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Neuropsychotherapy
Acknowledging
and validating Freud's psychoanalytical concepts, and based on
recent neuroscientific research, Neuropsychotherapy is one of the
current integrative approaches that provides a deep understanding
of the interconnection between the human brain and human
psychological functioning, hence, assisting clinicians to improve
clients' therapeutic outcomes (Grawe, 2007, p.12).
Neuropsychotherapy
was named by the clinician and researcher Klaus Grawe, and
describes the combination of neuroscientific concepts with
phychotherapeutic practice (Walter,
Berger, & Schnell, 2009, p.180).
This new science had incredible development during the last decade
and has reconstructed the bridge left by Freud's work, between the
biological and psychodynamic functioning of the human being, as
well as between neuroscience and psychoanalytical concepts
(Beutel,
2003, p.773).
Grawe emphasizes how brain function knowledge is remarkably important to
the client's assessment and therapeutic treatment (Walter,
Berger, & Schnell, 2009, p.
174). The idea that psychotherapy can change people's behaviour
and eliminate unwanted symptoms, was empirically
validated by the new definition of the brain as a network of
neurons that communicate by synapses, which are constantly
modified by external experiences (Grawe, 2007, p. 32). The brain's
ability to change and produce new neuronal pathways is called
neuroplasticity (Draguns,
2007, p.119). When therapists facilitate change in their clients' behaviour
through talking therapy, they are, actually, changing their
clients' brains neural patterns (Grawe, 2007, p.23).
The
psychoanalytical theory that focus on the consequences of
childhood experiences and attachment patterns with the mother as
described by Freud were expanded by neuroscientific findings,
which demonstrate that from early childhood years, neural
connections in the brain are created to represent life
experiences, and form patterns of behaviour and symptoms that can
last for a life time (Draguns,
2007, p.119).
The investigation of brain biology through neuroimages (Beutel,
2003, p. 781)
also
brought to light how brain structures react to external signals,
as well as the effects of these reactions to the human body and
mental function, especially in relation to stress response
(Draguns,
2007, p.119). The origin of mental disorders is, therefore,
regarded as a consequence of inconsistency in the mental process,
due to unsatisfied basic human needs (Draguns, 2007, p.119).
The
neuropsychotherapy treatment process is programmed and aims to
decrease individual psychological inconsistencies, allowing the
accomplishment
of four basic human needs: the establishment of gratifying
relationship bonds, a sense of control and orientation of the
person's own life, increased pleasure experience by avoiding
distress, and the preservation of a satisfactory level of self-
esteem
(Draguns,
2007, p.119).
Therapy goals are decided by taking into
consideration the type and duration of the disorder, and the
inconsistency presented (Grawe, 2007, p. 410). When choosing the
most appropriate interventions for long lasting problems, the
empirically approved manual is recommended (Grawe, 2007, p. 410).
If high levels of incongruence are detected, an “incongruence
questionnaire” (Grawe, 2007, p. 410) and analysis can be applied
(Grawe, 2007, p.410).
Each session must have a specific and steady target in order to
facilitate synapses' changes, better brain functioning and
consequent psychological comfort (Grawe, 2007, p. 415).
Additionally, homework is proposed to allow the continuation and
retention of the new neural patterns (Grawe, 2007, p. 415).
The
neuropsychotherapist's role is directive, whilst working
collaboratively with the clients in deciding what desirable,
specific and approachable therapeutic goals can be achieved,as
well as utilising the client's strengths and means (Grawe, 2007,
p. 410). Clients are encouraged to make decisions and the
therapist must provide a safe environment, building a solid
therapeutic alliance (Draguns, 2007, p.119). Within this secure
space, the client's emotional state can be regulated, while under
the guidance of the therapist, clients may feel sufficiently in
control to explore their difficulties, interrupting the
consistency of unhelpful patterns of behaviour, and, therefore,
replacing them with more adaptive ones (Grawe, 2007, p. 418). The
client's brain activity changes throughout the treatment but time
and repetition is necessary to fixate the new neural patterns,
thus achieving long lasting results (Beutel,
2003, p.485).
A
positive therapeutic relationship experience with the therapist
can facilitate an increase in the client's self-esteem, provide a
restorative attachment involvement, which also generates a
reorganisation of the brain activity, by creating new and helpful
neural patterns (Grawe, 2007, p. 413). These pleasurable
relationship therapeutic moments can be also fostered during the
sessions by the application of mindfulness exercises, relaxation
techniques, positive mental representations, or simply by
recognition of the client's achievements (Grawe, 2007, p. 414).
Throughout the treatment, the therapist can obtain better
therapeutic results, and the establishment of a secure and
positive therapeutic alliance, if they are able to demonstrate
personal qualities such as empathy, respect,
a non-judgemental attitude, genuine interest and engagement,
pleasant tone of voice, appropriate body language, and communicate
competency (Grawe, 2007, p. 411).
Strengths
of neuropsychotherapy are an immense contribution for
psychotherapeutic assessment and treatment through the provision
of precise results produced by neuroimaging and other measures, as
well as an alternative description of pathologies to the
Diagnostic and Statistical Manual of Mental Disorders (DSM)
medical model (Beutel,
2003, p. 729).
Additionally, it is considered more effective than medical
intervention (Beutel,
2003, p. 729).
On the contrary, this approach has been criticised for the
directive therapeutic role and the greater focus on the biological
side rather than on client's psychodynamic (Grawe, 2007, p. 410).
Moreover, the assessment measures are too complex to be analysed
by counsellors who do not have specific medical training (Beutel,
2003, p. 793).
Mrs Glaucia Barbosa, PACFA Reg. Provisional 25212 MCouns, MQCA(Clinical) ABN: 19 476 932 954
References
Beutel,
M. E. (01/09/2003). "The emerging dialogue between
psychoanalysis and neuroscience: neuroimaging perspectives".
Journal of the American Psychoanalytic Association (0003-0651), 51
(3), p. 773-801. DOI:
10.1177/00030651030510030101
Draguns,
J. G. (2007). Review of neuropsychotherapy: how the neurosciences
inform effective psychotherapy and neuropsychotherapie
(Neuropsychotherapy). [Review of the books Neuropsychotherapy: How
the Neurosciences Inform Effective Psychotherapy. &
Neuropsychotherapie (Neuropsychotherapy). K. Grawe & K.
Grawe].
Psychotherapy: Theory, Research, Practice, Training, 44(1),
118-120. doi:10.1037/0033-3204.44.1.118
Grawe,
K. (2007). Neuropsychotherapy.
how the neuroscience inform effective psychotherapy.
New York-USA: Taylor and Francis Group.
Walter,
H., Berger, M., & Schnell, K. (2009). Neuropsychotherapy:
conceptual, empirical and neuroethical issues.
European Archieves of Psychiatry and Clinical Neuroscience. V.259(2),
173-182.
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