Psychotherapy Is Chaotic—(Not Only) in a Computational World

Abstract

Objective: The aim of this article is to outline the role of chaotic dynamics in psychotherapy. Besides some empirical findings of chaos at different time scales, the focus is on theoretical modeling of change processes explaining and simulating chaotic dynamics. It will be illustrated how some common factors of psychotherapeutic change and psychological hypotheses on motivation, emotion regulation, and information processing of the client's functioning can be integrated into a comprehensive nonlinear model of human change processes.Methods: The model combines 5 variables (intensity of emotions, problem intensity, motivation to change, insight and new perspectives, therapeutic success) and 4 parameters into a set of 5 coupled nonlinear difference equations. The results of these simulations are presented as time series, as phase space embedding of these time series (i.e., attractors), and as bifurcation diagrams.Results: The model creates chaotic dynamics, phase transition-like phenomena, bi- or multi-stability, and sensibility of the dynamic patterns on parameter drift. These features are predicted by chaos theory and by Synergetics and correspond to empirical findings. The spectrum of these behaviors illustrates the complexity of psychotherapeutic processes.Conclusion: The model contributes to the development of an integrative conceptualization of psychotherapy. It is consistent with the state of scientific knowledge of common factors, as well as other psychological topics, such as: motivation, emotion regulation, and cognitive processing. The role of chaos theory is underpinned, not only in the world of computer simulations, but also in practice. In practice, chaos demands technologies capable of real-time monitoring and reporting on the nonlinear features of the ongoing process (e.g., its stability or instability). Based on this monitoring, a client-centered, continuous, and cooperative process of feedback and control becomes possible. By contrast, restricted predictability and spontaneous changes challenge the usefulness of prescriptive treatment manuals or other predefined programs of psychotherapy.

Sudden gains in day-to-day change: Revealing nonlinear patterns of individual improvement in depression.

“…Although not the only avenue of interest, having found these continuous and discontinuous changes means we should not overlook a complex dynamical systems explanation for understanding patterns of treatment response in depression (Abel et al, 2016;Hayes & Strauss, 1998). Some empirical research has supported the idea that sudden changes in symptoms may be indications of a critical shift in the mood system, where a move toward a more adaptive state is reached after the positive influence of therapy (Schiepek, 2009;Schiepek et al, 2018Schiepek et al, , 2017van de Leemput et al, 2014;Wichers et al, 2016). Examining whether sudden gains in depression indicate tipping points is relevant, as dynamical systems theory may provide us with methods to anticipate changes in symptoms or depressive burden.…”

Bridging the gap between complexity science and clinical practice by formalizing idiographic theories: a computational model of functional analysis

“…The behavioral reaction has perceived benefits and costs, reinforcing or inhibiting the behavior Note that in this paper, we primarily focus on modeling linear differential equations. Extending the framework to including non-linear equations would be a relevant step for future research, given that prior literature found that psychotherapeutic processes are often chaotic, a feature that is characteristic for non-linear dynamics [41,51]. For the sake of implementation, however, we decided to focus on linear equations, since many aspects of non-linear dynamics require an extensive mathematical understanding.…”

“…Sim, Gwee, and Bateman [40] identified five key advantages associated with formulating thorough case conceptualizations in clinical practice: (a) the integration/relation of multiple problems of a patient, (b) the explanatory nature of the resulting model, (c) the prescription of interventions, (d) the prediction of outcomes, and (e) the support for the therapeutic relationship. Schiepek and colleagues [36,37,41] pioneered the integration of case formulation and idiographic system modeling and argued that these key advantages could be strengthened through computational models. Clinicians are required to make more rigorous decisions in specifying relations in the case conceptualization, which makes the formalization of idiographic theories a promising avenue to foster more scientific practices in designing patient-tailored treatment.…”

“…The top and middle part show the simulated time-series for the discriminant stimulus, panic, and avoidant coping along with catastrophizing and the credibility of the catastrophic interpretation (a) and perceived benefits and costs (b). The bottom part of the figure (c) shows the three-dimensional phase portrait for panic, avoidant coping, and the credibility of the catastrophic interpretation, where the white box indicates the start and the black box the end of the trajectory dynamics found that processes in therapy are often nonlinear and chaotic [41,62]. Such dynamics are, by definition, hard to predict and are heavily dependent on the specific set-up of the simulation; slight changes in the set-up of initial conditions and parameters might have dramatic effects on the simulated behavior.…”

What Can Synergetics Contribute to Embodied Aesthetics?

“…While I think it is at least plausible to consider intrapersonal ratings as (more or less) reliable, I believe that interpersonal ratings are highly questionable due to the qualia problem. Based on quantification, promising models of psychological processes have been developed by Schiepek et al [14], Tschacher et al [13] and others.…”