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Post-rationalist cognitive therapy is a type of constructivist cognitive therapy that was created by the Italian neuropsychiatrist Vittorio Guidano in the 1980s and 1990s. [1] [2] [3] [4]
In the early 1980s, Guidano published the book Cognitive Processes and Emotional Disorders (1983) with his colleague Giovanni Liotti. In this book the authors still adhered to and used the cognitive restructuring techniques created by Albert Ellis and Aaron Beck, although they added to them their own theoretical model about evolutionary development from childhood, influenced by the Jean Piaget's genetic epistemology and John Bowlby's attachment theory. [4] [5]
This model, which the authors call the "evolutionary-structural" approach to cognitive therapy, stated that human beings form certain knowledge schemes from childhood that are affective in nature and more central than propositional knowledge schemes in linguistic format. Central affective knowledge schemes are formed from attachment ties with parents or caregivers, and establish certain biased ways of perceiving the world, perceiving oneself, and relating to others.
Guidano and Liotti distinguish two levels of human knowledge: the tacit level of sensorimotor, imaginative, and emotional knowledge, and the explicit level of linguistic and propositional knowledge.
The tacit level is hierarchically supra-ordered, that is, it orders and determines the possibilities that the more superficial explicit schemes take. Furthermore, tacit processes do not appear in consciousness, that is, they determine explicit cognition without being included in it.
Another postulate of the structural evolutionary approach is that the evolution of knowledge during childhood and later life operates in a dialectical manner, that is, the subject encounters situations in the world that confirm his previous schemes and others that are discrepant. The latter make it necessary to modify the knowledge schemes and/or modify the environment, giving rise to more flexible and abstract cognitive structures. [4]
Guidano's constructivist epistemology means that, unlike the cognitive therapies of authors such as Aaron Beck and Albert Ellis, the post-rationalist cognitive-processual systemic approach, like other constructivist therapies, does not assume that the therapist has a superior access to reality than the patient and can identify irrational thought processes in the patient so that the patient can correct them.
Instead, both the patient and the therapist are constructors of meanings that must be reconstructed throughout the therapy. These meanings refer to the patient's life situation and, in later stages of the therapy, to his or her life history.
Guidano stresses that the therapist's attitude must be such that at no time can he give the patient the impression that there is an adequate way of living, thinking and feeling; nor should the therapist seem to know a way that, if the patient were to discover and adopt, would allow him to stop suffering forever. Furthermore, Guidano recommends that the therapist avoid showing his patient a critical or worried attitude about the disturbing emotions that bring him to the consultation, since this attitude would reinforce in the patient the feeling of strangeness with which he experiences these emotions, thus reducing the possibility that he will refer to them and integrate them into a new notion of himself.
Ultimately, everything that happens in the patient, whatever it may be, even what seems most bizarre, will always belong, by definition, to the repertoire of human experience, precisely the domain of phenomena to which the therapist has dedicated his life of study, who can now, together with his patient, dedicate himself to examining, explaining and understanding how these phenomena occur in the patient in their specific singularity.
Guidano borrows the notion of autopoiesis, originally developed by Chilean biologists Humberto Maturana and Francisco Varela.
Autopoiesis is the self-organizing nature of living beings, which means they have autonomy. Maturana and Varela defined autopoiesis as the characteristic of a system that maintains and reproduces itself through its own processes. A system is autopoietic if it is capable of producing and maintaining the components that constitute it. [3] [6] [7]
These systems have distinct boundaries that separate them from their environment, but they are open to interactions with the environment, such as the exchange of energy or matter. These interactions are regulated by the system itself.
The key idea is that the system's internal processes are organized in a way that they produce the system's own components in a self-sustaining cycle. This makes the system autonomous, as it doesn't rely on external forces for its reproduction.
In their view, living organisms are examples of autopoietic systems because they continually produce and regenerate the components necessary for their existence, such as proteins, cells, and organs. Vittorio Guidano extended the concept of autopoiesis to the realm of psychology and cognitive science. He applied the theory to human psychological development, suggesting that the mind itself is an autopoietic system. According to Guidano, our subjective experiences and the meaning we derive from them are generated by the mind through an ongoing self-organization of cognitive processes.
Guidano also argued that self-identity is formed through this self-referential process. The way we perceive ourselves is constructed by an internal, dynamic system that adapts and responds to both internal and external stimuli. [1] [3] [6] [8]
Guidano adopted the concept of narrative identity in the context of his psychotherapy. According to Guidano, human identity is not constructed in a static manner or simply from a series of fixed traits, but is constructed through a personal narrative, that is, from the stories that each individual tells himself about his life, his experiences and his relationship with others.
For Guidano, narrative identity implies that people organize their experiences and give them a coherent meaning through an internal narrative. This narrative is not something fixed or immutable, but is constantly changing, since the person can reconfigure it as he progresses in life, faces new challenges or undertakes new experiences. In fact, identity is seen as a dynamic process, influenced both by social interactions and by the internal reflection that the individual carries out on his own existence.
Thus, Guidano proposes that identity is not a set of fixed attributes, but a narrative construction that adapts over time, depending on the experiences and the interpretation that each person makes of them. Narrative, therefore, becomes a means of giving meaning and continuity to a person's life, helping to integrate the various episodes and experiences into a coherent and meaningful story.
This idea is especially relevant in psychotherapy, where working with a person's narrative can help them find new ways of interpreting their life and, therefore, transform their identity in healthier and more adaptive ways. [1] [3]