An Application of Concepts of Existential Psychotherapy to Art Therapy

Humanistic and existential psychotherapies use a broad range of approaches to case conceptualization, therapeutic goals, intervention strategies, and inquiry methodologies. They are united by an emphasis on understanding human experience and a focus on the client rather than the symptom. Psychological problems (including substance abuse disorders) are viewed as the consequence of inhibited ability to brand authentic, meaningful, and self-directed choices most how to live. Consequently, interventions are aimed at increasing client self-awareness and self-agreement.

Whereas the key words for humanistic therapy are acceptance and growth, the major themes of existential therapy are client responsibility and freedom. This chapter broadly defines some of the major concepts of these two therapeutic approaches and describes how they can be practical to brief therapy in the treatment of substance corruption disorders. A short case illustrates how each theory would arroyo the client's issues. Many of the characteristics of these therapies have been incorporated into other therapeutic approaches such as narrative therapy.

Humanistic and existential approaches share a belief that people accept the capacity for cocky-awareness and selection. Yet, the two schools come to this belief through unlike theories. The humanistic perspective views human nature as basically good, with an inherent potential to maintain healthy, meaningful relationships and to brand choices that are in the interest of oneself and others. The humanistic therapist focuses on helping people free themselves from disabling assumptions and attitudes so they can live fuller lives. The therapist emphasizes growth and self-actualization rather than curing diseases or alleviating disorders. This perspective targets present conscious processes rather than unconscious processes and past causes, but like the existential approach, it holds that people have an inherent capacity for responsible self-direction. For the humanistic therapist, non being ane's truthful cocky is the source of problems. The therapeutic relationship serves equally a vehicle or context in which the procedure of psychological growth is fostered. The humanistic therapist tries to create a therapeutic human relationship that is warm and accepting and that trusts that the client'southward inner drive is to actualize in a salubrious direction.

The existentialist, on the other hand, is more interested in helping the client find philosophical meaning in the face up of anxiety by choosing to call up and act authentically and responsibly. According to existential therapy, the cardinal problems people face are embedded in feet over loneliness, isolation, despair, and, ultimately, death. Creativity, love, authenticity, and gratis will are recognized every bit potential avenues toward transformation, enabling people to alive meaningful lives in the confront of uncertainty and suffering. Everyone suffers losses (e.g., friends die, relationships finish), and these losses cause anxiety because they are reminders of human limitations and inevitable death. The existential therapist recognizes that human influence is shaped by biology, culture, and luck. Existential therapy assumes the belief that people's problems come from not exercising choice and judgment enough--or well plenty--to forge meaning in their lives, and that each individual is responsible for making significant out of life. Outside forces, however, may contribute to the individual'southward limited power to exercise choice and live a meaningful life. For the existential therapist, life is much more of a confrontation with negative internal forces than information technology is for the humanistic therapist.

In general, brief therapy demands the rapid formation of a therapeutic alliance compared with long-term treatment modalities. These therapies accost factors shaping substance corruption disorders, such as lack of meaning in ane'southward life, fear of death or failure, alienation from others, and spiritual emptiness. Humanistic and existential therapies penetrate at a deeper level to issues related to substance corruption disorders, often serving as a catalyst for seeking alternatives to substances to fill the void the client is experiencing. The advisor's empathy and acceptance, as well as the insight gained past the client, contribute to the customer'south recovery by providing opportunities for her to make new existential choices, beginning with an informed decision to use or abstain from substances. These therapies tin add for the customer a dimension of cocky-respect, cocky-motivation, and self-growth that will improve facilitate his treatment. Humanistic and existential therapeutic approaches may exist specially appropriate for short-term substance corruption treatment because they tend to facilitate therapeutic rapport, increment self-awareness, focus on potential inner resources, and establish the client every bit the person responsible for recovery. Thus, clients may be more probable to see beyond the limitations of short-term handling and envision recovery as a lifelong process of working to accomplish their full potential.

Because these approaches endeavour to accost the underlying factors of substance abuse disorders, they may not e'er direct confront substance abuse itself. Given that the substance abuse is the principal presenting problem and should remain in the foreground, these therapies are most finer used in conjunction with more traditional treatments for substance abuse disorders. Nonetheless, many of the underlying principles that have been adult to support these therapies can be applied to almost any other kind of therapy to facilitate the client-therapist relationship.

Using Humanistic and Existential Therapies

Many aspects of humanistic and existential approaches (including empathy, encouragement of touch, reflective listening, and acceptance of the client's subjective experience) are useful in any type of brief therapy session, whether information technology involves psychodynamic, strategic, or cerebral-behavioral therapy. They aid establish rapport and provide grounds for meaningful engagement with all aspects of the treatment process.

While the approaches discussed in this chapter comprehend a broad diverseness of therapeutic interventions, they are united by an emphasis on lived feel, authentic (therapeutic) relationships, and recognition of the subjective nature of human being experience. In that location is a focus on helping the client to understand the ways in which reality is influenced by past experience, present perceptions, and expectations for the future. Schor describes the process through which our experiences presume meaning equally apperception (Schor, 1998). Becoming aware of this process yields insight and facilitates the power to choose new ways of being and acting.

