Book review iv. General Psychotherapy: Principles and Common Theoretical Aspects - Rediscovering Humanity

   General Psychotherapy

My late teens - early twenties coincided with the emergence of chaos, fractals and yes - emergent phenomena. Consequently, I had to refer back to Chapter 3, as Hartmann-Kottek writes:

"If we imagine a fractal that encompasses all categories similarly to a quantum in this regard, all cells, organs, particularly the human brain, the entire person, groups of people, races, nature and the earth would also be in field and structure at the same time. This does not appear to be an abnormal notion. Several experiences with field phenomena of the relationship level would consequently gain their natural allocation.

Indeed, we are familiar with notions that cross categories with regard to states of matter: Water as ice, snowflakes, liquid, vapour, mist and clouds are normal aspects of daily life."p.215.

This resonates at present with reading on categories, seeking theory and to what extent can mathematics and logic be applied to Hodges' model and more importantly, to the humanities? There is some toing-and-froing in the book, but for me having read the book - it works. If a student asked me what is a good subject to study at high school. It would be Social and Economic History, especially if you are thinking of pursuing mental health nursing, psychiatry, or psychology. General nursing too, I would add, acknowledging the need for holistic and integrated theory, practice and management. 

Chapter 7: is a regular rollercoaster in terms of history and cultures:

The Spirit of the Times and Cultural Epochs as Reference Systems Along with Their Transformation of the Ideal Level of Human Development – A Historical Journey Into the Past to Learn for the Future

In healthcare we need to constantly ask (it's called mandatory training) about the protected characteristics, the various literacies, including emotional, spiritual, cultural; and all the determinants of health. And we need to be cognizant of all of them: individual, environmental, commercial, educational, social, and educational (hence why 'categories' are salient).

The discussion of non-European cultures are particularly rewarding - Africa, Australia, Polynesia, Ancient far East, Native Americas, Egypt, Yoruba and others. Page 437 brings Martial arts, where synergy between mind, body and spirit is central. Reflecting culture and the association between health, well-being, the human condition and pastoral care chapter 7 covers the main religions and relationships between several. The influence of aesthetics in certain cultures is also introduced. The book is a springboard for further reading. Section 7.1.2 on an Integrative, Holistic Stance as a Countermovement provides the names and dates of  more than fifteen personalities: Alexius Meinong (1853-1920) ... Wilhelm Witte (1915-1985). Through the history described, it is interesting to reflect on the significance of the holding of knowledge and power imbued through its use. The end of chapter is an effort to take stock of social development - a non-trivial task given the dynamic world we try to exist within. 

 I found I was rolling together chapters 6,7 and 8 even as they hold-their-own in content and placement. As a community mental health nurse I still reflect upon:

• There is no overarching theory of health communication.
• Gatekeeping is alive and well.
• The current often vociferous 'debate' between psychiatrists, psychologists, patients/clients, carers and nurses too.

Chapter 8 returns to the integration of psychotherapy with the politics of research, or how the exercise of power within psychotherapy research has resulted in crises. I wished I'd paid more attention, but I do recall at some events, conferences instances of animosity between different therapeutic camps. Hartmann-Kottek does not labour the final chapter. There are positive messages here too. A page and a half overview informs us that globally there is research attending to the knowledge and not the interests of particular therapeutic organisations and associations. Statistics, evidence, fake science are discussed, the history in psychotherapy and how this frames the future. When I started reading the book behavioural science was in the news for the wrong reasons. 

Chapter 8 reminds me of the proverb 'Reap what you sow'. Now across health and social care how many gates and gate-keepers are there? Outside of 'emergency' triage: how many are legitimate, needed? How as the original role - processes changed? In England there is ongoing debate about IAPT - Improving Access to Psychological Therapies. Fascinating and troubling the apparent increase in diagnosis of autism and attention deficit hyperactivity disorder (ADHD). Still many questions to be asked, especially on access to therapy within  the auspices of universal health coverage.

Here on the blog and in my application of Hodges' model, it may seem that the POLITICAL domain is the constant elephant. The thing to be climbed over, circumvented, accepted for all its ills (no pun intended). Politics, the political is a tool. It is, in Hodges' model, an essential domain in terms of care delivery and knowledge. The idea of that "Competitive constellations happen." (p.465) is of course a reality. In championing and studying Hodges' model this is well recognised. Chapter 8 is a mélange of socio-political concepts which briefly reveal what must be better resolved not just in psychotherapy, but health and social care: all the determinants.

Hodges' model = a natural home for contextual research?

 "At long last, 'contextual research' (Wampold et al.) has put an end to the belief solely in standardised and manualised treatment programmes." p.345.

While the above gives me great encouragement - a note in book: "Generalising partial perspectives only ever lead to impasse." (p.458) reminds me to take nothing for granted.

Chapter 8 places an emphasis on balance.

Hartmann-Kottek uses the term '(r)evolutionary' in chapter 8. This is fitting as the chapter begins with history - with or without the Dodo. Perhaps quantum descriptions can be found by (necessarily) and paradoxically increasing the theory-practice gap. Taking 'theory' even further away from the noise, complexity of practice. We often consider theory, as an opportunity to be idealist. How often (in the past?) have nurses found the nursing theory - model they are trying to apply ungainly as the day-to-night pressures of care delivery make themselves known? Perhaps ironically by venturing further into theory new vistas will appear, with timely and much needed perspectives given the demands of health in the 21st Century.

 'I' - 'Individual' 'SELF' 'Patient' 'Client'

  |

    INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

dyad / couple  family  GROUP community population

PSYCHO - PSYCHO - ... experience-related,  mind and	- TECHNICS^ - MECHANICS^ confrontational connections in the physiological patterns ... (p.480).
foundational collective context i dyad, triad, couples, families, small and large groups	foundational collective context ii gates, gate-keepers, gate-keeping access, accessibility

Many thanks to Prof. Hartmann-Kottek and Springer for the review copy. I will add the related posts below soon.

An enjoyable, informative read and a great contribution to my CPD. There are many more points to highlight and I may do so in the future.

Hartmann-Kottek, L. (2022). General Psychotherapy, Principles and Common Theoretical Aspects - Rediscovering Humanity. Springer. https://doi.org/10.1007/978-3-030-87466-7.

^Used in the text.