Behavior therapy (1st wave), based on the application of scientific methods and learning theory, emerged in the fifties. The first therapy per se was systematic desensitization for the treatment of phobias (Joseph Wolpe ). Originally behaviour therapy addressed visible and measurable behaviors. Later the notion of behaviour was extended to include thoughts and feelings (Radical Behaviorism). Having first proven useful in the treatment of anxiety, behavior therapy soon was applied in institutional settings to treat more severe problems: autism, mental retardation, and dementia using principles of reinforcement to stimulate and maintain adaptive behaviors (token economy).
Cognitive therapy (2nd wave) appeared in the 60s (Albert Ellis et Aaron Beck ). At the time researchers were approaching the human brain and its functioning through the lens of information science: the brain was thought to process information in much the same way as computers. Cognitive therapists observed the relationship among thoughts, feelings and behaviors. Negative thoughts and what a re called cognitive schemas were believed to generate psychopathology, irrational thinking being the cause of suffering. The aim of the therapist was to help the patient identify and modify thoughts and schemas (cognitive restructuring) about self and the world.
Cognitive therapy has been successful in treating anxiety, depression, personality disorders and many other disorders.
Behavior therapy (1st wave) was designed to modify the environment in order to modify behavior. Cognitive therapy (2nd wave) focused on changing thoughts as a way of changing behaviour. 3rd wave therapies, influenced by Buddhism and Oriental philosophy, target the relationship between a patient and his inner experience (thoughts and emotions).
ACT, acceptance and commitment therapy, appeared in the 90’s. Unlike previous CBT therapies, ACT does not purport to reduce symptoms but to increase psychological flexibility. The patient learns to relinquish avoidance of internal experience and emotional control (creative helplessness) in favor of valued living. Techniques include opening up to emotional experience (acceptance) using exposure to painful “stuff”; identifying and detaching from thoughts and rules (defusion); being present through mindfulness meditation and identifying values or what really counts.
ACT therapy starts with behavioral or functional analysis of the problem (1st wave). ACT considers thought and more importantly language as important in human behavior (scnd wave / 2nd wave). ACT therapists understand behaviour as emerging in a context (given situation) with a given function or consequence. Patients learn to evaluate their actions through the lens of what works and not what is right or true. They learn to detach from rules: shat should be, what is right in favour of what their own experience shows is effective or workable.
Rosemarie Bourgault is a dual national, born in the US but having spent much of her adult life living in France. She studied French literature in the US hoping to become a professor. Soon after her arrival in France, she returned to university to study psychology with a particular interest in how humans learn. In so doing, she discovered traditional behaviour therapy, theories of conditioning and more recently ACT and the role of language in human behaviour.
In 1990, she began her career as a psychologist in a Parisian psychiatric unit. From there she was hired to work in a private stress and anxiety clinic. She opened her own practice in 1995 specializing in stress anxiety, depression. Shortly before the rash of terrorist attacks in Paris in the late 90’s, she developed an interest in traumatic stress. Since that time, she has devoted a part of her clinical practice to traumatic stress intervening in institutions following critical incidents.
In her search for new and more innovative approaches, Rosemarie discovered ACT and Mindfulness based therapies. These approaches emphasize the search for meaning and the identification of values which contribute to a rich and meaningful existence.
In addition to her clinical work and to her training and consulting in institutions, Rosemarie teaches at the French Association for Cognitive and Behavior Therapy and she is an instructor in the clinical psychology program at the University of Paris V.
Rosemarie is a cat lover. Presently she shares part of her life with Bulle a ten-year old orange tabby.
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