Course philosophy
The development of psychotherapy in the last decades has led to an integrative approach in psychotherapy. This idea is not new in existential psychotherapy. Yalom (1980) said that existential psychotherapy is more than a specific approach. As a result, the integration of theories becomes a necessity within the existentialist perspectives. As early as 1995 Schneider and May proposed an integrative existential approach to psychotherapy, which took into account the new directions of development in existentialism, including how existential psychotherapy and integrative psychotherapy can be brought together under the same umbrella.
According to the existential theory, we create a new form of psychotherapy with each client (Yalom, 2002). In other words, the psychotherapeutic approach must always be adaptable and adapted to the client, his/her needs, his/her desires and his/her values.
The general idea of integrative existential psychotherapy is to help the client optimize the freedom of choice within the limitations of life. These limitations refer to physiology, environmental conditioning, cognitive ability, affective range and so on. The choice is characterized by the capacity of expansion or constraint depending on the situational demands. Although choice always involves volitional processes, it does not necessarily imply what we call classical will. In this context, the client’s desire and capacity for change is the key determinant of the choice. On the other hand, the change follows the stages of change described by Prochaska and DiClemente, being an aspect that concerns the integration in psychotherapy, from a theoretical point of view.
The existential perspective, unlike the psychodynamic one, emphasizes that the main form of conflict experienced by the individual is found in the individual confrontation with own given existence. By the given of existence we mean fundamental anxieties, intrinsic properties of the existence of human beings in the world. From an integrative perspective, we are talking about the influences of the social, family and political environment in the formation and evolution of the self. Of these influences, the extreme experiences are those that shape human beings most profoundly – the experiences or fundamental concerns: death, freedom, isolation and meaninglessness.
Death is the most obvious fundamental concern. The core of the existential conflict is the awareness of the inevitability of death, versus the desire to continue to exist. Freedom in turn is accompanied by anxiety, and in the existential sense it refers to the absence of an external structure. Existential isolation, the third fundamental concern, is an isolation that comes with accepting the fact that no matter how close we are to the others, each of us comes into existence alone and leaves it alone. Finally, the fourth fundamental concern is meaninglessness. If in the end we have to die, what is the meaning of life? The existential dynamic conflict stems from the dilemma of an individual who seeks meaning, but is thrown into a meaningless universe.
All these are processes that belong to the sphere of integrating psychotherapy with philosophy, social, political and psychodynamic aspects. Thus, anxiety feeds the psychopathology, and the four fundamental concerns are integrated with the individual’s needs and the meeting of own needs from early childhood.
History of existential psychotherapy
The source of this therapeutic orientation resides in European philosophical existentialism, which has as main representatives M. Buber, M. Heidegger, S. Kierkegaard, G. Marcel, JP. Sartre, as well as in Eastern philosophy and psychology. According to these ideas, the “normal” individual is in the world, is part of existence and as such, manifests freely and spontaneously, creatively and naturally. Through the process of alienation, the “breaking of the world”, the “cutting” of existence takes place; the subject goes on vertiginous towards closed, blocked, psychopathological roads. At this moment the intervention of the psychotherapist is required to provide psychosocial support and to participate in the cleansing of the “psychosphere” and the “sociosphere” of which the client is a part – the “world” of depressive, manic, obsessive, schizophrenic etc. Putting themselves in the patient’s situation, they try to interpret the individual symptoms on the basis of philosophical concepts. “Man, as a free and creative being, builds existential projects and then commits himself – to become a being – on the path provided and included in the project. The obstructions or wrong orientations on such an “existential path” can profoundly mark the individual, sometimes pushing him/her towards the field of psychopathology. That is why the therapist assures a bridge to reality for the client in existential impasse, and participates in his/her liberation from fear and affective complexes, giving him/her hope and freedom. The existentialist therapeutic approach considers man as unique in its own way, an entity sui generis, an immeasurable value that must be perceived as such. Emphasis is placed on the self-determination of personality, on building one’s destiny, on creativity, spontaneity and authenticity of the human being. Existentialist therapy does not work with abnormality, but with what is still good and healthy in the human being. There is no mental illness in the existentialist framework, but only problematic situations and existential setbacks, which means the loss of the meaning of existence, as a result of the diminution and repression of human potential. Existential impasse is thought to be an ontological phenomenon and the expression of existential despair neuroses. Anxiety, fear, panic and feelings of guilt arise due to an underestimation of one’s own person or to the non-acceptance of the human condition, which leads to depersonalization and apathy, to “limit situations” that determine an alienated, absurd, isolated and meaningless human existence.
