Biomedical Engineering Reference
In-Depth Information
variability, are subjected to a minor risk because they are more able to activate effective
decompensation strategies in crisis situations of the system (Reda 1986; Guidano 1987, 1991;
Cionini 1991, 1998). Because each organization constrains the generative directionality of
the personal life span while fixing the range of the tolerable variability, it includes in itself
the causes of its own crisis. This is in agreement with the theory of the functioning of com-
plex and autopoietic systems.
A system's functionality depends on its own capability of experiencing reality while con-
structing the reality. These meanings are dependent on the processing quality with respect
to analysis and anticipatory conceptualization. They determine or guide the behavior,
defined as the set of actions (including the speculative and emotional ones) aimed at reach-
ing the goals that at each time and in every place the individual maintains must be reached.
The equilibrium, the efficiency, and the health of the system depend on the capacity to
process meanings and models of the self that are realistic. These models should allow fore-
casts about the ways to reach goals, or rather they should indicate the necessity of chang-
ing goals, each time allowing that the constructed knowledge again enters the “circle” to
feed the incessant process of living in the experience (Reda 1986; Cionini 1998).
In all cognitive approaches referring to Beck's and Ellis' theories, and in general in all cogni-
tive-behavioral approaches, the relationship between the therapist and the patient is not con-
sidered the main tool for change; rather, it is appraised according to the treatment outcomes.
In different epistemological approaches the therapeutic relationship is considered as
having different functions: support of ego functions, cognitive revealing of unconscious
processes aimed at reaching insight and learning, increasing of meta-cognitive functions,
and so on. Although all approaches have in common the necessity of creating a therapeutic
alliance, an empathetic collaboration between therapist and patient, each of them con-
structs its experiments in the relationship in a way that is metaphorically similar to what
happens in a laboratory (Semerani 2002).
Instead, in Guidano's postrationalist perspective (1987, 1991), the change coincides with
a reorganization of the personal meaning and with the construction of a new equilibrium,
not predictable in nature and quality but able to assimilate the imbalance through the
increase of complexity and self-knowledge. During the therapeutic relationship the thera-
pist avoids being surprised or criticizing the negative emotions tied to the imbalance so as
not to confirm the noninvolvement sense experienced by the patient toward these discrep-
ancies. In this sense the systemic approach is aimed at increasing the patient's knowledge
of his or her own background and functioning rules using the disturbing emotions as
information sources, in the meantime maintaining the internal coherence necessary to the
conservation of the personal identity.
However, the change of these cognitive processes, activated by thought processes acting on
thinking, develops according to different and speedier rhythms than motivations and emo-
tional backgrounds that form the immediate experience. The systems language-thought and
emotiveness-affectivity seem to be processed in distinct ways because the cognitive nucleus
entails the application of operative rules of the formal logic whereas the affective aspects
seem to combine in a much more stable way, following rules concerning the specific func-
tioning of the person's system that is his or her auto-organization. Therefore, the implicit
emotional nucleus can be modified only introducing new emotional tonalities that, while
entering structured patterns formed during the life-span experience, are able to change their
configuration. In other words, because thinking is able to change only the thoughts and only
the emotional feeling is able to change emotions, psychotherapeutic change processes neces-
sarily imply new emotional experiences that will be added to the affective nuclear themes.
No change in knowledge and no change in process, in the therapeutic process too can occur
