2012. Vol.3, No.12A, 1148-1152
Published Online December 2012 in SciRes (http://www.SciRP.org/journal/psych) http://dx.doi.org/10.4236/psych.2012.312A169
Copyright © 2012 SciRes.
Psychodynamic Positive Psychotherapy Emphasizes the Impact
of Culture in the Time of Globalization
Private Psychotherapeutic Practice and Inter natio na l Lecturing, Cologne, Germany
Email: henrichs@inter pun kti on.net
Received September 30th, 2012; revised October 25th, 2012; accept e d No v e mber 23rd, 2012
The emphasis of Positive Psychotherapy on culture is a specific contribution to psychodynamic psycho-
therapy and to contemporary psychological reasoning and intervention in general. In this article, it is ar-
gued that a consistent psycho-cultural perspective as introduced by the founder of Positive Psychotherapy,
the Persian-German psychiatrist and psychotherapist Nossrat Peseschkian (1933-2010), is beneficial for
humanity’s psychological needs in the time of globalization. Also elementary concepts and the style of
intervention in Positive Psychotherapy are described.
Keywords: Positive Psychotherapy; Cross-Cultural Psychotherapy; Psychodynamic Psychotherapy;
Humanistic Psychotherapy; Short-Term Therapy; Globalization
A traditional Chinese proverb says: “When you drink water,
think of its source”. We live in a time in which we’re getting
better at understanding how much every one of us is influenced
by global events. On the basis of this general insight, Nossrat
Peseschkian (1933-2010) developed a “positive” psychothera-
peutic approach that integrates the cultural factor into therapy.
Cross-Cultural Reality in the Time of
Our time is characterized by interdisciplinary and cross-cul-
tural diversity, which has an increasingly obvious influence on
the individual. A humanistic psychotherapeutic concept, which
serves man’s interest, should therefore recognize and portray
this diversity. In other words: A positive form of psychotherapy
should not just completely accept the cross-cultural and inter-
disciplinary dialogue, but should also help to give this dialogue
a human shape.
By realizing that culture is an essential determinant in human
reality, people will not be satisfied anymore with a conception
of man that forces our experiences into an individual-centered
or technocratic framework. A deliberate and cultural reflection
is needed to account for human capacities in an adequate way.
In Nossrat Peseschkian’s obituary a quote stated: “All men
have been created to carry forward an ever-advancing civiliza-
tion.” (Bahá’u’lláh, 1976) Maybe this is an appeal not to under-
stand globalization as the last days of an escalated capitalistic
world, but to shape it with humanity and grace.
Being an immigrant himself, Nossrat Peseschkian was in a—
as he put it himself—cross-cultural situation. Coming from Iran
to Germany, he liked to recount the anecdote that in his first
months in Germany, he was always glad that Germans kindly
greeted him while driving, because in oriental cultures people
greet each other by tapping their foreheads. What he did not
know at this point was that German people signal that someone
is round the bend by tapping their foreheads.
In this article, the conceptual framework of “Positive Psy-
chotherapy” will be described which Nossrat Peseschkian and
co-workers developed and introduced worldwide, but especially
in emerging nations (e.g., Peseschkian, 1974; Peseschkian,
1982). Today, there are centers for Positive Psychotherapy in
about 25 countries and there is a formal training system with
so-called “basic” and “master” courses, which comply with
international standards (e.g., of European Association for Psy-
chotherapy, EAP). The approach is acknowledged in many
countries, corresponding to the respective regional legal and
professional frameworks. There have been five world con-
gresses for Positive Psychotherapy so far. The fifth one took
place in Istanbul in 2010, shortly after its founder’s death (for
details on institutional aspects, see World Association for Posi-
tive Psychotherapy, 2012). Positive Psychotherapy has been
scientifically evaluated as an effective method of psychothera-
peutic intervention (Tritt et al., 1999).
During his cross-cultural observation, Nossrat Peseschkian
noticed that different cultures deal with a lot of phenomena of
life with quite different strategies of problem-solving. On this
topic, he gave examples such as choice of partner, handling of
money, death and mourning, meaning of work, meaning of the
body, and many more (e.g., Peseschkian, 1986).
