Cognitive-Structural Psychotherapy: What It Is And How It Is Used In Patients
Constructivism is an approach in psychotherapy that considers reality not as something true or false, but as something variable, and that gives an active role to the individual in their own experience. Specific, Cognitive-Structural Psychotherapy was born from this approach by Guidano and Liotti
We are going to learn about the characteristics of this type of psychotherapy, which gives an essential role to personal identity in the construction of knowledge about ourselves and the world.
Cognitive-Structural Psychotherapy was created by Guidano and Liotti from the constructivist approach. Constructivist models were born in the 80s.
This approach is based on the way in which people generate knowledge from our experiences It gives a proactive role to the individual in his or her own experience, and in creating unique systems of meaning; Thus, there are as many realities as there are people. In this way, valid knowledge (true or false) cannot be affirmed, but rather viable.
According to this approach, knowledge is interpersonal, evolutionary and proactive It understands reality as a social construction of belief systems and our “realities.” On the other hand, it recovers the role of non-conscious or tacit processes.
On the other hand, constructivism understands the therapeutic relationship from expert to expert.
In Cognitive-Structural Psychotherapy, Guidano and Liotti consider the individual’s cognitive system as a scientific theory that attempts to describe the world (creates models of reality) and himself (progressive self-knowledge creating a model of self). In this way, the knowledge that people have about ourselves involves also knowing what others have about us; The construction of our self includes others and the world (Guidano, 1991). Cognitive-Structural Psychotherapy relates problems to the lack of complexity of the cognitive system.
On the other hand, this type of psychotherapy gives special importance to therapeutic timing that is, when the various techniques are used and when the patient’s different problems are addressed.
On the other hand, Guidano and Liotti used Bowlby’s theory (1969) as a basis and starting point to establish the criteria to distinguish cognitive organizations According to the authors, the origin of individual differences is found in the different development itineraries, which allow describing the structural aspects, cognitive, emotional, behavioral characteristics and strategic processes of each patient.
Levels of self-organization
Cognitive-Structural Psychotherapy establishes two levels of self-organization of knowledge. Personal identity is constituted as an intermediate structure that integrates the two levels. These levels are:
1. Tacit or deep
Is about knowledge integration frameworks derived from early attachment bonds (Bowlby). In relation to Bowlby’s attachment theory, we know that the child recognizes himself through the people around him. Interpersonal relationships are of vital importance for Cognitive-Structural Psychotherapy to create self-knowledge.
2. Explicit, superficial or structural
They are beliefs about oneself, the assessment of one’s own emotions and behaviors, the evaluation of situations, self-esteem, etc. This level is developed from language and involves the construction of models of representation of reality.
Dynamic balance
On the other hand, Cognitive-Structural Psychotherapy proposes the concept of dynamic balance to refer to a dissipative self-organizing process, which encompasses two concepts: an evolution (progressive changes) and processes of maintaining the experience.
The therapy itself consists of overcome imbalances in development (discrepancies) and avoid regressive changes or stagnation To achieve this, two types of changes occur, which are not exclusive:
They are the first to appear. In general, it is not possible to move on to the second (deep) changes without achieving them. These types of changes generally implies alterations in the attitude towards reality, without strongly implying the attitude towards oneself They are generally sufficient to achieve most goals in therapy.
2. Deep changes
They appear later, from the attitude towards the self, that is, towards oneself. Profound changes are usually accompanied by a painful process since the subject carries out important variations in his identity, in the attitudes and beliefs that he had always maintained regarding himself.
It is recommended not to make these types of changes unless the patient requests it and voluntarily assumes the cost in all respects.
Processes in therapy
Thus, and in relation to all of the above, there are two types of processes (first and second level) in therapy:
1. First level processes
We work at the level of tacit or deep organization, that is, in the deep structures of the person’s tacit self-knowledge; these, in turn, are bidirectionally related to the person’s attitude toward himself and the latter with two concepts: self-identity and self-esteem.
These two attitudes end up determining the attitude that the patient has towards reality. The attitude towards reality is formed by the rules of assimilation of experience (how we assimilate what we are experiencing) and by problem-solving procedures.
2. Second level processes
These operate on the explicit structural level, based on two types of models: self models (personal identity) and reality models. The explicit structural level, in turn, acts along with the level processes, on self-identity, self-esteem and, ultimately, the attitude towards reality.
