Insight-oriented Therapy
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Insight-oriented psychotherapy is a category of
psychotherapies Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome prob ...
that rely on conversation between the therapist and the client (or patient). It involves developing the patient's understanding of past and present experiences, how they are related to each other and the effect they have on the patient's
interpersonal relationships The concept of interpersonal relationship involves social associations, connections, or affiliations between two or more people. Interpersonal relationships vary in their degree of intimacy or self-disclosure, but also in their duration, in t ...
,
emotions Emotions are mental states brought on by neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure. There is currently no scientific consensus on a definition. ...
and
symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an disease, illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormali ...
. Insight-oriented psychotherapy can be an intensive process, wherein the client must spend multiple days per week with the therapist.


Overview

Forms of insight-oriented psychotherapy include
psychoanalysis PsychoanalysisFrom Greek: + . is a set of theories and therapeutic techniques"What is psychoanalysis? Of course, one is supposed to answer that it is many things — a theory, a research method, a therapy, a body of knowledge. In what might b ...
and
Gestalt therapy Gestalt therapy is a form of psychotherapy that emphasizes personal responsibility and focuses on the individual's experience in the present moment, the therapist–client relationship, the environmental and social contexts of a person's life, ...
. Insight oriented psychotherapy places a large emphasis on personal discovery for the patient. Through dedication to trust filled conversations, the patient will go through a process of enlightenment with the therapist. The patient will begin to understand significant life events of theirs as triggers or agents of change for how they live their lives today. Researchers have concluded that
Insight Insight is the understanding of a specific cause and effect within a particular context. The term insight can have several related meanings: *a piece of information *the act or result of understanding the inner nature of things or of seeing intu ...
has a clinically significant effect on the therapeutic outcomes of psychotherapy, to the point where it is now considered as relevant as long-standing factors like
empathy Empathy is the capacity to understand or feel what another person is experiencing from within their frame of reference, that is, the capacity to place oneself in another's position. Definitions of empathy encompass a broad range of social, co ...
, positive regard and
therapeutic alliance A therapeutic alliance, or working alliance, is a partnership between a patient and his or her therapist that allows them to achieve goals through agreed-upon tasks. The concept of therapeutic alliance dates back to Sigmund Freud. Over the cour ...
.


History

The oldest form of insight-oriented psychotherapy was developed by
Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating pathologies explained as originating in conflicts in ...
and is known as psychoanalysis.Freud avoided ordinary experimental methods and sought to establish the case history as a method of research. His first main collection of case histories was included in his book titled Studies on Hysteria. In this book, Freud and Breuer argued that regaining repressed memories associated with trauma would lead to resolution of
dissociative amnesia Psychogenic amnesia or dissociative amnesia is a memory disorder characterized by sudden retrograde episodic memory loss, said to occur for a period of time ranging from hours to years to decades. More recently, "dissociative amnesia" has been d ...
and the associated psychological symptoms.


Psychedelic therapy

Some evidence suggests that the process of insight-oriented psychotherapy can be improved by the use of drugs, which can be described as
psychedelic drugs Psychedelics are a subclass of hallucinogenic drugs whose primary effect is to trigger non-ordinary states of consciousness (known as psychedelic experiences or "trips").Pollan, Michael (2018). ''How to Change Your Mind: What the New Science of ...
(meaning "mind-manifesting").Grinspoon, L., & Doblin, R. (2001). Psychedelics as catalysts of insight-oriented psychotherapy. ''Social Research'', 68(3), 677–695. Psychedelic substances, such as the amphetamine
MDMA 3,4-Methylenedioxymethamphetamine (MDMA), commonly seen in Tablet (pharmacy), tablet form (ecstasy) and crystal form (molly or mandy), is a potent empathogen–entactogen with stimulant properties primarily used for Recreational dru ...
, can be used in psychotherapy to reinforce and enhance the relationship between the healthcare professional and his or her client (or patient). Such substances can be used to better manage
abreaction Abreaction (german: Abreagieren) is a psychoanalytical term for reliving an experience to purge it of its emotional excesses—a type of catharsis. Sometimes it is a method of becoming conscious of repressed traumatic events. Psychoanalytic origin ...
and
catharsis Catharsis (from Greek , , meaning "purification" or "cleansing" or "clarification") is the purification and purgation of emotions through dramatic art, or it may be any extreme emotional state that results in renewal and restoration. In its lite ...
and improve the quality of understanding between the healthcare professional and patient. Numerous clinical papers on the effectiveness of psychedelics in insight-oriented drug therapy have been published. These psychedelics were used to treat a wide variety of psychological issues, including "
alcoholism Alcoholism is, broadly, any drinking of alcohol (drug), alcohol that results in significant Mental health, mental or physical health problems. Because there is disagreement on the definition of the word ''alcoholism'', it is not a recognize ...
, obsessional neurosis, and
sociopathy Psychopathy, sometimes considered synonymous with sociopathy, is characterized by persistent antisocial behavior, impaired empathy and remorse, and bold, disinhibited, and egotistical traits. Different conceptions of psychopathy have been u ...
". Furthermore, it was found that psychedelics were effective in easing the process of dying patients. A major reason for the clinical interest in psychedelic drugs for psychoanalysis was the belief of some experimental subjects that the experience of using psychedelic medication reduced their feelings of
guilt Guilt may refer to: *Guilt (emotion), an emotion that occurs when a person feels that they have violated a moral standard *Culpability, a legal term *Guilt (law), a legal term Music *Guilt (album), ''Guilt'' (album), a 2009 album by Mims *Guilt ( ...
and made them less depressed and
anxious Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
and more self-accepting, tolerant, and alert.


Role of therapist

The two main roles for the therapist are to stay neutral and abstinent towards their patients. Patients who are engaging with Insight-oriented psychotherapy attempt to build a trust-infused
rapport Rapport () is a close and harmonious relationship in which the people or groups concerned are "in sync" with each other, understand each other's feelings or ideas, and communicate smoothly. The word stems from the French verb which means liter ...
with the therapist. It is believed that patients will be able to speak freely without feeling judgement if they understand that their therapist is not reacting, either positively or negatively towards what the patient is saying. In this way, the therapist is keeping a neutral disposition towards the patient.


Issues

The popular treatment methods used can also generate
placebo A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures. In general ...
insights within clients. Since patients may face a lot of pressure in the therapeutic encounter, they may experience "insights" such as illusions, deception, or adaptive self-misunderstandings—and it can also generate therapeutic artefacts that seem to confirm these insights. Different treatment options based on other assumptions about certain ameliorative factors in psychotherapy have been affected by this trend towards shorter treatment procedures. Insight-oriented therapies have generally consisted of treatment approaches that share the premise that behavior is disturbed in some manner through a lack of client awareness. Many problems have emerged in clinical treatment settings, in large part due to time limitations, as well as the restricted, minimal focus placed upon each of the above types of treatment.


Case study

In one example of insight-oriented psychotherapy, a nearly middle aged woman was having difficulty with her cancer treatment. The treatments themselves were not the issue. The issue was that this cancer patient was confusing her past, tumultuous relationships with her current ones—specifically with the doctors who were supposed to be treating her. "Associations to the follow-up pelvic exams and second-look surgery (which was negative) reminded her of her father's violation and denigration of women. She felt as though she was subjecting herself to yet another uncaring man who was out to hurt and humiliate a woman." It was ultimately these realizations that the patient came to in her insight-oriented sessions that allowed her to continue her cancer treatment.


References

{{Reflist Gestalt therapy Psychotherapies