Introduction
Psychotherapy has an interesting history of evolution beginning from the days when it was part of biology. Phenomenology, a term first expressed by Edmund Husserl in Germany in the mid-1980s, has been defined as “Stumpf’s introspective method that examined experience as it occurred and did not try to reduce experience to elementary components” (Schultz and Schultz, 2008). The analysis is not done in this method as this approach to knowledge relies on an unbiased description of immediate experience as it occurs. This philosophical reflection has been used for research purposes in psychology. The entry into the psychology of this philosophy has allowed the evolution of realistic phenomenology which is associated with human actions, motives, and selves. Different philosophers have added different aspects to the subject. The philosophy of Law was added by Adolf Reinach and the aspects of ethics, value theory, religion, and philosophical anthropology have been added by Max Scheler. Existential phenomenology is related to action, conflict, desire, and oppression. Gestalt psychology has been associated with existential philosophy.
Cultural psychology is another aspect of the discipline which has a role to play in all psychological approaches. The relationship between culture and mind is significant in all scientific studies of the mind. Culture is essential for human experiences. Cultural psychology is a study of the human mind through a study of cultural products. Structuralism and functionalism were the early schools of thought of psychology. Structuralism surfaced when psychology was separated from the discipline of biology and philosophy. It was first advocated by Wilhelm Wundt but his student E.B. Titchener is considered as the founder of this entity which deals with conscious experience (Schultz and Schultz, 2008). Functionalism followed structuralism. Functionalism is a system of psychology concerned with the mind as it is used in an organism’s adaptation to its environment. It was formed as a reaction to structuralism. Mental processes were explained in a more accurate manner and systematically. Instead of focusing on consciousness, the purpose of consciousness was considered. Individual differences were also thought about. Psychotherapy has evolved so much that many approaches are prevalent. The Logan case has been taken up for case study in this paper.
The Case
When Logan was in his last year of college he realized that he was spending more and more time studying for his classes. His new habit was a time-consuming and worrying one. His notes never seemed to be perfect; writing and rewriting his notes till they achieved perfection conveyed the impression that he was industrious to onlookers but the reason for the extra hours of work was totally different. Logan’s hard work paid off in school and he graduated in the top five percent of his class.
Majoring in Psychology, he accepted a job working with troubled teens after graduation. Extremely ambitious and hopeful of making it, Logan persevered in his job. However, people at the facility he worked with observed his eccentricity of taking too much time to complete his assignments. Their doubts were justified: Logan was checking and rechecking his work for no obvious reason. He spent more than a week on a job that should have taken 2 hours. Though he realized that extra time was being consumed, he could not stop himself from rechecking. When his probation period was over, the company let him go.
Logan’s problems
Logan is an over-anxious person who has recurrent or persistent thoughts and ideas. These ideas have become uncontrollable. Repetitive behaviors are evident in him. The repeated checking is an obvious feature of his compulsions. He is actually responding to an obsession. Logan may be driven to compulsions as compensation for reducing anxiety or discomfort. Aiming for perfection, he believes that redoing things may produce a better result.
Treatment possibilities for Logan
Behavior therapies
Behavior therapies can be understood through two theories: the classical conditioning theory and the operant conditioning theory. Classical conditioning is explained by the stimulus-response and the stimulus-stimulus theories. Operant conditioning involves an alteration of conduct due to influences of the environment. The social learning theory indicates that a person learns from observing others. Cognitive behavior therapy allows for more flexibility in application and is a good response to the distress of the patient (Merrick and Dattilio, 2006). The concepts of the development of schemas or cognitive beliefs are woven into the therapy. This therapy has inputs from gestalt therapy where exposure to the environment has affected thought, emotion, and behavior. Human existential concepts also can be found. When working with families, concepts of systems theories are also incorporated (Merrick and Dattilio, 2006).
Logan can have cognitive behavior therapy which is time and cost-effective. It would allow him to return to his job as early as possible. Practically it integrates comfortably with other modes of treatment if the necessity for a combination of therapies has arisen (Merrick and Dattilio, 2006). Logan may need to have pharmacotherapy along with his CBT. Cognitive behavior therapy can be easily combined with pharmacotherapy because goals are short-ranged and the focus is on human biochemistry (Merrick and Dattilio, 2006). Cost-effective treatments are better administered due to the shortage of trained therapists and the increase in hospital costs. The biological and physiological causes of anxiety disorders, depression, and psychotic illnesses can all be addressed by cognitive behavior therapy. A common ground approach is possible with CBT. The CBT model elaborates Logan’s personal experience, personality, knowledge, clinical acumen, and cultural sensitivity (Merrick and Dattilio, 2006). It is a combination of strengths from theory, methodology, and scientific outcomes. The therapist would be able to use practice that is open-minded and firmly grounded with CBT. The threat of territoriality is reduced as the CBT merges with most therapies (Merrick and Dattilio, 2006)
Rational behavioral emotive therapy is one type of CBT that would be good for Logan. The approach would be problem-focused and goal-oriented. It would be structured in nature and presented in a logical manner (Dryden, 2001). It is also an educational approach to counseling and psychotherapy. The focus is on the present as well as the future and is skills-focused. Logan must be convinced that he will be helped to change his beliefs. He will be shown to understand the healthy and unhealthy negative emotions towards negative events (Dryden, 2001). The healthy alternative to a disturbing emotion is pointed out. Feeling options are introduced to Logan and he selects one that he feels would help him in the long run. Logan will be guided to set his own goals. Behaviors that go against the grain are discouraged. Those who help him to achieve his goals would be encouraged. He would be helped to develop a realistic view without any thinking distortions (Dryden, 2001). Interpersonal and problem-solving skills would be introduced so that Logan becomes more affectionate, friendly, and capable. Logan is first of all convinced about the irrationality of his beliefs (Dryden, 2001). Then he must be taught to develop a level of emotional insight. Strengthening his conviction in rational beliefs, Logan must be guided towards believing them. Psychotherapy helps him to change but Logan must feel adequate to do it himself. Even if Logan respects the therapist, he may not be ready for changing his irrational beliefs. Only if he does that, will he begin his passage to good health. With REBT, Logan would be able to recognize and understand his unreasonable, unrealistic, and self–defeating thoughts. He develops the ability to logically avoid the unhealthy construct and thereby future dejection (Sharf, 2008).
