Dialectical Integration: The Case of Psychoanalysis and Cognitive Behavioral Therapy

Based on Hegel's dialectics, we argue that different psychotherapies considered monolithic such as cognitive behavioural therapy (CBT) and psychoanalysis, even though they hold radically different views on human suffering and therapy's aims, profoundly influence each other. We call this mutual influence dialectical integration (DI). DI is the result of unconscious processes that are activated by antagonism and negation for self-constitution. In a dialectically formative process, the self-constitution of CBT and psychoanalysis each is achieved by means of the negation of part of itself, which undergoes alienation in the other, thereby superficially taking the form of a rejection of the other approach. But whenever theoretical or practical lacunae occur in the unfolding of these disciplines, they negate this primary negation and re-internalize the alienated self-component. This part does not return in its original—and negated—form, but, through a sublation introducing theoretical and practical development. This is illustrated here by Hartmann's ego psychology, Beck's cognitive theory, Young's schema therapy, and Bateman & Fonagy's mentalization-based therapy (MBT). We show how these developments incorporate elements of otherness, which are not simply extraneous to the tradition but also part of it. We conclude by showing how DI gives rise to recognition and containment of otherness in both schools.