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Psychological Therapy

:	Klaus Grawe
:	Psychological Therapy
:	Hogrefe Publishing
:	9781616762179
:	1
:	CHF 60.30
:

:	Angewandte Psychologie
:	English

:	656
:	Wasserzeichen/DRM
:	PC/MAC/eReader/Tablet
:	PDF

The original edition of Klaus Grawe's book exploring the basis and need for a more generally valid concept of psychotherapy fueled a lively debate among psychotherapists and psychologists in German-speaking areas. Now available in English, this book will help spread the concepts and the debate among a wider audience. The book is written in dialog form.

A practicing therapist, a research psychologist, and a therapy researcher take part in three dialogs, each of which builds on the results of the previous dialog. The first dialog explores how therapeutic change takes place, while the second looks at how the mechanisms of action of psychotherapy can be understood in terms of basic psychological concepts. Finally, in the third dialog, a psychological theory of psychotherapy is developed.

The practical implications of this are clearly shown in the form of case examples, as well as guidance on indications and treatment planning. The dialog ends with suggestions as to how therapy training and provision of psychotherapy could be improved on the basis of the model of psychotherapy that has been developed.

Part 3: Determinants of Experience and Behavior (p. 267-268)

2.27 Who Controls Our Mental Life?

To address the question of which motives drive mental processes I would like to return to the first part of this conversation where I introduced you to Powers’ control theory. Powers termed the seventh regulation level of the control hierarchies the"program level." This is the level where our intentions are implemented into reality. Staying with the terminology we used in the first dialogue, one could also call this level the"realization level." It is the level of intention realization.

Our wishes need not adhere to the conditions of reality. Similar to our thoughts, they may transcend the restrictions of time and space, the possible and the impossible. Thoughts and wishes are free. Unfortunately, this is also true of fears. They also need not halt at the conditions of reality, but oftentimes exceed what may realistically, or is likely to occur.

For wishes to be realized they have to pass through the bottleneck of reality. For optimal realization they have to be transferred into a mode of psychological functioning which is tightly in tune with the actual real life conditions. Freud termed this functional mode the"secondary process," differentiating it from the primary-process-related mental functioning, which does not stick to the restrictions of the possible, such as our dream life, for instance. Secondary processes are connected to the waking consciousness.

In their conscious realization, wishes become concrete goals and intentions, and from intentions, they turn into plans and actions. We experience goal setting, planning, decision making and action as something that we ourselves control. But who is this"our selves?" Who am I? Can we also control our own wishes and fears ourselves? We all experience this differently. Wishes and fears emerge spontaneously. At times, we can push or chase them away, but we do not experience them as generated by us in the form of a consciously set goal. Even our emotions are usually not experienced by us as something we ourselves generated. We experience them as a part of us, but not, or at least only partially, as a subject of our conscious control. The same applies for our perceptions and memories. They are also experienced by us as something controlled by whatever is perceived and recalled, and not as something that we essentially created ourselves. We are able to consciously direct our attention towards something, and in doing so feel that we influence what we perceive. Yet whatever we perceive within the focus of this attention, we perceive as something set, as something that is not controlled by us, but by the"actual" situations. What we experience is for us"the" reality.

Yet, we know from what we discussed before that at least our perceptions, memories and emotions are, to a large extent, controlled by ourselves and not just by the external situations, such as the emotions for example, which are controlled by our goals and appraisals."The" reality is thus"in reality" one largely created by ourselves in line with our neural activation tendencies. Included in those are predominantly also motivational tendencies. Our experience, our subjective reality, is a goal-controlled interpretation of the"objective" reality independent from us. The experience or feeling of our self is blind to this self-contributed portion.

Another important constituent of our feeling of self is the consciousness that I am the originator of my actions and cognitions. As I now sit before you, I know that I could raise the index finger of my right hand if I chose to. I also know that I could willingly direct my attention to this or that, that I could bring to mind my workroom at home, or where I had my last vacation, or that I could even think about the Pythagorean theorem.

If I imagine raising my index finger right now, an EEG electrode appropriately placed in the area of the cortex responsible for this movement would actually demonstrate on an electroencephalograph the appearance of a so-called"activation potential" (Kornhuber& Deecke, 1965) several hundred milliseconds prior to beginning the movement. The same happens if I only imagine this movement, but do not actually follow through with it. What triggers this activation potential preceding the movement? As the originator of my actions, I naturally presume that it was triggered by my decision. This presumption is, however, mistaken. In reality, the temporal sequence is exactly the reverse.

