After Constructivism - Part I, II

O convidado nesta nova gravação, desta vez em volta da psicoterapia, hermenêutica e fenomenologia ,  é o Professor Giampiero Arciero, psicoterapeuta, investigador e Professor  da Universidade de Siena .

A entrevista  teve lugar a 25 de Março de 2011, em Lisboa, e segue a seguinte estrutura:

Part I - From Psychiatry, to Postrationalist Psychotherapy, to hermeneutic phenomenology.
Part II - My clinical practice distinctive Features. Caring, treating, and effectiveness.
Part III - Acceptance and Empathy.
Part IV - Facing other models
Part V - After Constructivism. Neuroscience integration, and Psychotherapy integration.
Part VI - Participants questions (PDF only)

Part I

From Psychiatry , to Postrationalist Psychotherapy, to Hermeneutic Phenomenology

Aníbal Henriques: Giampiero thank you so much for your willingness to have this conversation. Your training as a psychiatrist started with a focus on severe disturbances, like psychosis and schizophrenia, correct?

Giampiero Arciero: Right.

A.H.: And how did you come to embrace the Cognitive Post-rationalist Therapy theories and practice in the nineties?

G.A.: Well that was the eighties.

A.H.: The eighties, yes. Late eighties.

G.A.: Early.

A.H.: Early? I’m sorry I'm misinformed… The eighties, ok.

G.A.: The eighties, ok. I went to Switzerland to work with psychotics because at the time we didn’t have psychiatric hospitals in Italy, they had been closed  by law. But I already was at University of Rome doing an internship in psychiatry, and there I met Guidano.

A.H.: Ok, that was the eighties.

G.A.: That was the eighties. Guidano and I began a philosophical conversation about Kant – because in the meantime, during my medical studies, I continued to study under the direction of a philosopher , most of all phenomenology. Guidano and I started a friendship over our long lasting discussion  about Kant and about Popper – everyone read Popper at the time. So this ongoing conversation was, of course, not only about epistemology and psychosis but about human being more in general – Guidano was a thinker. So through this conversation I ended up in Santa Barbara,California, where I met and worked with Mike – Michael Mahoney – and Oscar Goncalves. It was part of a wider  conversation that took form  in the summer of '88,  in the first summer school here in Portugal. I was supposed to go back from the US to join the group but I had green card problems and could not leave the country. You too were part of this conversation.

A.H.: Yes, this conversation in 1988.

A.G.: I was supposed to come here in Portugal that summer. Everybody was speaking about constructivism. There was a great excitment. This same year  I met Les ,Bob,Jeremy, and a lot of other people … all the people that were trying to  be  part of this new movement that was  constructivism. But my personal development took shape most of all  in the conversation - during the nineties – with Vittorio and Michael. It was a conversation where I maintained my philosophical position –   the  philosophical position and tradition that  I was trained in – hermeneutical phenomenology. So I maintained also a critical stance towards constructivism and  its cognitive basis in terms of a much more experiential focused – using term that…

A.H.: 'Experiential' is a risky term.

G.A.: Well I’m using here  a term that for example Les Greenberg likes a lot but also , and for different reasons, those cognitivists that practice the so called  Experiential-Focused Cognitive Therapy. For a phenomenologist the attempt to go back to the lived experience is the real theme of the research and of the analysis. The Philosophical maxim is “Back to the things themselves”. Of course experience is  cognition, experience is  imagination, experience is  body training and so on ,but the task of phenomenology is to bring lived experience to language  - not as  an object of knowledge   but in itself, ok? And the… I think that at the core of  our  conversation – most of all with Mike and with Vittorio  until the last years of their lives and often also with Les – I think that the basic drive of our conversation was  not  a desire for a  technique, not a need for a theory but a deep curiosity, a strong passion about  the mystery of human experience.

A.H.: That was emerging…

G.A.: Yeah that was also the big drive for all of us  ..

A.H.: Ok, good. Time passes, and we finally meet and I find that you also moved a lot in your thinking, in your way of conceptualizing our practice. How much distance are you feeling nowadays from Cognitive Post-Rationalist Therapy main distinctive features and principles? Or in what direction did you moved?

