REFLECTIONS ABOUT PSYCHOTHERAPY IN LATIN AMERICA

Dr. Osvaldo José FILIDORO
Docente de grado y miembro
de la Comisión de Doctorado
en Psicología de la USAL

en español

INTRODUCTION

I feel very pleased to participate in the Third Congress of the Latin American Federation of Psychotherapy which with the up most dedication enrich at our community who share the same profession beyond any circumstantial differentiation.

For this reason I want to congratulate on Doctor LUCIO BALAREZO on his commitment to welcome us in ¨Quito, the Beauty¨, as he would refer to this city so full of charm and tradition with its geographical location, equidistant from the rest of Latin America.

Moreover, I express my congratulations to the following professionals;

GUILLERMO GARRIDO from VENEZUELA
VERONICA BAGLADI and ROBERTO OPAZO from CHILE
MARIA ESTHER LAGOS from URUGUAY
JOSE DE ABREU from BRASIL
SUSANA MARISCAL from BOLIVIA
ARTURO HEMAN from MEXICO
RAMON MON from PANAMA
EDUARDO NICENBOIM, HECTOR FERNANDEZ ALVAREZ, ROBERTO ROCCA,CURT HACKER and our dearest ALEJANDRA PEREZ from ARGENTINA

All of the people before mentioned have enabled us, the Latin American people to enjoy this historical possibility to make up a forum which may help confront the challenges posed by the daily practice of Psychotherapy on the one hand, and the inner problems of Psychology on the other.

Each congress offers us a new meeting, which must be characterized by therapeutic presence. Each congress suggests an exhaustive review of our professional performance which will lead us, in a near future, to the use of resources in Psychotherapy, which I think, will be implemented through the multiple services. The use of Psychotherapeutic resources must be the response to the needs as they arise. The needs are great in amount and in fact they are urgent. Furthermore, a strict controlling system can be required so as to guarantee an efficient therapy. An expertise study must also be required as well as the intervention of professionals ...Per via de porre o per via de levare.

People should be warned about the risk of converting Psychotherapy into Psychology or even Psychology into Biology. A hope reflected by many psychological tendencies, classic as well as contemporary ones. Modals of behavior extremely developed in some non-Latin countries.

In the same way as cognitive psychologies and neurosciences have been influenced by data processing updating through neuronal links. It becomes necessary to recognize that our subject matter can be analyzed in an indirect way .The analysis method being so indirect as the one used to analyze the atomic theory or the structural organization of the language.

It is convenient to draw a line between Optics and Electromagnetism. Likewise, we’d rather study those disciplines acting over different approaches to research, which lead us to a new view in the analysis of the scientific theory supporting the Empirics as a group of conjectures about the way that a sector of the reality behaves. We must also be adjusted to a juridical frame of reference that defines, facilitates and guarantees the exercise of Psychotherapy.

By all said is unquestionable that we have a fragmented knowledge in all aspects, whether psychiatric, psycho physiological, psychoanalytical, etc. Because scientific discoveries and new technology are overwhelming and they give no time for the necessary sedimentation of learning, even though, changes in the social structure, human relations and economy are unpredictable and not measurable.

Latin America has followed a different way from the science development. For this reason there is a tendency to believe that the low complexity of the services in mental health are gratuitous and we do not realize that human resource is the most expensive.

An example of it is the use of robotics in factories. From that point, the importance to punctuate that any project, and in this case, in mental health is priceless, it does have a price in which we cannot escape from because we are involved in the treatment of resources, there is always someone who support it.

Nowadays, we are able to actualize ourselves a little more thanks to the Internet as a scientific instrument of updating in all over the world. We are not isolated anymore, we are on line, we do not have to think about classical terms of disorder into order where knowledge as an information in action was inevitable, except for the fact that we have to approach, as a consequence of the crisis of the determinism, to enunciations such as: instability, probability, irreversibility, due to the arrow of time which is implacable.

So it is necessary to find the economic and financial mechanisms that permit to develop plans and projects, which we are subject to. Otherwise, frustration will be the same as big as their consequences.

