Constructive Therapy Constructivism Is a Theoretical Perspective

Constructive Therapy Constructivism is a theoretical perspective that asserts that people attempt to make sense of the world by developing their own set of personal individualized constructs. Personal experience, interpretation, social context, and linguistic factors define a person's subjective reality. Constructive psychotherapy focuses on individual experience, personal resilience, change, and the therapeutic relationship to assist people with change.

The current article asserts that constructivism and constructive psychotherapies heavily draw from principles of past theorists such as George Kelly and Kurt Lewin, and constructivism and constructive psychotherapies do not represent facets of a new paradigm. In this sense constructive psychotherapy is not a unified form of psychotherapy but instead a form of integrated psychotherapy.

Finally the article applies five basic principles of constructivism: activity, order, the self, social-symbolic relations, and lifespan development in the proposed psychotherapy of Sam, a man who is experiencing frustration and anger-management issues at his work and in his relationships. The therapeutic process is viewed as an integration of several schools of psychotherapeutic thought. Constructivism can be broadly defined as a theoretical perspective that asserts that people attempt to make sense of the world and the events in the world by developing their own set of personal individualized constructs (Mahoney, 1988).

Constructivism is not a system of psychology, despite what some would lead us to believe but instead would be best described as a metatheory or an epistemology which is centered on the presumption of the active involvement of people in construing their own personal reality, and not necessarily their reflecting on or their representing reality (von Glasersfeld, 1984). This last point is very important in understanding how constructivism fits in with both psychological theories and psychotherapeutic models. However, the term "constructivism" has taken on a number of different definitions.

Von Glasersfeld (1984) described a radical constructivism in which knowledge does not necessarily reflect reality but instead personal knowledge is an ordering of the world based on experience. Mahoney (1988) did not agree with von Glasersfeld's model and assumed a more realistic ontological formulation, and yet when one reads some of his later works Mahoney appears to accept the notion of personal constructs as more idealistic (e.g., Mahoney & Granvold, 2005).

Chiari and Nuzzo (1996) tried to settle these types of discrepancies by identifying two broad classes of constructivism: (1) epistemological constructivism is the view that believes that there can be numerous and yet equally legitimate constructions of a single reality, whereas (2) hermeneutic constructivists view knowledge as an interpretation that is historically founded, contextually confirmable, and socially and linguistically created (sort of a post-modernistic slant). Constructivism has found its way into psychology becoming a brand of psychotherapy known as constructive psychotherapy.

One can see where a viewpoint like constructivism would eventually find utility in psychological thought, especially in schools of psychotherapy. However, the question that a serious student of psychology might ask is "What is so new and innovative about all this?" Indeed constructivism has roots in philosophy and can be detected in learning theory where it was first popularized in psychology (Raskin, 2002).

For me, a student of personality theories, the constructivist movement in psychology is a blatant plagiarism of the work of Kurt Lewin and George Kelly with a touch of Hazel Markus thrown in for good measure (e.g., Kelly, 1955; Lewin, 1935; Markus, 1977). Mahoney states that constructivist themes can be found in the work of such greats as Adler, Bandura, Kelly, and others (Mahoney, 2003; Mahoney & Granvold, 2005). But he is wrong. Constructivism contains themes from Aldler, Bandua, Kelly, and others.

Personally, I am able to see constructivist-like themes in psychotherapeutic models as far back as Freud and extending to Aaron Beck. The difference is that Beck and Freud outlined some universal principles of "constructivism," whereas in the post-modernistic era things like subjectivity, context, social values, and linguistic variables are given priority.

To me this is all old wine in new bottles, but also an example of theory development as admittedly there is a sense of evolution involved in going from Lewin to Mahoney in terms of updating certain aspects of theory. Regardless, Raskin (2002), who shares many of my sentiments, acknowledges that constructivist psychologies (hence constructive psychotherapies) have grown in quantity and in their influence. This has resulted in a large number of theoretical and research settings that have gradually intermingled and become entrenched with psychology at large.

In fact, there is even a Journal of Constructivist Psychology that has attempted to make a mark on the vast area of psychotherapy research. However, in spite of the growing influence of constructivist psychologies and constructive psychotherapy the field has not been able to evolve into a unified and theoretically consistent orientation. So we have Personal Construct Psychotherapy and Narrative Psychotherapy, etc. All have different constructivist flavors. For me, constructive psychology, aside from being old wine in new bottles, is really a form of integrative or eclectic psychotherapy.