G.A.: Yeah. I think my first book was my last attempt to conciliate phenomenology – in terms of hermeneutic phenomenology – with theoretical approach to psychology that was basically the mainstream for Guidano, a theoretically, biologically oriented approach to psychology. And if my first book was the last attempt   in this respect it was also a failure because it tried to reconcile two traditions that cannot be reconciled: the tradition of natural sciences and the tradition of historical-social sciences . They are two different postures, two different positions of investigation; they can speak to each other but one cannot be reduced to the other. They are supported by, they are based on two different ontologies so that they cannot be reassumed in one theory. The awareness that emerged from that book changed my  direction of research. The Constructivist World Congress of 2003 in Bari, organized by the Institute co-founded with Guidano  that I direct, was really the public exposition of this transformation  and the definition of the difference with Guidano's Constructivism. In Bari I took a very clear position. The Post-Rationalism of Guidano it’s now part of our history, the history of the school, but does not inspire our conceptual research or our scientific research, it’s just an historical step that is part of our tradition.

A.H.: Ok, so you developed, you moved.

G.A.: Yeah.

Part II

My Clinical Practice Distinctive Features.

Caring ,treating and effectiveness

A.H.: Is it possible for you to describe the main distinctive features of your practice?

G.A.: Well I think that in a nutshell, I think that the basic attention in my clinical practice is to the first-person experience, and when I say the first-person experience I mean the experience of the client or of the patient. That means that only the client  can offer testimony of his own experience, can have access to his own experience. Therefore as therapists we should be  at the service of the story of the client in terms of helping him to re-interpret his own experience  through a science that is capable of giving him fresh access to his life without forcing it in pre-established theories. This science and the methodology that comes with it can not be based on a theoretical attitude but has to  take its own categories from the client's story. This means: “Back to the things themselves” and this is the main difference with other approaches. Typically theories have an observational point of view and understand a person's story in the light  of theoretical principles and categories related to them.

A.H.: Ok.

G.A.: What I'm proposing is exactly the opposite. You are at the service of the story of the client and your science is finalized to make the client more capable to access his own, her own, experience. We call this science hermeneutics.

A.H.: Hermeneutics. And how effective is this science – hermeneutics – with the variety of clinical experiences you have?

G.A.: Well I think that … I can underline two points, ok? First one: this science is a very old science, it comes with the Bible, so it’s a science that has developed  conceptual tools to deal with human understanding – the first point. Second point: it's possibile to access different kinds of disorders. If the client has the capability to appropriate  his own experience  - that is not always the case! - and has the possibility to open himself to the world and to the other through language, then hermeneutics can be effective. So, of course, there are pathologies where that is very difficult - for example psychosis, schizophrenia, ciclotimic disorders in the acute phases – but I would say that in all the disorders that we usually work with in psychotherapeutic practice this methodology is effective.

A.H.: From the point of view of either the therapists or the client?

A.G.: Well I think that… you know, when we speak about effectiveness there is a lot to say, but I would say one thing, one basic thing. I think that everybody knows that philosophy – antique philosophy – was first of all not a theoretical discipline but a practice of living,a way to take care of the self. So in the Letter Number Seven of Plato –  it’s not sure if it was Plato's or from the school of Plato, but let say that it’s Plato's – speaking about care, Plato says something very precise: he says “in order to take care of somebody in terms of therapeutical care – this person has to be ready to change life”. So the effectivity of a therapeutic encounter is always… I would say: it takes two.

A.H.: It takes two. You don’t treat people, you care for people as a therapist? Would you say this, as a therapist you don’t treat people, you don’t treat patients, you care for them?

G.A: Ah… ok, this word care it’s a… in German we can say sorgen or        bekümmerung, that means being preoccupied, attentive, taking care in a much wider way. The Latin roots it’s curare –  cura – it’s  something that you bring to, that you provide for, but it means also a worried search,ok? And you… when you  take care of somebody that means you enter in his life and you try to relieve from his life the suffering he is unable to take care of himself.