Cognitive-Structural Psychotherapy: what it is and how it is used in patients

Constructivism is an approach in psychotherapy that considers reality not as something true or false, but as something variable, and that gives an active role to the individual in their own experience of it. Specific, Cognitive-Structural Psychotherapy was born from this approach by the hand of Guidano and Liotti.

We are going to know the characteristics of this type of psychotherapy, which gives an essential role to personal identity in the construction of knowledge about ourselves and the world.

• Related article: "History of Psychology: authors and main theories"

constructivism

Cognitive-Structural Psychotherapy was created by Guidano and Liotti from the constructivist approach. Constructivist models were born in the 80s.

This approach is based on the way in which people generate knowledge from our experiences.. It gives the individual a proactive role in their own experience, and in creating unique systems of meaning; Thus, there are as many realities as there are people. In this way, valid knowledge (true or false) cannot be affirmed, but viable.

According to this approach, knowledge is interpersonal, evolutionary and proactive. Understands reality as a social construction of belief systems and our "realities." On the other hand, it recovers the role of non-conscious or tacit processes.

On the other hand, constructivism understands the therapeutic relationship from expert to expert.

Cognitive-Structural Psychotherapy: characteristics

In Cognitive-Structural Psychotherapy, Guidano and Liotti consider the individual's cognitive system as a scientific theory that attempts to describe the world (creates models of reality) and himself (progressive self-knowledge creating a model of self). In this way, the knowledge that people have of ourselves goes through also knowing what others have of us; the construction of our self includes others and the world (Guidano, 1991). Cognitive-Structural Psychotherapy relates problems to the lack of complexity of the cognitive system.

On the other hand, this type of psychotherapy gives special relevance to therapeutic timing, that is, when the different techniques are used and when the different problems of the patient are addressed.

On the other hand, Guidano and Liotti used Bowlby's theory (1969) as a basis and starting point to establish the criteria to distinguish cognitive organizations. According to the authors, the origin of individual differences lies in the different development itineraries, which allow describe the structural aspects, cognitive, emotional, behavioral characteristics and strategic processes of each patient.

• You may be interested in: "John Bowlby: biography (and the bases of his Attachment Theory)"

Self-organization levels

Cognitive-Structural Psychotherapy establishes two levels of self-organization of knowledge. Personal identity is constituted as an intermediate structure that integrates the two levels. These levels are:

1. unspoken or deep

Is about knowledge integration frameworks derived from early attachment bonds (Bowlby). In relation to Bowlby's attachment theory, we know that the child recognizes himself through the people around him. Interpersonal relationships are of vital importance for Cognitive-Structural Psychotherapy to create self-knowledge.

2. Explicit, superficial or structural

They are the beliefs about oneself, the assessment of one's own emotions and behaviors, the evaluation of situations, self-esteem, etc. This level is developed from the language and implies the construction of models of representation of reality.

dynamic balance

On the other hand, Cognitive-Structural Psychotherapy proposes the concept of dynamic balance to refer to a process dissipative self-organizational, which encompasses two concepts: an evolution (progressive changes) and processes of maintenance of the experience.

The therapy itself consists of overcome imbalances in development (discrepancies) and avoid regressive changes or stagnation. To achieve this, two types of changes are produced, which are not mutually exclusive:

1. superficial changes

They are the first to appear. In general, it is not possible to move on to the second (deep) changes without achieving them. This kind of changes generally implies alterations in the attitude towards reality, without strongly implying the attitude towards oneself. They are generally sufficient to achieve most goals in therapy.

2. profound changes

They appear later, from the attitude towards the self, that is, towards oneself. Profound changes are often accompanied by a painful process, since the subject carries out important variations in his identity, in the attitudes and beliefs that he had always maintained regarding himself.

It is recommended not to make these types of changes unless the patient requests it and voluntarily assumes the cost of it in all senses.

Processes in therapy

Thus, and in relation to all of the above, there are two types of processes (first and second level) in therapy:

1. first level processes

Work is done at the tacit or deep level of organization, that is, in the deep structures of tacit self-knowledge of the person; these, in turn, are bidirectionally related to the person's attitude towards himself, and the latter with two concepts: self-identity and self-esteem.

These two attitudes end up determining the attitude that the patient has towards reality. The attitude towards reality is formed by the rules of assimilation of experience (how we assimilate what we are experiencing) and by procedures for solving problems.

2. Second level processes

These operate on the explicit structural level, based on two types of models: models of the self (personal identity) and models of reality. The explicit structural level, in turn, acts along with the level processes, on self-identity, self-esteem and, ultimately, the attitude towards reality.

Bibliographic references:

• Guidano, v. (1991). The Self in Process. Guilford Press. [The Self in Process, Paidós, 1994].
• Bas, F. (1992). Cognitive-behavioral therapies: a second critical review. Clinic and Health, COP Madrid, 3(2).
• Moltedo, A. (2008). The Evolution of the work and the Model of Vittorio Guidano: Biographical Historical Notes. Journal of Psychology, 17(1), 65 - 85.