During a lecturing trip, the author of this paper encountered a
couple in China: She was Chinese and he was Danish. The
woman said that at the beginning of their relationship, she was
proud and fascinated by her Western European spouse. Every-
thing was so wonderful. Unfortunately, after two years of mar-
riage she noticed that her husband was crazy. Asked for the
reason of her judgement, she replied that he was distrustful,
miserly and that he hated her whole family. Digging deeper, she
revealed that she blamed her husband for insisting on separate
bank accounts and not wanting to give her parents money.
It is understandable that the woman was shocked and upset.
In China, the wife generally administers the money and shares
it with the family, but this is unusual in Western Europe. One
can say: The partners interpreted the conflict situation in an
emotional, but unconscious way. They operated on the basis of
different cultural concepts on the issue of money, which they
developed while growing up in their families. In their marriage
crisis, the different concepts were activated by everyday life
demands. From the above, it is obvious that the conflict of the
couple can be described in a psychodynamic style. However, a
cross-cultural dimension is needed in order to explain it effi-
ciently: The individual biographical concepts of money became
the source of conflict because of a current context of cultural
Culturally shaped concepts frequently appear in sayings.
Hence, in Positive Psychotherapy, the therapist asks his or her
client during the first sessions for so-called “mottos” of their
family a nd parent s. May be the client re plies: “My fat her alway s
said: ‘Work is work and booze is booze’” or “Not scolding is
enough praise”. Biographical and cultural mottos like these
provide valuable access to the client’s inner world.
In Positive Psychotherapy, culture is not only seen as an ad-
ditional factor in etiological conceptualization. It is just as im-
portant to create awareness for culture as a customizable di-
mension in terms of empowerment and inspiration. The thera-
peutic interaction becomes a stage for a culturally reflective
intervention followed by conscious action. In order to promote
this, the therapist can provide, for instance, cultural models of
problem-solving in the form of traditional resources such as
stories or words of wisdom.
Humor as a Relationship-Oriented
Change of View
Also humor can be used as a culturally shaped alternative
concept in a situation of perceived powerlessness and its appli-
cation can be seen as a treatment method. Humor is a cultural
resource and often works as a relationship maintaining protest
against prevailing circumstances, in a subtle anarchic way.
Humor does not submit to situational conditions, but releases
and at the same time shapes the relationship-level. In this way,
humor becomes a symbol of hope. As if to say: “Darling, did
you park the new car carefully in the garage?”—“Not the whole
car, but the main parts of it.”
Nossrat Peseschkian loved to say: “Humor is the salt of life
and who is salted, stays fresh for a longer time”. One of his
favorite stories was the following: A lady is sitting in the thea-
tre. Suddenly she says: “Take your hands off my knee.” First
she looks to the left and then to the right: “You—but not you!”
In Positive Psychotherapy, humor is not so much understood
as an expression of charisma or a coincidence, but as a thera-
peutic strategy and technique. Humor helps to change the point
of view. The client often comes to the therapist in a situation of
excessive emotional demand. Traditional wisdom expresses this
with sayings like: “Sometimes one is not able to see the wood
for the trees.”
The art of humor lies in creating a distance from crisis and
enhancing the interpersonal contact at the same time.
Hope and a Capacity-Oriented
Conception of Man
Scientific research on psychotherapeutic effectiveness shows,
that already at the beginning of the course of therapy, there is
indication for future success or failure of the therapy (e.g.,
Grawe et al., 1994). Sometimes this phenomenon is attributed
to placebo effects or elements like social demographic fitting.
Maybe a mechanistic preconception forms the basis for the
limitation to this interpretation. Maybe the activation of the
ability to hope is central to the healing process. The German
poet Hermann Hesse once said: “There is magic in every be-
ginning.” (Hesse, 1943). Maybe it is of great significance to
shape the beginning of a meeting in a refined manner. Because
of that, offering humor, words of wisdom and unexpected
changes of view in the first therapy sessions are no coinci-
dences, but therapeutic strategies. Especially in the first ses-
sions of therapy, a lot of sayings, cross-cultural examples and
moments of surprise should therefore be used. In this way, new
ideas, views and perspectives might potentially light the candle
of hope in the darkness of crisis.
