Peter F. Schmid ACKNOWLEDGEMENT OR KNOWLEDGE? A person-centred approach to psychopathology and diagnosis

1. Peter F. SchmidACKNOWLEDGEMENT OR KNOWLEDGE?A person-centred approach to psychopathology and diagnosis Metanoia, London, April 9, 2006

3. I. Personal anthropology:Authenticity and alienation • Health? • Dis-order? • Healing? II. Phenomelogical epistemology: Acknowledgment and knowledge • Not-knowing? • Conceptions? • Disorder-specific knowledge? • Diagnosis? III. Criteriafor a genuine person- centred conceptualization

4. „Don’t ask the doctor, ask the patient“ Jewish proverb

5. I. Personal anthropology: Authenticity What is „psychological health“?

6. I. Personal anthropology:Authenticity Rogers’ personality theory includes social criticism. We are not only in relationships; as persons we are relationships. A person is independence and interrelatedness (substantial & relational).

8. I. Personal anthropology:Authenticity Rogers’ personality theory includes social criticism. We are not only in relationships; as persons we are relationships. A person is independence and interrelatedness (substantial & relational). A person-centred consideration on what a “healthy” or “fully function” person is, must include a theory of social criticism.

9. I. Personal anthropology:Authenticity To be a person meansto live the process of authenticity. To live authentically means to be able to always gain anew the balance between one’s uniqueness and living together with the others and the world. In the “fully functioning person” self-realization and solidarity coincide.

10. “This above all: to thine own self be true, And it must follow as the night the day, Thou canst not then be false to any man.“ Shakespeare, Hamlet

11. “You shall love your neighboras yourself." Lev 19:18; Mt 22:39

12. I. Personal anthropology:Authenticity Authenticity is the process of becoming the author of one’s own life. in order – dis-order firm – in-firmity ease – dis-ease ? “health / heal”: * “whole”

13. I. Personal anthropology: Authenticity • To be a person meansto live the process of authenticity. • Person-centred is process-centred. • The process is the contents is the meaning. • Person-centred personality & society theory starts from a process theory of authenticity, not from a theory of disorders.

14. I. Personal anthropology: Alienation What is „inauthentic“? What does psychological suffering mean?

15. I. Personal anthropology:Alienation A person becomes inauthentic, if he or she is alienated from him- or herself and the others. Psychological suffering is the result of a fundamental “self-contradictoriness”. The “maladjusted person” lacks self-confidence (sovereignty deficit)andtrust in the others and the world (relationship deficit).

16. I. Personal anthropology:Alienation Suffering due to alienation is a signal of a deficiency or a loss of authenticity. A psychological symptom is a cry for help. Symptoms are as manifold as persons and situations are manifold. The therapeutic answer is not uniform but unique.

17. I. Personal anthropology: Alienation • Inauthentic persons are alienated from themselves and their others. • Suffering persons communicate to themselves and to others by symptoms that they need help, because their process of striving towards authenticity failed or got stuck. • Process-specific is not symptom-specific.

18. I. Personal anthropology: Therapy What is the response? What “helps”?

19. I. Personal anthropology:Therapy Therapy is the facilitation of personalization as a process of becoming independent and of co-creating relationships. Therapy is personality development through encounter. Despite of symptom specifity the therapeutic answer is always a certain kind of relationship: encounter.

20. I. Personal anthropology: Therapy • Person-specific is not symptom-specific and not disorder-specific, but uniquely process-specific. • Disorder-oriented or goal-oriented is not person-oriented or process-oriented. • The relationship is always the same and it is always different: the therapist is different, if the client is different.

21. I. Personal anthropology:Authenticity and alienation • Health? • Dis-order? • Healing? II. Phenomelogical epistemology: Acknowledgment and knowledge • Not-knowing? • Conceptions? • Disorder-specific knowledge? • Diagnosis? III. Criteriafor a genuine person- centred conceptualization

22. „Each experience, which deserves this name, thwarts an expectation.” Hans–Georg Gadamer

23. II. Phenomelogical epistemology: Acknowledgment The epistemological paradigm change of PCT:In encountering the Other I do not think what I could know about him or her, rather I am ready to accept what he or she is going to disclose. Acknowledge refers to psychotherapy as the art of not-knowing.

25. II. Phenomelogical epistemology: Acknowledgment The epistemological paradigm change of PCT:In encountering the Other I do not think what I could know about him or her, rather I am ready to accept what he or she is going to disclose. Acknowledge refers to psychotherapy as the art of not-knowing.

