Humanistic Integrative Psychotherapy
by Professor Vanja Orlans and Professor Maria Gilbert Integrative Humanistic Psychotherapy has its roots in a number of different traditions which have come together in the 19th and 20th centuries, but which are based on much earlier philosophical ideas. In this movement we can see the origins of the humanistic challenge to positivistic psychology, a challenge that has been supported by philosophical developments through Kant, Hegel and 19th century writers within the phenomenological and existentialist traditions. Kant (1724-1804) in particular, drew attention to the relationship between the perception of an object and the object itself, claiming that the object itself, the noumenon, could not be known, and that knowledge therefore resided only in the object as it appeared to us, the phenomenon.These ideas place a particular focus on the nature of perceptual reality, and importantly for psychotherapy, on the nature and role of the perceiver.From such a starting point, any one theoretical perspective as a potential ‘truth’ within the psychological therapies becomes impossible.These early humanistic ideas paved the way for further thinking which has a direct relevance to the practice of psychotherapy and which is highlighted through developments in the phenomenological tradition. Of particular importance to later thinking and practice within the field of psychotherapy was the notion of the co-creation between observer and observed, an idea which lies at the heart of the phenomenological position, and which forms the basis of our integrative stance on the co-creation of all relationships, and the inseparable nature of figure and ground. In the US these ideas were developed in a slightly different way with the movement of humanistic psychology being viewed as having emerged from the work of Abraham Maslow (1908-1970).This movement takes us more directly into the psychological realm, both in terms of the nature of the writings as well as in terms of the professional identity of the writers.A writer who linked European existentialism with the humanistic movement was James Bugental who is credited with setting out the key postulates of humanistic psychology.These postulates covered five key aspects suggesting that human beings could not be reduced to ‘components’, were associated with a uniquely human context, included the capacity to have an awareness of oneself in the context of other people, had the possibility of choices and responsibilities, and had the uniquely human quality of seeking meaning, value and creativity.Maslow’s emphasis on human striving and self actualization was heralded, along with others who emphasized the importance of advancing a more holistic vision of psychology, as the third force in psychology, after behaviourism and psychoanalysis.The Journal of Humanistic Psychology was launched in 1961 and the Association of Humanistic Psychology was formed in 1963.In 1971 humanistic psychology was recognized by The American Psychological Association and granted its own division (Division 32).
Since that time this interest in humanistic ideas has continued, reflected in the development of a range of therapies within the humanistic tradition, and in the development of associated professional bodies.These developments have been supported within the UK by the United Kingdom Association for Psychotherapy Integration (UKAPI), in Europe by the European Association for Psychotherapy (EAP) and the European Association for Integrative Psychotherapy (EAIP), and in the wider context by the Society for the Exploration of Psychotherapy Integration (SEPI) all highlighting the significant contribution of an integrative perspective.Since these early developments the integrative humanistic movement has grown in strength and numbers.When the UK Council for Psychotherapy (UKCP) was first formed in 1987 these historical developments were represented by the establishment of the Humanistic and Integrative Psychotherapy Section (HIPS).There are now more than 2,500 HIPS registered Integrative and Humanistic Psychotherapists working in the NHS, education, social services, and in the private and voluntary sectors. There are twenty eight recognised training organisations within the HIPS section, of which the Metanoia Institute is one.
Integrative Psychotherapy as a specialist training pathway within the humanistic tradition takes as its fundamental starting point the philosophical position that there can be no one truth.Taking this starting point seriously requires the development of a capacity to work at the meta level, to claim an interest in holding ambiguities and different starting points, to be willing and able to articulate the fundamental philosophical starting points of different therapeutic conceptualisations and to commit to finding a transparent way through these which creates a coherent form in itself.In this enterprise we do not support unaware eclecticism and related fragmented technique.Rather, the therapist needs to work from a coherently organized reflexive philosophical and theoretical position within a relational framework, informed by a humanistic approach.Such a standpoint involves a commitment to collaboration with the client on client needs, treatment possibilities, and agreement about outcomes, as well as rigorous analysis of the therapist’s own conscious and unconscious position.
Central to our approach is a key emphasis on the healing quality of a good therapeutic relationship supported by outcome research (see Wampold, 2001) and linked to the crucial importance of attending closely to patient factors such as patient strengths and preferences (see Hubble, Duncan and Miller, 1999). At the Metanoia Institute we have over many years developed such a framework based on a relational perspective which seeks to understand the relationship of self to self (the intrapsychic and body based perspective), the relationship of self with other at both explicit and implicit levels of exchange (the interpersonal frame), and the relationship of self with context, both historically and in the present.Our contextual conceptualization is informed by Kurt Lewin’s field theoretical ideas, as well as by postmodern conceptualisations highlighting the impossibility of excluding context from any analysis.
Such a perspective on the therapeutic endeavour requires constant critical analysis, the careful comparison of emerging ideas and theories, and the translation of this process into a coherent set of clinical skills.Treatment planning and interventions both need to be contained within a coherent framework for practice as well as collaboratively developed in the relational space between therapist and patient, with a sensitivity to individual difference.The commitment to such a meta-perspective is demanding for trainers and students alike, as well as for mature practitioners.However, such a meta perspective ensures constant evaluation of emerging theories and practices, literally a commitment to ’integrity’ within the developing professional setting, as well as an on-going critical evaluation of research findings which speak to the potential appropriateness and excellence of service delivery.The ‘modality’ formulations as currently conceived appear to exclude this meta-level way of conceptualizing, and serve to maintain the separation of philosophy from theory and practice, thus promoting a system of internal evaluation rather than a broad based perspective which seeks to monitor wider developments in a way that goes beyond ‘schoolism’.Such a focus also excludes the consideration of an integrative method and fails to make central co-created relational factors highlighted in the outcome research literature.
At the Metanoia Institute we have developed an explicit philosophy of integration for therapeutic training, one which emphasizes the interrelationship between theory, practice and research, between the personal and the professional, and the bringing together of different kinds of knowledge as a way of offering the highest capabilities in service provision and the related contribution to the development of practice based knowledge.We also train humanistic practitioners in Transactional Analysis, Gestalt Psychotherapy and Person Centred Psychotherapy, all of which endorse a relational philosophy.At the present time we have some 450 trainees across these different pathways including the pathway of Integrative Psychotherapy and Counselling Psychology. We would hope that the work that we have done, and our commitment to exceedingly high standards of training and practice, could both be recognized and supported through the possibility of an additional official framework termed Integrative Humanistic Psychotherapy (IHP) alongside the three modalities of CBT, psychoanalytic/psychodynamic and family/systemic.
Professor Vanja Orlans
Joint Head of Integrative Dept. & Programme Leader DCPsych, Metanoia Institute, London
Professor Maria Gilbert
Joint Head of Integrative Dept. & Programme Leader, MSc Integrative Psychotherapy, Metanoia Institute, London
25 March, 2008
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