Tag Archives: theories

Three Pounds of Theoretical Elegance in 888 Words

Rita and Driftwood 2017

As you may or may not recall, we have several new features in our forthcoming Counseling and Psychotherapy Theories in Context and Practice (3rd ed.) text. Here’s a draft of what we’ve tentatively titled a “Brain Box” from Chapter One.

Brain Box 1.1

Three Pounds of Theoretical Elegance

John Sommers-Flanagan

This Brain Box is a brief, oversimplified, description of the brain. I apologize, in advance, to you and to brains everywhere for this oversimplification and likely misrepresentation. The problem is that even if I took a whole chapter or a whole book to describe these three pounds of elegance, it would still be an oversimplification. Such is the nature of the human brain.

You may already be familiar with the concepts described here. If so, it’s a review. You may be less familiar; then, it’s an introduction. For more information on neuroscience and therapy, we recommend Neuroscience for counselors and therapists: Integrating the sciences of mind and brain by Chad Luke.

Brain Structure: The human brain has indentations, folds, and fissures. It’s slick and slimy. Put simply, it’s not a pretty sight. But the brain’s form maximizes its function. One example: If you could lay out and spread its surface area onto a table, it would be about the size of two pages of a newspaper. The folds and fissures allow more surface area to fit within the human skull.

Scientists describe the brain as having four lobes: The frontal, parietal, occipital, and temporal (see Figure 1.2). The fissures or sulci of the brain demarcate the four lobes. At the bottom of the brain is the brainstem and cerebellum.

Each lobe is generally associated with different brain functions. I say generally because brains are specific and systemic. Although individuals have similar brain structures, individual brains are more unique than a fingerprint on a snowflake.

The frontal lobe is primarily associated with complex thought processes such as planning, reasoning, and decision-making (much, but not all, of what psychoanalysts refer to as ego functions). The frontal lobe also appears involved in expressive language and contains the motor cortex.

The parietal lobe includes the somatosensory cortex. This surface area involves sensory processing (including pain and touch). It also includes spatial or visual orientation.

The temporal lobes are located symmetrically on each side of the brain (just above the ears). They’re involved in auditory perception and processing. They contain the hippocampus and are involved in memory formation and storage.

The occipital lobe is located in the back of the brain and is the primary visual processing center.

I’m using all four lobes right now to type, read, edit, re-think, re-type, re-read, shift my position, and recall various relevant and irrelevant experiences. The idea that we only use 10% of our brains is a silly myth. They even busted it on the Mythbusters television show.

The brain includes two hemispheres. They’re separated by the longitudinal fissure and communicate with each other primarily via the corpus callosum. The hemispheres are nearly mirror images of each other in size and shape. However, their neurotransmitter quantities and receptor subtypes are quite different. The right hemisphere controls the left side of the body and is primarily involved in spatial, musical, and artistic/creative functions. In contrast, the left hemisphere controls the right side of the body, and is involved in language, logical thinking, and linear analysis. There are exceptions to these general descriptions and these exceptions are larger in brains of individuals who are left-handed. Woo-hoo for lefties.

The limbic system is located deep within the brain. It has several structures involved in memory and emotional experiencing. These include, but are not limited to the: amygdala, basal ganglia, cingulate gyrus, hippocampus, hypothalamus, and thalamus. The limbic system and its structural components are currently very popular; they’re like the Beyoncé of brain science.

Neurons and Neurotransmitters: Communication within the brain is electrical and chemical (aka electrochemical = supercool).

Neurons are nerve cells (aka brain cells) that communicate with one another. There are many neuron types. Of particular relevance to counseling and psychotherapy are mirror neurons. Mirror neurons fire when you engage in specific actions (e.g., when waving hello) and the same neurons fire as you observe others engaging in the same actions. These neurons are central to empathy and vicarious learning, but many other brain structures and systems are also involved in these complex behaviors (see Chapter 5).

