MULTIMODAL DYNAMIC PSYCHOTHERAPY by ALFREDO ANANIA Editor of

MULTIMODAL DYNAMIC PSYCHOTHERAPY by ALFREDO ANANIA Editor of the Journal PSICOLOGIA DINAMICA treatise presented in the workshop “Ecology of Psychotherapy” 1. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

I thank Prof. Marco Casonato and the Milan-Bicocca University for having invited me to this very interesting conference. The title of the workshop immediately addresses toward a vision of a man immersed in a relational system. Relationships with: a) itself; b) other people; c) natural environment. A title that, therefore, stimulates, in the psychotherapeutic field, the idea of an ecosystem inside which the human being can develop a continuous exchange among interior world and external world and in active form because, becoming more and more deeply aware of it, she/he has the possibility of usefully self-determining, self-adapting and, besides, participating, together with the others, to the construction of a common satisfying environment. 2. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

By now the traditional psychotherapeutic methods, one by one, seem incapaple to satisfy so many and subtly linked needs. Post-modernity, in fact, asks therapist to found new solution to complexity that characterizes the contemporary human being. The necessity to utilize new, more appropriate to the new western society, psychotherapeutic ways has emerged also in the course of the recent 6° Itinerant Seminar “L’Immaginario Simbolico (1 -7 September 2006). 3. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Some short passages from the treatises of the Academics Teachers of the University of Palermo Daniele La Barbera and Girolamo Lo Verso (Round Table: “The Cultural matrixes of the Historical Self and the post-modern community”) seem to confirmer these needs of innovation. 1 September 2006 Municipal Theatre - Marsala 6° Itinerant Seminar “L’Immaginario Simbolico” 4. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Prof. Daniele La Barbera “The Symbolic imaginary in the post-modern epoch” 1 September 2006 Municipal Theatre - Marsala 6° Itinerant Seminar “L’Immaginario Simbolico” Prof. La Barbera says: we are living a fascinating epoch because of many enormous changes that require the capacity – more and more urgent in many ways for our individual and collective psychological surviving – to orientate ourselves through the rapid transformations that more and more overhang us every day; and all of this has some very remarkable implications, repercussions, also in the clinic ambit. Today perhaps we can start to delineate the tracts of a post-modern clinic, that is everything is “new pathology” or, however, old troubles that nonetheless appear in a new, very new, manner; we can think, for example, to the Japanese Syndromes, that initiate to spread also inside our cultural areas. This allows us the hazard to talk about a post-modern psychotherapy. The psychiatric rehabilitation, for example, is a therapeutic discipline that puts together a series of things, some times in a congruous and other times in incongruous form, some times systematically and other times eclectically, but anyway it is the prototype of a post-modern modality to approach the patient, to say nothing of systemic psychotherapy that has in itself clearly a post-modern hearth … 5. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Prof. Girolamo Lo Verso “Inside the sea, the inside sea: the transpersonal among myths and tales" 1 September 2006 Municipal Theatre - Marsala 6° Itinerant Seminar “L’Immaginario Simbolico” Also Prof. Lo Verso, wondering what’s post-modern psychotherapy, answer that everyone is not an individual river but a net; this, in the eyes of psychopathology, means that more a person is suffering (and we have difficulty to understand cure it) and less she/he is an “individual”; more she/he is conditioned by the family, anthropological, transpersonal worlds and more she/he is a “depersonalized” individual”; probably all this is particularly true about the grave psychosis since we assume to treat them with therapeutic community or with the work placement, giving to the patient the possibility of reconnecting to networks. All in all, Lo Verso says, we have been cured and ourselves are easy therapists about persons that have the capacity to think their subjectivity; but when we treat more hard disorders, so as personality disorders, we need somehow integrated treatments through a therapists’ group, that is a pharmacological intervention, a study of family situation, to open progressively subjectivity-spaces; they are treatments were the relationship among therapists is fundamental. From this view point, post-modernity, Lo Verso underlines, is exactly all that we have avoided until now: a true relationship among therapists! With awkward patients the treatments have to be integrated otherwise they don’t go! 6. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

