- Why psychology?
- Why psychotherapy?
- Why Cognitive Behavioral Therapy (CBT)?
- Why clarification-oriented psychotherapy (COP)?
- Why EMDR?
- Why self-awareness and supervision?
Curiosity, thirst for knowledge and joy of learning have always been my best and most loyal life companions. Questions like “What is perception? How is it possible that two people who saw the same thing at the same time experience and remember different things? How do 3-D images or double images work or what happens why in our brain in this respect? What exactly is intelligence? How do we learn? What are emotions? What do we need relationships for? What exactly is motivation? etc.” have fascinated me since I was a child. It was only logical to study psychology!
During my psychology studies with a focus on “clinical psychology” and “industrial and organizational psychology” at the University of Heidelberg (Germany), I therefore also completed several internships to gain an insight into the various practical areas of psychology:
- in the human resources department at BASF in the area of further education, especially leadership training (Ludwigshafen, Germany)
- in an orphanage (Cuernavaca, Mexico)
- in a psychological counseling center (Heidelberg, Germany)
- in a psychiatric clinic (Heidelberg, Germany)
- in a research project (Heidelberg, Germany)
But not only psychology is exciting and fascinating: already as a child I was fascinated by music, especially classical singing, which almost turned me away from studying psychology… In the end, I have both: psychology as a profession, and singing as a regenerating and stimulating hobby.
The step further – from psychology studies to psychotherapy training – has resulted from the combination of two of my core values: my sincere respect, unprejudiced acceptance, and honest understanding towards people on the one hand; and my deeply inherent willingness to help, teach, and encourage on the other.
During my training in cognitive behavioral therapy with an interpersonal focus in Bern and Zurich, I had the honor of learning directly from Klaus Grawe, Rainer Sachse, and Franz Caspar. Of course, there are numerous other brilliant and extremely capable psychotherapists and trainers, but I cannot mention them all by name here. Since July 17, 2009 I am a federally certified psychotherapist and opened my practice in 2010 in the building of the “Ecumenical Council of Churches” (World Council of Churches), where I still practice today.
Why Cognitive Behavioral Therapy (CBT)?
On the one hand, I like the pragmatic approach and focus on improving symptoms, and on the other hand, the careful analysis and understanding of a person’s psychological functioning, thinking and feeling.
Cognitive therapy methods focus on what are called cognitions. Cognitions include attitudes, thoughts, evaluations, and beliefs. Cognitive therapy techniques assume that the way we think determines how we feel and behave and how we react physically.
I often liken psychotherapy to detective work in this regard: why is this person experiencing situations exactly the way they are? What learning experiences and personal beliefs (called schemas) cause her to weight and perceive these elements in the situation exactly the way she does? As a therapist, we shimmy from assumption/hypothesis to the next assumption/hypothesis, testing them and confirming or refuting them, and so on. In doing so, we make use of various theoretical models as well as the direct experience of the person in specific situations. This kind of work is both exciting and demanding and requires sensitivity.
With cognitive behavioral therapy we have not only 2, as the name implies, but in principle 3 approaches to analysis and change, each of which is interconnected and to a large extent mutually dependent:
- the emotions
- the relevant cognitions, and
- the subsequent behavior.
Why clarification-oriented psychotherapy (COP)?
Clarification-oriented psychotherapy is a therapeutic direction that was developed by Rainer Sachse on the basis of conversational psychotherapy and cognitive behavioral therapy. It pays special attention to clarification and awareness as well as to the change of so-called schemas.
From the clarification-oriented psychotherapy I got my attitude and identity as a therapist: it is, as in conversational psychotherapy, characterized by empathy, appreciation, acceptance and authenticity. Effective psychotherapy is, after all, as well as so, only possible when there is a trusting, sincere and committed therapeutic working relationship between client and therapist. The therapist in clarification-oriented psychotherapy makes a mental model of the client and specifically applies strategies (similar to cognitive behavioral therapy) to control the therapeutic relationship and to initiate clarification processes. What needs to be clarified are so-called schemata: cognitive patterns which, in particular, control people with chronic complaints in interpersonal relationships in an automated and unconscious manner to a high degree. The term “personality disorder” quickly comes up in this context, although one thing must be said right away: in COP we speak of “spectra” and “stronger or weaker tendencies”, not of diagnoses of so-called personality disorders, which should actually be called “relationship disorders” according to Rainer Sachse, since they always manifest themselves as problematic in the interpersonal.
