Post-Rationalist Cognitive Psychotherapy: What is it and how does it help patients?
Post-rationalist Cognitive 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 would be as many realities as there are people. This therapy also gives a lot of 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.
Post-Rationalist Cognitive Psychotherapy: Characteristics
Post-rationalist Cognitive Psychotherapy was created by Vittorio Guidano throughout his life; approximately, from the 70’s until 1994. It is considered a type of cognitive but also constructivist therapy, in which the therapeutic relationship is understood as “from expert to expert”. Its main objective is for the person to be able to construct his/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 human beings try to create a certain continuity in the sense of themselves and their 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 Post-Translational Cognitive Psychotherapy, he also created the Systemic Procedural Cognitive Model . Thus, his theoretical orientation was fundamentally cognitive and constructivist. However, unlike previous 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 partner Giovanni Liotti, who published the book “Cognitive Processes and Emotional Disorders” in 1983. But what does post-rationalism mean?
This current, created by Guidano, and where Post-Rationalist Cognitive Psychotherapy is located, tries to go beyond the external, real and rational world . Thus, this constructivist type of current starts from the idea that knowledge is created through the interpretation of reality, and from a series of subjective aspects in the processing of information and the world around us.
In Guidano’s Post-Rationalist Cognitive Psychotherapy two levels are proposed in which all human experience is developed . The aim of this therapy, as well as that of the therapist, will be to work between these two levels (which involve 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 have, which is formed by 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 immediate experience; that is, how do we order, understand and conceive that reality?
On the other hand, Post-Rationalist 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 himself from the outside” and reflect on his behavior, thoughts and attitudes.
Moreover, this technique also allows to discriminate two dimensions of oneself : on the one hand, the “self as immediate experience”, and on the other, the “self”, which is the explanation that the person develops about himself through language.
In addition, self-observation, a central strategy of Post-Rationalist Cognitive Psychotherapy, allows the person to explore their own experience, as well as construct alternative meanings to understand and name what they are feeling.
The meanings that the person constructs in relation to his reality and his life experience, arise from the fact that the person in a certain way “orders” his reality. On the other hand, it will be convenient that the person feels reality as something continuous that is happening to him, in coherence with himself.
The Self: Personal Identity
Thus, in relation to the above and to the process of self-observation, we find that V. Guidano in his Post-Rationalist Cognitive Psychotherapy gives much importance to personal identity (the aim of the 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 to levels
We can relate the concept of the self to the levels of human experience, previously discussed . Thus, in the first level of immediate experience, we would find the concrete situations that the person experiences, and that he lives with an internal sense of continuity. All of 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 the image we have of ourselves. This image is built by the person throughout his life. The therapy will also focus on making it coherent with the person’s values and consistent over time (that the patient can form a vital “continuum”).
On the other hand, self-observation is developed through another technique that is within the very process of self-observation: the Moviola Technique .
The name of the technique refers to the first machine that allowed the editing of 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 applies through each of your steps:
1. Panoramic view
First, the patient is trained to learn how to divide a particular experience into a sequence of scenes, thus obtaining a kind of panoramic view.
Afterwards, he is helped to enrich each scene with details and diverse sensory and emotional aspects.
Finally, the patient must reinsert the scene(s), already enriched, into the sequence of his or her life history. In this way, when the patient sees himself, both from a subjective and an objective point of view, he can begin to build new abstractions and alternative ideas about himself and his life experience.
Structuring the emotional experience
Finally, another component of Post-Rationalist Cognitive Psychotherapy is the structuring of the emotional experience . To structure everything we are experiencing, the use of language will be essential. This will allow us to order the experience and structure it into sequences, as we have already seen in the moviola technique.
Furthermore, it will also help us to separate the different components of this experience (knowledge component, emotional component…). Thus, within Post-Rationalist Cognitive Psychotherapy, the narrative structure of the human experience is actually a network of experiences that we live, 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. 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.