Classical existential psychotherapeutic techniques and procedures
Existential analysis is an “attitude” that the therapist adopts toward other people. The therapist must be flexible in the use of techniques, which are chosen on a case-by-case basis. Most existential analysts use techniques from dynamic orientation therapies. The most commonly used are: paradoxical intention; nonverbal techniques; guided fantasy; dramatic techniques involving role play with directed imagination; fantasy and reverie, preferable to dry expressions; muscular relaxation for awareness of sensations; education of the will; concentration of attention; relaxation.
D.Polkinghorne proposes the following action plan in existential analysis:
1. Self exploration. It is a thorough examination of the four dimensions of the client’s life: the natural world, the public world, the private world and the ideal world. It is the description of one’s own world, of one’s memory, feelings and reactions. The client is encouraged to recognize and define his/her own experience as it is in reality, to accept a critical-constructive position for a clear understanding of his/her way of existence.
2. Changing the direction of life, by which the decision to change one’s life is taken. The therapist helps the client analyze and evaluate all possible alternatives and then select the optimal option.
3. The manifestation of the new dignified life. The new axiological system is implemented and manifested. In this stage, the methods of valuing and putting into action the client’s talents and personal skills are established. The focus is on talent discovery. Now the client is struggling to build his own destiny and therefore he must be encouraged
The problem of fundamental concerns
Irvin Yalom, the therapist who developed upon the existentialist current, defines existential psychotherapy as a dynamic psychotherapeutic approach, focusing on accessing and resolving unconscious intrapsychic conflicts, which disrupt the adaptive functioning of the individual. These inner conflicts are the result of the encounter with the ultimate preoccupations of existence: death, freedom, isolation, meaninglessness. The issue of death refers to the conflict between awareness of the inevitability of death and the desire for immortality. The paradox is that although death physically destroys man, the whole idea of death can save him from an anostatic existence. Certain life-limiting situations pave the way for an awareness of the degradation of existence. When this encounter with death is used in a constructive sense (the role of psychotherapy), the person has the opportunity to truly appreciate the gifts of the essence. Existential psychotherapy states that psychopathology is the result of the inefficient way to transcend death.
The issue of freedom is about the confrontation between the awareness of lack of structure, of the foundation of the universe in which we live and our desire for foundation and organization. In daily life we are subject to many concrete requirements. But beyond these restrictions we are free to choose how to act in a situation, what attitude to adopt, whether we are strong, courageous, fatalistic, or panicked. The choice belongs to us, to live a life full of bitter regrets, or to find a way to overcome our disability, and despite it, to find a meaning in our lives. The general existential therapeutic principle is that when the client complains about his or her life situation, it is to ask him and help him understand how he created this situation, in what way he is responsible for what happens to him. Therapeutic intervention involves, first and foremost, assuming responsibility and then taking action in the manner chosen by the client. The problem of isolation results from the tension between the awareness of our existential loneliness and our desire for contact, protection, as being part of a larger whole. Terrified of isolation, people generally try to escape the horror by seeking help at the interpersonal level (they establish relationships because they must do so, and such relationships are based on the need for survival, and not growth. One of the major goals of existential therapy is to solve the fusion – isolation dilemma The healthy person enters in contact with the other, without the desire to escape isolation, becoming one with the other, or without transforming it into a defense instrument against isolation. One of the therapist’s first interventions is to help the clients identify and understand their personal way of interacting with others The problem of meaninglessness refers to the confrontation between the awareness that there are no universal “meanings” or “projects” and the human need to have goals, values, ideals to relate to. The existential crisis breaks out unless man is confronted with events that destroy his safety, stability, belief system and goals that, and make him realize their relativity. The therapist’s task is to examine the legitimacy of the complaint that “life does not make sense”. The existentialist view is that the human being is the only one that creates meaning in the world: there is no predetermined project, no other purpose outside of man. In this sense, the therapist’s task is to help the client realize that “meaning” is a very relative concept.
