The systemic conception of our psychotherapy school

The systemic conception of our psychotherapy school is based on theoretical foundations in the human sciences, the theory is integrated with practice and focuses on the approach to the person at the psychological, cognitive, emotional, and spiritual levels, in the context of the socio-political space, taking into account the national specificity of Romania and the European context.

Thus, EAIP defines "integrative" as any method that exemplifies or develops a conceptual, principled, theoretical combination between two or more specific approaches or that represents a model of integration as such.

The central doctrine of integrative psychotherapy, while recognizing the importance of a specific leading-edge approach, still places at the center of priorities those elements that are common to all psychotherapies, especially the psychotherapeutic relationship in all its dimensions. Given the integrative dynamic model, in the context of holism, which asserts that the whole is more than the sum of its parts, "the epistemological foundations of our approach to integrative psychotherapy support non-linearity and multi-causality in the field of theory, illuminating the subjective personal experiences of phenomenology and the simultaneous exploration of both, adding a new essential dimension to the approach of integrative psychotherapy – the interhuman dimension." (Evans, Gilbert 2005).

In this regard, there is an ethical obligation for integrative psychotherapists to engage in dialogue with colleagues about various professional orientations and to remain informed about discoveries in the field.

Integrative psychotherapy primarily embraces a particular attitude towards the practice of psychotherapy, affirming the importance of a unified approach to methods in the treatment of individuals. An important aspect is the appropriate and effective response to the psychological, cognitive-behavioral, emotional, and spiritual needs of the person. The goal is to facilitate integration so that the qualities of the person, which exist and function in the intra-psychic, interpersonal, and socio-political space, are maximized, taking into account the limits of each individual and external conditions.

Integration is a process to which therapists must also adapt.

In this framework, it is recognized that integration is a process to which therapists must also adapt. The personal integration of therapists is an important point. However, it is acknowledged that in addition to personal integration, there is also a need for a commitment to improving knowledge in the field of psychotherapy and related areas. The recent resurgence of interest in neuroscience and neurobiology provides another bridge of integration among clinicians from different orientations.

Integrative psychotherapy therefore promotes flexibility in approach, the epistemological foundations support non-linearity and multi-causality in the field of theory, and subscribes to maintaining standards of excellence in client services, training, and supervision. Thus, when integrative psychotherapists create different strategies, techniques, and constructs for addressing various situations, this process is not done haphazardly, but in a manner based on clinical intuition and a solid and clear understanding of existing problems and necessary solutions.

In a final analysis, integrative psychotherapy highlights particular and combined approaches in treating various issues, and also places a priority on those common factors across all types of psychotherapy. On the other hand, it places a special emphasis on an attitude of respect, kindness, honesty, and equality regarding the client's personality, in a manner that affirms the integrity and humanity of the other, as well as of oneself.

Integrative psychotherapy asserts the importance of ensuring a suitable environment in which growth and healing can take place in an inter-subjective space created together by the client and the therapist. The integrative approach that our school proposes includes the dynamics and study of relationships in the context of the individual (self with self), couple, family, group, social, and the broader cultural environment.

Elefteriadou (1994) defines culture as "a way of creating common modes of operation, so that we can communicate effectively," including "common events, practices, roles, values, myths, beliefs, customs, symbols, illusions, and realities." Culture, he specifies, exists within individuals (psychologically speaking) and outside of them (in existing social institutions). Culture is not a closed system, but changes with each generation.

Andrew Samuels wrote: "...depth psychology must confront the fact that it is not possible to imagine a person separate from their cultural, social, gender, ethnic environment, and, above all, from the economic and ecological context." (Samuels, A., 1993).

The clear implication is that integrative psychotherapy (and psychotherapy in general) needs to question its assumptions about all therapeutic processes and the relevance of the psychotherapy models that integrate them in order to effectively respond to clients from diverse cultural backgrounds and contexts. Ridley (1995) states that many psychotherapists are unaware of the perpetuation of racism as a result of assumptions made about their model interpretations.

The integrative therapist is not a detached observer, but works with a horizontal attitude, trying to avoid hierarchizing when describing behavior.

According to Eleftriadou, the therapist "must aspire to equality even when exploring clients with opinions about other cultures and races, but also include the ability to accept from clients of various ethnic minorities the anger towards the majority culture" (Eleftriadou, 1994). This attitude of equalization is compatible with the dialogical approach that requires an assessment of differences to facilitate true contact (Evans, 1996).

