**2.8 Discussion. Three-component, structural-dynamic theory of psychotherapy**

The performed analysis of sociopsychological, individual-psychological, biological components of psychotherapy allows to proceed to a systematic presentation of the three-component theory of psychotherapy, highlighting its main points [21, 49].

1.The existence of social, psychological, biological components of human nature predetermines the presence of sociopsychological, psychological, biological components of psychotherapy, which determine the patterns and mechanisms of the psychotherapeutic process.

The primary basis of the sociopsychological component of psychotherapy is the MDT, which represents the system block of MW of mass consciousness. The MDT of mass consciousness and an individual, being a historically developing hierarchical system, retains in a latent form previous information and is subject to socially conditioned and individual dynamics in progressive, regressive, reactivation variants.

The psychological component of the psychotherapeutic process is formed by communicative-interpersonal and intrapsychic components. We highlight intrapsychic component of psychotherapy that is described in the context of the PSPA—a spontaneous homeostatic ontogenetically formed hierarchical structure, which includes adaptive mechanisms that are consistently formed from early primitive, typological, to complex individualized, personal, which have regressive, reactivation, progressive dynamics.

The biological component of psychotherapy includes a complex of neurophysiological, organismic mechanisms that ensure the processes of readaptation, successful learning (including neurogenetic ones).

2.The psychotherapeutic process is based on complex psychological interaction and is carried out at two related levels of: sociopsychological, cultural interaction; interpersonal interaction founded on actual communicative style, methodological goal setting, and instruments of therapy, partially spontaneous interpersonal interaction.

Psychotherapeutic interaction at the sociopsychological level uses a connecting script that coordinates the theoretical and methodological tools of psychotherapy with the actual MDT of the patient. The actual MDT of mass consciousness plays the role of the communicational "language" between the patient and the therapist. The psychotherapeutic method may correspond to the actual MDT completely, partially, or differ from it. In the first case, the content of psychotherapy is understood and accepted by the patient initially and completely. In the second and third cases, when the content of psychotherapy does not correspond to the actual MDT, it becomes necessary to reconcile them. In such cases, the methods of psychotherapy, mainly at the beginning of work with the patient, use the connecting script that fills the existing semantic, logical gaps between the applied therapy and MDT. The initial or achieved correspondence between the patient's MDT and the method of psychotherapy leads to the establishment of psychotherapeutic contact and includes individual psychological and biological mechanisms of psychotherapy, initiating the psychotherapeutic process.

3.The complex psychological interaction carried out in the course of the psychotherapeutic process generates and supports the systemic psychological and biological

reactions of the individual to the psychotherapeutic action, including intrapsychic sanogenic mechanisms and a complex of organismic mechanisms (biological, neurophysiological, neurohormonal, etc.). In addition to the obvious mechanisms of effective learning, our study of psychotherapy at the intrapsychic level reveals the mechanisms of reactivation and formation of PSPA of the individual or their combination. We believe that at the biological level, psychotherapy engages mechanisms of stress-readaptive optimization of disturbed biological (and neurobiological) indicators.

#### **2.9 Section conclusion**

The three-component theory of psychotherapy focuses on natural phenomena of human life at social, psychological, biological levels. The most significant data are obtained on the phenomenon of mass consciousness, its WM and MDT mythological nature, regressive dynamics in dead-end situations. The author is inspired by the fact that the modern mass consciousness in a latent, indirect, and common form preserves the entire historical totality of cultural ideas about the world and man (from the Stone Age to the present day). And the deepening regressive dynamics of mass consciousness is capable of consistently updating the previous levels of perception of the world, up to the most ancient ones. For the first time, the possibility of regressive dynamics of an individual's ideas about illness and therapy in an experimentally created dead-end situation is shown. In the light of author's research, the phenomenon of mass consciousness contains Jungian "collective unconsciousness."

Psychotherapy presents a secondary phenomenon in relation to the current mass consciousness, everyday culture; therefore, the connecting scenario of psychotherapy becomes its most important means, the effectiveness of which increases in cases of cognizant application by therapist.