Integrative existential psychotherapy
Integrative existential psychotherapy seeks to create a bridge between the existentialist principles and the modern integrative ones. Considering the classical existential principles, a coherent theoretical-application framework is created, which starts from unifying integrative principles and emphasizes the interaction of the individual with the world. We consider integrative existential psychotherapy as a way of extending integrative principles in the field of philosophical existentialism and traditional existential practice.
TRAINING CURRICULA – EXISTENTIAL PSYCHOTHERAPY
MODULE 1. INTRODUCTION TO INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. The philosophical sources of integrative existential psychotherapy: existentialism, phenomenology; 2. Representatives of existential psychotherapy; 3. Existential Analysis – Rollo May; 4. Logotherapy – Victor Frankl; 5. Existential psychotherapy – Irvin Yalom.
MODULE 2. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. The approach to integrative existential theory: the human experience as levels of freedom: a. b. The environment; c. Cognitive; d. Psychosexuality; e. The interpersonal; f. The experiential. 2. Freedom and attachment.
MODULE 3. PSYCHOTHERAPEUTICAL RELATIONSHIP IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY.
1. The ingredients of the therapeutic relationship in integrative existential psychotherapy; 2. Common factors in integrative existential psychotherapy; 3. Breaking and repairing the therapeutic relationship in existential integrative psychotherapy.
MODULE 4. PSYCHODIAGNOSTICS IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY.
1. Diagnosis of presuppositions: attention, epochs, checking and becoming aware of your own presuppositions; 2. Psychotherapeutic diagnosis: 3. Relational diagnosis; 4. Projective diagnosis; 5. DSM 5, ICD 10
MODULE 5. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND THE STRATEGIC INTEGRATIVE MODEL OF THE SELF
1. Introduction to the strategic integrative model; 2. Existential axis in the strategic integrative model of the self. 3. The Self in the Humanist-Existential Orientations (Transactional Analysis – Eric Berne; Logotherapy; Psychodrama; Gestalt Psychotherapy; Person-Centered Psychotherapy).
MODULE 6. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND FUNDAMENTAL RELIGIONS
1. The philosophical foundation of fundamental concerns; 2. Internal working models for fundamental concerns: death, freedom, relationship and the meaning of life; 3. To work phenomenologically: the core of existential therapy.
MODULE 7. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND TEMPORALITY
1. Approaching time in the existentialist philosophy; 2. The internal working model of time in integrative existential psychotherapy; 3. Time in psychotherapy.
MODULE 8. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND SPIRITUALITY
1. An integrative approach to spirituality; 2. Spirituality and religiosity in integrative existential psychotherapy; 3. The Jungian archetypes of spirituality and religiosity
MODULE 9. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND CONTACT
1. Existentialism, Personalism, Gestalt; 2. Diagnosis of contact disorders in Gestalt
MODULE 10. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND MULTICULTURALITY
1. European / Asian / African / American intercultural differences; 2. Psychotherapy and multiculturality in Romania. 3. Physical dimension (confrontation with life and death: reality in Umwelt) and social dimension (isolation and association: relations in Mitwelt)
MODULE 11. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND GENDER PERSPECTIVE, POWER, SEXUALITY
1. Feminist psychotherapy; 2. The gay and lesbian perspective; 3. Crises of human devotion in men and women.
MODULE 12. QUANTITATIVE AND QUALITATIVE METHODS OF RESEARCH IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. Qualitative and quantitative methods of research in psychotherapy; 2. The phenomenological method; 3. Exploring the human experience.
MODULE 13. THE BIOLOGICAL DOMAIN IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. Existential needs versus vulnerability and genetic resilience; 2. Existential needs and internal working models for the body diagram, body image and protoschemes related to health and illness
MODULE 14. BEHAVIORAL COGNITIVE INNOVATIONS IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. Addressing existential problems in cognitive behavioral psychotherapy; 2. Fundamental concerns and protocogni- ties; 3. Fundamental concerns and internal working model for positive and negative self-esteem.
MODULE 15. INNOVATIONS OF PSYCHOANALYSIS IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. Addressing the existential problems in psychoanalysis and the new orientations in psychoanalysis; 2. Intersubjectivity in integrative existential psychotherapy
MODULE 16. INNOVATIONS OF FAMILY SYSTEMIC PSYCHOTHERAPY IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. The model of family and couple psychotherapy; 2. Integrative existential psychotherapy and internal working models for family roles and the family unconscious.
