Source:

(Crisanti, 2023, Springer Nature-in printing) — https://link.springer.com/chapter/10.1007/978-3-031-15959-6_19.

Abstract:

The human brain emerges both phylogenetically and ontogenetically, that is, over many years during the course of evolution, and individually as each person develops throughout their lifetime. The complexity of the evolution of cognitive reasoning and the interaction between cognition and emotion is such that Dual Process Theories in neuromarketing and neuroscience research are not always able to capture the nuances of multiple modes of thinking. Further understanding of these complex modes of thinking are needed in psychotherapy to guide people to greater awareness of their thought processes. The development of conceptualisations in Compassion Focused Therapy (CFT) have helped Cognitive Behavioural Therapists (CBT) to understand that human beings are ontogenetically and phylogenetically designed to respond to the care and kindness of others. Although CFT focuses particularly on early childhood experiences and how they have affected emotional regulation systems, in this chapter, it is argued that CFT has not ontogenetically conceptualised individual development, and that integrating Transactional Analysis (TA) can be valuable in providing guidance to evidence-based clinicians in many challenging situations. I aim to develop a theoretical phylogenetic and ontogenetic model, which is clinically useful and empirically based, free of jargon and suited to understanding clients who are in treatment for depression and anxiety. Previous literature was analysed and examined, and empirical findings on maintenance factors were reviewed. A model was developed based on clinical utility and current knowledge of processes and maintenance factors in depression and anxiety. Results support the concept of continuous variation in cognitive ability and suggest four different ways of reasoning: a) System 1 Instinctive (survival thinking/non-conscious thinking); b) System 2 Algorithmic, Child or Parent driven; c) System 2 - Safe, Reflective; d) System 2, Metacognitive Awareness. Awareness of the TA-CFT model and continuous variation in cognitive ability enables psychotherapists to pay particular attention to metacognition, games, post hoc justifications and thus avoid ineffective interventions. Seven clinical interventions are also presented.

Source: Journal of Evidence-Based Psychotherapies. Mar 2019, Vol. 19 Issue 1, p27-47. 21p.

Abstract:

Background: About 2 million years ago, (pre) humans began to evolve a range of cognitive competences for reasoning. Research across disciplines (Barnard, 2009) has developed multiple levels of analysis related to cognitive reasoning, interlinking neural, mental and interpersonal levels influenced by social motives and emotions (Gilbert, 2014). The complexity of cognitive reasoning and the interaction between cognition and emotion is such that further understanding is needed in psychotherapy. The integration of widely recognised Dual-Process Theories (DPT) and Compassion Focused Therapy (CFT), an evolutionary functional analysis of basic social motivational systems (Gilbert, 2014) provide an understanding of mechanisms that may not be adequately comprehended and formulated in psychotherapy. Aims: The aim of this paper is to merge DPT and CFT in order to gain insight into reasoning in psychotherapy. Method: Previous literature is reviewed, examined and summarised. Semistructured interviews and observational data are also included. Results: This paper suggests that System 1 is rooted in the Old Brain and can override System 2. As a result, this paper can make a contribution to psycho-education and treatment by helping clinicians and clients to recognise and understand why their ability to exert influence and self-regulate their thinking can be compromised. Conclusion: Clinical implications and limitations are discussed.

Clients sometimes do not share information with their therapists because of four main reasons:

Fear of not being understood or believed. Clients were not believed in the past and they are fearful to not be believed again, which could hurt them further:

C: If you break a leg, everyone sees it, but when you have something invisible no one believes you and you can't say this to anyone.

The client is concerned or scared about what could happen if a thought or a feeling is verbalised:

C: I think what people could think of me? I fear being sick in front of someone, what could they think of me? Is it paranoia?

C: ‘I could go crazy’

C: ‘I could be sectioned’

The client perceives the therapist as incapable of handling an emotion or experience:

C: ‘My problem was so big that even the therapist couldn't deal with it’.

Thoughts or feelings are unavailable:

C: Do you remember when you asked me if I could remember any painful emotional experience and I said no, well actually I don’t know how it is possible but I couldn’t remember something very important.

Watching a loggerhead sea turtle struggle out of the nest and make its way to the water is an emotional experience. They scramble to the sea and begin navigating an enormous journey, 8,000 miles across the open ocean and back home again. Migrating birds, honeybees, and millions of dragonflies fly thousands of miles from India to Africa.

Scientists have puzzled for years about how they find their way, and they have been looking in astonishment for explanations such as possible guiding particles in the brain. Driftwood, crabs, birds, raccoons, fish etc, are just a few of obstacles that sea turtles may have to overcome for their survival. Before scientists, philosophers pondered the spontaneity of some of the activities of living beings such as the healing of wounds, the regeneration of mutilated parts, the mechanical skill of animals (Schopenhauer, 1844) - as though an internal force, will or instinct may drive the development and maintenance of the body. A ‘knowledge of things in themselves’ (Schmidt in Schopenhauer, 1844).

Like one of these travellers, human beings are involved in a flowing process of direction and change in which autopoiesis, self-organisation and self-determination are fundamental principals, whilst freedom and safety are essential conditions. This seems to suggest there is a risk of malpractice when the therapist's expectations or knowledge is projected or imposed on the patient, driving their processes of exploration, discovery, understanding and constructing meaning. This is aligned to Rogers' core idea that, “as material is given by the client, it is the therapist's function to help him to recognise and clarify the emotions which he feels” (Rogers, 1940).

A client's view: "This is helping me to get my head in order. I like making lists, and if my head is not in order then I don’t know what I am doing. This is leading me to organise my thoughts; it makes me feel looked after and you are helping me to understand. It is an intellectual discussion. It seems like me teaching you about me, and you taking a genuine interest in me. I like when you asked “can you help me to understand this?”

Clients teach therapists about themselves, and not vice versa; paraphrasing Galilei, therapists can’t teach anything - only make clients realise that the answers are already inside them.