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Peter F. Schmid ACKNOWLEDGEMENT OR KNOWLEDGE? A person-centred approach to psychopathology and diagnosis

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Title: Peter F. Schmid ACKNOWLEDGEMENT OR KNOWLEDGE? A person-centred approach to psychopathology and diagnosis


1
Peter F. Schmid ACKNOWLEDGEMENT OR KNOWLEDGE? A
person-centred approach to psychopathology and
diagnosis
  • Metanoia, London, April 9, 2006

2
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3
  • I. Personal anthropology Authenticity and
    alienation
  • Health?
  • Dis-order?
  • Healing?
  • II. Phenomelogical epistemology Acknowledgment
    and knowledge
  • Not-knowing?
  • Conceptions?
  • Disorder-specific knowledge?
  • Diagnosis?
  • III. Criteria for a genuine person- centred
    conceptualization

4
  • Dont ask the doctor,
  • ask the patient
  • Jewish proverb

5
I. Personal anthropology Authenticity
  • What is psychological health?

6
I. Personal anthropology Authenticity
  • Rogers personality theory includes social
    criticism.
  • We are not only in relationships as persons we
    are relationships.
  • A person is independence and interrelatedness
    (substantial relational).

7
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8
I. Personal anthropology Authenticity
  • Rogers personality theory includes social
    criticism.
  • We are not only in relationships as persons we
    are relationships.
  • A person is independence and interrelatedness
    (substantial relational).
  • A person-centred consideration on what a
    healthy or fully function person is, must
    include a theory of social criticism.

9
I. Personal anthropology Authenticity
  • To be a person means to live the process of
    authenticity.
  • To live authentically means to be able to always
    gain anew the balance between ones uniqueness
    and living together with the others and the
    world.
  • In the fully functioning person
    self-realization and solidarity coincide.

10
  • This above all to thine own self be true,
  • And it must follow as the night the day,
  • Thou canst not then be false to any man.
  • Shakespeare, Hamlet

11
  • You shall love your neighbor as yourself."
  • Lev 1918 Mt 2239

12
I. Personal anthropology Authenticity
  • Authenticity is the process of becoming the
    author of ones own life.
  • in order dis-order
  • firm in-firmity
  • ease dis-ease
  • ?
  • health / heal whole

13
I. Personal anthropology Authenticity
  • To be a person means to live the process of
    authenticity.
  • Person-centred is process-centred.
  • The process is the contents is the meaning.
  • Person-centred personality society theory
    starts from a process theory of authenticity, not
    from a theory of disorders.

14
I. Personal anthropology Alienation
  • What is inauthentic?
  • What does psychological suffering mean?

15
I. Personal anthropology Alienation
  • A person becomes inauthentic, if he or she is
    alienated from him- or herself and the others.
  • Psychological suffering is the result of a
    fundamental self-contradictoriness.
  • The maladjusted person lacks self-confidence
    (sovereignty deficit) and trust in the others
    and the world (relationship deficit).

16
I. Personal anthropology Alienation
  • Suffering due to alienation is a signal of a
    deficiency or a loss of authenticity.
  • A psychological symptom is a cry for help.
  • Symptoms are as manifold as persons and
    situations are manifold.
  • The therapeutic answer is not uniform but unique.

17
I. Personal anthropology Alienation
  • Inauthentic persons are alienated from themselves
    and their others.
  • Suffering persons communicate to themselves and
    to others by symptoms that they need help,
    because their process of striving towards
    authenticity failed or got stuck.
  • Process-specific is not symptom-specific.

18
I. Personal anthropology Therapy
  • What is the response?
  • What helps?

19
I. Personal anthropology Therapy
  • Therapy is the facilitation of personalization as
    a process of becoming independent and of
    co-creating relationships.
  • Therapy is personality development through
    encounter.
  • Despite of symptom specifity the therapeutic
    answer is always a certain kind of relationship
    encounter.

20
I. Personal anthropology Therapy
  • Person-specific is not symptom-specific and not
    disorder-specific, but uniquely process-specific.
  • Disorder-oriented or goal-oriented is not
    person-oriented or process-oriented.
  • The relationship is always the same and it is
    always different the therapist is different, if
    the client is different.

21
  • I. Personal anthropology Authenticity and
    alienation
  • Health?
  • Dis-order?
  • Healing?
  • II. Phenomelogical epistemology Acknowledgment
    and knowledge
  • Not-knowing?
  • Conceptions?
  • Disorder-specific knowledge?
  • Diagnosis?
  • III. Criteria for a genuine person- centred
    conceptualization

22
  • Each experience, which deserves this name,
    thwarts an expectation.
  • HansGeorg Gadamer

23
II. Phenomelogical epistemology Acknowledgment
  • The epistemological paradigm change of PCT In
    encountering the Other I do not think what I
    could know about him or her, rather I am ready
    to accept what he or she is going to disclose.
  • Acknowledge refers to psychotherapy as the art of
    not-knowing.

24
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25
II. Phenomelogical epistemology Acknowledgment
  • The epistemological paradigm change of PCT In
    encountering the Other I do not think what I
    could know about him or her, rather I am ready
    to accept what he or she is going to disclose.
  • Acknowledge refers to psychotherapy as the art of
    not-knowing.