In the same time, let’s reflect and warn about the theme that now is compromising the interest of all the international psychotherapeutic movement promoted by World Council of Psychotherapy from 1996,and above all in relation with the problems posed at the clinic; the psycho social pathologies where Psychology defines a field of action that must not be confused with social work or with the psychological consulting manuals known as; Counseling, which its object of operation results tangential as regards the exercise of therapeutics which concerns a way of treating psycho emotional, affective and existential difficulties, whether in its phenomena expression ,in psycho somatic disorders or other types of pathologies. Thus the need of delimitate the field of analysis in different methods of access, being able to take as a reference the feedback of two criterion.

a) In an ample sense:

1. The Psychotherapy in its expression as an ART or ability and its skillfulness in the process of healing.

2. In its formulation as a Science: as an attitude of observation, explanation, systematization and integration of the phenomenon determined by an empirical field of observation is defined.

b) In a strict sense it would be subject to:

1. A way of research that consists in proving through words or other forms of symbolization certain imaginary productions that would be unbalanced from other vital forms.

2. A methodology in the process of healing or procuring in the widest sense of carefulness in its ontic-ontological; in a reencounter though experiences, compressions and testimonies of the vicissitudes.

3. An open theoretical and a systematized organization that would enable to create a constant path of actions, so strengthening a different way of contrasting, not only with the inner coherence of the statements but also with the exchange inter disciplinary. Most of all, when the reality that surrounds us, as the object of analysis gets virtually confused as a mere fact of perceiving or perceive equivalences in imaginary observations, which can be weighted, measured or quantified, but bringing a model or a conception of unreal healing. I think it is one of the fundamental reasons to the creation of an expertise study in Psychotherapy.

4. An understandable well grounded terminology, as opposed to the incoherencies in the daily use of inconsistent neologisms. Respecting the symbolic efficiency.

5. A constant supervision and a revision of the task as an opening exercise, opposed to probable obstacles as well as the own difficulties that the professional in Psychotherapy has to face, who is an instrument an a in the same time a vehicle of the anxieties to solve.

6. A misuse of the exercise in Psychotherapy could produce harmful effects, leading to demoralization or a lessen self-esteem in patients with manifestations of pessimism in diverse classes. It must be warn, that a mistake in the interpretation from the therapist or from the patient could lead to a series of associations and contradictorily feelings, aggravating even more the future problems.

What can we do in and with this context?

Psychotherapy exists in Latin America for several years; but it is known that it will clinically emerge over the phenomena that are showing to us. Meaning that is something, which cannot be reduced to a mere object neither the production of subjects; it has a complexity from other order that inevitably involves us. If we wish to reconstruct our experiences of what we wrote in the past ten years it resides so far away and so close as what we wrote twenty years ago. Is distant anyway.

The historian, the observer, the psychotherapist that gazes at this phenomenon, however, should begin somewhere even if the door remains closed, it must be rebuilt; what does this mean? It means that a reality must be designed. A reality that can be named structure, which not necessarily do without but it is comprised by details knitted from a totality. In this order we will be speaking of Psychotherapy in Latin America.

At the same time the comprehension is not limited to understand a whole instant experience. It is extended to several entities of the experience; anyway, they have a resemblance as an essential community.

This assertion means that apart from being subject to a spatial territoriality of region, if you prefer, there is an instant temporality that convoke us.

What it is showed, it is showed in sound and image; it behaves as other appearing entities whether by resemblance, contrast or under other thousand shades, with attendance or distance, but they are comprehensible relations as there is an object that convoke us: Psychotherapy.

We must talk about that thing that has been shown to us and we name at what it is visible to us that is we are not only looking.

The simple use of the name refers and constitutes a way of thinking that is located between the person and its conformation. In other words, we classify, insert or reject; therefore no more refuge in Psychiatry and even in Psychology. Though they are necessary in its presence, they are determining. They are not decisive in its function, however, because we know the danger of being seduced by the name, whether Psychology, Psychiatry or Latin America. In all case we will be satisfied because of it.

