What Is Existential Psychotherapy?

Psychotherapy is a professional helping activity. The first to implement this help is a therapist who is specially trained in the theory of personality formation and development, as well as in theory and skills of behavior change. Secondly, this help is carried out under a professional framework. This includes that such professional activities are recognized by laws or regulations, the venues and procedures of the activities have certain regulations, and are regulated by industry norms. Thirdly, the recipients and the aspects of their assistance are limited. This restricted nature is its "psychological nature", which is mainly manifested in (1) the reason why a visitor asks for help is because of some aspects of impaired psychological function, which leads to difficulties in adapting to life, school or career; ( 2) The focus of treatment is to assist the client to make psychological and behavioral changes, and to restore or rebuild the damaged psychological function during the period.

Xu Ren (Psychotherapist) Department of Clinical Psychology, Beijing Huilongguan Hospital
Liu Huaqing (Chief physician) Department of Clinical Psychology, Beijing Huilongguan Hospital
Psychotherapy is a formal process of interaction between two parties. Each party is usually composed of one person, but may be composed of two or more people. The purpose is to improve the other party's use of any theory or any of the following areas through therapists who are proficient in the theory of the origin, development, maintenance, and change of personality, using professionally and legally recognized treatment methods related to the theory. Distress caused by inability or dysfunction: cognitive function (abnormal thinking), emotional function (pain or emotional discomfort), or behavioral function (inappropriate behavior).

Basic introduction to psychotherapy

Psychotherapy is a professional helping activity. The first to implement this help is a therapist who is specially trained in the theory of personality formation and development, as well as in theory and skills of behavior change. Secondly, this help is carried out under a professional framework. This includes that such professional activities are recognized by laws or regulations, the venues and procedures of the activities have certain regulations, and are regulated by industry norms. Thirdly, the recipients and the aspects of their assistance are limited. This restricted nature is its "psychological nature", which is mainly manifested in (1) the reason why a visitor asks for help is because of some aspects of impaired psychological function, which leads to difficulties in adapting to life, school or career; ( 2) The focus of treatment is to assist the client to make psychological and behavioral changes, and to restore or rebuild the damaged psychological function during the period.

Development track of psychotherapy

Psychotherapy originated in Europe and developed from psychiatry. Psychotherapy in Europe has a long past, but its formal history is relatively short.
It can be said that since humans have discovered that some members of them have mental disorders, humans have tried to "treat" them.
The treatment of mental disorders depends to a large extent on the interpretation of the cause of the disorder. In history, human beings' explanations of abnormal psychological phenomena have roughly three directions: first, supernatural explanations; second, natural explanations, which explain abnormal behaviors from physical or physical aspects; and third, psychological explanations. Correspondingly, the ancients' treatment of psychological disorders also generally had three orientations: exorcism corresponds to the possession of the devil; physical methods correspond to physical causes, such as Maxima's magnetism; enlightenment and comfort provide psychological reasons.
Psychological treatment in the strict sense should meet two criteria: first, in theory, it treats psychological disorders as different from physical diseases, and the main cause of the disease is not physical or supernatural factors, but psychological factors; The strategies and methods of treatment are psychological, not medical or voodoo. According to this standard, the west began to have real psychotherapy attempts after about the 18th century. Such attempts originated in the practice of hypnosis to treat hysteria. In the late 18th century, hypnosis was widely used clinically to treat hysteria.
It is generally believed that the true founder of modern psychotherapy is Freud. In 1895, Freud and Bloyer published the book Hysteria Research, which is often regarded as the beginning of psychoanalytic psychotherapy.
Psychoanalytic therapy is the first formal psychotherapy system in human history. Psychoanalysis has been in a unique position in the field of psychotherapy from its birth until the 1950s. However, in the development of psychoanalysis, there have been some people who have become independent or developed a certain modified system because of their disagreement with Freud. Earlier, Jung had developed his own analytical psychology out of orthodox psychoanalysis, and Adler separated from psychoanalysis to establish individual psychology. In the 1930s and 1940s, some of the psychotherapists who originally belonged to the psychoanalytic genre emigrated to the United States to escape from Nazi persecution or pursue free development space. In the context of knowledge, some of Freud's ideas seem a bit outdated. So there was a power on American soil that was later called the New Psychoanalysis. Some of these representatives include Adler, Sullivan, Horney and Frome. These people did not completely discard classic psychoanalysis, but made corrections to some of the important concepts. In the history of the development of psychoanalytic therapy, neo-Floydists have played a certain role in building on the past. They have had an important influence on the mainstream thought of contemporary psychoanalytic therapythe theory of object relations.
Starting around the 1940s, some new psychotherapy systems that really differed from psychoanalysis began to appear. At first, Rogers developed a kind of "unguided psychotherapy" under relatively independent conditions. Then in the 1950s and 1960s, the innovation of psychotherapy entered a short period of eruption. New treatment systems such as behavioral therapy, cognitive therapy, rational emotional therapy (later developed into "rational emotional behavior therapy"), existential therapy, realistic therapy, and eclectic therapy have been created. After the 1970s, the creation of a new system slowed down. A more important development during this period was family therapy. Of all these later systems, the humanistic system, the cognitive behavior system, and the family therapy system are recognized as more important systems.