Nossrat Peseschkian liked to quote the wisdom: “Regard
man as a mine rich in gems of inestimable value” (Bahá’u’lláh,
1976). Is this just a humanistic appeal or is it possible to think
of a systematic psychotherapeutic approach to establish contact
with those gemstones? In order to approach this question, some
selected capacity-oriented concepts of Positive Psychotherapy
are described in the following: the “model dimensions”, the
“actual capacities” and “step-by-step treatment strategy”.
Model Dimensions, Actual Capacities
Figure 1 provides a schematic representation of the concept
of the “model dimensions” which is mainly used in anamnesis
and biographical work (Peseschkian, 1986). It addresses ques-
tions such as: How was the emotional situation concerning the
“I”, the “You”, the “We” and the “Primal We” (life itself)?
How did your parents act towards you? What did they say to
you, have they been patient (“I”)? How did you see the rela-
tionship of your parents? Was it a marriage of love or conven-
ience? Were there a lot of conflicts? How were those conflicts
delivered? How did your parents experience similarities? By
common activities, by conversations etc. (“You”)? Did your
family take a stand as a whole? Was there a family system?
Was it a nuclear family? Did you have siblings? How did one
appear? Did your family stay in contact with your aunts and
uncles? Was your family integrated in neighborhood (“We”)?
How did your parents teach you to deal with destiny, with the
unknown and the unexpected? Were they optimistic or pessi-
In the German city Cologne, a traditional word of wisdom
says: “It happens as it happens and it has always gone well in
Model dimensions in positive psy-
Copyright © 2012 SciRes. 1149
the end!”— What concepts did your parents have for life? Was
it maybe the concept you sometimes find in some Oriental
families: “Outside the family there are wolves?” or was it the
concept you sometimes find in some Western families: “Fa-
miliarity breeds contempt”. How did one treat strangers? How
did one deal with new ideas? How important was a certain ide-
ology, spirituality or religion (“Primal We”)?—With the con-
cept of the model dimensions, the client’s life is explored right
from the beginning not just focusing on the individual-centered
biography, but also in terms of relations to the social and cul-
Another question concerning the early phase is: How are the
client’s “emotional issues” structured, regarding their experi-
enced inner focus? For this, current psychodynamic psycho-
therapy approaches frequently use conflict-oriented diagnostics
systems like the “operationalized psychodynamic diagnostics”
(OPD Working Group, 2009): Is it about a guilt conflict, an
identity conflict, a control conflict, a dependence-autonomy
conflict? In Positive Psychotherapy, those systems are very
helpful, at the same time it is also asked: What is the content of
possible emotional dynamics? How does the client set his or
her emotional priorities?
Nossrat Peseschkian and co-workers worked out a cross-
cultural content analysis concerning “micro-traumatic” daily
life situations (Peseschkian, 1974; Peseschkian & Deidenbach,
1988). Such a situation could be for example: “I’m angry, be-
cause my boss hands every unimportant record, completely
edited, back to me!” (accuracy, obedience). Other examples are:
“I’m angry, because my wife doesn’t remove her hair from the
shower, after taking a shower!” (cleanliness). Or: “I had a fight
with my girlfriend, she earns 100.000$ and still has the opinion
that she can’t afford a cleaning lady!” (thrift). Situations like
these were examined cross-culturally: Subject areas were iden-
tified—the primary and secondary “actual capacities”—which
obviously come up over and over again: punctuality, order,
cleanness, politeness, obedience, time, patience, belief, hope etc.
The summary of the most important themes or actual capaci-
ties constitutes the “Differential Analytical Inventory” (DAI)
depicted in Figure 2. The DAI is, for instance, a useful tool for
diagnostic interviews on emotional relationships: “How do you
see punctuality and order in your relationship?” or: “Who is
more patient, who has more time, who is short of time, how
important is trust?”.
The personal concepts, which are thematically assignable to
Differential Analytical Inventory (DAI).
the actual capacities, are also shaped culturally. This becomes
clear, if one looks at everyday life phenomena and the life span.