Neurotransmitters are chemicals packed into synaptic vesicles. They’re released from an axon (a part of a neuron that sends neural transmissions), travel through the synaptic cleft (the space between neurons), and into a connecting dendrite (a part of a neuron that receives neural transmissions), with some “leftover” vesicles re-absorbed into the original axon (referred to as “reuptake,” as in serotonin-specific reuptake inhibitors).

There are somewhere between 30 and 100 (or more) neurotransmitters (NTs) in the brain, divided into three categories: (a) Small molecule NTs (e.g., acetylcholine, dopamine, GABA, Glutamate, histamine, noradrenaline, norepinephrine, serotonin, etc.); (b) neuropeptides (e.g., endorphins, oxytocin, etc.); and (c) “other” (e.g., adenosine, endocannadinoids, nitric oxide, etc.). Neurotransmitters are classified as excitatory or inhibitory or both. For example, norepinephrine is an excitatory neurotransmitter, dopamine is both excitatory and inhibitory, and serotonin is inhibitory. Although several chemical imbalance hypotheses regarding the etiology of mental disorders have been promoted (e.g., “low” serotonin at the synaptic cleft causes depression), when it comes to the brain, I caution you against enthusiastic acceptance of any simplistic explanations. A significant portion of the scientific community consider the dopamine and serotonin hypotheses to be mostly mythical (see Breggin, 2016; Edwards, Bacanu, Bigdeli, Moscati, & Kendler, 2016; Moncrieff, 2008, 2015).

Figure 1.2: A Look at the Brain — If the image was here, you would see it. In its absence, use your brain to imagine it. Yes. It’s beautiful. In the real textbook, we’ll have a real image of a brain and not my snarky suggestion that you use more than 10% of your brain to imagine a brain.

Constructivism vs. Social Constructionism: What’s the Difference?

This is an excerpt from the beginning of Chapter 11 of Counseling and Psychotherapy Theories in Context and Practice (2nd ed., John Wiley & Sons, 2012). Despite the heavily intellectual content, I hope you’ll get the joke at the end.

Without question, the best way to begin a chapter on constructive theory and therapy is with a story.

Once upon a time a man and a woman met in the forest. Both being academic philosophers well-steeped in epistemology, they approached each another warily. The woman spoke first, asking, “Can you see me?”

The man responded quickly: “I don’t know,” he said. “I have a plethora of neurons firing back in my occipital lobe and, yes, I perceive an image of a woman and I can see your mouth was moving precisely as I was experiencing auditory input. Therefore, although I’m not completely certain you exist out there in reality—and I’m not completely certain there even is a reality—I can say without a doubt that you exist . . . at least within the physiology of my mind.”

Silence followed.

Then, the man spoke again,

“Can you hear me?” he asked.

This time the woman responded immediately. “I’m not completely certain about the nature of hearing and the auditory process, but I can say that in this lived moment of my experience I’m in a conversation with you and because my knowledge and my reality is based on interactive discourse, whether you really exist or not is less important than the fact that I find myself, in this moment, discovering more about myself, the nature of the world, and my knowledge of all things.”

There are two main branches of constructive theory. These branches are similar in that both perspectives hold firmly to the postmodern idea that knowledge and reality is subjective. Constructivists, as represented by the man in the forest, believe knowledge and reality are constructed within individuals. In contrast, social constructionists, as represented by the woman in the forest, believe knowledge and reality are constructed through discourse or conversation. Constructivists focus on what’s happening within the minds or brains of individuals; social constructionists focus on what’s happening between people as they join together to create realities.

Guterman (2006) described these two perspectives:

Although both constructivism and social constructionism endorse a subjectivist view of knowledge, the former emphasizes individuals’ biological and cognitive processes, whereas the latter places knowledge in the domain of social interchange. (p. 13)

In this chapter, we de-emphasize distinctions between constructivist and social constructionist perspectives. Mostly, we lump them together as constructive theories and therapies and emphasize the fascinating intervention strategies developed within these paradigms. This might be upsetting to staunch constructivists or radical social constructionists, but we take this risk with full confidence in our personal safety. That’s because most constructive types are nonviolent thinkers who very much like talking and writing. Consequently, within our socially or individually constructed realities we’ve concluded that we’re in no danger of harm from disgruntled constructive theorists or therapists.