Forms of psychotherapy

Psychotherapy (I) Individual Psychotherapy

This is a psychotherapy in which the therapist talks to the visitor individually. The purpose of the therapist's conversation with the visitor is to understand the process and characteristics of the disease, help the visitor to grasp the condition of the disease, have a correct understanding of the disease, eliminate nervousness, accept the treatment measures proposed by the therapist, and Work with the therapist to fight the disease. Individual psychotherapy is a commonly used method of psychotherapy.

Psychotherapy (II) Collective Psychotherapy

This is the therapist who organizes visitors with similar problems for psychotherapy. Visitors are generally divided into several groups, and each group consists of several or a dozen visitors, and the team leader is selected. The main methods of collective psychotherapy are lectures, activities and discussions. The therapist will explain the related symptoms, etiology, treatment and prognosis to the visitor in a simple way according to the psychological factors and viewpoints prevailing in the patient. Make visitors understand the law of the occurrence and development of problems, eliminate concerns and build confidence. Or organize group members to carry out activities, and then everyone will discuss in groups. Visitors should contact their actual situation to carry out activities, and strive to be lively during discussions to encourage visitors to analyze and self-analyze. The therapist can invite visitors who have better treatment effect to introduce the experience of treatment, which can be used as a demonstration by showing up.
Individual psychotherapy and collective psychotherapy can also be combined. Group psychotherapy focuses on the common problems of similar visitors, and individual psychotherapy focuses on solving the specific problems of patients.

Psychotherapy (3) Family psychotherapy

According to the relationship between the visitor and the family members, the therapist adopts the way of family talks to establish a good family psychological atmosphere and psychological compatibility between the family members. The family members work together to make the visitors adapt to the family life. During family psychotherapy, necessary family members are involved.

Indications and characteristics of psychotherapy

Indications: Neurosis, personality disorder, behavior disorder, psychosomatic disorder, sexual psychological abnormalities, certain mental disorders in remission
Intervention characteristics: emphasis on personality transformation, correction of problem behaviors, emphasis on elimination of symptoms

The main variables of psychotherapy

Psychotherapy (1) Visitor

1. Indications [1]
(Rehabilitation) mental patients; neurosis patients; mentally hit people; serious offenders
Personality Traits
(1) The sensitivity of visitors to interpersonal influences.
(2) The visitor is in distress, has psychological pain, and can promote treatment.
(3) Visitors with a certain coping ability and successful coping experience have a better prognosis.
(4) General intelligence is also an important factor, especially the ability of speech understanding and speech expression, as well as self-understanding and inner ability.
3. Motivation change: Generally speaking, the stronger the client's motivation to change, the better the treatment effect.

Psychotherapy (2) Therapist

1. Professional training and experience:
Psychiatrist, mainly trained in medical school; clinical psychologist, mainly trained in Psychology or Department of Clinical Psychology
Personal characteristics
(1) Maturity: It mainly refers to the maturity in personality development. The coordination of personality (degree of integration) and stability are two important indicators. People with high personality coherence and stability have no basic long-standing conflicts in personality tendencies. Such characteristics help the therapist maintain an open and accepting attitude towards the visitor, and maintain objectivity in the consultation, avoiding the personal projection effect.
(2) Skill factor: It is required that not only the therapist has the ability to deal with specific issues such as diagnosis and procedure operation in the treatment, but more importantly, the ability to creatively solve problems. The ability to communicate in a way that is appropriate for a particular visitor is an important indicator of the therapist's skills.
(3) Sensitivity: It is mainly related to the therapist's perception and understanding of the visitor, especially the perception of the visitor's emotions and internal conflicts. The therapist's sensitivity is one of the basic conditions that determine the understanding of empathy, and the latter is the most important variable affecting the change of treatment.