MODULE 17. INNOVATIONS OF POSITIVE PSYCHOTHERAPY IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. Needs in positive psychotherapy; 2. Interview, differential diagnosis in integrative existential psychotherapy; 3. Analysis models in integrative existential psychotherapy.
MODULE 18. VERBAL SKILLS AND ARGUMENTATIVE SKILLS IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. The ability to ask questions; 2. Silence in psychotherapy; 3. Dialogue, meaning and significance in integrative existential psychotherapy; 4. Non-verbal communication; 5. Hypnotic techniques; 6. Hypnotic induction techniques;
MODULE 19. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY IN CHILD PSYCHOTHERAPY
1. The relational and existential needs of the child; 2. The meaning of life and death in the child; 3. Child psychopathology; 4. The client-psychotherapist relationship; 5. Hypnotherapy of the child; 6. Fairy tales and their use in psychotherapy
MODULE 20. CLINICAL PSYCHOLOGY
1. Models of sanogenesis and pathogenesis; 2. Clinical diagnosis and evaluation; 3. Research paradigms in clinical psychology; 4. The philosophical foundation of psychopathology.
MODULE 21. SUPERVISION IN INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY
1. Common factors, learning principles in supervision; 2. The patient / client file
MODULE 22. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY IN ANXIOUS DEPRESSIVE DISORDERS
1. Diagnosis of anxiety and depressive disorders; 2. Recent interventions of existential psychotherapy in anxiety-depressive disorders
MODULE 23. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY IN EATING DISORDERS
1. Classification and diagnosis of eating disorders: 1.1. Pica, 1.2. Rumination disorder, 1.3. Avoidant or restrictive eating disorder, 1.4. Anorexia nervosa, 1.5. Bulimia nervosa, 1.6. Compulsive eating, 1.7. Other eating disorders, 1.8. Unspecified feeding and eating disorders; 2. Analysis of fundamental concerns in eating disorders; 3. Diagnosis of contact with oneself / others / environment in eating disorders.
MODULE 24. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY IN SCHIZOPHRENIA
1. History of schizophrenia; 2. Spectrum of schizophrenia: 2.1. Characteristics of disorders in the spectrum of schizophrenia, 2.2. Evaluation of symptoms and clinical signs in psychoses; 3. Diagnosis and symptomatology of disorders in the schizophrenia spectrum: 3.1. Schizotypal personality disorder, 3.2. Delirious disorder, 3.3. Short psychotic disorder, 3.4. Schizophreniform disorder, 3.5. Schizophrenia, 3.6. Schizoaffective disorder, 3.7. Substance or medication-induced psychotic disorder, 3.8. Psychotic disorder due to medical illness, 3.9. Catatonia, 3.10. Other specified disorders of the spectrum of schizophrenia and other psychotic disorders, 3.11. The unspecified spectrum of schizophrenia; 4. Family / group psychotherapy for patients diagnosed with schizophrenia.
MODULE 25. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY IN PERSONALITY DISORDERS
1. Personality disorders – generalities; 2. Classification of personality disorders by clusters. 3. Other personality disorders: 3.1. Personality changes due to a medical illness, 3.2. Other specified and unspecified personality disorders; 4. Personality disorders along a continuum according to DSM5: 5. Psychotherapy of personality disorders: 5.1. Reconstructive interpersonal psychotherapy, 5.2. Treatment of personality adaptations through psychotherapy through redecision, 5.3. Dialectical Behavioral Psychotherapy (DBT), 5.4. Short psychodynamic psychotherapy, 5.5. Psychoanalytic psychotherapy, 5.6. Cognitive-behavioral psychotherapy, 5.7. Schema-focused integrative psychotherapy; 6. Particular aspects of psychotherapy of personality disorders: 6.1. Psychotherapy of antisocial personality disorder, 6.2. Psychotherapy of avoidant personality disorder, 6.3. Psychotherapy of obsessive-compulsive personality disorder, 6.4. Psychotherapy of dependent personality disorder, 6.5. Psychotherapy of histrionic personality disorder, 6.6. Psychotherapy of narcissistic personality disorder, 6.7. Psychotherapy of schizoid personality disorder, 6.8. Psychotherapy of schizotypal personality disorder, 6.9. Psychotherapy of paranoid personality disorder, 6.10. Borderline personality disorder psychotherapy; 7. Specificities of the fundamental concepts of integrative existential psychotherapy in personality disorders.