From our perspective on integrative psychotherapy, we appreciate the notion of consensus – put forward by Varela – that human beings create, by mutual agreement, constructions of reality. A person creates their own world moment by moment, but needs the existence of another to make it a co-dependent creation. Varela's image is that of a "path created by walking" (Varela et al., 1993).

Integrative approach: multicultural and transcultural

We also agree with Elefteriadou's correct distinction between a "multi-cultural" approach and a "trans-cultural" one. The former involves using one's own reference points to understand another person, while the latter emphasizes the need to "go beyond cultural differences" (Eleftriadou, 1994).

The integrative psychotherapist, supported by a foundation based on the phenomena of integrative psychotherapy, adopts a position where all phenomena are accepted as "normal", as the subjective reality of a person. Thus, the integrative psychotherapist can transcend cultures while respecting the client's unique worldview and values, and consequently allows cultural issues to influence the process and direction of therapeutic work.

The Romanian Integrative Psychotherapy School believes that the belief system is the factor that filters how an individual represents their world. Chekhov says that "a man is what he believes he is" and, usually, when we think of beliefs as creeds or doctrines, we understand by this the organized, predetermined filters for how we perceive reality. The belief system represents the compass by which we draw the map of the intra-psychic reality with which we enter the therapeutic relationship.

Therefore, it is important to take into consideration the internal and external reference frames of each participant in the therapeutic act. Any human behavior is based on a pattern according to which experiences are organized and function according to the meta-programs existing at any given moment in each individual. Meta-programs are the programs or internal patterns through which a person forms their representations and directs their behavior.

The spatio-temporal framework

In this context, the spatio-temporal framework of the therapeutic relationship configures both the conscious and especially the unconscious of the two protagonists of the therapeutic act, having a major influence on the choice of strategies and, above all, their adaptation to the unique particular context of each therapy, aiming to harmonize the therapeutic approach with the specific cultural, geopolitical, and ecological space.

The time frame, the historical period in which the psychotherapeutic process takes place, as well as the imprint of an order in trans-generational relationships, establishes the specific relational patterns in the process of psychotherapeutic interaction.

An essential coordinate in the relational dynamics within the therapy office, in the process through which both the therapist and the patient write their life script, as well as in modeling their own belief system, in the relationship of the self with oneself, is the implementation of scientific discoveries in the fields of quantum physics, biology, and genetics and their assembly into the belief system existing at a given moment. This fact determines the transmutation of the human potential involved in the relationship, both of the therapist and the patient, to a higher level, generating new meanings about the mechanisms of evolution and allowing an approach that favors the adjustment of the belief system to the new reality of the context in which science has surpassed beliefs in the Newtonian material universe, as people have come to understand that the universe is not made of matter suspended in empty space but of energy, (Bruce Lipton, 2003,) being a quantum universe, a fact that Einstein realized when he wrote his famous formula E=MC2, demonstrating that we do not live in a universe where physical objects are separated by a lifeless space, but the universe is an indivisible whole in which matter is condensed energy, and energy and matter are so deeply intertwined that it is impossible to consider them as independent elements.

While conventional biologists apply a reductionist view in which they believe that the mechanisms of our physical body can be understood if we take each cell individually and study the chemical parts that compose it, believing that the biochemical reactions that sustain life are generated through a linear flow of information – (The Biology of Belief, Bruce Lipton) the quantum perspective recognizes the enormous complexity of the intercommunication between the physical pieces and the energy fields that form the whole. The flow of information in a quantum universe is holistic.

The map of interaction between matter and energy, between human fields viewed as interaction from this perspective gains new and profound meanings, to which, applying the theory of resonance, we can conclude that the functionality of the psychotherapist influences the selection of patients who will participate in the therapeutic process and determines changes in their structure, once they enter into resonance, even before the moment of the first physical contact and then throughout the duration of the therapy.

“I work from a relational and developmental perspective and support clients in deepening their contacts with me so that, after some time, they can assimilate and integrate into their relationship and experience a correct emotional relationship. In this process, the therapist, through their presence, with commitment and courage, gradually becomes a transformational object (not just a transitional object). Through this “alchemical” process, the innate powers of the client can be enhanced and realized. The journey is human and profoundly spiritual,” (Evans, 2009).

Co-creation of the therapeutic relationship

“Central to our conception of psychotherapy is the focus on the co-creation of the therapeutic relationship as an interactional event in which both parties participate.

