Contemporary Methodologies in Psychotherapy

4th Year Psychiatry Program

St. Vincent's Hospital  New York

Spring Semester 2008/9


Assumptions and terminology used in this course.

  • All life is organic, interdependent, interactive, and driven on a moment-to-moment basis by the need to sustain itself. This is no less true of humans than it is of microorganisms.
  • The interdependence of organic life gives rise in humans to empathy, a necessary pre-requisite of self-sustenance.
  • Empathy can be defined as the capacity to think and feel oneself into the inner life of another person (Kohut).
  • Empathy fosters sustenance because it enables us to negotiate for sustenance with others on mutual terms, to consider both their needs and our own.  
  • Absence of empathy interferes with normal development and causes suffering. 
  • Humans make adaptations in the cognitive and behavioral domains to avoid suffering and optimize sustenance.
  • Psychotherapy is one of the many methods humans have evolved to sustain themselves more effectively. Some other methods are agriculture, medicine, art and religion.
  • Individuals seek psychotherapy when they experience distress at being unable to sustain themselves in the world according to their own wishes, i.e they experience the world as being inadequate to meet their needs (lacking in empathic responses to them) or they experience themselves as unable to derive a necessary degree of sustenance from the world.   
  • All psychotherapies have in common that they seek to nurture the development of an observing ego.
  • Observing ego can be defined as the capacity to experience ones experience, i.e thoughts, and feelings as well as the effect ones behavior has on others.  
  • The establishment of an observing ego is a generally accepted maturational goal.
  • Meta-cognitive awareness is a further development of the observing ego.
  • Meta-cognitive awareness can be defined as the ability to think about thinking, i.e to examine one’s thoughts as mental phenomena which are linked to emotions and condition ones behavior.
  • Mental illness is construed as being made up of adaptive, though ‘automatic’, i.e unmediated behaviors, both interpersonal and cognitive, which are experienced as or can be seen to impair normal functioning and the ability of the individual to sustain themselves in the world.