By this we must insert Psychotherapy even more in life itself; perhaps under the figures of expertise studies, which is not an act given to sudden fancies because reality is always my reality, but we can educate ourselves to feel something equal, to be able to listen little by little strings that vibrates similarly; Psychotherapy in Latin America.

Of course there are frontiers that are limiting this cohabitation. Maybe it’s hard to accept the far off distance experience, but sometimes the affirmation that human thing results victorious remains understandable, except for if there is something that was not preserved of the humankind, which is not infrequent.

What it is correspondent has to be joint. The heterogeneous thing has to be separated. Quiquet et sun. At each what it’s to each.

We are trying to incorporate this group of therapists to a major whole. In this sense, the chaotic reality becomes information. The empirical fact becomes a piece of information, the thing, in a living language.

From that very point, a logo is the word and the word of all the words.

Observation gets transformed into empirical base and in which it will be approached from different areas or theoretical models, each and every one come or have come from some need, whether; clinical, institutional, or from other order.

For the Psychotherapy fulfils this task, has to be subject to the visit, not to a control of a continuous conviction on behalf of the most scrupulous research.

It must be willing to face the confrontation with the factual and clinical material. We do not have to be afraid of showing how we work with patients, and what we are we saying to them, respecting their private life.

Its about the text, is about interventional necessities, is about the translated thing in other words. It is natural that this demands a sense for the psychotherapeutically comprehension. Neither will be survive with a single Psychotherapy in each country, due to pathologies that convoke us in where the psychopathology of the daily life has been updated into real areas of addiction to drugs, under nourishment, helpless people, criminality, alcoholism that brings profound familiar transformations. Apart from the nourishing pathologies that impose that the exercise of our profession has an active and different presence from the social worker.

For this reason, is well known that an expertise study has to be made so as to quality of life is not an abstract argument but a possible fact that can be acceded by diverse schemes of work that sustain in time an be able to manage an emotional tension in where the concept of health is not reduced into physical health; leaving aside the mental health as well as the moral health, having the Prichard’s style as a Historical Psychiatric model.

All this procedure seems complicated in its appearance, does not have other purpose, but objectivity as a way to accede to the inner reality, independent from any interpretation that damages, distorts, whether empirically, logically or metaphysically.

In this way, we will avoid the temptation of being masters of the world, because Psychotherapy, in our point of view, wants to offer a service of testimony of what it is shown, is not a hypnotically suggestion neither a ideology or politics from the therapeutically resources.

We know that the road is not direct, but it is trough a reconstruction as it happens in a historical fact, as a contemplated element that is possible to talk about.

The encyclopaedically interest about Psychotherapy faces a nameless pragmatism. At this very confrontation has to be added the enthusiasm and presence of a tolerance that has mediation, because I would dare to say that all the psychotherapies could have all the peculiar that they want, but surely in its depth they have a resemblance with other psychotherapies, even in the features that differ from themselves.

Because they are not separated in their duty from the way we are liable to.

The solitude is a different way of being with others.

OBSTACLES

How to get criterion in spite of the linguistic uniformity when there are countries that have more than twenty three languages that cohabitate under the roof of the Spanish language?

How we could accede to the symbolic efficiency so explained by Levi Strauss in his works of Anthropology opposed to an abysmal reality?

Who anything does, receives anything and who does not grow, perish. But we have also understood that individual and personal efforts are not enough though the schools in a time of our formation were idealized. We can run the risk, sometimes, to repeat such idealization with our pluralistic attitude as a way of approaching in order to know the different developments that have been produced in psychotherapy in the last times.

Perhaps it is strongly enough to admit this assertion, but, to tell the truth, a meeting beyond the congresses implies a commitment in other levels, saying it so-so real as getting in touch with schools from the past, so remote as Pythagoras and so close as the future we have to built. In that order, the idea of the Federation has a real character with regard to its operative updating dimension, diluting, in that way, the pseudo power of fantasy. Meaning that we have to avoid dogmatically scholastics religiosity, in one hand, and the nameless pragmatism in the other, as a manifestation of the institutional or congressional stagnation. It’s an internal debt.