For many clients, momentary circumstances and problems surrounding substance abuse may seem more pressing, and notions of integration, spirituality, and existential growth may be too remote from their immediate experience to be effective. In such instances, humanistic and existential approaches can aid clients focus on the fact that they exercise, indeed, brand decisions about substance abuse and are responsible for their own recovery.

Essential Skills

By their very nature, these models do not rely on a comprehensive ready of techniques or procedures. Rather, the personal philosophy of the therapist must be congruent with the theoretical underpinnings associated with these approaches. The therapist must exist willing and able to appoint the client in a genuine and authentic style in society to help the client make meaningful alter. Sensitivity to "teachable" or "therapeutic" moments is essential.

When To Utilise Brief Humanistic and Existential Therapies

These approaches can exist useful at all stages of recovery in creating a foundation of respect for clients and mutual acceptance of the significance of their experiences. There are, nonetheless, some therapeutic moments that lend themselves more readily to one or more specific approaches. The details of the specific approaches are laid out later in this chapter. Client-centered therapy, for example, can be used immediately to establish rapport and to clarify problems throughout the session. Existential therapy may be used most finer when a client is able to access emotional experiences or when obstacles must be overcome to facilitate a client'due south entry into or continuation of recovery (e.thou., to become someone who insists on remaining helpless to take responsibleness). Narrative therapy may be used to help the client conceptualize treatment as an opportunity to assume authorship and begin a "new affiliate" in life. Gestalt approaches can also be used throughout therapy to facilitate a genuine encounter with the therapist and the customer'south own experience. Transpersonal therapy tin can raise spiritual development by focusing on the intangible aspects of human experience and awareness of unrealized spiritual capacity. These approaches increase cocky-awareness, which promotes self-esteem and allows for more than client responsibility, thus giving the client a sense of command and the opportunity to make choices. All of these approaches can exist used to back up the goals of therapy for substance corruption disorders.

Duration of Therapy and Frequency of Sessions

Although many aspects of these approaches are found in other therapeutic orientations, concepts similar empathy, meaning, and choice prevarication at the very middle of humanistic and existential therapies. They are specially valuable for brief treatment of substance corruption disorders because they increase therapeutic rapport and enhance conscious feel and acceptance of responsibleness. Episodic treatment could be designed within this framework, with the treatment plan focusing on the client's tasks and experience between sessions. Humanistic and existential therapies assume that much growth and change occur outside the meetings. When focused on broader bug, these therapies can exist lifelong journeys of growth and transformation. At the same fourth dimension, focusing on specific substance abuse issues can provide a framework for change and more detached goals. These techniques will as well work well in conjunction with other types of therapy.

Initial Session

The opening session is extremely important in cursory therapy for building an alliance, developing therapeutic rapport, and creating a climate of common respect. Although the approaches discussed in this chapter accept different means of addressing the client's problems, the opening session should endeavour the following:

• Beginning to develop the alliance

• Emphasize the client's freedom of choice and potential for meaningful change

• Articulate expectations and goals of therapy (how goals are to be reached)

Developing the brotherhood can be undertaken through reflective listening, demonstrating respect, honesty, and openness; eliciting trust and conviction; and applying other principles that sally from these therapies. The therapist's accurate manner of encountering the client can set the tone for an honest, collaborative therapeutic relationship. Emphasizing freedom of choice and potential for meaningful modify may exist deepened by a focus on the electric current conclusion (withal it has been reached) to participate in the opening session. Expectations and goals can be articulated through strategic questions or comments like, "What might exist accomplished in treatment that would assistance yous live better" or "Y'all now face the selection of how to participate in your own substance corruption recovery."

Because of time constraints inherent in approaches to brief substance corruption treatment, the early stage of therapy is crucial. Unless the therapist succeeds in engaging the client during this early phase, the treatment is likely to exist less effective. "Engaging" includes helping the client increment motivation for other aspects of substance abuse treatment such as grouping therapy. Moreover, the patterns of interaction established during the early phase tend to persist throughout therapy. The caste of motivation that the customer feels after the first session is determined largely by the degree of significance experienced during the initial therapeutic encounter. A negative experience may keep a highly motivated customer from coming back, whereas a positive feel may induce a poorly motivated client to recognize the potential for treatment to be helpful.

Compatibility of Humanistic And Existential Therapies and 12-Step Programs

Humanistic and existential approaches are consistent with many tenets of 12-Step programs. For instance, existential and humanistic therapists would embrace the significance stressed past the "repose prayer" to have the things that cannot be changed, the courage to change what can be changed, and the wisdom to know the difference. However, some would argue against the degree to which Alcoholics Anonymous (AA) identifies the person'due south "disease" as a key grapheme trait, or the mode in which some might interpret the notion of "powerlessness." The principles of existentialism, free choice, and gratuitous will may announced incompatible with the 12-Step philosophy of acceptance and surrender. Yet, such surrender must result from conscious decisions on an individual's part. The AA concept of rigorous self-assessment--of accepting ane's own personal limitations and continually choosing and rechoosing to act according to certain principles as a way of living life--are uniform with both existential and humanistic principles.