For instance: For dealing with illness one might broadly dis-
tinguish between an Oriental and an Occidental concept. An
example from the author’s practice: A young man said that his
female colleague had been ill for weeks. But he didn’t want to
call her, because he didn’t want her to feel monitored. This
behavior can serve as an example of a Western concept. In the
Orient, the active expression of care would have been pre-
dominant. On the basis of different cross-cultural concepts of
dealing with illness, there are often situations of excessive de-
mand in Western hospitals when an Oriental patient is visited
by his or her whole family.
The reflection of and play with cultural perspectives can also
become an interesting and effective treatment technique. This
can be illustrated by another example from author’s practice.
There was a couple that did not get out anymore since their first
child was born. Both were loving and committed parents. They
reported that they had installed a video camera to visually and
acoustically check the breathing of their baby—with monitors
in different rooms. The feeding went according to schedule.
Reviewing this case, one could say that the couple developed
certain capacities like accuracy and punctuality in a good but
over-accentuated way. But other capacities like contact came
off badly, which led to further problems over time.
Also a story can demonstrate the one-sided development of
capacities vividly: A businesswoman comes home after a long
work trip, she is completely exhausted. The house husband is in
joyful expectation. He has arranged everything perfectly and
the apartment is shining. Unfortunately, the businesswoman,
after such a long trip in such heat, feels the need to spit some-
thing out. She looks for the dirtiest spot in the apartment, does
not find anything and has to spit out into her husband’s face
(adapted from Peseschkian, 1982)—also in this story, one set of
capacities is over-accentuated whilst others are neglected. The
capacity of household cleanliness is over-emphasized and at the
same time other fields of experience such as dealing with one-
self and cultivating social relationships are not developed suffi-
In a lot of situations, it is effective to immediately work on a
cultural level—by offering alternative scenes from different
cultures for example: In the case above, the young couple was
given the suggestion to take their baby with them to a friend’s
place, and to let it lie on the couch there and let other guests
play with it—like in Southern and Eastern cultures. And if it
would be getting later than 9 PM as a special exception it does
not matter so badly. One can understand this kind of use of a
cross-cultural alternative concept as a specific treatment tech-
nique in Positive Psychotherapy.
Multi-Stage Treatment and Working
At the beginning of therapy, words of wisdom and stories are
brought in anecdotally to provide new perspectives and inspira-
tion. Later, metaphors might be dealt with in more depth to
work through the client’s issues that have been focused as cru-
cial. To conceptualize working with the case in time, the treat-
ment in Positive Psychotherapy is planned and monitored in
multi-stage approach, the “5 Stages Procedure”, depicted in
Figure 3 (Peseschkian, 1987).
The first step of treatment aims for the client to connect with
Copyright © 2012 SciRes.
Multi-Stage procedure in positive psychotherapy.
his or her current situation in a new way—more aware and
creative. In the current psychotherapeutic discourse, the term
“mindfulness” is often used in this context (e.g., Allen, 2007):
The human being steps out of narrowed emotional identifica-
tion in a situation and carries out a change in perspective. There
are a lot of techniques in the different therapy schools, which
would be of appropriate use here, yet without being able to
account for the diversity of human experience: One achieves
more mindfulness through artistic work; another one achieves it
by medi tation. In a be havioral psy chotherapy , for instance, one
might reach this goal through self-observation or a pain diary.
This stage in therapy is about connecting with the situation in a
new way. The experiencing and the observing self—the worm’s
eye view and the bird’s eye view—are objects of this work. At
this point, specific techniques of Positive Psychotherapy are,
e.g., relating situations to different cultures, throwing in unex-
pected sayings or telling a story, which creates emotional reso-
nance and a new perspective.
