in most cases referring to a situation in which he or she merely knows about. He or she does not fully understand it in terms of its workings to integrate it into his or her life. Additionally, such a person faces difficulties in discerning any viable alternatives or may have the conviction that the alternatives are unachievable.
One of the most important pillars of Gestalt therapy is patient-therapist contact. The therapist and patient are expected to create a solid relationship over time. This link is important since it communicates essential information to the patient regarding the therapist’s care for the patient, an important element of psychotherapy. One of the elements of a good patient-therapy relationship involves the psychoanalyst paying close attention to the patient’s actions during the therapy session. The success of the therapy also requires the Gestalt therapist to believe that the subjective experience of the patient is just as valid as the reality from the therapist’s point of conception.
To overcome the limitation of the therapist’s interpretation and reflection of the patient’s subjective experiences, Gestalt therapy incorporates an experimental method of psychoanalysis. Simply put, the patient and the therapist can experiment using different ways of thinking and acting to gain a better understanding of the victim’s experiences. An important element of Gestalt therapy is that the therapist is allowed and even rallied to share his or her personal experiences both during the session and in his or her life. Hence, in Gestalt therapy, therapeutic data is sourced from the patient and the therapist. The process where the psychoanalyst and the victim take part in the healing through a productive sharing discussion is called a joint phenomenological investigation.
Similarities
Assumptions
The three forms of therapy assume that the patient’s experiences are the focal point of healing. This case is clearly illustrated by the patient-centered approach where the emphasis is laid on the victim’s past and present experiences or perceptions. According to the approach, experiences and perceptions are essential in shaping an individual’s behavior. In the existential therapy, experiences and anxieties of the client play a pivotal role in defining the client’s existence.
Thus, the psychoanalyst needs to understand the client’s experiences through a forged client-therapist relationship and provide hope to the client. Gestalt therapy assumes that through the sharing of experiences between the therapist and the user, the counselor communicates his or her observations about the patient, an essential component of the current psychotherapy.
Models of Personality
In the three clinical approaches, the therapists use the personalities to understand the patients and/or help them to overcome their ordeal. For instance, in the case of a patient-centered approach, the counselor is expected to understand the patient’s dynamic personality based on his or her experiences and perceptions. Existential therapy also requires the therapist to understand the patient’s individuality based on his or her anxieties and experiences derived from everyday existence. Concerning Gestalt therapy, the therapist is expected to comprehend the current state of awareness or insight of the patient to help the sick people to overcome their state of helplessness and/or make a desirable change in their personality.
Clinical Processes or Strategies
The techniques emphasize strategies that focus on the process of therapy, rather than the results. A person-centered approach highlights the importance of continuous review of the patient’s experiences and perceptions throughout the therapeutic process. Existential therapy is also focused on the process of understanding the patient’s personality that is heightened through his or her experiences and anxieties in addition to using this knowledge to guide the patient in overcoming the struggle to change his or her personality. Gestalt therapy also emphasizes the process of engagement between the therapist and the patient. It suggests a mutual dialogue between the patient the therapist where both parties share their experiences and anxieties, which are then used to heal the patient.
Targeted Areas of Therapeutic Change
The three models target personality change as the key area of therapeutic change. A person-centered approach targets the patient’s dynamic experiences and perceptions. Here, the therapist fosters an open relationship, which he or she uses to empower the patients to take control of their personality. Existential therapy also targets the patient’s experiences and anxieties, which are considered as part of their personality. By targeting the clients’ anxieties and experiences, the therapist can better help them to change their personality by instilling a sense of hope. Regarding the Gestalt therapeutic model, the personality of the client is the core target. The approach targets the clients’ personality that is defined by the presence or absence of awareness and insight into reality as perceived by the users.
Limitations and Weaknesses
None of the approaches can completely resolve personalities derived from inescapable occurrences such as death. Unfortunately, all people suffer the loss of a loved one once in their lifetime. As a result, they face great anxiety, lack of awareness, and experiences of negative perceptions. Such experiences are hard to treat, even when using a combination of the three approaches. Nonetheless, therapy by any of the three models can help in reducing anxiety, negative perceptions, and lack of awareness among individuals.
Differences
Assumptions
According to the person-centered theory, the behavior is regarded as the basic goal of an individual. Behavior satisfies the needs derived from perceptions of self and experiences. Existential therapy assumes that a client’s behavior is not an essential element of understanding clients’ perception of their existence, but instead emphasizes the formation of a constructive relationship between the client and the patient. The goal is to instill a sense of hope and quest for a struggling client. In the case of Gestalt therapy, the key assumption revolves around the creation of behavioral awareness that enables the clients to not only know but also own what they are doing.
Models of Personality
The person-centered approach proposes that personality is not a static element, but rather a constantly changing aspect that depends on one’s own experiences. Therefore, people take action and/or reply about their individual experiences and discernment. Regarding the existential therapy, personality is defined by a person’s anxiety and experiences that he or she faces during his or her daily existence.
