Psychotherapy Essay

1693 words - 7 pages

The aim of psychotherapy is to encourage self-awareness and self-evaluation in order to enable transformation and facilitate possibility. It is this self-evaluation process that is crucial to personal agency (McKay, 1987) and integral to psychodynamic therapy (PDT) and cognitive behavioural therapy (CBT). This essay will critically evaluate cognitive behavioural and psychodynamic theories regarding self-awareness and self-evaluation and explore ways in which these theories and their understanding of self may be utilised within clinical hypnosis.
CBT and rational emotive behaviour therapy REBT (Ellis, 1955) rely on self-reflection and evaluation in order to achieve success. CBT utilises the stimulus -response (SR) model (Pavlov, 1903). Reflexive response to stimulus (Gross, 2005) becomes modified to stimulus –cognition- response (SCR) (Beck, 1967). This introduces a reflective element, similar to the input- processing -output schema found in the computational model of the mind (Putman, 1961, 1988; Fodor, 1979). Decision-making and rationality (Jones and Pulos, 1993) are employed in order to negotiate knowledge of internal influence. Once this knowledge is perceived cognitions are evaluated and reassessed before rational alternatives are generated (Ellis, 1962). Thereby introducing the possibility of transformation. CBT is most effective with anxiety disorders (Beck et al 1985; Schoenberger et al, 1997; Brown 2007) and eating disorders (Baker and Nash, 1987; Griffiths et al, 1996). Meta analysis also supports the use of CBT with depression (Gaffan, Tsaosis, Kemp-Wheeler, 1995; Butter and Beck, 2000). However, whilst some studies suggest that CBT is most effective when used alone i.e. without drugs (Marks, Swinson, Basoglu, Kuch, Noshirvani, O’sullivan et al, 1993) later research suggests otherwise (Hollon, Jarret, Nierenberg, Thase, Triveldi and Rush, 2005). This could suggest that drugs may be useful in order to achieve chemical stabilization within the brain, providing an ‘even playing field’ for therapy.
In CBT the use of hypnosis facilitates self-change by enhancing cognitive, behavioural and perceptual flexibility (Schoenberger, 2000; Yapko, 2001). Furthermore, hypnosis aids learning (Kroger, 1977) and may be utilised in order to abbreviate repetition and reduce treatment length as well as enhancing visualisation imagery, receptivity, comfort and security. During hypnosis neurological processing abilities are more powerful (Fromm, 1992; Nash, 1992). Therefore, employing a variety of senses, allows the patient to experience therapy on a deeper level e.g. hallucinations (Edgette and Edgette, 1995). Incorporating sensory manipulation, in order to manage internal dialogue and modifying thought patterns e.g. visualising the word ‘stop,’ enhances the effect of CBT. Suggestions may be given to change the colour or shape of thoughts, or reframe to a more appropriate context (Wazlawick, Weakland and Fisch, 1974). Furthermore, suggestions may be...

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