26
II. Phenomelogical epistemology Reflection
  • Personal encounter needs reflection.
  • Immediate presence is followed by co-reflection.
  • The initial encounter transcends into a personal
    encounter relationship.
  • While in the encounter mode categorization is
    impossible

27
  • the existential encounter is important.
  • in the immediate moment of the therapeutic
    relationship, consciousness of theory has no
    helpful place.
  • we become spectators, not players and it is
    as players that we are effective.
  • at some other time we may find it rewarding to
    develop theories. In the moment of relationship,
    such theory is irrelevant or detrimental.
  • theory should be tentatively, lightly,
    flexibly, in a way which is freely open to
    change, and should be laid aside in the moment of
    encounter itself. Carl Rogers, 1962

28
II. Phenomelogical epistemology Reflection
  • While in the encounter mode categorization is
    impossible ,
  • in the reflection mode we cannot but use
    concepts and categories.
  • We cannot not think,
  • we cannot not categorize.

29
II. Phenomelogical epistemology Conceptions
  • Conceptions are always our own constructs.
  • We decide what we perceive out of a
    pre-understanding.
  • Conceptions must become explicit in order to
    enable their falsification.
  • Responsibility requires to reflect the
    conceptions.

30
II. Phenomelogical epistemology Knowledge
  • Existential knowledge is the basis for our
    decisions to act.
  • Knowledge means to be in-form-ed.
  • Knowledge must be experience-based.
  • Knowledge must be relationship-based.
  • Knowledge serves acknowledment.
  • Comprehension always is knowledge-based
    knowledge in-forms empathy.

31
II. Phenomelogical epistemology Acknowledgment
and knowledge
  • The task is to personally and professionally
    handle the dichotomy of not-knowing and knowing,
    acknowledgment and knowledge.
  • A personal use of conceptions and theories does
    not hinder experience but foster it.
  • Therefore it is crucial to decide which theories
    we use.

32
II. Phenomelogical epistemology Disorder-specific
?
  • It is with some fear and trembling that I
    advance the concept that the essential
    conditions of psychotherapy exist in a single
    configuration -
  • even though the client may use them very
    differently.
  • Carl Rogers, 1957

33
II. Phenomelogical epistemology Disorder-specific
?
  • Process-differentiation? Yes.
  • Process-specificity? Yes.
  • Disorder-centered concepts? No.
  • Which knowledge should we use?
  • We do not yet have a genuinely person-centred
    systematics.

34
II. Phenomelogical epistemology Diagnosis?
  • It is not stated that it is necessary that the
    therapist has an accurate psychological diagnosis
    of the client. Here too it troubles me to hold a
    viewpoint so at variance with my clinical
    colleagues.
  • The more I have observed therapists, and the more
    closely I have studied research, the more I am
    forced to the conclusion that such diagnostic
    knowledge is not essential to psychotherapy.
  • Carl Rogers, 1957

35
II. Phenomelogical epistemology Diagnosis?
  • In a very meaningful and accurate sense,
    therapy is diagnosis, and this diagnosis is a
    process which goes on in the experience of the
    client, rather than in the intellect of the
    clinician.
  • Carl Rogers, 1951

36
II. Phenomelogical epistemology Diagnosis?
  • Psychological diagnosis can only be a
    phenomenological process diagnosis, not a
    diagnosis in terms of symptomatology or etiology.
  • It is a co-diagnostic process by experiencing and
    reflecting which development the client needs in
    the process of personalization.

37
II. Phenomelogical epistemology Specific
training?
  • The process of becoming a therapist is
    personality development through encounter (as is
    therapy),
  • it is not the accumulation of skills, tools,
    rules and techniques.
  • Process-specific training? Yes.
  • Problem-centred training? No.

38
II. Phenomenological epistemology
Process-specificity
  • Does person-centred disorder-specific knowledge
    exist? Yes.
  • Does a person-centred systematic description of
    inauthentic processes exist? Scarcely.
  • Does a genuinely person-centred systematics of
    process-specificity exist? No.

39
  • I. Personal anthropology Authenticity and
    alienation
  • Health?
  • Dis-order?
  • Healing?
  • II. Phenomelogical epistemology Acknowledgment
    and knowledge
  • Not-knowing?
  • Concepts?
  • Disorder-specific knowledge?
  • Diagnosis?
  • III. Criteria for a genuine person- centred
    conceptualization

40
III. Criteria for a genuine person-centred
conceptualization of different processes of
personality development
  1. on the basis of personal anthropology
  2. phenomenological close to experience
  3. falsification must be possible
  4. hermeneutic
  5. existential
  6. including social criticism
  7. triggering genuine humanistic research

41
Back to the clients ...
  • ... to the challenge to open up and to risk the
    co-creation of becoming a unique relationship and
    to co-reflect it

42
Back to the clients ...
  • to further develop the unique stance of
    person-centredness, its image of the human being
    and its ethics

43
Back to the clients ...
  • to face the challenge to create an
    understanding of ourselves beyond the categories
    of order and disorder

44
ACKNOWLEDGEMENT AND KNOWLEDGE
45
  • Dont ask the doctor,
  • ask the patient!

46
Person-Centered and Experiential
Psychotherapies Journal of the World Association
for Person-Centered and Experiential
Psychotherapy (WAPCEPC)
47
          more on pca-online.net  
The Person-Centered Website by Peter F.
Schmid Die personzentrierte Site Le site centré
sur la personne De Persoonsgerichte Site Site da
Abordagem Centrada na Pessoa Página Web Centrada
en la Persona Il Sito Internet Centrato sulla
Persona ? ???s?p??e?t????? ???t?a??? ??p??
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