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Why it makes sense not to blend the ‘flavours’

When I was younger and used to eat ice cream with abandon, I was not content with just one flavour. If I got a cone, I’d get two different flavours. At one establishment we used to frequent they would let you choose your flavours for a banana split, and so you’d have to select three flavours of ice cream and then choose three kinds of toppings, one for each flavour.

Now, that was the best (or from my current perspective the worst). I did not think of it so much then, but what I was doing was integrating. I was an integrative ice cream fanatic. I wanted to see what it was like when the flavours blended or when I ate one and then went right for another. At the same time, I also instinctively knew that some flavours did not go well with others. For instance, I would never attempt to integrate strawberry with chocolate mint. That’s how to wreck a perfectly good ice cream cone.

When it comes to the practice of psychotherapy, some clinicians consider themselves to be “integrative psychotherapists”. However, it’s not quite as simple as eating ice cream. There are four kinds of integration when it comes to integrative psychotherapy. The four primary means for understanding psychotherapy integration are assimilative integration, technical eclecticism, common factors research and theoretical integration.

In technical eclecticism the clinician patches together his or her own pragmatic system using methods and techniques observed in the practitioners of various single-school theoretical models. So, in this way a person might read about two-chair work and then decide to do some two-chair work along with the other things he or she has collected to do. This approach tends to be more technique oriented and less driven by an organised and systematic theory. It has been frowned upon as being nothing more than a bag of tricks, but of course, those who practice this way would say they are simply utilising what works. The argument in return would be that extracting a technique from its theoretical context might cut the legs out from under its effectiveness.

In assimilative integration methods and techniques are not simply appropriated intact from other modalities; they are chewed up and digested so that when they appear in a person’s practice, they are thoroughly consistent with the main established theory that informs the clinician’s practice. In this approach, widely disparate techniques and methods do find themselves being appropriated, because there needs to be some way in which they lend themselves to the common theoretical base. They have to be capable of being assimilated.

In the common factors approach, theory and method are developed in harmony with core features of treatment, called factors, which have been empirically shown to contribute significantly to positive outcomes. This is the observation that certain elements of all approaches to therapy are effective. In this approach to integration, the various theories of psychotherapy are united through their utility and reliance upon such things as the relationship between therapist and client or the realisation that client factors/extra-therapeutic factors (what gestalt therapists call “the field” or what relational systems psychoanalysts call “the context” or the “system”) are significantly important and determinative of outcome.

In theoretical integration elements of different theories are joined to form another, cohesive theoretical system, one that is a true synthesis and more than a simplistic combination. The integration yields an emergent theory that is, as the saying goes, more than a sum of its parts. Gestalt therapy is a contemporary example of early theoretical integration in psychotherapy (which has matured in its last 50 years) in that it was originally a combination of phenomenological and existential philosophy (a la Edmund Husserl, Soren Kierkegaard, and others), psychoanalysis (a la Freud and Reich), organismic theory (a la Kurt Goldstein and others), field theory (a la Kurt Lewin and others), and experiential/experimental elements from behaviourism and drama therapy (a la Jacob Marino).

Extending the trend of technical and theoretical integration to its logical end, there would ensue the creation of one cohesive system of psychotherapy. Charles Gelso makes a case for the unification of psychotherapy as a form of integration, unification being the creation of one grand model that satisfies various critical criteria. While that may be one aspiration, the critical response is to maintain that the creation of one grand model would homogenise psychotherapy and lose valuable distinctives found in the various individual and specific theoretical models.

There does exist a significant “push” toward integration in psychotherapy. A professional association exists for it, and there is a journal dedicated to it. Many in addition to Gelso would like to see the field unified. However, I’m not so sure that can actually be done. It would be like blending all the various flavours of ice cream into one, sugary sludge. Just think of it. No more rocky road. No more marble fudge. No more chocolate mint. Yikes! What a thought. I just don’t think behaviourism blends all that well with object relations or psychoanalysis.

And that is the same thought when it comes to the subject of all the various kinds of churches and denominations of churches that exist in the world. Each one originated out of the needs and perspectives of a given group of people living in a particular time and place, taking their own particular interpretation of scriptures and/or spiritual experience. The divisions exist because religious people differ in terms of what is most relevant and salient. There is a corresponding theory, or theology, that goes along with each of their respective denominations. Sure, there are differences, and the differences have resulted in bloody confrontations in the course of church history, but that is just about how to handle difference, not qualitatively dissimilar from the bloody conflicts that arise in people’s marriages, and not about the fact of difference itself. The trick is the appreciation of difference, that it actually enriches, and the willingness to communicate with one another about it.

Frankly, no church denomination has it all right; each one is a bit off in some way, and each one has captured something of the nature of Christianity as well. So, there is “good” and there is “bad”, there is truth and there is error in each flavour, and I would rather have it that way than to try blending them all together into one homogenised sludge.

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Published January 15, 2013 at 8:00 am (Updated January 14, 2013 at 4:37 pm)

Why it makes sense not to blend the ‘flavours’

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