International Dictionary of Psychotherapy

Giorgio Nardone, Alessandro Salvini, Giorgio Nardone, Alessandro Salvini

• Publisher: Routledge
• Year: 2019
• Print ISBN: 9780367110932
• eBook ISBN: 9780429656163
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The International Dictionary of Psychotherapy is a systematized compendium of the numerous psychotherapies that have evolved over the past 30 years. With contributions from over 350 experts in the field, it highlights the diverse schools of psychotherapy, tracing their histories and traditions, while underlining their specific strengths in dealing with human behaviours, feelings and perceptions in the contemporary world.

The book traces eight principal paradigms: psychodynamic, behavioural, existential-humanistic, body-expression, systemic-relational, cognitive, interactional-strategic and eclectic. It presents to the expert and non-expert reader an array of models that grew from a specific paradigm, sharing the same fundamental epistemology and therapeutic strategies. This is accomplished through a reader-friendly approach that presents clear definitions of the key constructs of each paradigm, and transversal concepts that are common to the diverse practices of psychotherapy.

The International Dictionary of Psychotherapy provides a clear picture of the numerous types of psychotherapeutic treatments and their applications, while offering a close examination of the efficacy and evaluative methods developed as a result of numerous debates and research carried out within the psychotherapeutic community.

It represents an essential resource for psychotherapeutic and psychoanalytic practitioners and students, regardless of background or creed.

DICTIONARY ENTRIES A–Z

A

ABC MODEL

In the context of cognitive-behavioural therapy, a pattern of interpretation of behaviours and beliefs and of their recurrence. In the behavioural version of ABC, A corresponds to the antecedent, B to the → behaviour and C to the consequences (and → reinforcements). Behaviour analysis (→ clinical behaviour analysis) consists of a detailed assessment of antecedents (A) and consequences (C) of a disturbing behaviour (B). In the cognitive version of ABC, A corresponds to the antecedent, B to the beliefs and C to the emotional and behavioural consequences. Cognitive ABC focuses on the cognitive component (→ cognition) that stands between an antecedent (event) and its emotional and behavioural consequences. [G. Palmieri].

REFERENCES. Beck A.T., Cognitive therapy of depression, 1979.

ABOUTISM

In Gestalt therapy, it is a defensive attitude aiming to “turn things around”, especially those causing great anxiety, rather than address them directly. It can be noticed that most of the → defence mechanisms, also analyzed by Freud, are connected to an avoidance attitude (negation, repression, displacement, etc.). In the words of Perls: “avoidance is the main characteristic of neurosis and concentration it is obviously its corrective opposite [. . .] the function of psychotherapy is to help the patient to listen to those facts that he hides to himself”. Beyond the perhaps excessive expectations given by the father of Gestalt to this attitude – as evidenced by expressions such as “Look at your thoughts, your emotions: whatever they are, they are yours, it is you; through the close contact with a neurotic symptom you will be in a position to dissolve it” – the process of change that is determined in an individual, through the exercise of awareness, is undeniable. The price is obviously connected with the emergence of unpleasant contents (Zerbetto writes: “it is often necessary to go through hell and not to go around it”). This indication evokes the paradigm of a process of self-knowledge, which is symbolically represented in the story of Oedipus – the hero who did not stop in front of the danger of “Know thyself”, up to its final consequences – as well as in Dante’s journey, which involves descent into the deepest hell and then leads to the prelude of “then we came forth to see again the stars”. In fact, it is all about “stepping into the black holes of consciousness”, from where we tend, instinctively, to run away. [R. Zerbetto, R. Sciaky]

REFERENCES. Perls F., Ego, hunger, and aggression, 1942; Zerbetto R., Gestalt: la terapia della consapevolezza, 1998.

ABREACTION

This concept, born with Freud’s Studies on Hysteria, expresses the idea of an emotional discharge capable of releasing the → affect linked to the memory of a traumatic event, which, having the possibility to move freely, does not acquire the characteristics of a fossilized pathogenic nucleus. The → cathartic method, in which abreaction occupies a central position, expresses the possibility of transferring the affect that has remained unconscious in a narrative, “purifying” it, in this way, from its traumatic part. The excitation phenomena, produced during traumatic events, will find their resolution (abreaction) in the use of language that frees the patient from the reminiscences of what he experienced. “Man finds a substitute for this action in speech through which help the affect can well-nigh be abreacted” (Freud, Studies on Hysteria, 1895, p. 180). Freud adds that the persistence of traumatic memories, even after many years, is explained by observing that “the reason why the pathogenically formed presentations retain their freshness and affective force is because they are not subject to the normal waste through abreaction” (ibid., p. 182). [M. Balsamo]

REFERENCES. Breuer, J., Freud, S. (1895), Studies on hysteria, in The Standard Edition, II, 1953–1974.

