‘I will never love anyone like that again’: cognitive behavioural therapy and the pathologisation and medicalisation of ordinary experiences

Psychiatry has a long history of being criticised for the pathologisation and medicalisation of ordinary experiences. One of the most prominent of these critiques is advanced by Allan Horwitz and Jerome Wakefield who argue that instances of ordinary sadness in response to events such as bereavement, heartbreak and misfortune, are being mistakenly diagnosed as depression due to an increasing lack of consideration for aetiology and contextual factors. Critiques concerning pathologisation and medicalisation have not been forthcoming for psychiatry’s close cousin, psychotherapy. Using Cognitive Behavioural Therapy, one of the most prominent schools of contemporary psychotherapy as a case study, I demonstrate that psychotherapy also contributes to medicalising and pathologising bereavement, heartbreak and misfortune.

Theology as Inquiry, Therapy, Praxis

In this chapter, theology is portrayed as a form of inquiry, a kind of therapy, and a mode of praxis. These are not perfectly separable roles for theology but can be distinguished for purposes of analysis. Peirce’s theory of inquiry, adapted here for theosemiotic purposes, is shown to be more complex than the standard account, organized around doubt as the stimulus for inquiry, tends to suggest. After a lengthy survey of the links between philosophical pragmatism and certain forms of contemporary psychotherapy, a theosemiotic grounded in pragmatic insights is presented as potentially therapeutic in its strategy and effects. The chapter concludes with an analysis of theology as praxis, as it must be conceived if it is grounded in pragmatism; the resonance of such a conception with liberation theology is also explored here.

Cognitive behavioural therapy

The field of psychotherapy has witnessed remarkable developments since it first emerged in the latter part of the 1800s. Perhaps the most significant advance in recent years began in the 1970s, with the evolution of what is now termed generally as the field of cognitive behavioural therapy (CBT). While any effort to capture the breadth and depth of CBT is bound to fail in some respects, the current chapter provides a review of six of the key articles that helped to propel CBT to a dominant position among contemporary psychotherapy models. These articles are related to disorders as varied as major depression, panic disorder, bulimia nervosa, anxiety in youth, and borderline personality disorder. The articles were also selected to demonstrate the development of the field from a focus on approaches that emphasized cognitive change as a critical aspect of treatment, to more contemporary models that also draw on concepts such as mindfulness and acceptance to effect therapeutic change. The chapter concludes with some general statements about the field of CBT and potential direction for the future.

Neuroscience and Symbolic-Experiential Family Therapy: Roots of [Contemporary] Psychotherapy

The purpose of this article is to review the symbolic-experiential family therapy model of Carl Whitaker and apply it specifically to recent neuroscience findings. The article concludes that symbolic-experiential family therapy reflects many of the recent findings in neuroscience including the role of implicit learning and memory formation, the importance of the relationship between the couple or family and the therapist, increasing stress and anxiety in order to facilitate change, which activates the right brain, and unstructured and spontaneous interaction, which promotes brain reorganization.

Changing the Sense of Self Through Ritual: Psycheritual as a Psychotherapeutic Intervention

This paper will show the results of a study into the experience of using ritual in contemporary psychotherapy*. Dr. Kress and Kerr have named this experience psycheritual as it is relevant for psychotherapy work and is a form of transition ritual which has transformative properties. Psycheritual can be defined as: an intentional act of communication between the conscious and the unconscious, where symbolic objects or actions are used to represent and/or to affect the psychic world, and where a close connection between the body and the mind is required. In this qualitative study we will illustrate how the ancient art of ritual can be successfully imple-mented in the modern discipline of psychotherapy, particularly in the process of changing the sense of self; and that indeed, psychotherapy itself already contains many elements that are generally associated with ritual. Our theoretical background is based in Transpersonal Psychotherapy, and we will also refer to an-cient and indigenous understandings that have been drawn together into the practice of contempo-rary Shamanism. To put the results of this study in context, we will start our exploration with a brief review of the Transpersonal and Shamanic worldviews, and then proceed to examine how ritual already plays a part in both these traditions. KEY WORDS Psychoyherapy, rituals, Self