This might be illustrated by an example. Once, a young de-
pressive man came into the author’s practice. He said that only
after his father’s death, he could be really happy. If it was not
for the high-tech medicine, his father would already be dead. At
the same time the client thought of himself as being creative,
After two or three sessions a story became the turning point
in the client’s stagnated inner situation. It was about a talented
boy who had problems at school. The boy refused to learn the
alphabet. The teacher was desperate. He asked the boy to learn
the alphabet, because he would face problems if he did not do
so. “We are building the basis in the first class. How do you
want to read, write and learn all other things in the following
classes?” The teacher said, he would inform the parents if the
boy did not improve. That did not help either, so the parents
were informed. The father opened the letter. He was shocked
and became angry. He insulted his wife and blamed her for
having spoilt the boy too much. The mother reproached the
father for putting too much pressure on his son and for never
showing his love to him.
At the weekend, his grandmother came for a visit and talked
to the boy. She put her arms around him and asked him to tell
her about his problems. The boy said: “First, I have to learn A,
B, C. When I’m able to do so, I have to learn reading and writ-
ing, then calculating, grades, homework. Then I’ll graduate,
then there’s college, the choice of partner, being afraid of losing
the job. And in the end I’m just like Mom and Dad” (adapted
from Peseschkian, 1982).
At this point of the therapy, the young man laughed for the
first time. He understood the boy. He was then asked to write
down what he thinks of the story. At the next session he
brought several pages. He found many analogies and reflected
on his own development—and now actual therapy could start.
Later, at the end of the therapy, the client had developed quite
well. He had won new life energy; he had moved out from his
parents’ home and started a job in a different city. He had
broadened his circle of friends and watered down his ideologi-
cal boundaries for the benefit of a more pragmatic approach.
The multi-stage strategy of Positive Psychotherapy offers a
concept for a psychodynamic and humanistic short-term ther-
apy. On the one hand, the anamnesis is carried out and conflicts
are worked through; on the other hand resources are activated
and developed. At first, therapy has to do with perceiving
problems more precisely and connecting oneself with the own
wishes (stage of “observation”). Then it has to do with the ca-
pability of understanding: The biographic anamnesis takes
place in a terminology, which is emancipatory. How was the
relationship with the “I”, how was the relationship with the
“You” and how was the relationship with the “We” and “Primal
We” (stage of “inventory”)? It is not worked with pathological
technical terms, but with terms of daily life, which are used
equally by both, therapist and client, towards action orientation.
Questions are asked such as: How did I learn to accept a chal-
lenge; which solutions come to my mind (stage of “encour-
agement”)? Finally comes the working through in terms of a
conflict-centered approach. Two to three conflict points are
focused on and worked through—also in systemic terms by
inclusion of the partner and family (stage of “verbalization”).
At last follows aftercare training. What do you want to do, if
you don’t have problems anymore? How do you want to de-
velop the different areas of life? What are your goals in the next
three to five years (stage of “goal broadening”)?
In the field of psychodynamic psychotherapy, Positive Psy-
chotherapy can be seen as an early and consistent implementa-
tion of general ideas such as resource-orientation and short-
term therapy. At the time of its first publication, these ideas
were controversially discussed, but today they have become
more and more state of the art (e.g., Wöller & Kruse, 2010).
Positive Psychotherapy itself can be seen as a psychodynamic
and humanistic method of psychotherapy. It serves the demand
“Become yourself”, which can be found in a lot of humanistic
and spiritual-religious traditions. The potential for self-actuali-
zation is activated right from the beginning, by not just ad-
dressing problems, but also addressing capacities to solve them.
The central concepts of Positive Psychotherapy—for example
model dimensions, actual capabilities and treatment stages—are
mirroring this enabling basic attitude.
With this attitude, Positive Psychotherapy has an immediate
effect on something one could call a disorder of the experience
of time. “In depression, the future becomes a copy of the past”.
But the future is open. Nobody is able to say, what will happen,
not even in the next half hour. And our own share in shaping
the future should not be underestimated—especially, when we
succeed in opening “the door to fantasy”. As if to say: “If you
want to have something you never had before, you have to do
something you have never done before”. Today, the possibili-
ties in planning are global for more and more people. That is
also a reason why Positive Psychotherapy integrates the cultural
dimension into the therapeutic work. Nossrat Peseschkian
commented on this: “In a good therapy one should talk about
the past 25% of the time, 25% about the present and 50% about
the possibilities in the future” (Peseschkian, 2006).
Copyright © 2012 SciRes. 1151
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