ABSTINENCE

In psychotherapy, this term has different meanings depending on the paradigm of reference. For example, the psychodynamic perspective focuses on sexual abstinence, while abstinence from food is relevant in the treatment of eating disorders and abstinence from experiences considered as dangerous is highlighted in the treatment of phobias. Therefore, the term abstinence refers to a voluntary induced or forced conduct consisting in giving up something that would be desirable. Abstinence can be pathogenic but also desirable as an element of wellbeing or as escape from certain diseases. [R.]

ABUSE

A physical and/or psychological coercion aimed at influencing other people’s freedom of action and thought, and exerted to obtain material, social, sexual or moral subjugation. The attempt to adopt and obtain control and power over other people can be expressed either directly or through conduct aimed implicitly at amplifying an already existing hierarchy. The phenomenon may concern different contexts and situations – such as family, school, workplace – and it can be repeated over time assuming the form of → mobbing, stalking, bullying. Several authors have pointed out that the harmful health effects may result both from direct and indirect experiences: an individual may be victim of a violent incident in person, or witness violent incidents or become aware of violent incidents, death or harm caused to another person. Such experiences may have important consequences for their health, leading to the development of disorders such as depression, anxiety and social withdrawal.

Abuse against children has been particularly studied. As evidenced by Hart and colleagues, it includes all the affective and cognitive aspects derived from the mistreatment of children such as negligence, omission of attention, aggression or verbal abuse; even emotional mistreatment, attitudes of isolation, denigration, lack of emotional responsiveness, neglect of psychological, medical and educational health, rejection and deprivation fall into this category.

The term abuse is also used in the literature on drug addiction and it defines a particular form of use of psychoactive substance characterized by an increased risk of somatic, affective and psychosocial harm, both for subjects themselves and for other people and society, even without a structured form of addiction, characterized by tolerance towards the psychoactive substance. [R.]

REFERENCES. Buka S.L., Stichick T.L., Birdthistle I., Earls F.J., Youth exposure to violence: Prevalence, risks and consequences, in «American Journal of Orthopsychiatry», 2001, III, 71; Di Blasio P., Psicologia del bambino maltrattato, 2000; Gulotta G., Elementi di psicologia giuridica e di diritto psicologico-civile, penale, minorile, 2000; Hart S.N., Brassard M.R., A major threat to children’s mental health, in «American Psychologist», 1987, 42; Hart S.N., Brassard M.R., Karlson H.C., Psychological maltreatment, 1996; Parquet P.-J., Reynaud M., Lagrue G., Les pratiques addictives. Usage, usage nocif et dépendances aux substances psycho-actives, 1999.

ACCEPTANCE AND COMMITMENT THERAPY

Third-generation model of cognitive-behavioural therapy deriving from a linguistic and semantic theory called Relational Frame Theory (RFT) developed by S. Hayes and his collaborators. The principles of RFT are based on the relationship between thought and language, and on how the representation of things by human beings is deeply influenced by learning through symbolic processes that are no longer recognized as simple relationships derived from verbal stimuli. This causes the domain of language and thought to become so excessive that the body no longer adapts to the demands of the environment, but it is subjected to control through the symbolic representations of the environment itself. In acceptance and commitment therapy, this is referred to as “language hegemony”.

RFT has shown that the human mind is capable of creating entirely arbitrary representations of the past, the present and the future, not based on direct experience. This means that human beings are capable of feeling pain, fear or any other emotion just through the memory of a past event or the imagination of a future event. For example, a person can develop an intense fear of highways without having ever experienced any negative episode or trauma on highways. If the mind is able to create authentic “virtual realities” that are perceived as real, it is not possible to control psychological distress by simply escaping from adverse situations. When facing a problem, the natural tendency of human beings is to check for the cause and to adopt strategies to eliminate it. On the contrary, according to this psychotherapy model, it is precisely the use of control and strategies for the elimination of the problem that, paradoxically, lead to increased suffering and to an apparent loss of control of symptoms that people would, instead, like to eliminate. In particular, the less people are willing to accept having a personal problematic experience, the more they end up producing it. Ironically, the strategies that have produced success in the evolution of the human species in relation to the outside world are the cause of suffering and psychopathology when applied to their inner world, because everything that is reasonably done to address the suffering ends up generating it.

This dysfunctional nucleus of responses has been described by acceptance and commitment therapy in the suffering pattern called FEAR: Fusion, Evaluation, Avoidance, Reason-giving. Fusion: the tendency of human beings to merge with the content of their personal experiences, which leads to the problem of “literality”, that is, the loss of distinction between the symbolic activity and the event that acts as its referent. Evaluation: the tendency to categorize the qualities of referents, as if they were owned by the referents themselves (i.e. “right–wrong”, “good–bad”, “fair–unfair”); through the fusion process, evaluations become inseparable from the real events. Avoidance: human beings are prone to avoid unpleasant situations but, paradoxically, this type of experiential avoidance may stimulate and increase feared or unwanted inner experiences, such as thoughts, feelings, memories or body sensations. Reason-giving: it is the tendency to give reasons that explain the cause of particular forms of personal experience and/or behaviour; this is a growing problem in human dysfunctionality, mainly for two reasons: not only do people have extremely limited access to the multitude of influences that shape the history of their learning, but there is no convincing evidence that personal events are the “cause” of such behaviour.