4 September 2006 Marsala - Convent of Carmine Prof. Gabriele Profita Prof. Giuseppe Ruvolo Large-group workshop "The cultural matrixes of identity" 5 September 2006 Theatre of Segesta Dott. Gabriella Signorello Psychodrama and dance-movement -therapy a workshop starting from the myth of Ariadne It appears fruitful the research of models and the experimentation of, above all, group applicative techniques and aimed to satisfy the different need to self-know by the contemporary man, whose therapeutic demand, in comparison with not many years ago, appears today securely more ample, sophisticated and, after all, more desirous to benefit from some symbolic-expressive moments and, probably, from contexts were the “cure of soul” is favoured by the happy marriage between nature and culture. 5 September 2006 Theatre of Segesta Dott. Rossana Messina the myth of Ariadne 5 September 2006 Theatre of Segesta The Bacchantes Directed by Maria Teresa Cucchiara Here I report some short footages by 6° Itinerant Seminar “L’IMMAGINARIO SIMBOLICO” 1 -7 September 2006 7. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

The main crossroads of this vast ensemble of theories, models, operative technique, is surely the dynamic psychology, to which the dynamic psychotherapy goes back. 8. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

But about this field we must remember the psychosynthesis by Roberto Assagioli. Considering the epoch when it was elaborated, it today appears really futuristic. In his article “Dynamic psychology and psychosynthesis”, Assagioli emphasizes the connexions between psychosynthesis and dynamic psychology. “If we now consider psychosynthesis as a whole, with all its implications and developments, we see that it should not be looked upon as a particular psychological doctrine, nor as a single technical procedure. It is first and foremost a dynamic, even a dramatic conception of our psychological life, which it portrays as a constant interplay and conflict between the many different and contrasting forces and a unifying center which ever tends to control, harmonize and utilize them. Moreover, psychosynthesis is a combination of several methods of inner action, aiming first at the development and perfection of the personality, and then at its harmonious coordination and increasing unification with the spiritual Self. These phases may be called respectively "personal" and "spiritual" psychosynthesis”. The therapeutic context of psychosynthesis is however linked to the classic psychoanalytical treatment - of which it is a filiation – that is founded on the dual relationship. 9. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Human being is suffering from many anguishes, but there is not an unique model of care. 5 September 2006 Theatre of Segesta The Blind (by Maurice Maeterlinck) “It is necessary to see for crying!” 10. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

According to Adriana Lis, Silvio Stella e Giulio Cesare Zavattini, Manuale di psicologia dinamica 1999 “Dynamic psychology is an extremely articulated branch of psychology and is based on psychoanalysis. However, even in the field of psychoanalysis, there are various trends of thought which differ from one another, therefore putting the coherence and unity of this discipline in doubt. These trends of thought have increased considerably, each having its own trademark (post-Freudian, post-Kleinian, post-Kohutian etc. . . ) and each claiming attention and visibility. Are we heading towards a mixture of languages which will simply cause confusion? The authors underline the elements the various schools of thought have in common regardless of the risk of eclecticism and "wars of religion". To the question: What is dynamic psychotherapy? The North West Institute of Dynamic Psychotherapy (N. W. I. D. P. http: //nwidp. com/) answers: “Psychodynamic psychotherapy recognises that problems in the present may have their roots in past experience, and that current behaviour may be motivated by feelings derived from that experience. Dynamic therapists work on the assumption that such problems will emerge in the relationship with therapist as well as in other relationships (with family, partners, children, work colleagues, etc. ), and thus therapeutic relationship is the central focus of therapy. The treatment consists of developing a therapeutic conversation focusing on the "here and now" experience of both patient and therapist. Dynamic psychotherapy is used for both in brief therapy where there is a defined area of difficulty (a "focus"), and over the longer term, aimed at helping change how patients function in relationships in all areas of their lives”. 11. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Certainly dynamic psychology was born from the demand to include, interlace, encompass and develop and reciprocally integrate many and at times very different fields of psychology but however all pertinent to the clinic ambit. By now it is diffuse in the most of Italian universities as teaching discipline in the psychology degree courses. The principal problem is that probably, beyond the common epistemological matrixes, the oneness of this teaching get lost into thousand rivulets when it has to become a well defined didactic program. Dynamic psychology, on my opinion, goes up to two implicit risks: the first is to become a sort of great container were everyone can put, at will, that she/he wants; the second is to become a multi-duplicate of various other teaching disciplines. The tenet subjects of the dynamic psychology often concern: the Freudian thought and the development of the most important post-Freudian psychoanalytic models like the model of the object relationships (M. Klein) and that of the psychoanalytic psychology of the Self (A. Freud, H. Hartmann, M. Mahler), as well as of the other psychoanalysts that have elaborated original models of development as the so-called Independent (among which Fairbairn, Balint, Winnicott); the thought of Carl Gustav Jung; the development and the functions of the Self, the development of the pulsions and the relationships with the object; the concepts of anguish, conflict, defence mechanism, motivation, mental space and so on. All that could also come under a teaching as “History of the Psychoanalysis from the origins until our days”. 12. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Today the emergent tendency in university field is to associate dynamic and clinic psychology in only one teaching. A course, in general structured for instance as the following, can probably meet the future dynamic psychology expert’s real needs. FORMATIVE BJECTIVES Theory and methodology of the research and the assessment in psychodynamic ambit Analytically oriented dynamic and clinic psychology Family relationships and community Psychology 13. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Purpose of the course is to form a figure of clinical psychologist, psychodynamically oriented, who can apply its knowledge to the preventive aspects, diagnostic, prognostic, therapeutic indication and cure. The theoretical approach is psychodynamic and psychoanalytic. This approach intends to form psychologists endowed with a scientific-professional identity able to operate a link between the basic dynamic-clinic psychological theories and the practice of the preventive, diagnostic and/or supportive intervention to which they are called to answer. Particular attention it will also turn to the acquisition of competences in methodological-clinical ambit, with particular attention to the specificities required by the dynamic psychology. For this reason a space will be given both to the quantitative (among which the various test techniques and the projective methods) and the qualitative, descriptive and interpretative (among which observation and clinical interview) methodologies. 14. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