It is not a unilateral relationship, where one party "acts" while the other party is just a passive recipient, but rather it is built as a relational process in collaboration that constantly evolves, to which both the therapist and the client contribute. Healing and change occur only in and through the co-constructed relationship, with the therapist and client evolving over time. The therapeutic relationship is seen as a dynamic process between two people in mutual interaction in the therapy room, always a unique meeting due to the individuality of the people involved. It is very much a bilateral view of the therapeutic process, recognizing that the client will also have a constant impact on the therapist. Therefore, we can say that the therapeutic relationship is reciprocal, but not symmetrical.” (Evans, Gilbert, 2005).

The therapeutic relationship is reciprocal, but not symmetrical

A therapeutic relationship built on reciprocity does not necessarily imply equality of influence or similarity of contribution. "Mutual influence does not imply equal influence; the analytical relationship can be mutual without being symmetrical" (Aron, 1991). Reciprocity does not imply a disappearance of the therapeutic role or tasks on the part of the therapist, but rather an awareness that two people cannot be in a meeting with each other without having an impact or being influenced by one another. (Maroda, 1991).

We emphasize, however, the importance of the patient as an architect of change to the same extent that we greet and recognize the quality of the therapist's contribution to the relationship. The therapeutic process is seen as a joint effort, and each therapeutic relationship is unique in its dyadic qualities. The therapeutic relationship always unfolds within a specific social, political, historical, and spiritual context that will influence the nature of the patient-therapist interaction.

We, therefore, emphasize the broader context in which the therapeutic dyad unfolds, in all its complexity and multiple dimensions. This approach focuses on the therapeutic encounter as the core of the therapeutic process and as the medium or container of change in a perpetually changing field. In this process, we give due credit to creativity in technique and strategy, as they emerge from the relational context and organically facilitate the therapeutic process.

The emphasis on the joint construction of the relationship means that we support a "dual" vision of the therapeutic process, in which both participants are viewed as members of a reciprocal relationship, an intelligent dance of empathy with reciprocal interactions and influences.

Our approach is, therefore, very aligned with contemporary relational psychotherapy.

• First of all, we consider intersubjective theory, which emphasizes the concept of "mutual influence" (Stolorow and Atwood, 1992). They use the term co-determination to describe the reciprocal process both in development and in psychotherapy.
• Secondly, we are associated with modern dialogues in gestalt therapy that focus on the healing dialogue in psychotherapy and emphasize the importance of the space between the therapist and the client – as the space in which healing takes place (Hyener, 1993) … if we truly consider the concept of the middle, then there is a reality greater than the sum of all experiences, both of the therapist and the client. Together they form a whole that provides context for each person's experiences. Perhaps this is the most succinct explanation of the middle.” (Gilbert, Evans, 2005).
• We also draw inspiration from contemporary relational psychoanalysis with the central doctrine: “The relational approach that I advocate sees the analyst-patient relationship as established and re-established through a continuous mutual influence in which both the patient and the analyst systematically affect and are affected by each other” (Aron, 1999).

These three contemporary approaches emphasize the reciprocity of the therapeutic process as a co-construction process between the therapist and the client. However, we must highlight that the techniques used, the therapist's use of self, views on transference and countertransference, the perspective on the use and disclosure of one's own feelings, the way of relating in the meeting with the client – all of these vary greatly.

• Relational unconscious: the analytical third person

Ogden, speaking about the inter-subjectivity of the "analytic third", takes this concept of mixture and takes it even further, drawing attention to an unconscious process co-created by the therapist and client that can provide an important insight into the client's process. The analytic third person arises from the interaction between subjectivity and inter-subjectivity that generates as if it were a third person in the room. Ogden (1994) argues that any daydreams or concerns from the analyst during the therapeutic hour, even if they seem frivolous or distractions from the subject at hand, still have meaning for the meeting. What we usually "put in parentheses" or reprimand ourselves for because it distracts us, may relate to the analytic third and may contain valuable unconscious communications about the quality of the therapeutic relationship.

Gerson (2004) talks about the "relational unconscious", which he describes as the "unrecognized link that binds each relationship, penetrating the expression and construction of each person's subjectivity and the individual unconscious within that relationship." The concept of the relational unconscious emphasizes the interconnectedness of each therapeutic pair and forms an "invisible bridge" between them (Gerson, 2004).

This definition of the concept of the analytic third adds another dimension to the co-creation or co-determination of the relationships mentioned earlier, suggesting that we create our relationships with each other, at both conscious and unconscious levels. In the therapeutic process, it is therefore important to be open to the messages filtered through the remnants of relational unconsciousness. They can arise – either from the therapist or from the client – in various forms, such as dreams, fantasies, distractions, obsessive concerns, physical symptoms, or other forms of manifestation. Relational psychotherapists will pay special attention to these phenomena, providing, as much as possible, insights during therapy moments that seem to be "stuck."

