MDC Humanistic Gestalt and Freudian Therapies Discussion

For the response posts to at least two of your peers:
Provide a suggestion for a different type of therapy and technique. There are many ways to approach therapy and no right or wrong answers. If you do not agree with your peer, then say why in a polite and nonjudgmental way. We are here to learn from each other. Explain why your suggestion would also be appropriate.

Camila Pertierra Delgado

Hi class,

Humanistic therapy, Gestalt therapy, and classical Freudian psychodynamic psychotherapy represent distinct therapeutic approaches with different underlying philosophies and techniques.

Humanistic therapy focuses on the individual’s experience and emphasizes personal growth and self-fulfillment. It operates on the principle that every person has the capacity for self-awareness and the freedom to make choices that lead to self-actualization. An essential technique from this approach is active listening, which could be particularly beneficial for James as it would provide him with a supportive environment to explore his feelings and the impact of his anxiety.

Gestalt therapy, in contrast, is more experiential and focuses on the here and now. It encourages clients to become aware of their immediate thoughts, feelings, and actions and to take responsibility for them. This approach often utilizes the ’empty chair’ technique, where James could be invited to have an imagined conversation with an aspect of himself (such as his anxious self) or a significant other (potentially his father) to externalize and work through his feelings.

Classical Freudian psychodynamic psychotherapy delves into the unconscious mind, exploring the influence of early life experiences and unresolved conflicts. Techniques such as free association, where James would share any thoughts or feelings without censorship, could uncover underlying issues related to his anxiety symptoms.

For James, humanistic therapy might be the most suitable, given his openness to treatment and reluctance to take medication. This approach can offer him a non-directive and empathetic environment where he can explore his anxiety triggers and develop coping strategies. Specifically, a technique such as Rogerian client-centered therapy could be utilized, emphasizing unconditional positive regard, empathetic understanding, and unity. This environment could help James better understand his panic symptoms and reassure him that they are not indicative of a heart attack, addressing his frequent calls to his daughter and concerns about his health.

In the context of James’ situation, emphasizing the here and now of his feelings could help him to understand the root of his panic and to develop strategies for managing it. For example, a specific technique like ‘focus on the present’ from humanistic therapy could be particularly beneficial. It would encourage James to concentrate on his current physiological sensations and emotions when he feels a panic attack coming on, which could help mitigate the intensity of his symptoms by grounding him in the present moment and reducing catastrophic thinking about his health.

James’ situation presents with a significant level of distress and functional impairment, given his frequent panic attacks and the pervasive worry about his health. Even though he is currently reluctant to start medication, it may be beneficial to have a detailed discussion with him about the role that medication can play in managing symptoms of anxiety, especially if his symptoms are severe or disabling. It’s important to convey that medication could potentially provide relief from the physiological symptoms of panic and anxiety, which can then be complemented by therapy to address the psychological and behavioral aspects. His mother’s history of generalized anxiety disorder may suggest a genetic predisposition to anxiety disorders, which could potentially make him more responsive to certain medications. Moreover, given that his father died in a car accident at his age, there may be complex grief or trauma-related aspects contributing to his anxiety, which could be addressed in therapy and may or may not necessitate medication.

Reference

Wheeler, K. (2020). Psychotherapy for the Advanced Practice Psychiatric Nurse (3rd ed.). Springer Publishing LLC. Practice Psychiatric Nursing (2nd ed.). Springer Publishing LLC. issues while the others emphasize solutions to present problems with a holistic view.

Classical Freudian psychodynamic psychotherapy was developed by Sigmund Freud, who believed that all behavior is motivated by the subconscious mind with its unconscious forces or sexual or aggressive instincts. Psychodynamic psychotherapy seeks to understand the past to empower one to make more conscious decisions. This type of psychodynamic therapy works to bring to light repressed memories and emotions to resolve unconscious conflicts, which are the cause of psychopathologies like depression and anxiety. As one must be able to access and describe past experiences, this kind of talk therapy works best for those of reasonable intelligence and life stability but does not work well for people with intellectual disability, psychosis, or low ability to function.

Humanistic therapy or person-centered psychotherapy was developed by Carl Rogers, who built upon Abraham Maslow’s hierarchy of needs to help others develop healthier self-actualization through a positive, nonjudgmental, and holistic approach. The therapist empathetically guides the patient to gain understanding of issues to achieve goals and move forward.

Gestalt therapy is a humanistic-existential psychotherapy developed by Fredrick and Laura Perls. It involves a holistic and interactive focus upon accepting responsibility for the present and its challenges. This in turn allows for one to restore self-regulation to live life authentically and meaningfully.

I would recommend Gestalt therapy for James because it would allow for him to better understand himself and build upon his ability to self-regulate his emotions to diminish his anxiety. For instance, he can practice body awareness where he can learn to distinguish how his body exhibits certain emotions, such as the physical symptoms of anxiety presented by nausea, dizziness, and palpitations. He can also practice empty chair dialogue to express his feelings regarding any unfinished business with his ex-wife.

Other forms of therapy for James include panic-focused psychodynamic psychotherapy, cognitive behavioral therapy, expressive psychotherapy, supportive psychotherapy, interpersonal therapy, brief psychodynamic psychotherapy, and possibly couple therapy if the ex-wife is open to it. The therapist should emphasize the importance of maintaining supportive relationships and activities that provide a positive sense of self.

References

Boland, R., Verdiun, M. L., & Ruiz, P. (2021). Kaplan & Sadock’s Synopsis of Psychiatry (12th ed.). Wolters Kluwer.

Wheeler, K. (2022). Psychotherapy for the Advanced Practice Psychiatric Nurse: A How-To Guide for Evidence-Based Practice (3rd ed.). New York, NY: Springer Publishing Company, LLC.