More specifically the course intend to prepare experienced psychologists: - in the methodology of the psychodynamic assessment, through the specific competences matured in both clinician and methodological ambit, particularly the methodology of the research in the psychodynamic area; the assessment with particular reference to the most up-to-date versions of the projective methods; the evaluation of the psychological treatment; - in the field of the normal and pathological intrapsychic functioning with particular attention to the development, inside the psychic evolution, of the main subjective lived; evaluation, diagnosis and therapeutic indications; - in the evaluation and management of the intervention towards the parental role, in the management of the family counselling, in the analysis of situations at risk keeping in mind that the individual is a part of a wider community context, in the planning and realization of promotional programs about the wellbeing and the prevention of the uneasiness at different levels and the valuation of their efficacy. 15. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Another example of dynamic and clinic psychology university teaching, that integrates also the value in psychosocial and psychosomatic field of such disciplines, is the following: Course of Dynamic and Clinic Psychology of the Person, of the Organizations and of the Community. Objectives: the acquisition of an advanced preparation in theoretical, planning and operational ambits of the psychology related to the disciplinary sectors and to the professional areas defined as "dynamic psychology" and "clinical psychology", as well as a basic knowledge within the methodologies of the psychological research and the social psychology; an ability to take on full responsibility in the planning and the conduction of psychological-clinical interventions in relation to prevention, diagnosis and evaluation, psychological support and rehabilitation congruent with the people’s demands in the groups, in the organizations and in the communities; an ability to appraise the quality and the effectiveness of the aforesaid interventions; an ability to conduct the interventions in these areas with full professional autonomy; a knowledge of the computer tools and the telematic communication within the one’s competence areas; an advanced writing and oral knowledge at least of one European Union language over Italian. 16. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Competences: to develop projecting, planning, realization and verification of psychological interventions turned to single people, social groups, productive organizations or service, community. The realization of the psychological interventions involves the acquisition of competences within the followings professional areas: competence to apply and to use, for the psychological knowledge, the tools of investigation and survey what the psychometric and personality tests; interview for the assessment, the counselling, the analysis of the request, the scholastic and professional orientation, the psychological diagnosis, the support and the adaptation to the social and working trials; client and verification interviews; tools of analysis about the organizational cultures; group meetings for the survey of the attitudes, for the analysis of the interactions, the relationship and emotional systems within the organizations; application and use of intervention methods turn to the psychological support of single people or to the facilitation to the change of specific organizational components. A particular importance will be given to the acquisition of the psychological tools and methods aimed to support, from the point of view of the integration among physiological and psychological aspects, specifically psychosomatic, about the adult individual; to the acquisition of tools and methods turned to support and to facilitate the change, in the perspective of the dynamic integration between individual and social context. 17. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Not a long time ago I have written and published (What dynamic psychology means; in www. psicologia-dinamica. it, 18. 03. 206), that Dynamic Psychology represents the emergent psychological discipline since, even if it is related to the traditional psychoanalytic schools, integrates them with the modern theoretical and application acquisitions especially with reference to the experimental psychology, to the groupanalysis and the study of the transpersonal world, to the psychology of the Self and the intersubjectivity, to the family relationships system and the influence of the communicational interaction, finally, to the various factors that have a remarkable role at level of community psychology. An interesting sector of the dynamic psychology concerns the study of the role and the value of the symbolic world (the Itinerant Seminar "L’immaginario Simbolico" is an advanced model of this research trend). Today I have matured the necessity to also add the psychobiology. 18. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