The difference between integrative psychotherapy and eclectic psychotherapy is that integrative therapy ties together at least two different elements from at least two different schools of thought into a unified theoretical approach, whereas eclectic approaches combine different techniques from different schools on a case by case basis (Palmer & Woolfe, 1999). Probably the first true integration of two different schools of modern psychological theories was the integration of behavioral and psychodynamic models of thought to explain neurosis (Dollard & Miller, 1950).

Cognitive behavioral therapy would qualify as an integrated therapy that has become a unified school of therapy on its own as it has developed hypotheses that are distinct from which the original integration was based (Arkowitz, 1992). Given their numerous theoretical differences there is no agreement among constructivist psychotherapists arriving at a singularly recognizable orientation (Raskin, 2002). Even Mahoney (2003) acknowledges that constructive psychotherapy is not defined by specific therapeutic techniques. Again constructivism is not a school of psychology.

So, given the framework from which constructive psychology is drawn, I would currently classify it as another form of integrative psychotherapy. In fact, one might suspect that this form of integrative psychotherapy more often than not becomes eclectic psychotherapy in real practice. However, just because I view constructive psychotherapy as a form of integrative therapy that draws from past theorists does not mean that I am unable to find relevance in some of the themes from constructivism and apply them to my own orientation.

If nothing else the constructivist perspective for me combines elements of cognitive and humanistic perspectives along with schema theory and social cognition. I find myself agreeing with the five main features of constructivism as they apply to therapeutic practice outlined by Mahoney (Mahoney, 2003; Mahoney & Granvold, 2005). Consider the case of Sam, a 32-year-old male of Greek-American descent referred by a coworker who was concerned about Sam's recent poor work performance, marked by bouts of angry outbursts, moodiness, and sarcasm towards coworkers.

He is employed as a photographic editor at a large marketing firm. Sam's major concern is the stress that he is feeling at his current job. He is concerned that his supervisor does not recognize his efforts, and is trying to "keep him on the back burner" and prevent future advancement in the organization.

Sam is very frustrated by this, as he reports that when he first started working at the company, his supervisor "was an amazing mentor who literally took me under his wing." Sam reports that he has done "everything that he could" to win back the approval of his supervisor. Sam says he feels "empty and bored" lately. He is considering making a career change but is not certain what he would like to do next.

He reports that he has an active social life, going out several times per week to clubs and bars. Although Sam does not use recreational drugs, he does note that he sometimes "drinks too much when he is out partying." Recently, he was involved in a physical fight with another man at a bar. He has been married twice previously (for two and five years respectively). He described his second divorce as particularly painful, during which he was briefly hospitalized for a failed suicide attempt.

He is very eager to be in a relationship now, and believes that he just has not found "the right woman." Applying the themes of constructivism to Sam's case as outlined by Mahoney (2003) and Mahoney and Granvold (2005) we use the following five principles: The Principle of Activity. Unlike many of the behaviorists and hardcore Freudians constructivism asserts that people are active participants in their lives. People choose from alternatives and their choices can affect their lives and the lives of others with whom they have connections.

People can also be reactive as in conditioning, but survival is a process that is fundamentally proactive. People anticipate what they want to happen and what they think will happen and try to merge both of these. There are also factors outside our sphere of influence but people learn to read them and anticipate them based on their experiences. So people are agents acting on the world (likewise the world is an agent acting on us). Constructivism emphasizes self-efficacy, knowing, and personal relationships as key motivational components in one's life.

In Sam's case we can then hypothesize that Sam is actively seeking something in his relationships. His frustration indicates that he is not getting that, but it also indicates the potential for growth and learning. Here we integrate aspects of client centered therapy to develop a strong therapeutic relationship with Sam, develop trust, and to truly understand him while at the same time combine cognitive perspectives to understand how he views the world, especially his current situation at work, his relationships, and where he is heading in life.

Based on the information we have we can hypothesize at some of these answers, but instead it is better to let Sam tell the story from his point-of-view as the therapeutic relationship develops. This will avoid a confirmation bias (Watson, 1960) and will the therapist avoid imposing their own views and explanations on Sam's situation. The Principle of Order. This theme recognizes the need for people to have order in their lives. However, this idea of "order" does not necessarily mean orderly or logical.

People seek to organize their lives based on their experiences, their conclusions, and predictability. While people are active agents, constructivism also understands that the movement for order and the search for patterns in life may occur by means of which people are largely unaware. This where social cognition can nicely fit in with some of the ideas of constructivism. The Dual Process Theory of Cognition (e.g., Shiffrin and Schneider, 1977; Lieberman, Gaunt, Gilbert, & Trope, 2002) is a well-established paradigm in cognitive science.