Research Orientation

The predominant research strategy or methodology in social scientific discipline is rooted in the natural science or rational-empirical perspective. Such approaches generally attempt to identify and demonstrate causal relationships by isolating specific variables while decision-making for other variables such every bit personal differences among therapists as well as clients. For example, variations in behavior or outcomes are ofttimes quantified, measured, and subjected to statistical procedures in order to isolate the researcher from the data and ensure objectivity. Such strategies are particularly useful for investigating observable phenomena like behavior. Traditional approaches to understanding human experience and meaning, however, have been criticized as an insufficient means to understanding the lived reality of human feel. Von Eckartsberg noted, "Science aims for an ideal world of dependent and independent variables in their causal interconnectedness quite abstracted and removed from personal experience of the everyday life-world" (Von Eckartsberg, 1983, p. 199). Similarly, Blewett argued, "The importance of human experience relative to behavior is beyond question for experience extends beyond beliefs just as feeling extends beyond the concepts of language" (Blewett, 1969, p. 22). Thus, traditional methodological approaches seem sick-suited for understanding the meaning of man experience and the process by which self-understanding manifests itself in the context of a therapeutic relationship.

A humanistic science or qualitative approach, which has its roots in phenomenology, is claimed to exist more appropriate for the complexities and nuances of understanding human experience (Giorgi, 1985). The personal and unique structure of meaning, the importance of such subtleties equally "the human relationship" and the "fit" in therapy, and shifts in internal states of consciousness tin be quantified and measured simply in the broadest of terms. A more subtle scientific discipline is required to describe humans and the therapeutic procedure.

Rather than prediction, control, and replication of results, a humanistic scientific discipline approach emphasizes understanding and description. Instead of statistical analysis of quantifiable data, it emphasizes narrative descriptions of experience. Qualitative understanding values uniqueness and diversity--the "little stories" (Lyotard, 1984)--as much every bit generalizability or grander explanations. More often than not, this approach assumes that objectivity, such as is presumed in rational empirical methods, is illusory. For the qualitative researcher and the therapist, the goals are the same: openness to the other, active participation, and sensation of i's own subjectivity, rather than illusory objectivity. Intersubjective dialog provides a means of comparison subjective experiences in lodge to find commonality and difference as well as to avoid researcher bias.

Because humanistic and existential therapies emphasize psychological process and the therapeutic human relationship, alternative research strategies may exist required in order to understand the necessary and sufficient conditions for therapeutic change. For example, Carl Rogers "presented a challenge to psychology to blueprint new models of scientific investigation capable of dealing with the inner, subjective experience of the person" (Corey, 1991, p. 218). Some 50 years ago, he pioneered the use of verbatim transcripts of counseling sessions and employed audio and video taping of sessions long before such procedures became standard practice in inquiry and supervision.

The Humanistic Approach to Therapy

Humanistic psychology, often referred to as the "third strength" also behaviorism and psychoanalysis, is concerned with human potential and the individual's unique personal feel. Humanistic psychologists generally practise not deny the importance of many principles of behaviorism and psychoanalysis. They value the awareness of antecedents to behavior as well every bit the importance of childhood experiences and unconscious psychological processes. Humanistic psychologists would argue, still, that humans are more than the drove of behaviors or objects of unconscious forces. Therefore, humanistic psychology ofttimes is described as holistic in the sense that it tends to be inclusive and accepting of various theoretical traditions and therapeutic practices. The emphasis for many humanistic therapists is the primacy of establishing a therapeutic relationship that is collaborative, accepting, authentic, and honors the unique world in which the client lives. The humanistic approach is also holistic in that it assumes an interrelatedness between the client'southward psychological, biological, social, and spiritual dimensions. Humanistic psychology assumes that people have an innate capacity toward self-understanding and psychological wellness.

Some of the key proponents of this arroyo include Abraham Maslow, who popularized the concept of "cocky-appearing," Carl Rogers, who formulated person-centered therapy, and Fritz Perls, whose Gestalt therapy focused on the wholeness of an individual's experience at whatsoever given moment. Some of the essential characteristics of humanistic therapy are

• Empathic understanding of the client'due south frame of reference and subjective experience

• Respect for the client's cultural values and freedom to exercise option

• Exploration of issues through an authentic and collaborative approach to helping the client develop insight, backbone, and responsibleness

• Exploration of goals and expectations, including articulation of what the customer wants to attain and hopes to gain from treatment

• Clarification of the helping office by defining the therapist'due south office but respecting the self determination of the client

• Cess and enhancement of client motivation both collaboratively and authentically

• Negotiation of a contract by formally or informally asking, "Where do we go from here?"

