Monday, September 28, 2009

Insight Psychotherapy

Insight Psychotherapies are those which derived from psychoanalysis. The essential feature was that people learned in therapy to link their present behaviour with past events, usually traumatic events. As a result of gaining 'insight', the behaviour of the present could be changed. It was recognised that "repetition compulsion" had occurred unconsciously causing individuals to repeat the programs of their past in their present and thereby recreating the original trauma and chaos. When a person had 'insight' the unconscious became conscious and the present negative behaviours ceased to occur. Unfortunately this model of therapy which was very beneficial and effective in some individuals it was found to be of limitted value and quite harmful indeed in other situations. It was found in sociopaths and psychopaths that this just fueled their 'rationalization' and 'justification'. The key concept in 'insight' psychotherapy is that once a person had 'insight' then the negative behaviour evaporated. Unfortunately in others the 'insight' in no way changes the negative present day behaviour but is rather used by the individual as more 'justification' for their negative behaviour. This was seen commonly in drug and alcohol settings too where the expression arose "you can't think your way into right action but you can act your way into right thinking". That expression developed because "poor me, poor me,pour me another drink" was recognised as a form of justification for the negative behaviour and that therapies that focused on trauma initially resulted in more alcoholism and drug abuse.

In the example, I was abused so I keep picking people who abuse me, this was even seen by the 'insight psychotherapists' as only 'surface' insight since it continues to place the 'locus of control' and 'responsibility for change" outside individual. In insight psychotherapy the key message of empowerment was that your present life was the one you were creating, albeit unconsciously. Not only were you attracting negatives but you were attracted to the negative. Now with insight the 'choice' to change was restored.
Further the key insight that caused change was often the recognition of the 'secondary gain' which perpetuated the behaviour. In the example above the insight is that this is the safe and known behaviour and the change from it would require new learning and frankly new learning is difficult so better the 'devil' I know which is safer than the 'unknown'. Further a lot of 'so called' negative behaviours are extremely well paid for or provide immedidate gratification. Motivation therapy was developed to assess motivation for change because it was recognised that many "talk the talk" but few were willing to 'walk the walk".
The fact remains that if a person has 'insight' into their present negative behaviour and it persists they don't have 'true insight' but simply a surface 'justification' or 'rationalization'.
Insight psychotherapy is meant to 'extinguish' negative behaviour in the present not to justify or rationalize it.

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