Transcript Folie 1 - utanet.at

Peter F. Schmid
ACKNOWLEDGEMENT OR
KNOWLEDGE?
A person-centred approach to
psychopathology and diagnosis
Metanoia, London, April 9, 2006
2
I. Personal anthropology:
Authenticity and alienation



Health?
Dis-order?
Healing?
II. Phenomelogical epistemology:
Acknowledgment and knowledge




Not-knowing?
Conceptions?
Disorder-specific knowledge?
Diagnosis?
III. Criteria for a genuine personcentred conceptualization
3
„Don’t ask the doctor,
ask the patient“
Jewish proverb
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I. Personal anthropology:
Authenticity
What is „psychological health“?
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I. Personal anthropology:
Authenticity
Rogers’ personality theory includes social
criticism.
We are not only in relationships;
as persons we are relationships.
A person is independence and
interrelatedness (substantial & relational).
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PERSON
© Peter F. Schmid
1
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I. Personal anthropology:
Authenticity
Rogers’ personality theory includes social
criticism.
We are not only in relationships;
as persons we are relationships.
A person is independence and
interrelatedness (substantial & relational).
A person-centred consideration on what a
“healthy” or “fully function” person is, must
include a theory of social criticism.
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I. Personal anthropology:
Authenticity
To be a person means
to live the process of authenticity.
To live authentically means to be able to
always gain anew the balance between
one’s uniqueness and living together with
the others and the world.
In the “fully functioning person”
self-realization and solidarity coincide.
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“This above all: to thine own self be true,
And it must follow as the night the day,
Thou canst not then be false to any man.“
Shakespeare, Hamlet
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“You shall love your neighbor
as yourself."
Lev 19:18; Mt 22:39
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I. Personal anthropology:
Authenticity
Authenticity is the process of becoming the
author of one’s own life.
in order – dis-order
firm – in-firmity
ease – dis-ease
?
“health / heal”: * “whole”
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I. Personal anthropology:
Authenticity
 To be a person means
to live the process of authenticity.
 Person-centred is process-centred.
 The process is the contents is the meaning.
 Person-centred personality & society theory
starts from a process theory of authenticity,
not from a theory of disorders.
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I. Personal anthropology:
Alienation
What is „inauthentic“?
What does psychological suffering mean?
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I. Personal anthropology:
Alienation
A person becomes inauthentic, if he or she
is alienated from him- or herself and the
others.
Psychological suffering is the result of a
fundamental “self-contradictoriness”.
The “maladjusted person” lacks selfconfidence (sovereignty deficit) and
trust in the others and the world
(relationship deficit).
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I. Personal anthropology:
Alienation
Suffering due to alienation is a signal of a
deficiency or a loss of authenticity.
A psychological symptom is a cry for help.
Symptoms are as manifold as persons and
situations are manifold.
The therapeutic answer is not uniform but
unique.
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I. Personal anthropology:
Alienation
 Inauthentic persons are alienated from
themselves and their others.
 Suffering persons communicate to
themselves and to others by symptoms
that they need help, because their process
of striving towards authenticity failed or got
stuck.
 Process-specific is not symptom-specific.
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I. Personal anthropology:
Therapy
What is the response?
What “helps”?
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I. Personal anthropology:
Therapy
Therapy is the facilitation of personalization
as a process of becoming independent
and of co-creating relationships.
Therapy is personality development through
encounter.
Despite of symptom specifity the therapeutic
answer is always a certain kind of
relationship: encounter.
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I. Personal anthropology:
Therapy
 Person-specific is not symptom-specific
and not disorder-specific, but uniquely
process-specific.
 Disorder-oriented or goal-oriented is not
person-oriented or process-oriented.
 The relationship is always the same and it
is always different: the therapist is
different, if the client is different.
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I. Personal anthropology:
Authenticity and alienation



Health?
Dis-order?
Healing?
II. Phenomelogical epistemology:
Acknowledgment and knowledge