General treatment process of psychotherapy

Psychotherapy (1) Basic stages of treatment

1. Problem exploration and evaluation phase
(1) Tasks at this stage: Establish a good consultation relationship; clarify issues; collect relevant information; understand and define issues
(2) During the exploration phase, there are some important points to pay special attention to when collecting information:
1) Fact: What happened? At what time, place, and scenario? Causes and consequences of the incident?
2) Recognition: How did the visitor perceive the incident, and how did they evaluate or view it? How does he see himself and other people involved? Is there a bias in this perception and evaluation? Consider the characteristics of the client's general cognitive ability and cognitive style.
3) Emotion: Not only pay attention to the emotional response of the visitor during and after the incident, but also pay attention to the present emotional experience of the visitor. Emotional performance at that time is often an important indicator to judge the direction of problem exploration. Pay attention to the general emotional activity characteristics of the visitor, such as stability, impulsivity, and dominant mood.
4) Behavior: What did you do during the incident, what did you do afterwards, what do you want to do now? Pay attention to general behaviors, such as how to deal with people, how to cope with difficulties, whether there is insufficient behavior or excess behavior.
5) Environment: whether there are adverse environmental factors, etc. [2]
2. Goal setting stage
Tasks at this stage: The discussion of goals can begin by asking the client's expectations; the therapist should be aware of the existing interventions and the limitations of his ability; the goals of treatment must be negotiated to mobilize the enthusiasm of the client; The current goals in the structure should be discussed in as much detail as possible, and clearly stated, if necessary, can be recorded in the form of memos or tables; the determination of goals is often related to the action plan, so it may happen that the proposed action plan is discussed when discussing the goal
3. Scheme discussion stage
(1) The main work tasks in the scheme exploration stage
1) According to the nature and extent of the problem, the individual and the environmental conditions of the visitor, the therapist's strategy and technical reserves, etc., combined with the established treatment goals, conceive various possible plans;
2) Weigh and evaluate the advantages and disadvantages of these programs;
3) Determine a suitable plan.
(2) Some basic problems that may be encountered during the decision-making process of the scheme discussion phase
1) No need to find the only correct solution
2) It is necessary to explore solutions that will not be adopted in the end
3) The evaluation plan should be based on effectiveness, feasibility and economy
4) The two parties discussed and participated in the discussion, but the therapist played a more important role.
5) When the visitor feels that the plan requires him to make difficult or even painful efforts and is unwilling to accept it, the therapist should explain the efficacy of the plan or strategy, and may need a little assurance and encouragement. When a visitor thinks the plan is stupid and rejects it, the therapist needs to describe and explain the details of the plan or strategy as it is implemented. When the visitor has a clear vision of the change path, and he strongly hopes that the therapist will accept it, the therapist's first quality is patience and tenacity, and he needs to discuss the unreasonable impossibility of the visitor's plan. The proposed protocol explains and explains the therapist's confidence and ability in the proposed protocol. In many cases, it is feasible to encourage visitors to conduct trial treatment, and to ensure that if the trial fails, other approaches can be reconsidered.
6) The specificity of the plan depends on genre conventions and therapists
4. Action implementation phase
(1) The treatment / action stage cannot make the visitor a passive, accepting, and dependent role.
(2) The application of treatment methods is also trial and error.
(3) Pay attention to the practice and application of migration in real life.
(4) The treatment / action phase should be evaluated frequently.
5.Evaluation / end phase
(1) The evaluation / end phase may occur in one of three ways:
1) Both parties feel that all the treatment goals have been reached, thus ending the relationship.
2) The therapeutic goals have not been achieved, and the therapist will proactively propose to terminate the consultation relationship. It may be due to personnel changes, but it is more common that the therapist feels that his professional ability cannot effectively help the visitor, or that the visitor can get more appropriate help from another therapist, which is in the sense of the moral responsibility of the therapist Need to suspend the relationship.
3) The visitor discontinues the treatment relationship in advance. Common reasons are: 1. The visitor feels that there is some kind of threat in the treatment, because evading to continue the treatment is essentially an impedance to the treatment; 2. The visitor feels that the treatment does not have the harvest he expected, so he interrupts the visit. The termination of the third situation makes the therapist feel incompetent and frustrated. The therapist needs a calm analysis of who is causing the termination. If possible, try to save the therapeutic relationship. Whether a visitor wants to escape or is disappointed and wants to terminate, failure to develop an effective therapeutic relationship is often an important reason.
(2) For the first evaluation / end phase, four basic tasks:
1) Evaluate target gains
2) Deal with the end of the relationship
3) Prepare for learning transfer and self-dependence
4) The last meeting

