Constructivism is an approach in psychotherapy that considers reality not as something true or false, but as something variable, and that gives an active role to the individual in his or her own experience. Specifically, Cognitive-Structural Psychotherapy is born from this approach by Guidano and Liotti .

We will learn about the characteristics of this type of psychotherapy, which gives an essential role to personal identity in the construction of knowledge about ourselves and the world.

Constructivism

The Cognitive-Structural Psychotherapy was created by Guidano and Liotti from the constructivist approach. The constructivist models were born in the 1980s.

This approach is based on the way people generate knowledge from their experiences . It gives the individual a proactive role in his or her own experience, and in creating unique systems of meaning; thus, there are as many realities as there are people. In this way, it is not possible to affirm valid knowledge (true or false), but rather viable knowledge.

According to this approach, knowledge is interpersonal, evolutionary and proactive . It understands reality as a social construction of belief systems and of our “realities”. On the other hand, it recovers the role of unconscious or unspoken processes.

On the other hand, constructivism understands the therapeutic relationship from expert to expert.

Cognitive-Structural Psychotherapy: characteristics

In Cognitive-Structural Psychotherapy, Guidano and Liotti consider the cognitive system of the individual as a scientific theory that tries to describe the world (it creates models of reality) and itself (progressive self-knowledge creating a model of self). In this way, the knowledge that people have about themselves is also the knowledge that others have about us; the construction of our self includes the others and the world (Guidano, 1991). Cognitive-Structural Psychotherapy relates the problems with the lack of complexity of the cognitive system.

On the other hand, this type of psychotherapy gives special relevance to the therapeutic timing , that is, to the moment in which the different techniques are used and when the different problems of the patient are addressed.

On the other hand, Guidano and Liotti used Bowlby’s theory (1969) as a basis and starting point to establish the criteria for distinguishing cognitive organizations . According to the authors, the origin of the individual differences can be found in the different developmental pathways, which allow the description of structural aspects, cognitive, emotional and behavioural characteristics and strategic processes of each patient.

Levels of self-organization

Cognitive-Structural Psychotherapy establishes two levels of self-organization of knowledge. Personal identity is constituted as an intermediate structure that integrates the two levels. These levels are:

1. Tacit or deep

These are frameworks of knowledge integration derived from early attachment links (Bowlby). In relation to Bowlby’s attachment theory, we know that the child recognises himself through the people around him. Interpersonal relationships are of vital importance for Cognitive-Structural Psychotherapy in order to create self-knowledge.

2. Explicit, superficial or structural

These are the beliefs about oneself, the assessment of one’s emotions and behaviours , the evaluation of situations, self-esteem, etc. This level is developed from language and implies the construction of models of representation of reality.

Dynamic balance

On the other hand, Cognitive-Structural Psychotherapy proposes the concept of dynamic equilibrium to refer to a dissipative self-organizing process, which includes two concepts: an evolution (progressive changes) and processes of maintenance of the experience.

The therapy itself consists of overcoming developmental imbalances (discrepancies) and avoiding regressive changes or stagnation . To achieve this, two types of changes occur, which are not exclusive:

1. Surface changes

They’re the first ones to show up. In general, it is not possible to move on to the second (deep) changes without achieving them. This type of change generally implies alterations in the attitude towards reality, without strongly implying the attitude towards oneself . They are generally sufficient to achieve most of the goals in therapy.

2. Deep changes

They appear later, from the attitude towards the self, that is, towards oneself. Profound changes are usually accompanied by a painful process , as the subject carries out important variations in his identity, in the attitudes and beliefs he had always held about himself.

This type of change is recommended not to be made unless the patient asks for it and voluntarily assumes the cost in all senses.

Processes in therapy

Thus, and in relation to all the above, there are two types of processes (of first and second level) in the therapy:

1. First level processes

We work at the level of tacit or deep organization, that is, in the deep structures of the person’s tacit self-knowledge; these, in turn, are related bidirectionally with the person’s attitude towards him/herself , and the latter with two concepts: self-identity and self-esteem.

These two attitudes end up determining the patient’s attitude towards reality. The attitude towards reality is formed by the rules of assimilation of experience (how we assimilate what we are living) and by problem-solving procedures.

2. Second level processes

These operate on the explicit structural level , from two types of models: the models of the self (personal identity) and the models of reality. The explicit structural level, in turn, acts on the level processes, on self-identity, self-esteem and, in short, the attitude towards reality.

Bibliographic references:

  • Guidano, V. (1991). The Self in Process. Guilford Press. The Self in Process, Paidós, 1994.
  • Bas, F. (1992). Cognitive-behavioral therapies: a second critical review. Clínica y Salud, COP Madrid, 3(2).
  • Moltedo, A. (2008). The Evolution of Vittorio Guidano’s Work and Model: Historical-Biographical Notes. Journal of Psychology, 17(1), 65 – 85.