This is the groundwork in the development of a planning in primary prevention.

We start from the idea that man does not know himself; that man is not what he can be, for this reason he can neither resolve or nor have a commitment. He cannot decide anything in elation with the future .He is a person today. Tomorrow, he will be another one.

In the same way, we must differentiate in Psychotherapy, what does Philosophy, Theory and Practice means. Meaning that an expertise study has to be made on schools or psychotherapies.

There’s no general order as regards schools. Each and every psychotherapist is a specialist in this or other thing.

It will take a thousand years to learn it all. Every specialty will be unfolded in a mimetically dramatic scene; they will be jointed by an argument and accompanied by the necessary referents of any etiological mythic structure, avoiding the mechanical facts that deteriorates the same very reason that people presents among themselves. Even in cloning.

I think it’s apposite for this reason to observe that it’s not possible to collocate them under the same title, under the same package of representation.

A real machine does not know itself. When it gets to know itself, stops being a machine and starts being responsible of their acts. At the same time, it cannot be able to watch all their aspects. This can be possible in a school, in which our Federation is the pluralism. This is one of the goals that we have to achieve in time.

The outcome of the instable political regimes in all Latin America, has been a generating source of existential insecurity because the ill-timed changes were accompanied by disordered and pendulum ad equations, in a way that they are damaging the possible project and journey as well as individual, familiar and communitarian ones, unlike the globalise one.

In other hand, to sustain in an equal value the richness and stability, is to define the social context to a strait jacket that produces oppression due to its lack of flexibility.

In that order, Psychotherapy in Latin America is not tied to any dominant psychotherapy even if the arguments supporting other arguments have more epistemological solidity.

We are aware that the idiom configures identity but the identity is not a synonym of similitude. The identity strengthens and configures in the difference. The Latin American Federation has a different profile from the initial one in their beginnings. Now is the time to consolidate ourselves in a harmonically growth. Lets support it, otherwise, the lack of conviction lead us to a double speech that also take us to a systematic transgression and the non-fulfilment of the norms as a manifestation of the instability that restricts social goals, as I mentioned before.

Without movement, there’s no Psychotherapy, in the same time, health cannot be reached without struggle, without an intense struggle.

I mean health, is the goal of the eagerness. From this point appears the need to be based around the health as a way of hope opposed to the instable pathological systems like dissonant controversies in the world’s harmony.

From there, in my point of view, the need to the reconciliation of the positions, because all that has been separated, turns around once more. Foeder-Fodus, federation, league, alliance, in certain cases in that a union of states recognizes the sovereignty of a central authority, despite each and every of these states rules under their own laws. That’s it’s said by the dictionary: to lend, to guarantee, trust, security. For these very reasons, if we do not evolve we will become in something fully useless from the point of view in which was created, that is generating projects and sustain them in time.

Avoiding turning around into a tautological circle, some people invent a theory and immediately others invent another one, which is opposed to the first one, and they expect that every one of us should believe it.

From there, the need to be conscious of the development and growth of the federation as a whole, up to now, with the initial enthusiasm that inhabits in us, that involve us in this process, which is totally analogical from an organism in its individual evolution, meaning that it starts from a group of cells, then this group attracts other cells to coordinate one to another and it makes that its organism is useful for its purpose not only for drinking eating and sleeping.

I want to conclude this presentation with a contribution in a shape of a schematic diagram in which a theory will be the starting point of the decisions with probable inferences in the use of certain psychotherapeutically resources as regards others. Then, the conduct will be continuing with two interconnected extremes. In one hand, the research and new advances in Psychotherapy, in the other the efficiency in the psychotherapeutically act where the cost of any intervention is implied. It will allow a to major development and production in the therapeutically process.

This exchange of resources is not organized with isolated elements because a style of essay and error leads to an unnecessary distortion.

The study of the world and the study of the human activities are not from the outside, like the thoughts that, at times, do not have correspondence with our most profound feelings.

Quito, May 2001