In realty, the first theories and the practice of the psychoanalysis, after some time, have appeared less and less suitable to understand the post-modern man, because of its demand to not only have a cure about the unconscious problems but also to benefit from a psychotherapeutic support relatively both to the various real human and environmental problems met since the birth and relatively to the stress of adaptation to a too quickly changing society. Today one cannot deny that the confining the psychotherapy only to the deep study of the unconscious it is restrictive in comparison to the modern dynamic psychology that - besides the analysis of the patient's experiential world, the relationship with her/his parents and with the other important figures of the infancy - extends the analysis to the cultural matrixes to which the individual belongs and to the problems that can rise among her/his subjectivity (as unique and unrepeatable person) and the environmental ecosystem (human environment and natural environment), the community and the contexts were she/he is formed and has lived. Finally, a particular attention is necessary about the mind-body relationship because of the increase about the so called psychosomatic troubles, that is physical troubles in which psychological factors result determinants. What still today has been lacking in dynamic psychology it is the capacity to convert the ensemble of its approaches and models into a characteristic clinic-therapeutic practise: an apparently impossible task! 19. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

I have to clarify what I have aforesaid. We have already assumed that dynamic psychology embraces, integrating them inside itself, sometimes apparently distant research and scientific schools and approaches. We have assigned to these schools a common denominator which is to have anyway a value in the clinic ambit. The traditional psychotherapy does not foresee that therapist mixes two or more models in the course of a same treatment, evidently alternating them, for instance that systemic and that cognitive-behavioural or that psychoanalytically oriented. It is clear that an expert psychotherapist has a good knowledge, for example, not only of Freudian and post-Freudian theories but also of others as systemic, intersubjectivity etc. ; but to be a good theories connoisseur, and in this she/he will be facilitated by the end of the fights among schools, it doesn't mean to be sufficiently trained about the most disparate applicative methods. It doesn't exist a so “totipotent” psychotherapist to apply with skill the thirty percent of the application models which can fall into dynamic psychology. But even if a so omnipotent therapist existed her/his modus operandi would result largely “unusual”: it doesn’t reasonable that, for instance, for a certain time she/he treat the patient with an analytical method and subsequently with a behavioural method or vice versa and so on. One thing is to place side by side to a determined form of psychotherapy another different psychotherapeutic model, another thing (and methodologically not shareable) is that a psychotherapist uses, during the same a treatment, now a model and later a different model. Before reaching the solution that I will propose you to solve the matter, it is necessary that you tolerate a short apparent digression. 20. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Unfortunately the whole medical culture - and partly also the psychological culture - is still anchored to a tradition founded upon two essential aspects: the first is the dimension typically dual of the doctor-patient relationship; the second is the hospitalism (in the shape of a bedded patient in a specific department where a pool of operators diagnose-assist-cure her/him). 21. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