• Demonstration of actuality by setting a tone of genuine, authentic run into

These characteristics may prove useful at all stages of substance corruption handling. For instance, emphasizing the choice of seeking help as a sign of courage tin can occur immediately; placing responsibility and wisdom with the client may follow. Respect, empathy, and authenticity must remain throughout the therapeutic relationship. Placing wisdom with the client may be useful in later stages of handling, simply a customer who is currently using or recently stopped (within the final 30 days) may non be able to make reasonable judgments about his well-beingness or time to come.

Each therapy blazon discussed below is distinguished from the others by how it would respond to the case written report presented in Figure 6-1 .

Box

Effigy 6-i: A Case Study. This instance written report will be referred to throughout this chapter. It will provide an example to which each type of humanistic or existential therapy will be applied. Sandra is a 38-year-onetime African-American woman who has abused (more than...)

Client-Centered Therapy

Carl Rogers' client-centered therapy assumes that the client holds the keys to recovery but notes that the therapist must offer a relationship in which the client tin can openly notice and test his ain reality, with genuine understanding and credence from the therapist. Therapists must create three atmospheric condition that help clients modify:

1. Unconditional positive regard

2. A warm, positive, and accepting attitude that includes no evaluation or moral judgment

3. Accurate empathy, whereby the therapist conveys an accurate understanding of the customer's world through skilled, agile listening

According to Carson, the client-centered therapist believes that

• Each private exists in a private world of feel in which the individual is the center.

• The most basic striving of an individual is toward the maintenance, enhancement, and actualization of the cocky.

• An private reacts to situations in terms of the way he perceives them, in ways consistent with his self-concept and view of the globe.

• An individual's inner tendencies are toward wellness and wholeness; under normal conditions, a person behaves in rational and effective ways and chooses pathways toward personal growth and self-appearing (Carson, 1992).

A client-centered therapist focuses on the client's self-actualizing core and the positive forces of the customer (i.eastward., the skills the client has used in the by to deal with sure problems). The client should also empathise the unconditional nature of the therapist's credence. This type of therapy aims not to interpret the client's unconscious motivation or conflicts but to reflect what the customer feels, to overcome resistance through consequent acceptance, and to assist replace negative attitudes with positive ones.

Rogers' techniques are specially useful for the therapist who is trying to accost a substance-abusing client's denial and motivate her for further treatment. For example, the techniques of motivational interviewing draw heavily on Rogerian principles (encounter TIP 35, Enhancing Motivation for Change in Substance Abuse Treatment [CSAT, 1999c], for more data on motivational interviewing).

Response to the case study

A client-centered therapist would engage in reflective listening, accepting the client and her by, and clarifying her current situation and feelings. As Sandra developed trust in the therapist, he would begin to emphasize her positive characteristics and her potential to make meaningful choices to go the person she wants to (and can) become. Some other goal of therapy would be to assist her develop sufficient insight so that she tin brand choices that reflect more than closely the values and principles to which she aspires. For example, she may desire to tell her hubby almost her symptoms and try to strengthen her marriage.

If Sandra began to feel guilt most her past every bit a prostitute, the therapist would demonstrate appreciation of her struggle to have that aspect of herself, highlighting the fact that she did eventually choose to leave it. He may note that she did the all-time she could at that fourth dimension and underscore her current commitment to choose a better life. Sandra would be supported and accepted, not criticized. She would be encouraged to express her fearfulness of death and the issue this fear has on her. This might be the showtime time in her life that someone has been unconditionally accepting of her or focused on her strengths rather than her failings. She apparently has the ability to solve issues, which is reflected by her return to therapy and her insight nearly needing help. Past being understood and accustomed, her self-esteem and sense of hope would increase and her shame would decrease. She would feel supported in making critical choices in her life and more confident to resume her recovery.

Narrative Therapy

Narrative therapy emerges from social constructivism, which assumes that events in life are inherently ambiguous, and the ways in which people construct meaning are largely influenced past family, civilisation, and social club. Narrative therapy assumes that people's lives, including their relationships, are shaped by linguistic communication and the knowledge and pregnant contained in the stories they hear and tell virtually their lives. Recent approaches to agreement psychological growth have emphasized using storytelling and mythology to enhance self-sensation (run across Campbell, 1968; Feinstein and Krippner, 1997; Middelkoop, 1989).

Parker and Horton argue that "Studies in a diversity of disciplines accept suggested that all noesis is inherently metaphorical" and note "the vital function that symbolism plays in perception" (Parker and Horton, 1996, p. 83). The authors offer the "perspective that the universe is made up of stories rather than atoms" and suggest, "Myth and ritual are vehicles through which the value-impregnated beliefs and ideas that we live by, and for, are preserved and transmitted" (p. 82). From this perspective, narratives reveal a deeper truth nigh the meanings of our experience than a factual account of the events themselves. As Feinstein and Krippner note, "Personal mythologies give meaning to the past, understanding to the nowadays, and management to the future" (Feinstein and Krippner, 1997, p. 138).