Our own approach to integrative psychotherapy, while recognizing the importance of a specific frontline approach or combinations of approaches to specific issues, still places at the center of priorities those elements that are common to all psychotherapies, especially the therapeutic relationship in all its dimensions. Such a relational approach to integration affirms the importance of providing a protective environment in which growth and healing occur in an inter-subjective space created in cooperation by the therapist and the patient.

The practice of self-realization

A key theme in the integration approach is the focus on self-development, as inner harmony fuels outer strength. Evans and Gilbert address in their work "An introduction to Integrative Psychotherapy," 2005 the various aspects of the self in different relationships, "because we believe that change in psychotherapy can occur in one, several, or all of these areas. At any given moment, for any client, one of these points will be more important than others, and at another stage of life, others will be at the center.

We also see that all these areas of personal experience are inevitably interrelated, but we believe it is more useful to focus on each separately to highlight certain unique aspects of one's own experience.

In the process of developing the open concept of "self-in-relation," we will explore six different domains related to the self:

1. The biological domain: the relationship of the self with the body. This refers to the relationship I have with my own body. Here we explore a person's self-experience as a living being; how the person "animates" their own body and the relationship they have with their physical self.
2. The intra-psychic domain: the relationship of the self with the self. This refers to the inner world of a person's experiences, including the dialogues between the different parts of the self and how these are constituted and developed over time. We seek ways to understand the nature and functioning of a person's frame of reference that forms the basis of the self-in-the-world experience.
3. The interpersonal domain: the relationship of the self with others. Here we will explore the domain of interpersonal relationships and how we negotiate our connection with those around us. We will investigate the importance of the attachment process and the quality of early reciprocal and interactive inter-subjective relationships that create the model for later relating and personal needs throughout life.
4. The intercultural and contextual domain concerns the relationship between the self and context, focusing on the integration of the self-experience within context. We will study the social, political, historical, economic, cultural, and organizational influences on the development of the sense of self.
5. The ecological domain: the relationship of the self with the environment and nature. Here we will study the person's relationship with their natural environment and how their sensitivity (or lack thereof) can influence their existence in the world.
6. The transcendental domain: the relationship of the self with the transpersonal and spiritual world. Here we consider the way in which a person seeks to give a broader meaning to their existence and how this can be achieved through the development of the person's spiritual self.

In our training, it is our duty to stimulate dialogue beyond differences by respecting individuality, belief systems, and thinking.

The tendency for integration while simultaneously respecting the individuality of psychotherapeutic approaches in a context of harmonization is felt in the professional environment and at the European level: "At the European level, over the last 20 years or so, we have witnessed a significant trend towards a more ecumenical spirit among the psychotherapies represented in the United Kingdom by the UK Council for Psychotherapy (UKCP) and the European Association for Psychotherapy (EAP), highlighted in the range of issues explored professionally at conferences as well as in specialized publications such as 'The Psychotherapist', the UKCP Journal, the International Journal of Psychotherapy EAP, and the Journal of Integrative Psychotherapy (SEPI). All three of these organizations require high levels of cooperation among and between the different approaches represented by maintaining collaboration and dialogue." (Evans and Gilbert, 2005).

"Harmony is the secret principle that controls life and without which all existence would disintegrate. Breathing unfolds incessantly and it maintains the health of the body as long as the organs function harmoniously. The moment a problem arises, illness makes its appearance and breathing ceases, leaving behind an inert shell made of flesh and bones. The same is true for organizations created by man – for any structure composed of parts that interact with each other, from nature to its entirety and up to human relationships, from large corporations and industrial concerns to the smallest spiritual societies. Harmony is the soul of any organization. Harmony means the fruit of understanding. Harmony between human beings and peoples or nations will never be established solely on the basis of economic equality, nor by imposing it through military force. Understanding is undoubtedly doomed to failure if our attention is focused only on ephemeral things. Peace in the world cannot be created either through economic equality or by other means, but only through the development, cultivation of the inherent harmony of the souls that make up nations and social structures. That higher understanding is necessary whose sole purpose is to maintain and elevate the physical, mental, and spiritual happiness of all beings" (Yogananda, 1986).

On each person's journey to themselves, through love, empathy, and truth we can create harmony, managing to bring a spark of enlightenment into our lives and those of the people we interact with in the psychotherapeutic process, and as therapists, through altruism and dedication, through love, devotion, and sincerity, we heal, becoming ourselves the light in the temple of another's consciousness.

Dr. Gina Chiriac