Supplementary Counseling and Psychotherapy Theories Readings

Over the past four years I’ve written over 40 blog posts linked to teaching and learning the theory and practice of counseling and psychotherapy. While procrastinating on another project, I decided to organize these blog posts by topic. If you follow the links below, they’ll take you to blog posts relevant to specific theories. Included in some of these are a few links to short (and free) theories-based video examples. If you teach a theories course, you could select some of these links to assign students outside readings or you could peruse them yourself to stimulate a few lecture ideas.

Please note that if you use our Counseling and Psychotherapy Theories in Context and Practice textbook, there’s a bit of redundancy with the textbook’s content. However, if you don’t use the text, the material will be new to you and your students.

Chapter 1 – Opening and Overview

A Plan for Maximizing Positive Counseling and Psychotherapy Outcomes: https://johnsommersflanagan.com/2014/09/07/a-plan-for-maximizing-positive-counseling-and-psychotherapy-outcomes/

Teaching Counseling and Psychotherapy Theories: Reflections on Week 1: https://johnsommersflanagan.com/2012/08/29/teaching-counseling-and-psychotherapy-theories-reflections-on-week-1/

Reformulating Clinical Depression: The Social-Psycho-Bio Model: https://johnsommersflanagan.com/2013/09/03/reformulating-clinical-depression-the-social-psycho-bio-model/

Chapter 2 – Psychoanalytic Approaches

Attachment-Informed Psychotherapy: https://johnsommersflanagan.com/2015/08/12/attachment-informed-psychotherapy/

Chapter 3 – Adlerian Approaches: Individual Psychology

The Three-Step Emotional Change Trick: https://johnsommersflanagan.com/2012/09/23/the-three-step-emotional-change-trick/

A Parenting Homework Assignment on Natural and Logical Consequences: https://johnsommersflanagan.com/2011/11/30/a-parenting-homework-assignment-on-natural-and-logical-consequences/

More Than Praise — Other Ways Parents Can Be Positive With Their Children: https://johnsommersflanagan.com/2012/08/16/more-than-praise-other-ways-parents-can-be-positive-with-their-children/

Chapter 4 – Existential Approaches

Reflections on Listening to Irvin Yalom at the ACA Conference: https://johnsommersflanagan.com/2012/03/25/reflections-on-listening-to-irvin-yalom-at-the-aca-conference/

A Short Existential Case Example from Counseling and Psychotherapy Theories . . .: https://johnsommersflanagan.com/2015/08/25/a-short-existential-case-example-from-counseling-and-psychotherapy-theories/

Chapter 5 – Person-Centered Approaches

Reflections on Magic: https://johnsommersflanagan.com/2011/11/28/reflections-on-magic/

Listening as Meditation on Psychotherapy.net: https://johnsommersflanagan.com/2014/02/25/listening-as-meditation-on-psychotherapy-net/

An Interview with Natalie Rogers (Daughter of Carl Rogers) about Person-Centered Therapy: https://johnsommersflanagan.com/2015/08/04/an-interview-with-natalie-rogers-daughter-of-carl-rogers-about-person-centered-therapy/

Why Therapists Should Never Say, “I know how you feel”: https://johnsommersflanagan.com/2013/05/30/why-therapists-should-never-say-i-know-how-you-feel/

Carl Rogers and Brain-Science do an Empathy Smackdown in Chapter 3: https://johnsommersflanagan.com/2015/07/09/carl-rogers-and-brain-science-do-an-empathy-smackdown-in-chapter-3/

Chapter 6 – Gestalt Approaches

Go Go Gestalt: The Theories Video Shoot, Part I: https://johnsommersflanagan.com/2012/04/24/go-go-gestalt-the-theories-video-shoot-part-i-2/

Chapter 7 – Behavioral Approaches

A Black Friday Tribute to Mary Cover Jones and her Evidence-Based Cookies: https://johnsommersflanagan.com/2011/11/25/a-black-friday-tribute-to-mary-cover-jones-and-her-evidence-based-cookies/