When people tell and retell their life stories (with the assistance of a therapist), the stories evolve into increasingly meaningful and healing constructions. As narrative therapists listen to the stories clients tell, they assist them by identifying alternative ways of agreement events in their lives. Thus, they assistance clients to assume authorship of their lives in order to rewrite their stories by breaking patterns and developing new solutions. Narrative therapy helps clients resolve their problems by

• Helping them become aware of how events in their lives have assumed significance

• Allowing them to distance themselves from impoverishing stories by giving new meaning to their past

• Helping them to encounter the problem of substance abuse every bit a split, influential entity rather than an inseparable office of who they are (note the discrepancy between this and the AA member's statement, "My name is Jane, and I am an alcoholic")

• Collaboratively identifying exceptions to self-defeating patterns

• Encouraging them to challenge destructive cultural influences they take internalized

• Challenging clients to rewrite their ain lives co-ordinate to alternative and preferred scripts

Narrative therapy can be a powerful approach for engaging clients in describing their lives and providing them with opportunities to proceeds insight into their life stories and to change those "scripts" they notice defective. Storytelling is a way of articulating a subjective, experiential truth, and it is important for the therapist and client to become aware of the significance of the story existence told and its potential therapeutic value.

Narrative approaches to psychological healing accept been used across various cultures for thousands of years (Katz, 1993), only they have often been overlooked by mainstream mental health professionals. Gimmicky approaches to narrative therapy recognize the importance of understanding how human being experience becomes meaningful. A person's life is influenced by the narratives he constructs, which are in plough influenced past the narratives of those around him. Thus, therapy is viewed as a collaborative endeavor to increase clients' awareness of the ways in which events in their lives become significant. In effect, the therapist says, "Let'due south be curious most your story together."

The narrative approach often involves posing questions in a way that situates the problem equally an external influence. "When the problem is externalized, it's as if the person can peek out from behind information technology" (Nichols and Schwartz, 1998, p. 412). In substance abuse handling, for instance, a customer might be asked, "How has substance abuse influenced your life?" or "Accept in that location been times when you did not let addiction to take over?" Such questions tin can help place positive aspects and potential resources occurring in people'due south narratives that tin be enhanced, likewise every bit deficits that must be overcome.

In an try to be understood, clients sometimes tell a story as a way of educating the therapist to their culture or lifestyle. Therefore, it is essential for the therapist to appreciate the unique influences (positive and negative) of the customer'southward specific cultural experiences and identity. Often these stories practice not institute sharing in its usual meaning. When listening to them, one may sense that these stories accept been told repeatedly over the years. It is through this sense of storytelling--as oral history--that we reveal our values, expectations, hopes, and fears. For the therapist, a story provides insight into the clients' responses, their need to act on the responses, and their desire to be heard or understood. A story can become a mode for a client to become both participant and observer in gild to find new solutions or break down barriers.

Response to the case written report

The therapist may initially ask Sandra to draw some of the important transitional moments in her life. These may include examples of loss of innocence occurring early in her life, her experience of schoolhouse, circumstances and influences surrounding prostitution and drug utilize, the experience of being supported past her husband, and internal resources that enabled her to enter treatment and maintain sobriety. The therapist would inquire questions about expectations she felt from family, gild, and herself. She may be asked questions similar, "How did habit interfere with your attempts to be a practiced mother" or "How has fear contributed to your contempo relapse and feelings of hopelessness?" Positive aspects of her story and exceptions to destructive aspects of her narrative could exist identified by request questions similar, "Were there times that you lot didn't permit habit to make choices for you?" and "How has your ability to accept dear and support from your married man helped you?"

The focus of therapeutic dialog could then shift toward developing alternatives to hopeless aspects of personal and cultural expectations. It would be helpful to remind her that contempo advances in medical treatments hateful that AIDS may not be the death sentence it was one time thought to be. Other important questions can help her to begin to create an culling story: "As you begin to empathize the positive and negative influences in your life, what qualities must you lot possess in order to remain sober and develop better relationships with your married man and children?" She may need assistance replacing these stories with more positive narratives about herself. As Sandra talks near the people and events in her life, such equally her childhood and her children, she tin discover some of her feelings, as well as the personal significant in her story. She tin experience a great deal of healing through the therapist's feedback and questions that uncover the desires and emotions beneath her story. A connected focus on identifying, practicing, or fifty-fifty imagining changes in her story can brainstorm the process of developing new means of living.

Transpersonal Therapy

Transpersonal psychology emerged every bit a "fourth force" in psychology in the tardily 1960s and has strong roots in humanistic and existential psychologies, Jungian assay, the Eastward-West dialog, and ancient wisdom traditions. Transpersonal therapy may be idea of as a span betwixt psychological and spiritual practice.

A transpersonal approach emphasizes evolution of the individual beyond, but including, the ego. Information technology acknowledges the human spiritual quest and recognizes the man striving for unity, ultimate truth, and profound liberty. It cultivates intuitive ways of knowing that complement rational and sensory modes. This arroyo also recognizes the potential for growth inherent in "peak" experiences and other shifts in consciousness. Although grounded in psychological theory, transpersonal practitioners too tend to incorporate perspectives from ancient wisdom traditions.