We are still too tied to the cot, to the hospital divisions (precisely divisions!) (where the share by different experts from those of the department happens at the most through the consultation), to the series of private studies where doctor and patient end up remaining alone the one in front or alongside the other together with the illness. We are too conditioned by the separations, also in the university teaching: separations among the places of the doctrines (the course of degree, the school of specialization) and the places of the research (university department, special hospital division) and the places of the practical learning and application (training). How can one do research, prevention, cure, for instance in psychosomatics, without gathering in the same équipe the physician internist, the psychologist, the psychotherapist, the histo-immuno-pathologist, the neuro-psycho-pharmacologist, the sociologist and so on? 22. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

One see the necessity to transform the actual medical and psychological culture into a culture of the pluridisciplinary équipe, or rather into a culture that replaces the single therapist with a multidisciplinary net of therapists, the hospital department with the integrated functional services and the mobile assistance on the territory, therapeutic community with the social centre, and so on. The monospecialized equipé appears by now on the avenue of the sunset. Luckily in psychology we have an intermediary model, the group model, by now largely diffused, that represents an evolution - even if probably it still suffers from some prototypes (Foulkesian, Morenian etc. ), that is the treatment of the individual in a group context; except for the Bionian group, that, on my experience, is a good formative tool to knowledge the experential group but it is not suited for the clinical situations and, particularly, when patients are seriously disturbed. If “ecology of the psychotherapy”, we have said, prefigures a “ecosystem inside which the human being can develop a continuous exchange among interior world and external world and in active form because, becoming more and more deeply aware of it, she/he has the possibility of usefully self-determining, self-adapting and, besides, participating, together with the others, to the construction of a common satisfying environment”, we now have to make an effort to find a model of the dynamic psychology that can answer to such demands on the clinical plan, with the awareness that only inside this discipline we can find the outfit of potentialities that are necessary to reach that finalities. 23. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

It is true, as psychotherapists, it is our custom to consider more or less suitable one determined form of psychotherapy according to the kind of pathology from which the patient is suffering; myself have made mention of some generic indications in my publication “Psychotherapeutic methodologies, orientations for not-experts” (in www. psicologia-dinamica. it, 24. 06. 206) but I am not quite happy of it. One will understand well that the criterion of choice founded on the type of trouble is one of the parameters for a option but not the only one and at times not even the principal. It would be sufficient to consider the not low cultural, intellectual (and economic) level that are required to the patient to undertake a classical psychoanalysis; but all that is not enough: she/he hasn’t to be in a acute clinical state and has to possess an adequate insight and a good attitude to the introspection. She/he always will have perfectly clean her/his clothing (of course because the cot or the sofa must be uses by the next patient)! 24. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

At this point I would like to invite you to put yourself, for example, in a young patient’s shoes who to the tensions connected to common anguishes of postmodernity unites the feelings and the frustrations tied up a specific trouble – it could be a personality disorder, a depressive syndrome, an obsessive-compulsive disorder, an eating disorder and so on - and to try to mentally trace a hypothetical psychotherapeutic way. What form of psychotherapy should this hypothetical patient undertake? How to avoid that her/his choice to undergo to one determined form of psychotherapy - individual or group, psychoanalytic, analytically oriented, Jungian, Freudian, ecosystemic, arttherapeutic, autogene training and so on - is fruit of the case, of the suggestion by the family doctor or her/his aunt or a friend or another patient or, at last, by virtue of being attracted by the sagacity of therapist who more recently appeared on TV? 25. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Leaving aside the Japanese Syndrome, the Pathological Gambling, the Substances Abuse and so on, indeed think we that the contemporary man, the patients, above all the young people, have to go to any therapy on the model that is experienced by the consulted psychotherapist rather than on a model appropriate to the patient’s real needs? Do we succeed in conceiving that before giving the possibility to the patient, as Girolamo Lo Verso says, of “reconnecting to networks” it is necessary to offer her/him a net of therapists? 26. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Certainly, from the point of view of the psychotherapeutic setting, the acquisitions of the dynamic psychology are fundamental for a clinical work that mostly uses the armchair, the vis à vis therapeutic relationship, the group therapies and the expansion of the expressive and creative abilities of the person, and, besides, the techniques of empowerment finalized to allow the patient to find or to recover the strength (or the courage) to develop a more active role in the belonging community in the bosom of which her/he can bring the personnel "way of feeling" and ideas and, besides, can, together with the others, to try to build a more liveable social reality. Perhaps the time is ripe that psychotherapy, after having consented to the patient to leave the sofa and to sit down in an armchair, can now cure also allowing her/him to standing, to move and to find expression through the body, to dance, to narrate herself/himself through the dramatization and so on! 27. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Now the true new challenge that is set to the dynamic psychology is to find the way for doing a step forward, a further progress relatively to therapeutic plan. I invite you to consider if it is interesting the eventuality that therapeutic way of a patient doesn’t happen according to a casual or adventurous string but according to the opinion of a pluripotential team of psychotherapists, that is a équipe able to offer through the different specialization of its own components - a plausible pathway in relation to a preliminary reasoned evaluation of the case and a periodic revision, in other terms a real therapeutic program decided with the patient’s compliance and periodically checked about the achieved results. I am about to introduce the Multimodal Model of the Dynamic Psychotherapy 28. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