Gestalt therapy
Gestalt theory believes that personality is a result of different interdependent traits that work together to form an integrated human being (Koffka, 1999). The traits which work in a synchronized manner are physical, mental, emotional, and spiritual. When the mixing of traits occurs, a completely different trait can result. If a person wants to analyze his traits, he has to study all the aspects of his personality. Emergence, reification, multi-stability, and invariance are the principles of the therapy (Sternberg, 2003). An interaction between the organism and the environment constitutes the basis of the therapy. The search for the desired object by the organism is represented by the sensory activity. Motor activity indicates the finding of the object and its assimilation. Following both is the attaining of equilibrium. When the object has been assimilated, a state of equilibrium is reached.
Every perception is interpreted as a figure projected against a background. Gestalt therapy produces the development of the continuum of awareness. Logan will be facilitated by the therapist to increase awareness of himself. Some people block the awareness if disgusting. Defense mechanisms are expressed as intellectualization or escapades into the past. Other coping strategies could be denial or deflection. The environment affects every part of the organism whether externally or internally; this is explained as the concept of boundaries. Neuroses occur at the boundary. A cure following psychotherapy indicates that the process of reconstruction of the physiological system and resultant restoration of equilibrium is established (Gobar, 1968). Helping Logan to become aware of his feelings, perceptions, thoughts, desires, fears, and body processes, or in one word, his personality, the therapist can change his thoughts and attitude towards life (Sharf, 2008).
Psychoanalysis
Analytic psychotherapy includes the conscious and unconscious elements of the human psyche (Goldenberg and Goldenberg, 2008). The goals of psychotherapy would be reintegration, self-knowledge, and individuation associated with awareness, responsibility, and a connection to the transcendent. “Psyche is the combination of spirit, soul, and idea” (Goldenberg and Goldenberg, 2008). Jung proposed that perceptions are determined by what a person is. Psychotherapy involves the use of the psyche which is a self-regulating system, the unconscious which is a creative and compensatory part, the doctor-patient relationship which facilitates self-awareness and healing, and the personality growth occurring over the lifetime (Goldenberg and Goldenberg, 2008). A disturbance in the patient’s equilibrium causes neurosis. These are traced by the psychoanalyst back to the origins. Logan may have some secret that could have affected him and it would be elicited by the therapist in this treatment method. The process of psychotherapy would include confession when Logan’s personal history would be totally revealed, elucidation where the infantile origins would be identified, education where Logan would be moving into the stage of an adopted person with a health-promoting behavior, and the last stage of transformation when greater knowledge and insight further improves Logan. (Goldenberg and Goldenberg, 2008).
Conclusion
The cost-effective cognitive behavior therapy appears to be a good or the best method to bring Logan out of his illness as it allows for the inclusion of other therapies without creating a chaotic situation. Even pharmacotherapy can be associated. The shorter duration and speedier recognition of the problem or the time-effectiveness would permit Logan to return to normal life as early as possible. The range of Logan’s symptoms of anxiety and repetitive actions can be changed with CBT. Of the CBTs, rational behavioral emotive therapy seems to be suited to Logan’s illness. This problem-focused and goal-oriented therapy would have an educative approach too. Logan also is empowered to participate in his therapy by deciding what feelings of his he is going to develop as healthy alternatives to his previous ones. His convictions and emotional insights are strengthened. Logan would learn how to prevent his earlier symptoms from returning. Gestalt therapy and psychoanalytic therapy are also effective methods but not as competitive where Logan is concerned.
References
Dryden, W. (2001). The reason to change: A rational emotive behavior therapy. New York: Brunner-Routledge.
Gobar, A. (1968). Philosophic foundations of genetic psychology and gestalt psychology. The Hague: Martins Nilboff.
Koffka, K. (1999). Principles of Gestalt Psychology, Routledge.
Merrick, P.L. & Dattilio, F.M. (2006). The contemporary appeal of cognitive behavior therapy New Zealand Journal of Psychology, Vol. 35, Issue 3, New Zealand psychological Society.
Schultz, D. P., & Schultz, S. E. (2008). History of psychology. Cengage Learning: Mason, OH.
Sharf, R. (2008). Theories of counseling and psychotherapy: Cases and concepts, Belmont, C.A.
Sterberg, R. (2003). Cognitive psychology, 3rd Ed, Thomson Wadsworth.