The do of transpersonal therapy is defined more by its orientation and scope rather than by a item set up of techniques or methods (Boorstein, 1980). Wittine suggests five postulates for a transpersonal psychotherapy (Wittine, 1989):

1. Transpersonal psychotherapy is an approach to healing and growth that recognizes the centrality of the cocky in the therapeutic process.

2. Transpersonal psychotherapy values wholeness of existence and cocky-realization on all levels of the spectrum of identity (i.east., egoic, existential, transpersonal).

3. Transpersonal psychotherapy is a process of enkindling from a limited personal identity to expanded universal knowledge of self.

4. Transpersonal psychotherapy makes use of the healing restorative nature of subjective awareness and intuition in the process of awakening.

5. In transpersonal psychotherapy, the therapeutic relationship is a vehicle for the procedure of enkindling in both client and therapist.

Integrating insights and practices in everyday life is the goal of every therapy. Bringing the transpersonal dimension to the forefront may involve the following:

• Exploration of "inner voices" including those of a college cocky that provides guidance for growth of the private (Rowan, 1993)

• Refinement of intuition or nonrational knowing

• Practice of inventiveness in "formal" (art) or breezy (personal relationships) encounters

• Meditation

• Loving service

• Cultivation of mindfulness

• Use of dreams and imagery

These techniques may be taught and supported explicitly in the therapy session. At times, a therapist may directly cultivate shifts in consciousness (eastward.m., through meditation [Weil, 1972], or imaginal work [Johnson, 1987]), providing immediate insight and inspiration that may non be available through more conventional ways (Hart, 1998). This may provide clients with a skill they tin can practice on their own; initiating such activeness represents a potential for brief intervention.

Transpersonal therapy recognizes the demand for basic psychological development to be integrated with spiritual growth (Nelson, 1994). Without such integration there is danger of "spiritual bypassing," where problems of bones psychological operation are avoided in the name of spiritual evolution. In other words, the basic psychological work should be undertaken first.

Substance abuse disorders may be seen broadly as an endeavor to make full a spiritual void. They may also exist understood as a means for the ego to defend itself against a natural drive for growth. If growth were to occur, the ego might find its authorisation relinquished. Addiction, like spirituality, also raises questions of surrender (May, 1991): for example, to what and to whom do nosotros surrender? In a culture and a psychology that are dominated by issues of rational ego command, what is the function of constructive give up (regularly described in spiritual traditions)? How does constructive give up become destructive and distorted in substance dependency? In addition, substance abuse may be understood every bit a means for shifting out of a normal waking state of consciousness. This may be an endeavour to fulfill an innate drive (Weil, 1972) for nonrational consciousness.

Response to the example study

As the existentialists remind us, at that place is nothing like death to rivet our attending. A glimpse of death--for instance, seeing the aftermath of a serious car crash--reminds the witness of how valuable life is, bringing up other issues as well. Sandra is now confronted with decease due to AIDS. This opportunity to confront death and life squarely provides a run a risk to reconsider and reprioritize her life. In fact, information technology could exist argued that the all-time catalyst to brief therapy may be a death sentence precisely because it has the potential to wake up an individual. In many respects, helping the client wake from habitual, mechanical routines that are often based on ego protection and motion toward an appreciation that the individual is not jump to or defined by a limited ego, is the goal of transpersonal therapy. This tin can be seen every bit a transformation of identity.

Many inspiring instances of people facing death, including death through AIDS, accept shown that emergent spirituality can change the quality and direction of existence very speedily. For handling, the basic sharing of these experiences with a grouping of others in a like predicament often quickly moves the client across isolation and a sense of self-separateness to connect intimately with others who understand her situation. This community may not only bring comfort and back up simply also a deep sense of communion with humanity. In this example, breaking through the shell of isolation may enable Sandra to brainstorm to brand new connections with her family and with herself. A sense of interconnection, a key postulate and experience in the wisdom traditions, may supercede her perceived isolation.

Sandra may utilise this opportunity of facing possible death to begin to run across and permit get of such feelings as guilt, shame, disappointment, and anger that have kept her life less satisfying than it could be. Accessing the imaginal through art or dreams, for case, can provide a clear and symbolic expression of unresolved issues. The use of rituals or rites-of-passage inspired by the wisdom traditions tin provide some catalyst for shifting her consciousness through forgiveness and release.

The therapist may engage in a wide variety of methods (e.g., imagery, art, or dream work, meditation, rituals), but the heart of the piece of work is in the elementary and humane spirituality that is embodied by the therapist's loving presence along with the therapist's openness to explore the full range of human feel direct. For Sandra, this experience may be seen equally an opportunity for practicing beloved and forgiveness, moving out from behind rigid self-separateness, facing fears, and transforming her self-definition.