The Multimodal Dynamic Psychotherapy The model that I want here to propose implies four conditions: 1) the équipe gathering as mainstay of the work group; 2) the équipe’s polyvalence; 3) a culture of the reception; 4) the équipe members' ability the to net-interconnecting and to cooperate. 1) The équipe gathering as mainstay of the work group It is necessary to welcome the idea that the équipe is be able to use more therapeutic modalities in succession or placed side by side with multilevel interventions modulated following the indications that come from the specific clinical case and according to a dynamic program established by the multidisciplinary équipe during the équipe gathering (and stage by stage accepted from the patient). Every therapist intervenes in the global treatment exclusively with her/his own specific competences and when her/his professional work is considered essential. 2) The équipe’s polyvalence; At the minimum the équipe should be made up the following specialist figures: clinical psychologist experienced in personality tests; individual psychotherapist; groupanalyst; systemic family psychotherapist; psycho-drama-therapist; specialist in expressive psychotherapy; art-therapist; movement-dance-therapist; musictherapist; expert in psychobiology and neuropsychopharmacologist; experienced in autogene training and of relaxation tecniques psychotherapist; expert on empowering and community psychology. 29. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

3) A culture of the reception The patient has need of a welcoming reception, to feel comfortable and co -participating to a therapeutic project that requires a suitable preliminary evaluation founded upon the acquisition of all the clinical and testological parameters necessary to reach a deepened diagnosis. About the adoption of clinical evaluation means - as the psychological tests precise rules don't exist, but generally one can affirm that, the chose, in the phases that precede the beginning of the psychotherapeutic treatment, the application of an objective test of personality (for instance, the M. M. P. I. which is a rather complete test for evaluating the basic personality characteristic and the emotional disorders) can furnish important data on particular aspects of the patient’s psyche, whose knowledge can result particularly profit both when one has to establish the initial psychotherapeutic program and later in the course of the cure. Instead, the projective tests (for example, the T. A. T. or the Rorschach Test) - since, proposing stimuli a little diversified, vague and ambiguous, they also activate in the patient a projection of unconscious contents of the personality (therefore, they are able, in some cases, to favour the insight and the compliance of the subject) - it is preferable that they are eventually employed in the preliminary phases of the treatment directly by the designated psychotherapist. Particular emergencies excepted, it is not, instead, suitable to submit the patient to test during the other phases of the treatment. Particularly, in the final phases, it could result very useful to verify, also in a objective way, the achieved results, but we have to be aware that the ending of a psychotherapy perhaps is the most delicate moment of the whole treatment and it isn’t opportune to insert objectifying interventions. 30. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