MODULE 26. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY IN SLEEP DISORDERS
1. Normal sleep: 1.1. Sleep stages; 1.2. Sleep duration, 1.3. Sleep functions; 2. Insomnia: 2.1. Diagnosis and symptoms, 2.2. Psychotherapy in insomnia, 2.3. Fatal family insomnia; 3. Other sleep disorders that can be treated psychotherapeutically: 3.1. Bruxism during sleep, 3.2. Night terracotta; 4. Dreams and dream interpretation: 4.1. Dreams and sleep, 4.2. Dream neurobiology, 4.3. Theories regarding the activation of dreams, 4.4. The brain and dreams. The function of dreams, 4.5. Dream theories and their interpretation, 4.6. Dream analysis, 4.7. Jungian interpretation of dreams. 5. Life, death as fundamental concerns in sleep disorders. 6. Existential anxiety in sleep disorders.
MODULE 27. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY IN ADDICTIVE DISORDERS
1. Psychological models of addiction; 2. Disorders related to a substance; 3. Alcohol; 4. Substance dependence; 5. Nicotine / Smoking; 6. Pathological gambling; 7. Will, desire, decision in addictive disorders; 8. Freedom and limits of responsibility in addictive disorders.
MODULE 28. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND PSYCHOSOMATICS
1. Psychosomatics – definition and history; 2. Evaluation of psychological factors that affect the individual vulnerability to somatization; 3. Somatoform disorders: 3.1. Somatization disorder, 3.2. Hypochondria, 3.3. Conversion disorder, 3.4. Body dysmorphism, 3.5. Pain disorder, 3.6. Munchausen Syndrome, 3.7. Disease simulation; 4. Psychocardiology; 5. Psychodermatology; 5.1. Delusional skin diseases; 5.2. Psychiatric disorders with dermatological consequences, 5.3. Dermatological diseases aggravated by psychological factors; 6. Psychoendocrinology: 6.1. Aging diabetes, 6.2. Fatigue, 6.3. fibromyalgia; 7. Psychogastroenterology: 7.1. Irritable bowel syndrome; 8. Psychopneumology: 8.1. Bronchial asthma; 9. Psycho-oncology; 10. Psychodynamic interpretation of psychosomatic diseases; 11. The experiential cycle in somatic disease.
MODULE 29. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND PSYCHOSEXOLOGY
1. Psychiatric diagnosis and clinical evaluation; 1.1. The cycle of human sexual response; 1.2. Sexual desire diminished; 1.3. Sexual dislike; 1.4. The sexual arousal disorder of the woman; 1.5. Erectile dysfunction; 1.6. Woman’s orgasm disorder; 1.7. Man’s orgasm disorder (late ejaculation); 1.8. Premature ejaculation; 1.9. dyspareunia; 1.10. vaginismus; 1.11. paraphilias; 1.12. Sexual identity disorder; 2. Psychotherapy of sexual deaths; 3. Sex addiction; 4. The significance of death and freedom in sexual dysfunctions.
MODULE 30. INTEGRATIVE EXISTENTIAL PSYCHOTHERAPY AND TRAUMA-INDUCED DISORDERS
1. Diagnosis and symptomatology of disorders induced by trauma and stressors; 2. Post-traumatic stress syndrome psychotherapy; 3. Diagnosis and symptomatology of dissociative disorders; 4. Dissociation of the disorder of dissociative identity.
Personal development program
250 hours of personal development
Personal development focuses, on the one hand, on the development of communication skills, relational skills and self-reflection, and on the other hand on self-discovery, so that trained psychotherapists can discover the ways in which personal history helps or constrains them. regarding professional tasks and their own answers to professional dilemmas.
Supervision
200 hours of supervision
Supervision focuses on strengthening the integration of theory and practice, as well as developing a professional attitude. Supervised psychotherapists have the opportunity to gain insight into their clinical activity, as well as the opportunity to discover what they are already doing well and what they can replace or improve. Supervision implies respect for the supervisee’s knowledge and emphasizes how the supervisee’s experience is relevant in his professional practice.