Behavioral Activation Therapy: Let’s Just Skip the Cognitions: https://johnsommersflanagan.com/2014/06/30/behavioral-activation-therapy-lets-just-skip-the-cognitions/

Imaginal or In Vivo Exposure and Desensitization: https://johnsommersflanagan.com/2012/05/19/imaginal-or-in-vivo-exposure-and-desensitization-2/

A New Look at Time-Out for Kids and Parents: https://johnsommersflanagan.com/2012/08/04/a-new-look-at-time-out-for-kids-and-parents/

Information on Using Time-Out — Part II: https://johnsommersflanagan.com/2012/08/05/information-on-using-time-out-part-ii/

Talking with Parents about Positive Reinforcement: https://johnsommersflanagan.com/2014/09/06/talking-with-parents-about-positive-reinforcement/

Backward Behavior Modification: https://johnsommersflanagan.com/2012/12/02/backward-behavior-modification/

Chapter 8 – Cognitive-Behavioral Approaches

Positive Thinking is Not (Necessarily) Rational Thinking: https://johnsommersflanagan.com/2011/12/06/positive-thinking-is-not-necessarily-rational-thinking/

How to Use the Six Column CBT Technique: https://johnsommersflanagan.com/2014/02/18/how-to-use-the-six-column-cbt-technique/

A Quick Look at the Collaborative Cognitive Therapy Process: https://johnsommersflanagan.com/2012/09/30/a-quick-look-at-the-collaborative-cognitive-therapy-process/

Tomorrow’s Election and Confirmation Bias: https://johnsommersflanagan.com/2012/11/05/tomorrows-election-and-confirmation-bias/

Confirmation Bias on My Way to Spearfish, South Dakota: https://johnsommersflanagan.com/2014/04/30/confirmation-bias-on-my-way-to-spearfish-south-dakota/

Chapter 9 – Choice Theory and Reality Therapy

The Seven Magic Words for Parents: https://johnsommersflanagan.com/2012/12/23/the-seven-magic-words-for-parents/

Give Information and then Back-Off: A Choice Theory Parenting Assignment: https://johnsommersflanagan.com/2012/07/09/give-information-and-then-back-off-a-choice-theory-parenting-assignment/

How Parents Can Use Problem-Solving Power: https://johnsommersflanagan.com/2012/10/23/how-parents-can-use-problem-solving-power/

Chapter 10 – Feminist Approaches

Opening Thoughts on Feminism: https://johnsommersflanagan.com/2012/04/03/opening-thoughts-on-feminism-3/

The Girl Code by Ashley Marallo: https://johnsommersflanagan.com/2012/12/03/the-girl-code-by-ashley-marallo/

A Guest Essay on the Girl Code and Feminism: https://johnsommersflanagan.com/2014/12/07/a-guest-essay-on-the-girl-code-and-feminism/

Feminist Culture in Music: https://johnsommersflanagan.com/2013/11/18/feminist-culture-in-music/

Chapter 11 – Constructive (Solution-Based and Narrative) Approaches

Is Solution-Focused Therapy as Powerfully Effective as Solution-Focused Therapists Would Have Us Believe?: https://johnsommersflanagan.com/2012/07/01/is-solution-focused-therapy-as-powerfully-effective-as-solution-focused-therapists-would-have-us-believe-2/

Secrets of the Miracle Question: https://johnsommersflanagan.com/2015/03/04/secrets-of-the-miracle-question/

The Love Reframe: https://johnsommersflanagan.com/2013/04/07/the-love-reframe/

Chapter 12 – Family Systems Approaches

None posted on this topic. Obviously, I need help here.

