Cognitive Posrationalist Psychotherapy: what is it and how does it help patients?
Let's find out what this type of therapy consists of, what are its bases and in which cases it is effective.
Cognitive Posrationalist Psychotherapy is a type of therapy developed in the 1990s by the Italian neuropsychiatrist Vittorio Guidano.. It is framed within a constructivist perspective, which understands that reality is constructed in a unique and personal way.
Thus, there are as many realities as there are people. This therapy also gives great importance to personal identity and language. In this article we will know its general characteristics, as well as Guidano's ideas and some of the techniques he uses through his model.
- Recommended article: "The 10 most effective types of psychological therapy".
Cognitive Posrationalist Psychotherapy: characteristics.
Cognitive Posrationalist Psychotherapy was created by Vittorio Guidano throughout his life, approximately from the 1970s until 1994. It is considered a type of cognitive therapy but also constructivist, in which the therapeutic relationship is understood as "expert to expert". Its main objective is that the person is able to build his or her own identity through different strategies that we will see below..
This type of therapy is used as a clinical psychological intervention, and in turn constitutes a theoretical school in psychology. This school follows a theoretical model that defends that the human being tries to create some continuity in the sense of himself and his personal history, through a coherent and flexible narrative identity. This identity can be reflected in narrative elaborations developed by the patient.
Vittorio Guidano's ideas
Vittorio Guidano was born in Rome in 1944, and died at the age of 55 in Buenos Aires, Argentina. He was a renowned neuropsychiatrist, and in addition to creating the Postrationalist Cognitive Psychotherapy, he also created the Systemic Cognitive Process Model.. Thus, his theoretical orientation was fundamentally cognitive and constructivist. However, unlike the preceding cognitivism, in Guidano's theory the same author extols emotions over cognition.
It is worth mentioning, however, that the current of post-rationalism began with V. Guidano and his colleague Giovanni Liotti, who in 1983 published the book "Cognitive Processes and Emotional Disorders". But what does post-rationalism mean?
This current, created by Guidano, and where the Posrationalist Cognitive Psychotherapy is located, tries to go beyond the external, real and rational world.. Thus, this constructivist trend is based on the idea that knowledge is created through the interpretation of reality and a series of subjective aspects in the processing of information and the world around us.
In Guidano's Cognitive Posrationalist Psychotherapy two levels on which all human experience is developed are proposed. The goal of this therapy, as well as of the therapist, will be to work between these two levels (involving the experience and the explanation of the experience).
These levels "exist" or operate simultaneously, and are as follows:
1. first level
The first level consists of the immediate experience we experience, which is made up of a set of emotions, behaviors and sensations that flow unconsciously.
2. Second level
The second level of human experience consists of the explanation we give to the immediate experience; that is, how do we order, understand and conceive this reality?
On the other hand, Posrationalist Cognitive Psychotherapy promotes a very concrete method of work, which focuses on self-observation by the patient. Self-observation is a technique that allows the person to "see him/herself from the outside" and to reflect on his/her behavior, thoughts and attitudes.
In addition, this technique also makes it possible to discriminate between two dimensions, this technique also makes it possible to discriminate two dimensions of oneself: on the one hand, the "I" and on the other hand, the "I".On the one hand, the "I as immediate experience", and on the other hand, the "me", which is the explanation that the person develops about himself through language.
In addition, self-observation, a central strategy of Cognitive Posrationalist Psychotherapy, allows the person to explore his/her own experience, as well as to construct alternative meanings to understand and give a name to what he/she is feeling.
The meanings that the person constructs in relation to his or her reality and life experience arise as a result of the person "ordering" his or her reality in a certain way. On the other hand, it will be convenient that he/she feels reality as something continuous that is happening to him/her, in coherence with him/herself.
The self: personal identity
Thus, in relation to the above and to the process of self-observation, we find that V. Guidano in his Posrationalist Cognitive Psychotherapy gives much importance to personal identity (the goal of therapy), which is the same as the concept of "self", and which he understands as a complex cognitive-affective system, which allows the person to evaluate (and re-evaluate) his experience in a global or partial way.
All this is done by the patient according to an image he has of himself (a conscious image), which he assimilates through language and experiences.
Relationship with the levels
We can relate the concept of the self to the levels of human experience, previously commented on. Thus, at the first level of immediate experience, we would find the concrete situations that the person experiences and lives with an internal sense of continuity. All this, as we have already seen, is lived automatically and not consciously.
As for the second level, on the other hand (the level of explanation), we find the explanation we give to the experience and to the image we have of ourselves. This image is constructed by the person throughout his or her life. The therapy will also focus on making this image coherent with the person's values and consistent over time (so that the patient can form a vital "continuum").
On the other hand, self-observation is developed through another technique that is found within the process of self-observation itself: the Moviola Technique.
The name of the technique alludes to the first machine that made it possible to edit films on film (moviola), and is explained through a metaphor with this object. But how is the moviola technique applied?
Let's see how it is applied through each of its steps:
First, the patient is trained to learn to divide a particular experience into a sequence of scenes, thus obtaining a kind of panoramic vision.
Subsequently, he is helped to enrich each scene with details and various sensory and emotional aspects.
Finally, the patient must reinsert the scene (or scenes), already enriched, into the sequence of his life history. In this way, when the patient sees himself, both from a subjective and objective point of view, he can begin to construct new abstractions and alternative ideas about himself and his life experience.
Structuring the emotional experience
Finally, another component of Cognitive Posrationalist Psychotherapy is the structuring of the emotional experience.. In order to structure everything that we are living, the use of language will be essential. This will allow us to order the experience and structure it in sequences, as we have already seen in the moviola technique.
In addition, it will also help us to separate the different components of this experience (knowledge component, emotional component...). Thus, within the Posrationalist Cognitive Psychotherapy, the narrative structure of human experience is actually a network of experiences that we are living, assimilating and interconnecting with each other to end up forming the personal identity.
Feixas, G; Miró, T. (1993). Approaches to psychotherapy. An introduction to psychological treatments. Ed. Paidós. Barcelona.
Fernández, A; Rodríguez, B. (2001). The practice of psychotherapy. The construction of therapeutic narratives. Ed. Desclée de Brower. Bilbao.
León, A. and Tamayo, D. (2011). Post-rationalist cognitive psychotherapy: an intervention model focused on the process of identity construction. Katharsis, 12: 37-58.
(Updated at Mar 28 / 2023)