	Preface	4
	Prologue	6
	Table of Contents	12
	First Dialogue How Does Psychotherapy Achieve Its Effects?	18
	Part 1: Entering Into Dialogue	20
	1.1 The Participants Present Themselves	20
	1.2 Mysteries of Therapeutic Change	29
	1.3 The Phenomenon of Rapid Improvements at the Beginning of Therapy	32
	Part 2: Psychotherapy Seen From the Expectancy- Value Perspective	34
	1.4 Change of Expectations as a General Change Mechanism in Therapy	34
	1.5 Placebo Effects and Expectancy Induction	38
	1.6 Expectancy Induction and Resource Activation	44
	1.7 The Interplay of General and Disorder-Specific Working Principles	48
	1.8 Each Mental Disorder Has Its Own Disorder-Specific Dynamics: Agoraphobia as an Example	49
	1.9 The Significance of Expectancy-Value Theories for the Understanding of the Mechanisms of Psychotherapy	54
	1.10 Differences in the Mechanisms of Mastery- Versus Clarification- Oriented Therapies	55
	1.11 Therapy This Side and That Side of the Rubicon	65
	1.12 Therapeutic Effects Via Activation and Deactivation of Intentions	71
	1.13 The Formation and Realization of Intentions as Different Goals of Clarification- and Mastery- Oriented Therapies	72
	1.14 Psychotherapy as a Process of Motivational Clarification for the Formation of Clear Intentions	79
	1.15 The Process Aspect of Motivational Clarification	81
	Part 3: Working Mechanisms of Psychotherapy	87
	1.16 The Working Mechanism of Intention Realization	87
	1.17 The Working Mechanism of Intention Modification	88
	1.18 The Working Mechanism of Process Activation	91
	1.19 The Working Mechanism of Resource Activation	94
	1.20 Working Mechanisms Instead of Therapeutic Methods	97
	Part 4: Psychotherapy From the Conflict Perspective	100
	1.21 The Therapeutic Relevance of Motivational Conflicts	100
	1.22 On the Relevance of Corrective Emotional Experiences Regarding Unconscious Conflicts	103
	1.23 On the Mechanisms of Cognitive Therapies Under the Conflict Perspective	105
	1.24 On the Integrative Potential of the Cognitive Therapy Approach	107
	1.25 On the Relevance of Motivational Conflicts for Mental Disorders — Agoraphobia as an Example	109
	1.26 Conflict Dynamics as a Task of Empirical Research	114
	Part 5: Psychotherapy From the Relationship Perspective	119
	1.27 The Significance of Interpersonal Relationships for Psychotherapy	119
	1.28 The Therapeutic Relationship From the Aspect of Process Activation	119
	1.29 The Therapeutic Relationship From the Problem Perspective	121
	1.30 The Therapeutic Relationship From the Resource Perspective	125
	1.31 On the Interpersonal Nature of Human Mental Life	127
	1.32 On the Working Mechanisms of Interpersonal Therapies	128
	1.33 On the Mechanisms of Couples Therapy	130
	1.34 On the Mechanisms of Family Therapy	136
	Part 6: Summary and Conclusions	142
	1.35 The Multiple Meanings of What Happens in Therapy and Their Consequences	142
	1.36 Indication and Case Conception in a General Psychotherapy	148
	Second Dialogue Towards a Psychological Understanding of How Psychotherapy Works Or: Foundations of Psychological Therapy	156
	Part 1: Mental Processes From a Systems Perspective	158
	2.1 Experience, Behavior and Unconscious Processes in Psychology and Psychotherapy	158
	2.2 A Systems Conception of the Interaction between Behavior, Experience and Unconscious Processes	163
	2.3 The Interplay of Conscious and Unconscious Processes on the Higher Levels of Psychological Activity	172
	2.4 On the Simultaneity of Conscious and Unconscious Processes and Their Significance for Understanding Mental Processes	176
	2.5 On the Functional Role of Conscious Mental Processing	178
	2.6 Linking the Systems Conception with the Rubicon Model	183
	Part 2: Foundations of Experience and Behavior	188
	2.7 Perception as an Active Construction Process	188
	2.8 The Neural Basis of Perception	193
	2.9 No Perception Without Expectation	198
	2.10 Memory as the Sum of All Expectation