Psychotherapy and Neuroscience

Redecision Therapy

Redecision therapy, a less frequently known psychotherapy method, was developed by a social worker, Mary McClure Goulding, and her deceased psychiatrist husband, Robert Goulding, in the 1970s. Redecision therapy (Goulding & Goulding, 1979, 1989) is an integration of Eric Berne’s transactional analysis and Fritz Perl’s gestalt therapy. Transactional analysis views early emotional learning (childhood decisions) within the context of a child’s response to parental injunctions. Parental injunctions are subtle parental verbal and nonverbal messages (e.g. don’t be you, do, don’t think, don’t feel, don’t belong, don’t be competent, don’t be smart, etc). Children respond in emotion and then form decisions (holistic assessments of self in interaction) (e.g. I am powerless, I am not good enough, I don’t deserve to live, I am not lovable, I can’t trust, etc.), which they carry with them well into adulthood. These same decisions and assessments of life often evolve in response to later adult traumas as the following assessments of self in interaction: I am unsafe. I am in pain. I am not in control. Assessments of self become the adult’s later working model and shape the adult’s later responses to their environment without awareness (manifested in ongoing adult scripts). The redecision method helps the therapist to identify these assessments of self in interaction in the present and to look for present symbols that represent these decisions and the emotion underlying them. After the therapist can identify specific assessments of self in interaction, the therapist then asks the patient to reflect back in time when that specific assessment of self in interaction was experienced before. The therapist asks this over and over again to bring the patient back in time. After sufficient conscious age regression, the therapist then asks the patient to reflect on the many different feelings (of fear, sadness, anger, guilt, etc.) relating to the relationship or painful event. The patient is encouraged to talk to the source (person or event) in the empty chair (gestalt therapy of Fritz Perl) or any venue that would encourage the patient to talk to the source as if he/she were in the room in the present tense. This helps the patient to process material that had not been completely processed previously. After this material is reexperienced and processed, therapist guides the patient to make a new assessment of self in interaction (a redecision), i.e. I have control, I am good enough, I am fine, I am safe, etc.

Important concepts inherent in this therapy technique are the following:

  1. An individual’s current conflicts are metaphors from conflicts from the past. People unknowingly relive their responses to prior conflict with symbols provided in the present. It is important for therapists to identify these symbols, the arousing emotion, and to identify the assessment of self in interaction that summarizes holistically how one sees oneself interacting with one’s world.
  2. It is important to understand that a troubling painful relationship with another can be more upsetting to an individual than the actual abuse that had been inflicted on the patient by a particular individual. In addition the patient’s response to his/her negative assessment of self in interaction can be very disturbing to the patient. Examples of negative assessments of self in interaction are the following: I am powerless. I don’t have control. I am a disappointment. I am unlovable. I am not good enough. The patient’s negative assessment of self in interaction typically underlies manifestations of low self-esteem or one’s sense that the world is an unsafe and dangerous place. Depending upon one’s genetic predisposition this negative assessment is also accompanied by chronic arousal that is manifested in symptoms of anxiety, depression, the vague sensation of emotional pain, oppositional response, tension and sensitivity for arousal, etc. Both these components, the implicit holistic assessment of self in interaction and chronic arousal, underlie the chronic stress response that underlies symptoms that psychopharmacological therapies seek to treat.
  3. The gestalt therapy technique that is an integral part of the redecision technique encourages the patient to express him/herself in the present-as if the person or event were there in the room with the patient. Reliving a troubling event or relationship in the present will help to process the prior experience and allow it to transform into a part of the patient’s history.
  4. The redecision, shift from a negative to a positive assessment of self in interaction (e.g. positive cognition: I am powerful. I have control. I am fine. I am lovable), and acceptance of prior negative emotion and negative assessments of self in interaction reflects that processing has been completed. The memory is appropriately part of the person’s memory base and is easily retrieved. The individual is ready to move on. Chronic arousal and arousal associated with ongoing future conflict of similar nature will not emerge due to the separation of past and present with the conclusion of therapy.

Goulding M & Goulding R (1979: Changing Lives Through Redecision Therapy. Grove Press, California.

Goulding M & Goulding R (1989): Not to Worry: How to Free Yourself from Unnecessary Anxiety and Channel your Worries into Positive Action. Silver Arrow Books, New York, New York.