The approach requires the therapist to comprehend this aspect of the client’s personality to help him or her to overcome the ordeal. Gestalt therapy personality model is defined by the patient’s state of awareness and insight. For patients to be considered fully aware of what they are doing, they must know what they are doing, including owning and integrating what they are doing in their life.
Clinical Processes and Strategies
Person-centered therapy emphasizes providing the clients with the tools required to take control of their healing. This goal is achieved through fostering an open relationship with the clients that allows the therapist to empower them (users) to take control of their recovery. On the other hand, existential therapy uses a strategy of instilling a sense of hope to the user through a client-therapist relationship. Moreover, the therapist also plays a symbolic role by reassuring the client of the possibility to get better based on the perception that the counselor was once a victim who emerged victoriously. Gestalt therapeutic process is based on an interaction between the client and the psychoanalyst where both parties are permitted and advised to share their experiences and anxieties.
Targeted Areas of Therapeutic Change
A person-centered approach specifically targets the individual’s perceptions as defined by their experiences. The approach is based on the assumption that an individual’s reaction is purely based on the perceptions created by the experiences and that the individual strives to preserve and heighten these occurrences. Existential therapy specifically targets the anxieties created from an individual’s experiences with the focus being to guide the client through experimental and symbolic means. Gestalt therapy distinctively targets an individual’s sense of awareness and insight with the goal being to help the patient to become aware of his or her experiences and integrate them into his or her life.
Limitations and Weaknesses
The specific limitation of patient-centered therapy is that the therapists tend to be inflexible regarding applying a reflective model. This situation can limit their ability to be real with their clients and instead make them irritable through constant repetition of words while trying to reflect on their clients’ statements. A key limitation of existential therapy is the absence of regard for social factors as a cause of human problems.
Social factors such as racism and poverty are an essential facet that contributes to anxiety. The existential therapy emphasizes reassuring the client by creating a sense of hope that maybe contrary to their existing social reality. The effectiveness of Gestalt therapy is limited to the personality of the therapist since it requires one to have a high degree of self-development.
Case Reflection
Person-centered Therapy
The patient, Ms. Singh, conforms to the assumption that the personality of individuals is greatly determined by their experiences and perceptions. Ms. Singh’s negative experience of abuse, control, and manipulation by her husband has shaped her perception of marriage. However, after her mother’s death, Ms. Singh begins to reminisce about how the mother continued to respect her dad, despite the constant battering by the father.
This experience, triggered by her mother’s death, changes her perception regarding her husband and marriage. Regardless of her reservations about her husband, she admits that she is constantly thinking about him. Ms. Singh’s explanation that she misses her husband is a reflection of the dynamic change in her perception based on her experience with her parents. To tackle this situation, the therapist needs to build an open relationship with the client.
This plan will ensure that the client is comfortable and confident to provide the necessary information regarding her current perceptions of marriage. Such information is vital in discerning the core source of the problem to help Ms. Singh to overcome her negative perceptions of marriage. It will also help her to rebuild her life by finding a new partner to curb her loneliness.
Existential Therapy
Ms. Singh is in a state of anxiety derived from her experience of being abused and manipulated by her husband. The death of her mother has ignited her experience of leaving her husband, thus causing anxiety. Her recollection of her mother’s endurance of her father’s abuse begins to create doubt and anxiety concerning whether she made the right choice of leaving her husband and/or whether he would accept her again.
Therefore, to treat her condition, the therapist needs to understand that her loneliness and the possibility of being alone for the rest of her life is the main source of anxiety. Moreover, the anxiety has been compounded by her fear of getting into an abusive marriage once again. To achieve this end, the therapist needs to foster a relationship with the client to be in a better position of providing hope to her situation. Besides a supportive role, the therapist should portray a symbolic role of hope to the patient by creating a perception of having undergone a similar ordeal and having emerged victorious.
Gestalt Therapy
The patient seems to be a fully unaware and lacking insight into what is happening around her. She does not realize that the death of her mother has ignited a recollection of events from the past that have inspired her desire to find a partner. An important aspect of Gestalt therapy would be making Ms. Singh aware of how other people in her social circle have influenced her condition. Therefore, the goal of the therapy is to help the patient to explore her insight and awareness. By creating awareness, the patient will be able to discern her viable alternatives of either going back to her husband or finding another partner as a solution to curbing her loneliness.
However, this plan will require the therapist to create a good relationship with the patient by paying close attention to the patient’s action during the session. It is also advisable that the therapist should share his or her experiences, including relating them to Ms. Singh’s current situation. This mutual phenomenal approach is essential since both sides of the experiences can be useful in discerning a viable therapeutic solution.
Reference
Wedding, D., & Corsini, R. (2013). Current Psychotherapies. Boston. MA: Cengage Learning.