Gaetano Paola, Maselli Paolo, Meldolesi Giulio Nicolò, Picardi Angelo
Riv Psichiatr. 2015 Mar-Apr;50(2):51-60. doi: 10.1708/1872.20448.
Post-rationalist cognitive psychotherapy (PRCP), developed by Vittorio Guidano, focuses on the relationship between subjective experience and reflective explanation. Although this is a powerful, innovative, and flexible treatment model, there are some aspects that deserve reflection and could be further developed. We propose a treatment model that integrates PRCP with some principles of phenomenology, i.e., experience has a meaning that precedes reflection; it is structured according to "manifestation rules" that connect feelings, thoughts, and actions; personal identity is grounded in the action and cannot be reduced to what remains identical throughout the life course. As in traditional PRCP, a key aspect of treatment is the examination of the interplay between experience and explanation. However, treatment focuses more on the understanding of experience than on its verbally mediated evaluation. Moreover, it aims not so much at revealing the rules through which the patient relates his experience to him/herself, as at bringing to light all the relevant aspects of the patient's experience, validating the experience by making explicit the links, enabling the patient to take hold of his/her experience, and leading him/her to learn how to understand it without the mediation of reflection. The knowledge of the tendencies, characteristic of each personal meaning organization, to find difficulties in grasping specific aspects of experience helps the therapist identify the sequences of experience that are not sufficiently articulated and understood. The main therapeutic procedures are identification, exploration, validation, and narrative reconfiguration of the experience that was not understood by the patient, in order to reduce the related feelings of strangeness and unfamiliarity, facilitate emotion regulation, and help the patient reflect and make choices in harmony with self-realization. Future research priorities include developing a treatment manual and testing the effectiveness of the proposed treatment model in a clinical trial.
后理性主义认知心理治疗（PRCP）由维托里奥·朱达诺开发，专注于主观体验与反思性解释之间的关系。尽管这是一个强大、创新且灵活的治疗模式，但仍有一些方面值得反思并可进一步发展。我们提出一种将PRCP与现象学的一些原则相结合的治疗模式，即体验具有先于反思的意义；它根据连接情感、思想和行动的“表现规则”构建；个人身份基于行动，不能简化为贯穿生命历程始终不变的东西。与传统的PRCP一样，治疗的一个关键方面是审视体验与解释之间的相互作用。然而，治疗更侧重于对体验的理解而非通过语言中介进行的评估。此外，其目的与其说是揭示患者将其体验与自身联系起来的规则，不如说是揭示患者体验的所有相关方面，通过明确联系来验证体验，使患者能够把握自己的体验，并引导他/她学会如何在没有反思中介的情况下理解体验。了解每个个人意义组织在把握体验的特定方面存在困难的倾向，有助于治疗师识别那些未得到充分阐述和理解的体验序列。主要的治疗程序是对患者未理解的体验进行识别、探索、验证和叙事重构，以减少相关的陌生感和不熟悉感，促进情绪调节，并帮助患者进行反思并做出与自我实现相一致的选择。未来的研究重点包括编写治疗手册，并在临床试验中测试所提出治疗模式的有效性。