26. II. Phenomelogical epistemology:Reflection Personal encounter needs reflection. Immediate presence is followed by co-reflection. The initial encounter transcends into a personal encounter relationship. While in the “encounter mode” categorization is impossible …

27. “… the existential encounter is important. … in the immediate moment of the therapeutic relationship, consciousness of theory has no helpful place. … we become spectators, not players – and it is as players that we are effective. … at some other time we may find it rewarding to develop theories. In the moment of relationship, such theory is irrelevant or detrimental. … theory should be tentatively, lightly, flexibly,in a way which is freely open to change, and should be laid aside in the moment of encounter itself.”Carl Rogers, 1962

28. II. Phenomelogical epistemology:Reflection While in the “encounter mode” categorization is impossible …, … in the “reflection mode” we cannot but use concepts and categories. We cannot not think, we cannot not categorize.

29. II. Phenomelogical epistemology:Conceptions Conceptions are always our own constructs. We decide what we perceive out of a pre-understanding. Conceptions must become explicit in order to enable their falsification. Responsibility requires to reflect the conceptions.

30. II. Phenomelogical epistemology:Knowledge Existential knowledge is the basis for our decisions to act. Knowledge means to be in-form-ed. Knowledge must be experience-based. Knowledge must be relationship-based. Knowledge serves acknowledment. Comprehension always is knowledge-based; knowledge in-forms empathy.

31. II. Phenomelogical epistemology Acknowledgment and knowledge • The task is to personally and professionally handle the dichotomy of not-knowing and knowing, acknowledgment and knowledge. • A personal use of conceptions and theories does not hinder experience but foster it. • Therefore it is crucial to decide which theories we use.

32. II. Phenomelogical epistemology:Disorder-specific? “It is with some ‘fear and trembling’ that I advance the concept that the essential conditions of psychotherapy exist in a single configuration - even though the client may use them very differently.” Carl Rogers, 1957

33. II. Phenomelogical epistemology:Disorder-specific? Process-differentiation? Yes. Process-specificity? Yes. Disorder-centered concepts? No. Which knowledge should we use? We do not yet have a genuinely person-centred systematics.

34. II. Phenomelogical epistemology:Diagnosis? “It is not stated that it is necessarythat the therapist has an accurate psychological diagnosis of the client.Here too it troubles me to hold a viewpoint so at variance with my clinical colleagues. The more I have observed therapists, and the more closely I have studied research, the more I am forced to the conclusion that such diagnostic knowledge is not essential to psychotherapy.” Carl Rogers, 1957

35. II. Phenomelogical epistemology:Diagnosis? „In a very meaningful and accurate sense, therapy is diagnosis,and this diagnosis isa process which goes onin the experience of the client, rather than in the intellect of the clinician.” Carl Rogers, 1951

36. II. Phenomelogical epistemology:Diagnosis? Psychological diagnosis can only be a phenomenological process diagnosis, not a diagnosis in terms of symptomatology or etiology. It is a co-diagnostic processby experiencing and reflecting which development the client needs in the process of personalization.

37. II. Phenomelogical epistemology:Specific training? The process of becoming a therapist is personality development through encounter (as is therapy), it is not the accumulation of skills, tools, rules and techniques. Process-specific training?Yes. Problem-centred training? No.

38. II. Phenomenological epistemology: Process-specificity • Does person-centred “disorder”-specific knowledge exist? Yes. • Does a person-centred systematic description of inauthentic processes exist? Scarcely. • Does a genuinely person-centred systematics of process-specificity exist? No.

39. I. Personal anthropology:Authenticity and alienation • Health? • Dis-order? • Healing? II. Phenomelogical epistemology: Acknowledgment and knowledge • Not-knowing? • Concepts? • Disorder-specific knowledge? • Diagnosis? III. Criteriafor a genuine person- centred conceptualization

40. III. Criteriafor a genuine person-centred conceptualization of different processesof personality development • on the basis of personal anthropology • phenomenological & close to experience • falsification must be possible • hermeneutic • existential • including social criticism • triggering genuine humanistic research

41. Back to the clients ... • ... to the challenge to open up and to risk the co-creation of becoming a unique relationship and to co-reflect it

42. Back to the clients ... • … to further develop the unique stance of person-centredness, its image of the human being and its ethics

43. Back to the clients ... • … to face the challenge to create an understanding of ourselves beyond the categories of order and disorder

44. ACKNOWLEDGEMENT ANDKNOWLEDGE

45. „Don’t ask the doctor, ask the patient!“

46. The Person-Centered WebsitebyPeter F. Schmid Die personzentrierte SiteLe site centré sur la personneDe Persoonsgerichte SiteSite da Abordagem Centrada na PessoaPágina Web Centrada en la Persona Il Sito Internet Centrato sulla Persona Ο Προσωποκεντρικός Δικτυακός Τόπος