Modern psychotherapy is based on psychological communication, in which the therapist, as the architect of the project, together with the patient, builds a therapeutic result. The mechanisms of reactivation and the formation of a PSPA, which are triggered by the patient's psyche autonomously, based on the characteristics of the disorder and the resources of the psyche, which are empirically identified by the author and consistent with a positive psychotherapeutic approach, are fundamental and enrich the understanding of psychotherapy.

The biological mechanisms of psychotherapy are inevitable for its active forms, are universal and based on the mechanisms of fixing positive experience (learning) and readaptation.

### **3. Method of positive-dialogue psychotherapy**

In the 2000s, a similarity between the PSPA model and the resilience/resourcefulness model (Selinski M., Pylowski J.) [79, 82, 83], developed from the position of positive psychology, was revealed. A positive psychotherapeutic approach [79–83] relies on the patient's resources and his positive values, but not on overcoming psychological problems and symptoms. In contrast to the PSPA concept, which implies the neurobiological basis of the system of psychological adaptation of a person, the resilience and resourcefulness model has a philosophical foundation. Psychotherapeutic work in the resilience and resourcefulness model is based on stimulating corresponding mechanisms as positive targets of psychotherapy.

*General Three-Component Structural-Dynamic Theory of Psychotherapy and Its… DOI: http://dx.doi.org/10.5772/intechopen.104225*

#### **3.1 PDP specifications**

Positive-dialog psychotherapy (PDP) was developed by the author in the 2010s as a systemic, integrative, dialogically, procedurally, and causally oriented method of clinical psychotherapy intended for psychotherapy of anxiety, affective, personal, organic (with anxiety symptoms) disorders. PDP is based on the understanding of the psychotherapy process as the communicative staged dialog between therapist and patient using verbal and nonverbal means, carried out at the sociocultural, interpersonal, intrapersonal levels as a system of three dialogs: interpersonal dialog between patient and therapist, intrapersonal dialog of the patient, intrapersonal dialog of the therapist (when the therapist consciously builds such a systemic dialog). PDP includes three stages: diagnostic and psychoeducational with the conclusion of a psychotherapeutic contract (1 session), therapeutic (2–8–10–15 sessions), completion of therapy with an assessment of the results, recommendations (final session).

The psychotherapeutic process in PDP is realized as a sequential resolution of the patient's systemic request for psychotherapy, which is a set of successively manifested, staged patient requests for psychotherapy that are resolved in the course of psychotherapy, which reflects (in reverse order) the history and biopsychosocial mechanisms of the formation of the disorder.

#### **3.2 PDP protocol**

PDP is based on the protocol developed by the author [86]. The therapeutic intervention consists of three main components: (1) psychoeducational; (2) causal cognitive-orientated; and (3) hypnotherapeutic.

The psychoeducation component includes a didactic material covering the following information about: (1) anxiety as a normal reaction of mobilization, needed to cope or avoid a dangerous situation; (2) anxiety disorder and the phases of its development for PD and GAD, because of the "swinging" of anxiety reaction by a combination of social, biological, and psychogenic factors; and (3) possibilities of psychotherapeutic treatment of AD based on (a) the resolution of current psychogenic issues, (b) the excluding intoxicating mechanisms (if there are any), (c) the coping with phobic component (if it's present), (d) the general increase of adaptive resources of the organism (through lifestyle rationalization), and (e) the normalization of vegetative regulation by psychotherapy or combination of psychotherapy with pharmacotherapy. The psychoeducational component of PDP is realized during the first therapy session, in an individual or group format.

The causal cognitive-orientated component of PDP has the following objectives: (1) Individual assimilation of the psychoeducational component. (2) Normalization of patient's traumatic experiences during a panic attack (if there are any). (3) Stimulation of patient's coping of anxiety triggers, restrictive behaviors, and phobias. (4) Stimulation of a healthy lifestyle with normalization of vegetative regulation. (5) Development of patient's autonomous understanding and coping with problem situations. (6) Development of skills of positive thinking and attitude. The causal cognitive-orientated component of PDP is used during 2–7 sessions for about 20 min.