On one hand, these interpersonal patterns are difficult to see through, but on the other hand, a trusting and productive relationship can only develop if the therapist at least perceives the strongest schemata and reacts to them correctly. The most important goal of therapy is therefore first to make the client aware of his previously unconscious and uncontrollable schemas. Only then does he have the opportunity to question and correct independent habits, beliefs, desires, etc., and to allow new experiences to take hold of him.
Science has taught us many things, including how we learn, why we do or do not remember certain experiences, that neuroplasticity exists, how we can change mindsets, and much more. Changing schemas always requires what is called cognitive restructuring in the brain. To put it simply: new neuronal connections are formed and replace the “old”, less helpful or even dysfunctional ones (because they do not lead to the goal, but cause suffering). This is also the principle of changing schemas: forming new, functional schemas means creating new neuronal connections in exactly the same situation in which otherwise the dysfunctional ones always act. So in COP the schemas are specifically activated in order to specifically change them.
The same principle of cognitive restructuring applies in EMDR. EMDR, Eyes Movement Desensitization and Reprocessing by Francine Shapiro, goes a significant step further: whenever a negative self-schema has arisen in an emotionally highly stressful situation and therefore has a lasting effect beyond that (which is tantamount to a traumatic situation), EMDR offers a procedure that specifically activates these neural connections, desensitizes (means: neutralizes) the emotionally violent memory of it, and lets the brain restructure/link itself with the adaptive resources within the neural network. This is what the adaptive information processing (AIP) model states. In the AIP model, the basis for the patient’s disorder is seen in stressful past memories. The central assumption is that the human brain fundamentally has the capacity to adaptively process stressful life experiences with the help of an innate information processing system. Bilateral stimulation thus activates the adaptive information processing system so that the memory can be reprocessed and.
For me, EMDR is a logical continuation of COP for those cases in which the emergence of negative self-schemas is based on experiences that have a subjectively traumatic quality (which, in my opinion, is relatively often the case). The mechanism of action of EMDR therapy lies in bilateral stimulation by means of certain eye movements (or also acoustic or tactile stimuli), a synchronization among the cerebral hemispheres or an inner reorganization of the dysfunctional trauma experience is enabled.
Why self-awareness and supervision?
From the very beginning of my training as a psychotherapist, one question has constantly accompanied me: how can I be reliable in my role as a therapist, even when (or especially when) my client touches my own “sore spots” or my own life story? Especially in COP this is absolutely necessary. Thus, self-awareness and supervision were and are my constant companions, and I think that this should be the case for every colleague!
While self-awareness should clarify which situation and/or which clients trigger something in a therapist personally, because it has something to do with him and his history (and he should/must be aware of it!) or because he as a person resonates emotionally with the client, supervision focuses on more technical aspects: taking a good anamnesis and a clear definition of goals, a solid diagnosis and case conception, knowing when which intervention and why, what to do in case of difficulties, etc.
Of course, there is some overlap, but in supervision, the focus is on the “technical” knowledge, independent of the individual: keeping track, following the red thread, going through the different phases of a therapy, etc., while the focus of self-awareness is on the therapist as a person and individual.
As a supervisor, you need enough of your own experience in the therapeutic field, but it is still advisable and sensible to undergo supervisor-specific training: knowledge and experience alone are not always enough.
The ASPCo (Association Suisse de Psychothérapie Cognitive) has been offering this training for several years and has developed, among other things, a supervision model which I find very successful and extremely helpful. I am not only a proud graduate of this training, but I consider myself extremely privileged and happy to pass on this successful approach as a trainer in supervision of the ASPCo to my interested colleagues.