Positive Psychotherapy

Positive psychotherapy (PPT) (since 1968) is the name of the method of the psychotherapeutic modality developed by Nossrat Peseschkian and co-workers. Prof. Peseschkian, MD, (1933–2010) was a specialist in neurology, psychiatry, psychotherapy and psychotherapeutic medicine.

Positive psychotherapy is a method in the field of humanistic and psychodynamic psychotherapy and is based on a positive image of man, which correlates with a salutogenetic, resource-oriented, humanistic and conflict-centered approach. It is accredited by several institutions (e.g. State Medical Chamber of Hessen, Germany, European Association for Psychotherapy EAP; World Council for Psychotherapy WCP, International Federation of Psychotherapy IFP and other statutory institutions).

Today positive psychotherapy has been established in more than 33 countries with approximately 30 independent centres and institutions. In 1971, the Wiesbaden Postgraduate Training Institute for Psychotherapy and Family Therapy (WIPF) was established as a postgraduate training institution for professional studies for physicians, psychologists and pedagogues in the field of PP. WIPF is also the forerunner of Wiesbaden Academy for Psychotherapy (WIAP), which is today one of the leading state-recognized institutions of postgraduate psychotherapy training in Germany. Since 1974, more than 38,000 physicians and psychologists have been trained in Germany with this method, and since the late 1980s also several thousand colleagues in Eastern European and Asian countries.

Positive psychotherapy is represented worldwide by the World Association of Positive Psychotherapy(WAPP). It has so far organized the four World Congresses for Positive Psychotherapy – in St. Petersburg, Russia (1997), in Wiesbaden, Germany (2000), in Varna, Bulgaria (2003), in Lekosia, Cyprus (2007). The fifth World Congress will take place in October 2010 in Istanbul, Turkey. Standardized training programmes (in form of Basic and Master Courses) are taking place worldwide (e.g. in Bolivia, Bulgaria, China, Cyprus, Ethiopia, Kosovo, Romania, Russia, Switzerland, Turkey, Ukraine).

In 1997, a quality assurance and effectiveness study was undertaken in Germany. The results show the high effectivity of this short-term method. The study was awarded with the Richard-Merten-Prize. In 2006, Nossrat Peseschkian, founder of Positive Psychotherapy, was awarded the German order of merit. This order is the highest recognition of the Federal Republic of Germany for distinguished services and achievements in social-economical, political and spiritual fields as well as their particular services for the Republic, for example social charity and humanitarian help.

Approach
The objectives of positive psychotherapy as a modality are:
 * Promotion of a transcultural and positive approach to psychotherapy and psychosomatic medicine
 * Education, self-help and prevention
 * Promotion of intercultural understanding
 * Integration of different therapeutic directions

In terms of positive psychotherapy the traditional psychotherapy and medicine are described by three criteria: a) the psychopathologic procedure with the intention of eliminating diseases, disturbances and conflicts; b) a variety of methods, which exist beside each other; c) the passive attitude of the patient. Positive psychotherapy tries to broaden the traditional approach: a) positive approach in response to psychopathology; b) an approach in regards to contents as mediation for the co-operation of different technical disciplines (balance-model, basic-capacities and actual-capacities); c) the five-stage strategy of therapy and self-help in the sense of a positive conflict management to activate the patient and to support the therapist-patient-relationship. After the oriental wisdom: "The way to maintain one's happiness is to pass it on".

Main principles
The three main principles of positive psychotherapy address the positive, content-wise and strategic approach (Principle of Hope – Principle of Balance - Principle of Consultation).

1 - The Principle of Hope implies that one does not try to immediately eliminate a disturbance but to first understand it in a broader context and to respond to its positive aspects. The word "positive" (lat. positum) means "the actual", "the given", "really" – the aim of positive psychotherapists is to help their patients to clear the view on the disturbance and recognize their meaning (basic-capabilities and actual-capabilities). Accordingly the disorder will be reinterpreted.

Some examples:
 * Sleep disturbance is the ability to be watchful and get by with little sleep
 * Depression is the ability to react with deepest emotionality to conflicts
 * Schizophrenia is the ability to live in two worlds or to resort to living in a fantasy world
 * Anorexia nervosa is the ability to get along with few meals and identify with the hunger of the world

Through this positive view a change of standpoint becomes possible, not only for the patient, but also for his environment. Hence, illnesses have a symbolic function which has to be recognized by both therapist and patient. The patient learns that the symptoms and complaints of the illness are signals to bring his or her four qualities of life into new balance.