The hypnotherapeutic component of PDP uses the method of Universal Hypnotherapy (UH) [66, 67, 87], which contains the following therapeutic interventions: (1) Increase of self-identity and self-integrity. (2) Transformation of patient's projections of his/her psychogenic and somatic-sensorial content. (3) Use of sedative and detachment influences of reproduced colors. (4) Stimulation of detachment of stress experience and

completion of negative states and experiences based on modeling and realization of positive correct behavior. (5) Repeat of the interventions mentioned above (1–4). (6) Creation in hypnotherapy a positive vector semantic space for patient's active therapeutic changes. The UH, done in the second part of a 1-h session of PDP, lasts for 40 min. The frequency of PDP sessions is three times a week; the total number of sessions varies from 8 to 15 (till the stable improvement of patient's state). The UH method has previously been described in detail by the author in chapters of international monographs on positive psychology [67], hypnotherapy and hypnosis [66], psychotherapy [87], which allows, without repeating, to restrict ourselves to a reference to previously published available materials.

The implementation of the PDP, in accordance with the three-component theory of psychotherapy, includes the obligatory use of the connecting script component of psychotherapy involved in the implementation of: a general plan of subsequent psychotherapy; psychoeducational and causal cognitive-orientated components that explain the nature of (anxiety, affective, personality) disorder and the process of subsequent psychotherapy, hypnotherapy. The UH uses hypnotization and hypnotherapy scripts. The hypnotization script is realized before the beginning of hypnotherapy and allows effectively, in the interests of therapy, to transform the initial cultural ideas of the patient about hypnosis, hypnotization, with the achievement of a holistic acceptance by the patient of subsequent hypnotization and hypnotherapy. The patient's assimilation of all psychoeducational material is based on scientific data in the fields of positive psychotherapy and hypnotherapy, but is built on understanding of the mythological nature of mass consciousness, the involvement of the patient's imaginative thinking, and the dialogical form of information presentation. The PDP's deliberate appeal to the mythological side of mass consciousness, shaped into a formal-logical, consistent, scientifically grounded psychoeducational shell, makes the PDP procedurally and clinically effective.

#### **3.3 The results of the controlled study of the PDP effectiveness**

In 2010–2015, the author with the coworker [86] conducted a controlled study of the effectiveness of PDP for anxiety disorders. After diagnostic evaluation and completion of all questionnaires, 63 patients were randomly assigned to a treatment group or a waitinglist group. In the treatment group, patients went in therapy immediately and completed the self-report questionnaires at the end of the therapeutic process. Patients on a control waiting-list group were informed about a certain order for the beginning of the therapy and that they had to complete the questionnaires two times (the second time was 3 weeks after the first). The evaluation of psychometric data of the treatment group was carried out 3 weeks before the treatment, just before the start of treatment and at the end of treatment. The control waiting-list group was a control group for itself and for the first group. The study used psychometric and statistical methods accepted in the assessment of the treatment of anxiety disorders. Assuming a similarity of UH to mindfulness-based CBT methods, the study used additional psychometric estimation of UH mindfulness effect. The psychometric assessment used the symptomatic questionnaire SCL-90-R in Russian adaptation of N. Tarabarina [55], its scales: DEP, depression; ANX, anxiety; and GSI, general severity index, a measure of the overall psychological distress. The Spielberger State–Trait Anxiety Inventory (STAI) is a Russian adaptation of Hanin [56]. The following tools were also used: Beck's depression inventory (BDI) [57]; Sheehan Clinical Anxiety Rating Scale (ShARS) [58]; and Five-Factor Mindfulness Questionnaire (FFMQ) [59], its short version. The FFMQ was adapted for Russian-speaking population by the authors.