According to this idea there are generally two modes of processing information. The first one is a controlled mode of processing information that is slower in execution, conscious, and reflective. This is what most people think of when they think of the mind. It consists of logic and reasoning. However, it is slow and can be indecisive.

If one had to think "put my foot on the break" and then think out the entire process of breaking and accelerating at every red light one encountered one would end up with a lot of traffic tickets. The second mode of processing is an automatic mode of processing and responding. This automatic mode is fast in execution and processing, unintentional, uses little energy, difficult to change or stop, and does not conform to rational thinking or logic.

A person uses little thought and attentional direction when processing, remembering, and acting in this mode. This mode of processing and acting is driven by schemas and scripts, which are mental representations or models of the world that are formed over time and are often based on experience. These schemas are activated during certain contexts such as evaluating a situation or as a model to determine action or rules for behavior.

Habits are enacted out of automatic processes, but can be initially learned though controlled processes, as is the case with driving a car. Indeed much of our day-to-day behavior has become automatized. Automaticity also applies to feelings and patterns of thinking. Thus cognition is generative, reactive, and proactive. People are self-organizing and active in determining how order is interpreted in their lives. But the search for order and the drive to maintain it can soon become automatic.

Emotions are critical in directing the person's attention, shaping perceptions, organizing memory, and motivating the person's active engagement in seeking order. Sam is obviously looking for his own personal order (again we can speculate what that is, but it is best to find out from Sam). One thing we can speculate is that Sam's frustration indicates that he is either trying to impose order on the situation (as in his drinking or fighting) or he is not getting the type of predictability that he needs to make sense of things.

Again this frustration is not bad or unhealthy; it has important implications for what Sam believes, needs, and wants. By developing a therapeutic relationship via a Rogerian method and understanding his thoughts via cognitive and constructivist methods we can both learn what these are and then work on ways to achieve them. The Self. Constructivism believes that the person organizes their worlds by first organizing themselves. This begins with self-differentiation form one's caregivers and continues throughout life. One's body becomes an "axis" for the organization of personal experience.

One's relationship with oneself is very complex and psychotherapy in its broadest sense is therapy directed at the self (Guidano, 1987). However, the uniqueness of the self-organization is the emphasis in constructivism and constructive therapy. What people perceive and experience is related to how they have learned to create an orderly point of reference. Constructivists view the self as more of a process and not a thing or being; for them the self is more fluid. We need to realize that the self-change in relation to experience and contact with others.

So perception of I or me is activated by social influences and is never a complete representation of the fullness of one's being. This often overlooked in other schools of psychotherapy that attempt to define a person as a "type." For Sam, he is not just a frustrated employee looking for love or whatever someone might type him as. There is much complexity to him and he and his perceptions are unique to his situation. These are crucial points to remember when trying to understand and work with him.

One of the goals in therapy is to help Sam to expand his self-awareness and self-conceptualizations in positive ways that lead to self-satisfaction, growth, and contentment. This is through the development and enhancement of the therapeutic relationship. Social -- Symbolic Relatedness. The order that many people try to find in their lives and their perception of meaning is generated from their relationships. Language can be inadequate to express how relationships or the need for relationships is entrenched in our minds.

Experiences bring into play a perceptions and interpretations that depend on a vast network of relationships. Perceptions and experience can in part depend on the person's history with like events or if an experience is unfamiliar these can be unconsciously interpreted in terms of what is already familiar to the person. Things, people, events, etc. that are familiar and comfortable to a person depend on their personal history, their vocabulary and concepts, and their experience with others.

Since people are social animals there is no way separate social bonds from their symbolic roles. In Sam's case it is important to understand what his symbolic representation of relatedness and relationships are. How does Sam view his need to relate to others, what he expects in relationships, what relationships mean to him, etc. One way to achieve this is to listen to his stories. Stories about how he recalls his early relationships, his current relationships, and relationships he would like to have.

This helps to understand how Sam imparts meaning on his experience and how he understands himself in relation to the world. This takes a lot of active listening and reflection via a Rogerian approach. It extremely important to clarify Sam's feelings and perceptions, but not to put words in Sam's mouth on these issues. As emotions are powerful directors of symbolic meaning it is also crucial to understand how he feels about these things.

As is often the case people behave based on predictability; that is, actions are based on what we predict will happen as a result of our behavior. This notion of predictability is entrenched in a complex network of experience, symbolic relatedness, and personal semantics. In order.