Gestalt Therapy

Gestalt theory holds that the assay of parts can never provide an understanding of the whole. In a therapeutic setting, this arroyo opposes the notion that human being beings can be understood entirely through a rational, mechanistic, scientific process. The proponents of Gestalt therapy insist that the experiential world of a customer tin be understood only through that private's straight feel and description. Gestalt therapists seek to assistance their clients proceeds awareness of themselves and the world. Discomfort arises from leaving elements and experiences of the psyche incomplete-- primarily past relationships and intrapsychic conflicts that are unresolved, which Perls calls "unfinished business concern" (Perls, 1969). According to Gestalt theory

• The organism should be seen equally a whole (physical beliefs is an important component, every bit is a client'southward mental and emotional life).

• Being in the "here and now" (i.e., being aware of nowadays experience) is of primary importance.

• How is more important than why (i.east., causes are not as important as results).

• The individual'south inner experience is central.

• For Gestalt therapists the "power is in the present" (Polster and Polster, 1973). This ways that the "now" is the only place where sensation, responsibility, and change can occur. Therefore, the process of therapy is to help the client brand contact with the present moment.

Rather than seeking detailed intellectual analysis, the Gestalt therapist looks to create a "condom emergency" in the therapeutic come across. Perls' invocation to "lose your mind and come to your senses" implies that a feeling-level, "here and at present" feel is the optimal condition for therapeutic piece of work. This may be achieved in a fairly short corporeality of time by explicitly asking clients to pay attention (e.thou., "What are you aware of now? How does your fear feel to you?"). The therapist may point out how the client could be avoiding the present moment through inauthentic "games" or ways of relating such every bit "talking virtually" feelings rather than experiencing them straight. Clients may be asked to exaggerate certain expressions (east.g., pounding a fist) or role-play sure internal dialogs (e.grand., through an empty chair technique). These may all serve the goal of helping clients move into the immediacy of their feel rather than remaining distant from it through intellectualization or substance abuse.

The term contact in Gestalt refers to meeting oneself and what is other than oneself. Without appropriate contact and contact boundaries at that place is no existent meeting of the world. Instead, one remains either engulfed by the globe on i hand or, on the other manus, distant from the world and people.

Substance corruption interrupts the menstruum of what Perls chosen "organismic cocky-regulation." The result is that individuals do non achieve satisfaction of their needs and can remain unaware of what their needs are. The substance abuser may misconstrue or thwart the natural cycle at any of the following points:

• Experiencing the demand

• Mobilization of free energy

• Contact

• Satisfaction

• Withdrawal

• Remainder

Treatment involves bringing awareness to each of these dimensions and the client's strategies of avoidance.

Substance abuse may also be understood as "introjection" in which the customer attempts to "swallow whole" or "drink in" his environs without contact and discrimination. This blazon of client bypasses and blocks other experiences that might enable contact and the evolution of bigotry. Perls maintains that such a customer seeks firsthand confluence without preparatory contact. This design of interaction extends to other relationships (too the substance) as well.

In club for this work to proceed, the therapist must maintain a fine-tuned, nowadays-moment immediacy, even serving every bit a "resonance chamber" (Polster and Polster, 1973) for the client's feel. They, besides, must be able to brand and sustain contact with the client and with their ain reactions.

Response to the case study

The Gestalt therapist begins with Sandra's electric current experience of the world, starting with awareness and attending. The therapist may just assist her become aware of basic sights, sounds, somatic reactions, feelings, and thoughts likewise as what her attention drifts to. The immediate contact between therapist and client is a component of the "now" where these sensations are explored directly. The therapist might notice and ask about her manner of eye contact, or her fidgeting trunk, or stream of thoughts (east.k., "What is it like to make middle contact now? What is the sensation in your torso at this moment?").

Sandra may as well identify certain problems such as substance abuse, human relationship difficulties, and the threat of decease from AIDS that seem to dominate her life. The therapist might invite her to name and explore the sensation that the thought of decease, for example, brings; perhaps this involves a sense of a void, or feeling cold and dark, or a feeling of engulfment. She and then may exist asked to become these sensations--for example, the therapist may ask her to be "the void" and encourage her to speak equally if she were that void. This may then open possibilities for a dialog with the void through interim out the opposite polarity: separateness and choice. This might involve using an empty chair technique in which the client would literally movement into the chair of the "void," speak equally if she were that, and then move into an opposite chair and respond in a dialog. A therapist could also explore her introjection through questions such equally, "How is this void different or the same as from the feeling of alcohol or in relationships with your children or husband?" She might also use this same technique to dialog with family unit members, or certain aspects of herself.

Sandra seems to have a great deal of "unfinished business" that involves unexpressed feelings (e.thousand., anger, longing, hurt). Experimentation with these sensations may begin to gratuitous her to express and meet these feelings more directly. All of this work encourages Sandra's experimentation with new ways of relating both during and exterior of the session in social club to move into the "here and now" and work toward the resolution of "unfinished business."