4) The équipe members' ability the to net-interconnecting and to cooperate In the traditional formative baggage of the psychotherapists, in general a culture of the équipe and a specific formation to group-work are missing. This probably because the practice of the psychotherapy has not sufficiently been studied in its possible multimodal evolution. The psychotherapist who work in a public service certainly has a greater familiarity with the team and pluridisciplinary work and, surely, she/he will have been able to discover some advantages of this form of organization, at least in the more complex and more intricate clinical situations. Repeatedly I have proposed for the mental health services a model of cooperation that metaphorically goes back to the chess play (in fact, in the chessboard every piece has its own movements and a proper functional dynamism; A. Anania “The fourth element”, in, edited by G. Lo Verso, T. Federico, G. lo Coco, “Il lavoro clinico con i gruppi nel sociale” , Borla Ed. ; Rome; 2000), but the multimodal model has an extra and different something from the chess play, in fact it implies an interactive ability over that cooperative. The group training (groupanalysis, Bionian experiential group, and so on) appears useful to acquire the aforesaid abilities. 31. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Advantages of the Multimodal Dynamic Psychotherapy The first advantage of the model is to offer to the patient, if it needs, the different psychotherapeutic potentialities that can be attributed today to the dynamic psychology but that never the single one, also plurispecialized, psychotherapist could develop. Contemporarily the same psychotherapist is relieved about the heaviness and the risks (of failing in the treatment) connected to the isolated work, especially in the more serious and difficult clinical cases. Besides, the dynamic multimodal équipe offers to every of its components continuous possibilities of cognitive enrichment, support, exchange, sharing, monitoring and supervision otherwise relegated to the ritual moments foreseen by the different schools of affiliation. But it is above all the patient to benefit from the team operational light in the different phases of the treatment. In fact, it is not a foregone conclusion that it is preferable to adopt initially an individual psychotherapeutic treatment rather than a psychoanalytic group or a family therapy, or that one has to undertake an analytical psychotherapy without contemporarily to benefit from the participation to movement-dance-therapy group and so on. The équipe is probably more “prudent” and “wise” to appraise and to decide what, among the different reasonable therapeutic ways, can result the most suitable to a datum moment and to operate, if the verification of the results of the treatment is disappointing, the necessary changes of “setting” (readjustment relatively therapeutic program). 32. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Disadvantages of the Multimodal Dynamic Psychotherapy They are the disadvantages common to all the contexts organized on the teamgroup: a) the interpersonal dynamics; b) the role conflicts; c) the power plays. Everything, however, point to the fact that these events in a working group composed by psychotherapists are minimal if not entirely excluded! 33. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Avv. Fabio D’Anna “The space of soul in the technology age - among norm, visions and language” 1 September 2006 Municipal Theatre - Marsala 6° Itinerant Seminar “L’Immaginario Simbolico” The lawyer Fabio D’Anna says “also the myths, the gods seem eroded by the disenchantment of the world”. In D’Anna’s opinion, the contemporary man “ cannot find an escape in the social organization, not in the economy, not in the rule (that ends up to be imprisoned by a logic that makes to coincide the existence with the job and that therefore it doesn't exhaust the wealth of man) but in the return to the sentiment, to the caress the soul, to listen again its song”. Perhaps “the poetry”, says D’Anna evoking Giacomo Leopardi, “bringing back us to the song and the archaic feast, can allow us, both as beneficiaries and as creators, to found a way of knowledge of the soul, of listening to other and to ourselves”. The poet Prof. Antonino Contiliano and the guitar of the musician Gino De Vita 6 September 2006 Convent of Carmine - Marsala 6° Itinerant Seminar “L’Immaginario Simbolico” 34. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

Psychotherapy as a voyage. A true voyage, starting from the meeting and knowing places and the people, allows the individual also a trip into her/his past, in the present and into her/his future; in synthesis in the personal psychological interiority. The trip has a strong symbolic value, therefore, as a psychotherapy, involves always a process of personal transformation. If our purpose is to tend to an ecology of the psychotherapy, we perhaps have to learn also to resort to experiences that, as the Itinerant Seminar “L’Immaginario Simbolico”, beginning from the happy marriage between nature and culture, through the recovery of the Historical Self and the activation of the imaginal world, allow the partakers to taste a healing full immersion in the soul. If this kind of immersions can be counted among the “experiences alongside” a psychotherapeutic treatment within the multimodal model is too soon to state it with certainty, but in every case they introduce an interesting research trend in the field of the dynamic psychology. 5 September 2006 Theatre of Segesta The Bacchantes Directed by Maria Teresa Cucchiara Temple of Segesta 35. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it

THANKS FOR YOUR TOLERANT ATTENTION. I HOPE I HAVE AROUSED YOUR INTEREST AND I HAVE NOT BORED TOO MUCH YOU! Alfredo Anania 07. 12. 2006©www. psicologia-dinamica. it Reproduction is prohibited in whole or in part 36. The Multimodal model of dynamic psychotherapy. 17. 11. 2006©www. psicologia-dinamica. it