Systemic Counselling

It was in the year 1885 when Dr. Sigmund Freud started to develop his so-called Psychoanalysis. He started a new idea, that we can talk and work with people with mental health issues. After him came many followers and many approaches. One of them is called Systemic Therapie. Let me give you a quick overview of some of the most potent schools we have today. 

Behavioral therapy: Behavioral therapy assumes that people learn their behavior and experience through experiences in the course of their lives. A mental illness arises when the patterns learned are problematic or inappropriate; for example, by causing suffering to the patient or his surroundings. For example, in the case of an eating disorder, a patient experiences that slim people correspond to the ideal and are perceived as more popular than others. This may result in inappropriate eating habits such as anorexia or bulimia through the effort to live up to this ideal and the fear of gaining weight. The psychotherapist works with the patient to develop new patterns of behavior and experience, which the patient practices using various methods. The goal is to replace the negative patterns with positive ones. Behavioral therapy is a thought- and action-oriented, problem-related form of therapy.

 

Analytical psychotherapy: This therapy goes back to Sigmund Freud, is based on a theory of normal and pathological behavior and is the oldest form of psychotherapy. In the course of time, various variants of this type of psychotherapy have developed, but they largely agree in your understanding of the development of mental illnesses. The aim of analytical psychotherapy is to raise awareness of repressed feelings and memories that block the development of a healthy, independent individual. According to the theory of neuroses, the causes and solutions for current problems are to be found in the unconscious and in the patient’s past. In the course of therapy, the patient should relive the conflicts of formative development phases in order to process them. This is done in the systematic analysis of transference and countertransference. Commonly used methods are, for example, free association or dream interpretation. With this type of therapy, 2-3 sessions per week often take place lying down. The psychotherapist behaves neutrally in order to serve as a projection surface for the patient’s emotions, so he usually sits in such a way that he is not visible to the patient. The patient should have the ability and willingness to perform self-analysis so that psychoanalytic therapy can be successful.

 

Depth psychology: This form of psychotherapy has developed from psychoanalytic therapy. The underlying view of man as well as an understanding of how mental illnesses arise are similar: Psychotherapy, which is based on depth psychology, also assumes that the current problems are based on an internal psychological conflict. However, psychotherapy based on depth psychology focuses on the treatment of the so-called “central conflict” and uses this as a basis to look for possible causes in the patient’s personality or past. The patient should seek changes in his or her experience or behavior through insights into the relationships and causes of his problems, with the psychotherapist actively supporting him.

 

Conversational psychotherapy – Carl Rogers: This form of therapy belongs to the humanistic approaches and is also referred to as “client-centered”. The focus is not only on the patient’s symptoms or development history, but also on people as a whole in their living environment. It is based on a concept of man, since every person strives for self-fulfillment and thus already has the motivation and drive to work on his problems. Conversational psychotherapy is based on three variables that describe the behavior of the therapist: an emphatic attitude towards the client, genuineness of the psychotherapist and a valuation-free acceptance of the patient and his problems. With the help of a client-centered conversation, in which the emotional meaning is given special attention, the patient should learn to understand and accept himself.

 

Gestalt therapy: Perls Gestalt therapy also belongs to the humanistic forms of psychotherapy. Here too it is assumed that people basically strive for good and holistic. With this method, the patient is confronted with incompletely processed experiences or suppressed needs, whereby the therapy focuses on the patient’s condition in the here and now. The psychotherapist tries to motivate and support the patient in facing his problems and taking responsibility for his own actions. The goal of Gestalt therapy is to develop the patient into a holistic individual who is aware of all parts of his personality, his feelings and needs (the so-called „Gute Gestalt“).
Systemic therapy: There are different forms of systemic therapy, but all of them not only focus on the individual patient, but also include the most important caregivers, such as the family, and the patient’s environment. An individual patient’s mental illness is considered a symptom of a disorder in the behavioral or communication pattern of the system. On the one hand, the psychotherapist will try to identify the disorders in the system and, on the other hand, work out possible solutions with the patient. An example of a systemic intervention is the paradoxical prescription. Here the patient is asked to maintain his problematic behavior instead of fighting it, since it is important for the maintenance of the existing family structures. This forces the individual family members to deal with their contribution and their reaction to the central problem.

 

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