Appunti di Psicologia© - Sezione di Psicoterapia
(Copyright 1995-1996-1997 by Dr. Salvatore Manai)
Un approccio evolutivo alla psicoterapia
A Developmental Approach to Psychotherapy
(edited by J.C. Garelli, E. Montuori and S. Manai)
What do we mean by a Developmental Approach to Psychotherapy?
First of all, we would like to state that when we talk about psychotherapy,
we are practically using it as a synonym of psychoanalytic psychotherapy,
where "psychoanalytic" and "psychoanalysis" are two terms which we strongly
suggest not be taken for granted, particularly nowadays when the proliferation
of psychoanalytic-oriented schools is so vast and pervasive within our
Occidental Society, that it becomes hard to know, let alone accurately
to define what psychotherapeutic practice we are dealing with. Hence, psychoanalysis
and its forms of psychotherapy will be thoroughly discussed on this Appunti
de Psicologia website.
And what we may mean by "developmental"? Practically every psychological
school has its own theory of psychological development, for instance, confront
Freud's views about the development of the libido phases with Melanie Klein's
assertions about schizo-paranoid and depressive positions.
However, it seems that an author could hold principles regarding
a theory of psychological development while using only part, if at all,
during treatment, of the said developmental theory; this is actually rare,
for Mahlerians, e.g., will tend to understand their patients woes as regressions
to autism and symbiosis, Bionians as a departure from K, and an attempt
to use the mental apparatus as if it were a cathartic muscle, and so on.
Furthermore, since any psychological theory has either coined or adopted
a theory of normal and psychopathological development, and heavily rely
on it to build up both a theory of mental health and ill-health and the
contents of its approach within the actual field of psychotherapeutical
practice, it will be our contention throughout that such a theory will
influence what the therapist actually says to his patient and thereby the
effects of such therapies in actual practice.
We contend that all such theories of human psychological development
sustain an inescapable flaw: they cannot be refuted simply because they
have no empirical grounds. The method all of them use is speculation and
extrapolation from present symptoms to normal development during infancy.
That is, they are epistemologically retrospective in nature.
Our approach, contrastingly, is prospective. We set out to observe
mother-infant interactions from birth onwards, study those baby-mother
interactions -in terms that forthcoming articles will shed light on- describe
them and categorize them, predicting which interactions will probably generate
psychopathology by a steady follow-up during years. We rely heavily on
Bowlby's and Mary Ainsworth's studies (as well as our own observations)
to assert that no psychotherapy can be practiced without a good theory
of early psychological development. (As Jules Henri Poincare wittily put
it: "Nothing is more practical than a good theory").
Albeit a psychological community consensus has not as yet been reached
concerning the scientific status of the multifarious theoretical frameworks
still spawning the world -a feature Thomas Kuhn (1962) would label a stage
of "protoscience"- it would not seem irrational to talk about a scientific
approach to a theory of human behaviour. But even if we accept scientific
approaches to human behaviour are available, which would mean they are
liable to be taught and pass from person to person in a more or less unaltered
way, as natural science does, we would still be at a loss about what to
do with them, how to use or implement them functionally to improve reality:
how to help the mentally deranged.
With regard to this last remark, I am afraid we are still in our
infancy. Adopting a benevolent view as regards the state-of-the-art concerning
psychotherapy, the most we can do flawlessly to qualify the practice and
its practicers, is to earmark them as artisans. That is to say, we could
agree with Bowlby (1991) that psychoanalysis should be viewed as an art
and as a science.
Unfortunately, psychotherapy can only be carried out tailor-made,
theoretical generalizations are totally out of place at a psychotherapist's
consulting-room. For the time being, since every and each patient faces
us with widely different problems, we try to understand his particular
situation, but cannot help resort to our theoretical generalizable conceptualizations.
And as mentioned above, there is little consensus which ideas are shared
by all the scientific community. This lack of consensus; moreover, this
constant fight about fundamentals, renders psychotherapy, and for that
matter, any discipline, non-scientific.
We would like this brief introduction set up a comfortable ambience
to encourage contributions and discussions. Please, send comments to either:
garelli@attach.edu.ar (J.C.
Garelli) or eliana@attach.edu.ar
(E. Montuori)
Comments, as well as contributions are welcome in three languages,
Italian, English and Spanish.
|