Chapter 13 – Multicultural Approaches

Four Good Ideas about Multicultural Counseling and Psychotherapy—In Honor of Martin Luther King, Jr.: https://johnsommersflanagan.com/2012/01/16/four-good-ideas-about-multicultural-counseling-and-psychotherapy-in-honor-of-martin-luther-king-jr/

Good Ideas about Multicultural Counseling and Psychotherapy – Part II: https://johnsommersflanagan.com/2012/01/22/good-ideas-about-multicultural-counseling-and-psychotherapy-part-ii/

Cultural Adaptations in the DSM-5: Insert Foot in Mouth Here: https://johnsommersflanagan.com/2014/07/08/cultural-adaptations-in-the-dsm-5-insert-foot-in-mouth-here/

Psychic Communications . . . and Cultural Differences in Mental Status: https://johnsommersflanagan.com/2013/01/02/psychic-communications-and-cultural-differences-in-mental-status/

A White Male Psychologist Reflects on White Privilege: https://johnsommersflanagan.com/2012/09/14/a-white-male-psychologist-reflects-on-white-privilege/

Chapter 14 – Integrative Approaches

None on this chapter either.

Teaching Counseling and Psychotherapy Theories: Reflections on Week 1

Teaching Counseling and Psychotherapy Theories – Week 1

This past Monday evening in Missoula, Montana I met with my 80+ counseling and psychotherapy theories students for our first 3-hour class of the semester. Some student might have thought they’d get out early on the first day of the semester . . . but such was not the case. We had a nice evening together (my opinion). Although it was smoky outside (too many forest fires nearby) in the classroom the air was clear and the thinking sharp. Every year it feels humbling when I meet a new group of students in the fall and recognize their dedication and intelligence, not to mention the compassion for and interest in helping others that’s an intrinsic requirement of taking a class that’s all about counseling and psychotherapy theories and practice.

This group was especially generous – laughing heartily at my stories and gently confronting me when I misspoke and suggested I might spontaneously lie to protect my client’s confidentiality. One of my favorite moments was when, as we were talking about strategies for protecting client confidentiality in a public situation where someone might ask, “How do you know ______?” Several students shared excellent strategies (far better than my ‘spontaneous lying’ idea). One in particular said, “I just don’t respond to the question and make some comment like ‘Oh yeah, you know she’s really good at soccer’ and then hardly anyone follows that up by asking me how I know that person a second time.” Somewhat surprisingly, I was able to use that particular line several times later in class whenever students asked me questions I couldn’t answer. You should try it. Here’s how it works: Somebody asks you something you can’t or don’t want to answer, just say, “Hey, you know she’s really good at soccer.” It’s pretty much guaranteed you won’t have to answer the question.

As a method of providing a little extra intellectual stimulation, below I’m including two activities that go along with the content of Counseling and Psychotherapy Theories in Context and Practice. Have fun and good luck in your personal quest for better understanding of yourself and others . . . a particular quest that never really ends.

Activity 1: Creating and Testing Personal Hypotheses

One of our graduate students told us his “personal theory” of why some people become good cooks and other people develop poor cooking skills. He said:

I’m a bad cook because my mom was a good cook. I never had any reason to learn to cook because my mom did it all for us. But my girlfriend is a really good cook. I think that’s because her mom was a bad cook and so she had more reason to learn to cook for herself.

Although you can probably see a number of flaws with the reasoning underlying this “theory,” most of us carry these sorts of ideas around with us all the time. Let’s briefly analyze and test our student’s theory and then move on to identifying some of yours.

First, we should ask: Is this student’s statement really a theory? The answer is “No.” The reason this isn’t a theory is because it’s too narrow and not very elaborate. Theories don’t just predict behavior, they also provide detailed explanations for why particular behaviors occur.

As described in the text, a theory involves a gathering together and organizing of knowledge about a particular object or phenomenon. Also, theories are used to generate hypotheses about human thinking, emotions, and behavior.  Although our student has developed an interesting hypothesis about one factor that contributed to why he and his girlfriend have poor and good cooking skills, he really doesn’t have an overarching theory for generating the hypothesis . . . but he could develop one. Perhaps his bigger theory is about how individuals compensate for their caregivers strengths and weaknesses. He would need to work on describing, explaining, and predicting how this process works, but his idea has potential.

Theorists work both deductively (from the theory to the hypothesis) and inductively (from the specific hypothesis or observation to the bigger theory). Our student appears to be operating inductively. He observed himself and he observed his girlfriend and he developed an interesting hypothesis.

