IGB Symposium

Jean-Jacques WITTEZAELE

Systemic and Strategic Operative Diagnosis

The DOSS is 3 main types of logic of attempted solutions:

• Avoid, retreat, give up (contradictory logic)
• Controlling, anticipating (paradoxical logic)
• Define a course of action based on a "false" and anxiety-provoking premise (logic of "belief"). 

INTRODUCTION

For many pathologies we manage to find psychotherapeutic rather than medicinal solutions.

What are the disorders for which we can provide lasting relief through psychotherapeutic treatment.

You can't project the model onto patients.

Is there a risk in this case of losing individual specificities?

Way to try to formalize this approach:

Comparison with sports training in martial arts. If you are learning kung fu, karate or judo. In this case, we learn shapes or positions. Then we acquire techniques of defense or attack. And we know that when we find ourselves face to face with a combat partner, we will have to use good technique at the right time. And at the time of the fight it will be necessary to be guided by the other for the use and the sequence of the techniques.

That's kind of how we look at the model or the method.

The DOSS is not a directory.

The DOSS is above all a training tool for the therapist. Once he has properly integrated the different categories, then he will be able to intervene in the smooth running of the therapeutic process.

Attempts at a solution revisited

• The importance of emotional reactions
• Discovery of "experienced" or "spontaneous" reactions
• Transition from the notion of “worldview” to that of “perception – reaction”

Perception = interface between the individual and his environment

“We know the problems through the solutions” (Giorgio Nardone) 

 
Elements that affect the experience of perception - reaction

1) Behaviors and interactions

2) patterns of conduct (the “character” of the person in the Batesonian sense of the term)

3) Emotions . They :

• focus the attention, thus limiting the perceptual field
• can block rational thought
• prepare for action
• lead to changes in expression (facial, postural, vocal, etc.)
• trigger a cognitive evaluation, the search for "meaning"

-> The tasks aim to play with the perceptual field

4) Physiological reactions

5) Goals and expectations

6) Cognitive processes

"What we don't understand has captured us" (Richard Moss)

7) Spontaneous brain activity and imagination .

Systemic aspects of attempted solutions 

• Relational dynamics
  (e.g. double constraint, symmetrical or complementary relationships)
• The social expression of attempts at a solution
• Attempts by those around you to find a solution

The "problem" is therefore ...
the system formed by all the attempts at solution of the different people involved in its resolution.

The dynamic set of all the loops of perception – reaction …
contribute to the homeostasis of the system, to its “undesirable balance” (Ashby) and are mutually implicated.

Logic is: A method by which man applies his knowledge – conscious or not – to solve a problem or to achieve an objective.

The logical structure of dysfunctional interactions 

Patients apply different “logics” in their search for a solution, logics that are not adequate (since they do not allow them to find the solution) but logics that characterize their approach to the problem.

Starting from the “tasks”, we discover … 

3 main types of solution attempt logic:

• Avoid, retreat, give up (contradictory logic)
• Controlling, anticipating (paradoxical logic)
• Define a course of action based on a "false" and anxiety-provoking premise (logic of "belief").
  In this case, we seek to name and define the problem.

1- Attempts at a solution based on avoidance, withdrawal, renunciation

Principle: put an end to the emotional reaction by a global reaction of immediate withdrawal. This fallback solution creates a new, very precarious and dysfunctional balance.

Principles of intervention (logic of avoidance)

Show the link between the 2 “moments”: immediate relief jeopardizes the general resolution of the problem

Encourage confrontation (direct or progressive)

Avoidance Types:

1. Physical avoidance

• Avoid anxiety-provoking situations
• Hiding a defect, a weakness

2. Avoidance by selective attention

• Escaping thoughts, memories
• Denying information or emotions

3. Use of an alternative solution

• Rituals
• The use of a substance
• Delusions

4. Give up, give in

• Giving in to excessive demands
• To give up fighting, to give up.

2- Attempts at solutions based on control, anticipation (
paradoxical logic):

Principle : The patient wants to control, to exert a voluntary action, on a phenomenon by nature uncontrollable: the future, the spontaneous reactions, the feelings, the desire, the emotions, the reactions of the others...

Type of control

1 - By action

• Control his voice, his writing, his appearance...
• Do or say “what it takes”

2 - Control by thoughts

• controlling thoughts
• Control your body
• To provoke desires, desires
• Struggling with emotions or sensations
• Control your psychological reactions

3- Attempts to find a solution to confirm a “false” premise (logic of belief)

Principle : issues related to a "dominant thought", to a belief that becomes a "postulate".

The perception-reaction pattern is structured by a rigid idea associated with an often intense emotion “anger, fear, pain, etc.”, and leads to a process of self-
fulfilling prophecy.

Principle of the intervention (logic of belief)

• Lower emotional intensity
• Accepting and using the belief to direct the patient towards the active search for “distinctions”
• To make consider other points of view “(“as if”, for example)

Types of beliefs

1) Unfounded thoughts about oneself

• A defect (physical or psychological)
• A sickness

2 Unfounded thoughts about others

• Having to defend oneself from an “enemy”     
• Morbid jealousy

3 Unfounded thoughts about the world in general

• Rigid ideologies