2 - Principle of Balance: Conflict Dynamics and Conflict Contents. The four qualities of life. Primary and Secondary capacities. Despite social and cultural differences and the uniqueness of every human being, it can observed that during the management of their problems that all humans refer to typical forms of coping. Thomas Kornbichler explains: "Nossrat Peseschkian formulated with the Balance Model of Positive Psychotherapy (an innovative contemporary approach to dynamic psychotherapy) a vivid model of coping with conflicts in different cultures." According to the balance model, the four areas of life are: 1. body/sense – psychosomatic; 2. achievement/activities - stress factors; 3. contact/environment – depression; 4. fantasy/future/world view/meaning of life - fears and phobia.

If we get into conflict by stress or micro-trauma, we can express our conflict-situation in four typical forms of the conflict-solution:
 * body-oriented modes
 * achievement-oriented modes
 * relationship-oriented modes
 * fantasy-oriented modes

Though these four ranges are inherent in all humans, in the western hemisphere the emphasis is more often on the areas of body/senses and profession/achievement in contrast to the eastern hemisphere where the areas are contact, fantasy and future (cross-cultural aspect of positive psychotherapy). Lack of contact and imagination are some of the causes of many psychosomatic diseases. Everybody develops his or her own preferences on how to cope with conflicts that occur. Through a one-sided mode to the conflict solution, the other modes are getting eclipsed. This one-sidedness in the four qualities of life leads to eight typical modes of conflict reaction, depending on an active or passive type of coping:
 * Overcompensation in body-cult (narcissistic over-valuation of the body)
 * Decompensation in somatic illness (somatisation, addictive behaviours, risk factors: overweight etc.)
 * Overcompensation in activity and achievement
 * Decompensation in achievement- and concentration-problems
 * Overcompensation in sociality
 * Decompensation in loneliness
 * Overcompensation in megalomania, delusions, etc.
 * Decompensation in senselessness, existential fears.

The conflict contents (e.g. punctuality, orderliness, politeness, trust, time, patience) are described in terms of primary and secondary capacities, based on the basic capacities of loving and knowing. This can be seen as a content-wise differentiation of Freud's classical model of the instances.

3 - Principle of Consultation: Five-stages of therapy and self-help. The five stages of positive psychotherapy represent a concept in which therapy and self-help are closely interrelated. The patient and the family are getting informed together about the illness and the individual solution to it.
 * 1st Step: Observation; distancing (perception: the capacity to express desire and problems)
 * 2nd Step: Taking inventory (cognitive capacities: events in the last 5 to 10 years)
 * 3rd Step: Situational encouragement (self-help and resource-activation of the patient: the ability to use past successes in conflict solution)
 * 4th Step: Verbalization (communicative capacities: the ability to express outstanding conflicts and problems in the four qualities of life)
 * 5th Step: Expansion of goals (in order to evoke forward–looking orientation in life after the problems are solved, the patient is asked: "What would you like to do, when no more problems are left to be solved? Which goals do you have for the next five years?")

Help to change standpoint: Instead of insistently turning over old and well-known problems, the resources of the patient are mobilized by wisdoms, stories, parables, allegories for the emotional and mental relocation according to the wisdom: "You can stand on your position, but you should not sit on it". With cross-cultural examples and stories, prejudices and resentments are abolished. Stories can be seen as a decisive approach to a change of awareness which in turn is the premise for a change in, for example, political, economic, medical and environmental behaviour. Image of man: Positive psychotherapy places the individual development of a person into the context of globalization. It is argued that for the first time in the history of mankind, a global, interconnected society is emerging whose characteristic feature is its cultural diversity. The process of globalization – not only on a political level but primarily on a mental level – does not take place without challenges. From this emerges the challenge to also adapt the methodological approach to the situation today. A shift from a monocultural and monocausal consideration to a multicultural and multicausal one is required. These kind of experiences and considerations led Nossrat Peseschkian to conceiving man – especially in psychotherapy – not only as an isolated individual, but also to take into account his interpersonal relationships as well, and – in accordance with his own development – his "cross-cultural" situation, which, after all, makes up what he essentially is ("If you work alone, you can only add, if you work together with others, you can multiply.")

The idea of man in positive psychotherapy can be compared to the one in humanistic psychology. In contrast to the determinism of physical and emotional drives in classical psychoanalysis or the view of a "human machine" of the classical behaviourism, in positive psychotherapy the person is seen as basically good and healthy. He or she has a lot of capacities which are created like seeds but need to be developed by education and self-education. This in turn can be compared to the salutogenetic approach of Antonovsky.

Publications
Today there are more than 26 major books on positive psychotherapy, of which some have been published in more than 23 languages. Some of the main ones are:
 * (translated) (first German edition 1977)
 * (First German edition 1979)
 * (first German edition 1983)
 * , republished India: Sterling Publishers Pvt., Ltd., ISBN 9788120718395 (first German edition 1980)
 * (first German edition 1974)
 * (first German edition 1974)