It’s possible and reasonable for people to systematically test their personal theories or hypotheses. Most likely, if we asked our student to test his hypothesis, he would do so in a biased way. He would likely notice when his hypothesis is true and ignore or completely overlook evidence opposing his hypothesis. Social psychology has shown that humans just seem to operate that way . . . we look for evidence to support our ideas and ignore evidence that contradicts our ideas (see Snyder & Swann, 1978).

With all this in mind, take a few minutes to write down some of your personal hypotheses about human behavior. Pick anything that you tend to think is true about humans (e.g., women have greater pain tolerance than men; individuals from larger families have better social skills; pet owners have trouble relating to people) and describe it below.

Hypothesis 1:

 

Hypothesis 2:

 

Hypothesis 3:

 

After you’ve established a few hypotheses, think about whether they might fit together into an overarching theory—or are they just a few random and unconnected ideas about human behavior? Then, either way, think about how you might test the validity of your hypotheses. Also, think about how you could or would avoid being systematically biased toward validating your own hypotheses?

Activity #2: A Psychological Assessment Critique

Years ago, Rita had a cartoon on her office door that had two guys in their scientific lab coats in conversation. One of the guys was asking the other one something like: “Would you like me to come up with evidence to destroy this scientific argument or evidence to support it?”

The big point of the cartoon is that even science is subjective. Because science is subjective, it’s important to be able to criticize research in general and or own research in particular. For this activity, we’d like you to list five shortcomings or problems with measuring counseling and psychotherapy outcomes. For example, let’s pretend you’ve just conducted 10 sessions of therapy with a client. You’re interested in measuring your effectiveness and so you had your client complete a self-report questionnaire on depression at the beginning and again at the end of the therapy. Using a seven-point Likert scale, the client rated him/herself on 20 depression symptoms. If you used this scale or questionnaire, what might be the shortcomings or problems associated with this measurement system?

1.

 

2.

 

3.

 

4.

 

5.

 

At the end of this blog I’ve listed what I think are five of the most common problems with self-report outcomes measures. When you’re finished listing your five ideas, check out and compare your five ideas with my five ideas.

What are the Most Common Measurement Problems when Using Self-Report Measures in Therapy Outcomes Studies?

John’s Answers

  1. How do we know participants are giving us honest feedback about their feelings, beliefs, and response to the intervention? (Sometimes people lie, other times they deceive themselves, other times they automatically or intentionally respond in a socially desirable manner).
  2. How do we know participants are motivated to answer surveys, questionnaires, or interview questions with due diligence? (This variability in participant motivation can translate into a hasty response set or compulsive over-reflection on each item). It also results in a less than 100% response rate when surveys are administered.
  3. How do we know if participants are capable of defining or understanding what’s helpful for them? (Respondents may not have clear ways to distinguish whether what they received was helpful or they may not understand the question or they may misinterpret the question; even if they can make internal, individual distinctions of what’s helpful, how can we know how that compares with another person’s internal and individual standard for helpfulness)?
  4. How can we ever know if one person’s rating of a “5” on a 1-7 Likert (pronounced lick-ert) is ever really equivalent to someone else’s rating of a “5”? (For example, one of us has an issue with ever giving anyone or anything a perfect “7” or worthless “1” when completing seven-point Likert-type questionnaires and so his (or her) responses may not be comparable to people who don’t have such issues).
  5. Given that mood is highly variable and yet powerfully influential, how can we be sure that we’re not measuring, at least in part, something related to the respondent’s current mood, instead of current attitude or anything close to a behavioral inclination?

 

A Wiley Website with Info about our Brand New Counseling and Psychotherapy Videos

This spring and summer Rita and I have been working with John Wiley & Sons to produce DVDs to go with our textbooks Clinical Interviewing and Counseling and Psychotherapy Theories in Context and Practice. The Clinical Interviewing DVD is out and the Theories DVD will be available soon. There’s a new website with information about this at: http://lp.wileypub.com/SommersFlanagan/

Image

John reading the new textbooks to his twin grandchildren (who look quite excited about learning how to do psychotherapy).