chapter  6
24 Pages

Constructivism: Personality, Psychopathology, and Psychotherapy

In contradistinction to the above type of reasoning, Rogers and Kegan draw our attention to data suggesting that particular psychological disorders can be better understood by recognizing that patients of any one disorder can be at a variety of structural-developmental levels. One patient may be at a lower level of structural development and another at a higher level, although both may be diagnosed as having a borderline condition or some other psychological disorder. Furthermore, because there is no relationship between severity of disturbance and structuraldevelopmental level, it does not follow that a schizophrenic patient will necessarily be at a lower level of structural-development than a nonpsychotic patient, such as a neurotic one, in psychoanalytic nomenclature. To dismiss complex structures as reducible to earlier primitive developmental structures is to ignore the potential for understanding the patient as she is as she shapes and interprets her own symptoms and conflicts. It is to impose upon the patient the clinician's own ideology and forego the opportunity to genuinely be in contact with the patient's own meaning-making activity, which constitutes her essential way of being-in-and-understanding the world. The patient may more often exhibit a functional as opposed to a structural regression, due to the stresses of conflict and environment. Beck, a leading proponent of cognitive theory, suggested that whereas depressed patients resort to the activation of preoperational schemes, they do so only in their areas of "personal domain," which are affectively laden, and only when triggered by stressful events (Beck, Rush, Shaw, & Emery, 1979). Selman (1980) made a similar suggestion regarding "developmental oscillations" contingent upon situation and circumstance, which once again appears to be more a matter of functional than structural regression.