Psychotherapy (II) General model of the treatment process

1. Preparation and initial conversation [3]
(1) Visitor analysis
1) Visitors are generally divided into active visitors and passive visitors. For passive visitors, counselors should carefully consider:
First, why arrange and mobilize this person for treatment? Do you really need treatment? Is the visitor just a victim of someone else's abnormal psychology? What does the mobilizer or arranger expect from the treatment?
How does a second mobilizer mobilize visitors? Use encouragement or coercion, or both hard and soft? How do mobilizers introduce treatment to visitors? Are these presentations correct? What expectations and stereotypes might they create in the visitor's psychology?
2) psychological preparation of visitors
Fear and worry
Conflict of attitude
anxiety
Anticipation and response preparation
(2) Initial conversation (main task)
1) Let visitors relax, feel natural and eliminate tension
2) Make the visitor aware of the therapist and therapist
Record
(1) Explain to visitors the need for records and how records will be kept and used
1) Reason or necessity of recording:
To organize the discussion
Prevent forgetting
In order to use previous information in subsequent talks
For future evaluation and comparison
2) Preservation and use of records: It is important to explain who has access to these materials, and to understand who the visitor does not want to have access to, and provide assurance. The therapist's use of the visitor's data should follow the therapist's ethical guidelines. This can be affirmed to the visitors.
(2) How to make records
1) Audio or video recording often makes both parties feel restrained, so some people use concealed microphones to place the camera in an unobtrusive place.
2) Taking notes during a conversation can cause distractions and make the conversation less smooth. Therefore, it is generally advisable to write down after the talks. Remember only a few brief keywords or points in the talks for memorization.
3) Talking environment: The general requirement is to provide a relaxed, candid, and alert-free communication atmosphere.
4) The procedure and flexibility of the treatment process: The division of the treatment stages reflects the general law of the treatment process, so we must pay attention to its procedure. But treatment is both a science and an art. The rigid and rigid procedures of machinery will make him lose his vitality and vitality, and even become ridiculous. The flexibility and creativity of therapists in the counseling process can be said to be the life of counseling.

Psychotherapy expert opinion

1. More and more people in modern society have realized the importance of mental health. Nowadays, both psychotherapy and counseling are very popular at home and abroad and are increasingly recognized by the society. Many people are willing to accept the help of professionals. Improving your health and then improving your quality of life is a good change of mind. Psychotherapy is no longer a shame in people's hearts.
2. Because the social needs are very broad and strong, and to a certain extent psychotherapy has been accepted by the society. Through the promotion and advocacy of more and more mass communication tools, the whole society is paying more and more attention to this subject. Then there is the mysterious subject in the eyes of the public, coupled with the huge pressure of modern life, and psychological problems are becoming more and more common. Many people have begun to contact and love psychotherapy, and have begun to engage in and popularize psychotherapy. Related majors There are more and more people, and the level is getting higher and higher.
3. Some people still have some misunderstandings about psychotherapy. They think that the effect of psychotherapy can be seen immediately. Although professional psychotherapy is much faster than the visitor's own solution to their own psychological problems, it is not twice or once. Can be resolved immediately. Conversely, if you have too high or too strong expectations for psychotherapy and require immediate results, it will often be counterproductive.
4. Modern psychotherapy is no longer a single discipline through long-term development and accumulation of experience. It is no longer a simple psychotherapy when helping visitors. It often integrates various factors, such as combining family factors. Family therapy, combined with various theoretical schools.
5. Psychotherapy does not emphasize the expert effect as when seeking medical treatment for physical diseases. The style of each therapist is not the same. The expert may not adapt to or match your own personality and personality. Everyone has a choice of therapist that suits them. Power, you will feel whether the therapist matches you when the treatment is performed three or five times or earlier, if it is not suitable, you can terminate the treatment or propose to change the therapist. Many general hospitals have already opened or are preparing to open psychotherapy departments. There are also many psychiatric specialty hospitals in China. The benefits of psychotherapy in specialized hospitals can help everyone identify the need for medication in a timely manner with a more professional vision. Or take other auxiliary measures.

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