1. Discuss the four general psychotherapeutic strategies according to Victor Raimy. Raimy focused on the misconception of self. The first strategy is the expression of emotion hypothesis (what will help people is to have them express their emotions (psychodrama, Gestalt, emotion-focused family therapy, scream therapy, and existential)?). Second is the redistribution of energy hypothesis (similar to Freud's view of energy is that a person only has so much energy, and it should be expended positively). Third is the behavior change hypothesis (ways to help clients change their behavior. Fourth is the misconception hypothesis (if ideas or conceptions relevant to the psychological problems are changed, then maladjustments will be decreased or eliminated), and this one has led to various cognition theories.

2. Discuss personality as seen by Raimy (a cognitive therapist). People act as they do because they think as they do (cognition).

3. Discuss the causes of problems from Raimy's point of view. The causes of problems are misconceptions or thoughts that are not correct. First is their content, which are usually clustered around a few central themes and important content of cognitions that cause difficulties that differ with each therapist. Misconceptions persist because of isolation from awareness (people isolate them, or they are unconscious and isolated from their awareness), selective attention (people choose to not examine them), overlearning (practiced cognitions until they become automatic), defense against them (to bend one's thinking around them), and self-fulfilling prophesy (thinking oneself worthless will cause someone to behave in a worthless fashion).

4. Discuss the theory of therapy from Raimy's point of view. First, the therapist must work on the therapeutic relationship to keep people in therapy and allow for confrontation of misconceptions. Second, the therapist must try to create a therapeutic alliance to allow people to be motivated to work on the problem. Third, they should work on discovering the client's misconceptions. There are many methods for doing this. Looking at inappropriate emotions and contradictory emotions to what is going on around them are two of the most important methods to see that something is not right. They can look at misconceptions that are specific and concrete, often obscured by defensive misconceptions, and clustered in groups around a common theme. Fourth, they should work on goals to discover and change crucial misconceptions that control undesirable behaviors.

Fifth are methods of changing misconceptions (eclectic). Naive rationalism tries to explain the misconception to the patient and assume they will change (teacher's fallacy), but this is not cognitive and only works in about 1% of the cases. More effective approaches are self-examination, which is helping the client stay focused and discover their own misconceptions (Carl Rogers). Explanation is where the therapist teaches through therapeutic forms of references (confrontation, reflection of feeling, and questions). Self-demonstration is helping client participate in situations where they can observe themselves (homework, role play, analysis of transference, and an expression of countertransference). Vicariation is when the therapist empathizes with a model or role plays fixed role therapies.

Sixth is the client's part in changing misconceptions, which is a cognitive review of what goes on inside and outside of therapy. Seventh is progress, which is a quality and quantity of insights (an insight is recognizing and changing an ineffective misconception).

5. Discuss personality as seen by George Kelly (a cognitive therapist). Personality is based on personal constructs, which are ways that we perceive reality that are used to predict and control our world (every person is a scientist). An example is the way two things are alike but different than a third. Freud, Kelly, and Meichenbaum can be used in this example. Kelly and Meichenbaum are both clean shaven, but Freud has a beard. Kelly and Meichenbaum emphasized cognitive thinking, and Freud focused on the unconscious.

6. Discuss the causes of problems from Kelly's point of view. Personal constructs are used repeatedly in spite of consistent invalidation (people construct their own constructs, and they must be assessed to identify them). Invalidating experiences threaten the construct system. This threat produces anxiety, which is defended against by symptoms or defenses.

7. Discuss the theory of therapy from Kelly's point of view. Therapy happens in two phases. First is the controlled elaboration of constructs, which get the person to talk about how they see themselves and the world. Second is changing constructs, where the therapist tries to invalidate inappropriate constructs and replace with appropriate constructs (out with the bad and in with the good).

8. Discuss the methods of therapy from Kelly's point of view. The methods are, first, controlled elaboration, which consists of self-characterization (get the person to talk about self to see how they see themselves (RET test)), prescribed activities such as homework or role play where the client describes self, and confrontation (the therapist points out instances where the client says "x" but does "y"). The second method is an invalidation of old constructs and a replacement by a new one.

This can be done by the use of fresh elements, which is an unbinding of old constructs and getting into situations that are new and less threatening, by experimentation, by imposing recent structures on old elements (explain the past in terms of the new conceptual system - every mode of therapy does this), by the therapist acting as a validator (if you stand up, you probably will not fall. Also, validate new ways of thinking while invalidating the old ways of thinking), and by delimiting old constructs to impermeability (the things of the old self are not appropriate for the new self. This applies to Christians, too).

Using fresh elements might take the form of a novel approach (create an instance that is new), analogy (may have picked the only rotten apple in the bunch, so try again), metaphor (new stories to get point across), personal experiment (can open a client up to listen to the therapist), and personal anecdote. With experimentation, the therapist can recommend the trying of different behaviors (fixed role therapy) based on the happiness equation (happiness = performance / expectations), use role playing to have the client practice the new behavior, and imaginal rehearsal.

				Tom of Bethany

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Lesson 17. Cognitive Theories: Ellis

 

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