The aim of this therapeutic model is to intervene on these dysfunctional tendencies by giving more attention to direct experience and reducing the tendency to take all the thoughts and inner catastrophic representations literally. The patient should be led to discover that control and elimination strategies are the causes of suffering, not their treatment; to realize that acceptance and will are viable alternatives to control and attempts at elimination; to understand that acceptance is possible if people learn how to separate themselves from the rules that compose language and thought.

The final result consists in realizing that the road to vitality, to the achievement of purposes and meanings, is a journey that consists in choosing the actions that need to be evaluated, which are executed in the service of the ultimate value of life. Therefore, “acceptance” means accepting one’s own inner experiences without trying to control or explain them, otherwise an aggravation of suffering is produced; “commitment” refers to the ability to choose one’s own behaviour according to one’s own values, regardless of the discomfort caused by one’s own feelings, thoughts and emotional states. In other words, the answer that this model of therapy gives to the limiting effects of FEAR is to: accept, choose, act (ACT, or Accept, Choose, Take action). [R.]

REFERENCES. Hayes S.C., Strosahl K.D., A practical guide to acceptance and commitment therapy, 2004; Hayes S.C., Strosahl K.D., Wilson K.G., Acceptance and commitment therapy: An experiential approach to behaviour change, 1999; Strosahl K.D., Acceptance and commitment therapy, in M. Hersen, W. Sledge (eds.), Encyclopedia of psychotherapy, 2002.

ACT

It is a specific product of action that can be identified as the simplest significant intentional behaviour unit performed by an individual to adjust adaptively their relationship with the cultural, relational and social → environment. In this light, the speech-act theory states that language and communication are expressive behaviours, with an actionable meaning that modifies interpersonal relationships. In particular, a speech act can be examined for what it is said (locution), for the purpose of enunciation (illocution) and for the effects that it determines on onlookers and in the surrounding world (perlocution). In this view, speech acts are linked to the pragmatic conception of human communication that values, in particular, the tangible effects of symbolic interaction. More generally, all the psychosocial literature on suggestion, persuasion and social influence, emphasizes the factual importance assumed by communication within the process of social construction of reality and, in parallel, the construction of social reality.

In the sphere of psychoanalysis, the theory of faulty actions (parapraxes) developed by Freud in the interpretative framework of the so-called psychopathology of everyday life, is also well known. These behaviours (action slips), are the result of a neurotic conflict between norms and social constraints and unconscious drives that free the latter to the detriment of those that the person performing the faulty action defines as their real intentions. Speech acts can also be seen as the pillar of the ritual events that characterize the different social cultures, with particular reference to expressions of religious beliefs and magical practices. In this sense, even obsessive-compulsive disorders can be defined as behavioural syndromes governed by repeated and encoded speech acts that assume a specific regulation role between the person, the significant others and the world. [S. Smiraglia]

ACTING-IN

A typical psychodrama technique consisting in the exploration of a person’s inner world through the transformation of mental images in action on stage: the person (the protagonist) embodies their ghosts on the stage with the help of fellow group members (auxiliary-egos). The acting-in is a sequence of actions called for by the direction of the therapist and is designed to let subjects easily perceive ambiguous, obscure or denied aspects of themselves, in view of the enlargement of their own self-consciousness. This is a proper and productive act when it is appropriate to the representation that is taking place. It is called acting-in as opposed to the more well-known acting-out (→ defence-mechanisms), which indicates an inappropriate act taking place when the person comes out of their embodied role. In a therapeutic approach based primarily on verbal communication, this event occurs when the person uses expressive forms not considered by the setting. [G. Boria]

REFERENCES. G. Boria, Psicoterapia psicodrammatica. Sviluppi del modello moreniano nel lavoro terapeutico con gruppi di adulti, 2005; G. Boria, F. Muzzarelli, Incontri sulla scena, 2009; J.L. Moreno, Psychodrama first volume, 1946; J.L. Moreno, Who shall survive?, 1953.

ACTING-OUT → DEFENCE MECHANISMS

ACTIVATING EVENT

In rational emotive therapy, an acti...

Table of contents

• Cover Page
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of Contributors
• Introduction
• The Eight Paradigms and their Respective Theoretical-Applicative Models
• Therapeutic Paradigms and Their Models
• Dictionary Entries A–Z
• Appendix: Empirical Research in Psychotherapy