Not-knowing?
Conceptions?
Disorder-specific knowledge?
Diagnosis?
III. Criteria for a genuine personcentred conceptualization
21
„Each experience, which deserves this
name, thwarts an expectation.”
Hans–Georg Gadamer
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II. Phenomelogical epistemology:
Acknowledgment
The epistemological paradigm change of PCT:
In encountering the Other I do not think what I
could know about him or her,
rather I am ready to accept what he or she is
going to disclose.
Acknowledge refers to psychotherapy as the art
of not-knowing.
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ENCOUNTER
The relationship person to person
© Peter F. Schmid
24
II. Phenomelogical epistemology:
Acknowledgment
The epistemological paradigm change of PCT:
In encountering the Other I do not think what I
could know about him or her,
rather I am ready to accept what he or she is
going to disclose.
Acknowledge refers to psychotherapy as the art
of not-knowing.
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II. Phenomelogical epistemology:
Reflection
Personal encounter needs reflection.
Immediate presence is followed by
co-reflection.
The initial encounter transcends into a
personal encounter relationship.
While in the “encounter mode”
categorization is impossible …
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“… the existential encounter is important.
… in the immediate moment of the therapeutic
relationship, consciousness of theory has no
helpful place.
… we become spectators, not players –
and it is as players that we are effective.
… at some other time we may find it rewarding to
develop theories. In the moment of relationship,
such theory is irrelevant or detrimental.
… theory should be tentatively, lightly, flexibly,
in a way which is freely open to change, and should
be laid aside in the moment of encounter itself.”
Carl Rogers, 1962
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II. Phenomelogical epistemology:
Reflection
While in the “encounter mode”
categorization is impossible …,
… in the “reflection mode” we cannot but
use concepts and categories.
We cannot not think,
we cannot not categorize.
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II. Phenomelogical epistemology:
Conceptions
Conceptions are always our own constructs.
We decide what we perceive out of a
pre-understanding.
Conceptions must become explicit in order
to enable their falsification.
Responsibility requires to reflect the
conceptions.
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II. Phenomelogical epistemology:
Knowledge
Existential knowledge is the basis for our
decisions to act.
Knowledge means to be in-form-ed.
Knowledge must be experience-based.
Knowledge must be relationship-based.
Knowledge serves acknowledment.
Comprehension always is knowledge-based;
knowledge in-forms empathy.
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II. Phenomelogical epistemology
Acknowledgment and knowledge
 The task is to personally and professionally
handle the dichotomy of not-knowing and
knowing, acknowledgment and knowledge.
 A personal use of conceptions and theories
does not hinder experience but foster it.
 Therefore it is crucial to decide which
theories we use.
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II. Phenomelogical epistemology:
Disorder-specific?
“It is with some ‘fear and trembling’
that I advance the concept
that the essential conditions of psychotherapy
exist in a single configuration even though the client may use them
very differently.”
Carl Rogers, 1957
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II. Phenomelogical epistemology:
Disorder-specific?
Process-differentiation? Yes.
Process-specificity? Yes.
Disorder-centered concepts? No.
Which knowledge should we use?
We do not yet have a genuinely personcentred systematics.
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II. Phenomelogical epistemology:
Diagnosis?
“It is not stated that it is necessary
that the therapist has an accurate psychological
diagnosis of the client.
Here too it troubles me to hold a viewpoint so at
variance with my clinical colleagues.
The more I have observed therapists, and the
more closely I have studied research, the more I
am forced to the conclusion that such diagnostic
knowledge is not essential to psychotherapy.”
Carl Rogers, 1957
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II. Phenomelogical epistemology:
Diagnosis?
„In a very meaningful and accurate sense,
therapy is diagnosis,
and this diagnosis is
a process which goes on
in the experience of the client,
rather than in the intellect of the clinician.”
Carl Rogers, 1951
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II. Phenomelogical epistemology:
Diagnosis?
Psychological diagnosis can only be a
phenomenological process diagnosis,
not a diagnosis in terms of
symptomatology or etiology.
It is a co-diagnostic process by experiencing
and reflecting which development the
client needs in the process of
personalization.
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II. Phenomelogical epistemology:
Specific training?
The process of becoming a therapist is
personality development through
encounter (as is therapy),
it is not the accumulation of skills, tools,
rules and techniques.
Process-specific training? Yes.
Problem-centred training? No.
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II. Phenomenological epistemology:
Process-specificity
 Does person-centred “disorder”-specific
knowledge exist? Yes.
 Does a person-centred systematic
description of inauthentic processes exist?
Scarcely.
 Does a genuinely person-centred
systematics of process-specificity exist?
No.
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I. Personal anthropology:
Authenticity and alienation



Health?
Dis-order?
Healing?
II. Phenomelogical epistemology:
Acknowledgment and knowledge




Not-knowing?
Concepts?
Disorder-specific knowledge?
Diagnosis?
III. Criteria for a genuine personcentred conceptualization
39
III. Criteria
for a genuine person-centred
conceptualization of different processes
of personality development
1.
2.
3.
4.
5.
6.
7.
on the basis of personal anthropology
phenomenological & close to experience
falsification must be possible
hermeneutic
existential
including social criticism
triggering genuine humanistic research
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Back to the clients ...

... to the challenge to open up and to risk
the co-creation of becoming a unique
relationship and to co-reflect it
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Back to the clients ...

… to further develop the unique stance of
person-centredness, its image of the
human being and its ethics
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Back to the clients ...

… to face the challenge to create an
understanding of ourselves beyond the
categories of order and disorder
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ACKNOWLEDGEMENT
AND
KNOWLEDGE
44
„Don’t ask the doctor,
ask the patient!“
45
more on
pca-online.net
The Person-Centered Website
by Peter F. Schmid
Die personzentrierte Site
Le site centré sur la personne
De Persoonsgerichte Site
Site da Abordagem Centrada na Pessoa
Página Web Centrada en la Persona
Il Sito Internet Centrato sulla Persona
Ο Προσωποκεντρικός Δικτυακός Τόπος