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Yıl:2018; Cilt: 1; Sayı: 1>> Özet
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Türkiye Bütüncül Psikoterapi Dergisi; 2018;1(1):1-24
Psikoterapi Tarihi ve Bütüncül Psikoterapi
T Özakkaş
Psikoterapi Enstitüsü, İstanbul
Bu çalışmanın amacı insanlık tarihi boyunca insanların psişik sorunları veya psişik sorunları saklayan organik görünümlü hadiselere yaklaşım tarzının sürecini incelemek, bununla ilgili değerlendirmeleri ortaya koymaktır. Bu çalışmamızda insanlık tarihi kadar eski olan insanın ruhsal problemlerine çözüm bulma çabalarının geldiği noktada bilimsel verilerle incelenen bir psikoterapi tarihi ve son noktada bütüncül psikoterapilerin oluşmasına yol açan süreç incelenmiştir. Modern anlamda, yazılı ve kayıtlı olarak incelenebilen, değerlendirilebilen, eleştirilebilen bir veri olarak psikoterapi tarihini başlatmak gerekirse; bunu Sigmund Freud'la başlatmak doğru olacaktır. Freud'un insanın ruhsal yapısını nörobiyolojik bir kaynakla başlayan araştırma gayreti daha sonra ruhsal aygıtı sanal zihinsel bir tasarı olarak tanımlaması sonucuna ulaşmıştır. Süreç içerisinde kanıta dayalı tıbbın ve bilimsel paradigmanın zamanın ruhuna uygun bir şekilde üniversitelerde yer almasıyla beraber psikoterapiler farklı iki kulvarda yol almıştır. Bunlardan birincisi Freud'un geliştirmiş olduğu Klasik Psikanalizdir. Psikanalitik gelişim hattına baktığımızda; bağımsız, kendi enstitülerinde kendi literatürünü oluşturarak, vaka sunumlarıyla gelişen ve tartışmalarla zenginleşen bir psikanalitik kültür inşa edilmiştir. Diğer tarafta ise; kanıta dayalı tıbbın getirmiş olduğu gözlenebilen, denenebilen, sınanabilen, ölçülebilen ve değerlendirilebilen bir alan olarak davranışçılıkla başlayan psikoterapi yaklaşımı söz konusudur. Davranışçılıkla başlayan bu psikoterapi yaklaşımı, süreç içerisinde istatistiki yöntemlerin gelişmesi, insan zihninin temel kaynağı olan beyinde olan bitenlerin daha objektif değerlendirilebilecek araç ve gereçlerin gelişmesiyle beraber, bilişsel bir paradigmaya evrilmiştir. Sonuçta üniversiteler davranışçılıktan bilişselciliğe atlayarak süreç içerisinde davranışçı-bilişsel yöntemlerin birleşik hale geldiği bir sisteme doğru dönüşmüştür. Bilişsel-davranışçı süreç bu şekilde devam ederken psikanalitik literatür kendi içerisinde değişim ve dönüşüme uğramış; tek kişilik psikoterapilerden iki kişilik psikoterapilere ulaşmıştır. Oradan da nörobiyolojinin sağ beyin kaynaklarına doğru bir açılım sergilemiştir. İnsan beyninde olan biteni (her iki ekol için de) kanıta dayalı bir literatür haline getirilebilmesi amaç haline gelmiştir. Bugün gelinen noktada ister birinci kaynaktan ister ikinci kaynaktan olsun tüm kuramların entegre edildiği tek kişilik terapilerin iki kişilik terapilere, iki kişilik terapilerden sistem terapilerine, sistem terapilerinin aşkınlık ihtiyacı içinde ele alınmış olduğu kaos teorilerine kadar uzanan öznelliğin ve bağlamın temel aracı olduğu bir süreçteki evrimleşmiş bütüncül psikoterapilere doğru bir yaklaşım ortaya konmuştur. Çalışmamızda bu sürecin tarihsel kaynaklarından, bilimsel paradigmanın başladığı döneme, oradan da güncel nörobiyolojik gelişmeler ve öznelliğin ve kaos teorisinin ulaştığı noktaya kadar geçen süreç anlatılmaktadır.
History of Psychotherapy and Integrative Psychotherapy
The objective of this paper is to explore the process and procedures of addressing human psychological problems, or organic-looking issues concealing psychological problems, throughout the history. This paper examines the deep-rooted strivings to seek solutions to human psychological problems that culminated in scientific psychotherapy and eventually in psychotherapy integration. It has been Sigmund Freud who marked the beginning of the history of a scientific psychotherapy that involved written and recorded data that can be examined, assessed, and criticized. Freud’s search for the neurobiological roots of human psyche resulted in his definition of the psychic apparatus as a mental representation. The zeitgeist paved the way for evidence-based medicine and scientific paradigm to enter the universities, and psychotherapies began to move along two different paths. Freud’s psychoanalytic method developed independently in psychoanalytic institutes, creating its own literature enriched by case presentations and discussions. The other path included the behavioralistic start point that could be observed, experimented, tested, measured, and assessed as a result of evidence-based medicine. Along with the development of statistical methods and more sophisticated tools to assess the workings of the brain as the source of human mind, this psychotherapy approach that began with behavioralism evolved to a cognitive paradigm and began to examine the impact of psychopathology and workings of the mind on information processing and assessment. As a result, universities shifted from behavioralism to cognitive perspective, integrating behavioral and cognitive methods in the process. As the cognitive-behavioral process moved along this path, psychoanalytic literature evolved from one-person psychotherapies to two-person psychotherapies, and to right-brain emphasis indicated by neurobiology. Both schools aimed at forming an evidence-based literature of what is going on in human brain. The current point is integration of psychotherapies that evolved from one-person therapies to two-person therapies, system therapies, and chaos theories, on the basis of subjectivity and contextualism. This paper addresses this process, beginning with the historical sources through the scientific paradigm, current neurobiological findings, and the final destination of chaos theory.

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