The Existential Approach To Therapy

The existential approach to therapy emphasizes the following six propositions:

1. All persons have the capacity for self-awareness.

2. Equally costless beings, everyone must take the responsibility that comes with liberty.

3. Each person has a unique identity that tin can just be known through relationships with others.

4. Each person must continually recreate himself. The pregnant of life and of beingness is never fixed; rather, it constantly changes.

5. Anxiety is part of the homo status.

6. Decease is a basic human condition that gives significance to life.

The core question addressed in existential therapy is "How do I be?" in the confront of uncertainty, conflict, or death. An individual achieves authenticity through courage and is thus able to define and notice his own meaning in the present and the future. There are important choices to be made (e.k., to accept true freedom and to take responsibility for one's life, one must face up uncertainty and requite upwardly a false sense of security).

A core feature of the existential view is that an individual is a "being in the world" who has biological, social, and psychological needs. Existence in the globe involves the physical earth, the earth of relationships with others, and one's own relationship to self (May and Yalom, 1995, p. 265). The "authentic" individual values symbolization, imagination, and judgment and is able to use these tools to continually create personal meaning.

Existential therapy focuses on specific concerns rooted in the individual's existence. The contemporary existential psychotherapist, Irvin Yalom, identifies these concerns as expiry, isolation, liberty, and emptiness. Existential therapy focuses on the feet that occurs when a client confronts the conflict inherent in life. The role of the therapist is to assistance the customer focus on personal responsibility for making decisions, and the therapist may integrate some humanistic approaches and techniques. Yalom, for example, perceives the therapist as a "fellow traveler" through life, and he uses empathy and back up to elicit insight and choices. He strongly believes that because people exist in the presence of others, the relational context of group therapy is an constructive arroyo (Yalom, 1980).

Preliminary observations and research bespeak individuals with depression levels of perceived meaning in life may exist prone to substance abuse as a coping machinery. Frankl kickoff observed this possibility amid inpatient drug abusers in Federal republic of germany during the 1930s (Frankl, 1959). Nicholson and colleagues plant inpatient drug abusers had significantly lower levels of pregnant in life when compared to a group of matched, nonabusing control subjects (Nicholson et al., 1994). Shedler and Cake performed a longitudinal study and institute that lower levels of perceived life meaning among immature children preceded substance abuse patterns in boyhood (Shedler and Block, 1990).

In the context of treating substance corruption disorders, the existential therapist often serves as a coach helping the client confront the anxiety that tempts him to abuse substances. The customer is then focused on taking responsibility and making his ain choices to remain substance gratis. If he chooses to avert the anxiety through substances, he cannot movement forrard to find truth and actuality. The claiming for the existential therapist is to help the client brand personal decisions about how to live, drawing upon inventiveness and love, instead of letting outside events make up one's mind behavior.

Fourth dimension and Existential Therapy

Although existential therapy may not take been designed for practice in a time-limited fashion, its underlying principles relating to the client'southward struggle for meaning in the face of death tin be applied to a time-express setting. Cursory therapy (no matter what the modality) must be concerned with the "here and now." Both existential and cursory therapies are also concerned with the limitations of time. Hoyt suggests that in brief therapy time should e'er be an issue for word, and the therapist should make a point of reminding the client of his utilise of time and the time scheduled for terminating therapy (Hoyt, 1995).

Mann's model of fourth dimension-limited psychotherapy (Mann, 1973; Mann and Goldman, 1994), although based in part on psychodynamic theory, also uses an existential arroyo to the primacy of time. In Mann's approach, the fourth dimension limitation of cursory therapy is emphasized to help the customer confront bug of separateness and isolation. This facilitates the customer's becoming engaged in and responsible for the process of recovery.

Response to the example report

An existential therapist may assist Sandra understand that her diagnosis of AIDS forces her to confront the possibility of death and, consequently, face the responsibilities thrust upon her by life. The therapist could achieve this by helping her empathise that her life (like everyone else'southward) is finite. Therefore, she is challenged to forge pregnant from her life and make difficult decisions near her relationships and ways of dealing (or not dealing) with choices well-nigh substance corruption. The focus in her therapy would be on choosing the life she wants to live. The therapist would help her in dealing constructively with feet so that she tin can notice pregnant in the rest of her life. This could be accomplished past engaging her in the struggle to assume authorship of her choices. She may be encouraged to "play out" scenarios of choices she faces and admit the accompanying fears and anxieties. She might exist asked, "What keeps you lot from sharing your fears with your husband, and accepting the possibility of his support?" or "Imagine yourself expressing your love for your children and regret for the mistakes you accept made." Thus, the therapist would assistance her understand that making difficult choices in the face up of death is actually a fashion to discover integrity, wholeness, and significant.

The teachings of the existential therapist, Yalom, can be a useful resources in dealing with problems related to decease, since he has worked with terminally ill cancer patients for many years, helping them to utilise their crisis and their danger as an opportunity for change (Yalom, 1998). Yalom explains that although death is a primary source of anxiety for a customer, incorporating death into life can enrich life and allow one to live more purposefully.

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Source: https://www.ncbi.nlm.nih.gov/books/NBK64939/

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