Pedro R. Portes, Ph.D.
University of Louisville
Based on a Division E Symposium - Extending
Socio-Cultural Theory For Counseling, presented at AERA Montreal,
April 20, 1990
This article acquaints readers interested in psychotherapy and counseling with a relatively new, emerging socio-cultural theory. It provides snapshots , as well as implications of some of the basic contributions stemming from cultural-historical activity theory (CHAT). The theory or approach originated at a time when psychology was carving a scientific identity and to define the content boundaries and methods for the study of mind (van der Veer & Valsiner, 1994). In the latter part of this century, it has evolved considerably and its presence felt in various disciplines. Like other major paradigms in psychology, it carries implications for several sub-disciplines such as counseling and education. Unlike them, the theory represents perhaps a meta-paradigm because its focus extends beyond the development of individuals in changing social contexts in ways that integrate many current theories, and their development in a historical, social context. Unfortunately, extending this multi-level, dialectical model is difficult. It must be limited here to capture only some of the most basic themes and ideas that might interest those interested in the connection between mental health and a new psychology. The rest will hopefully be extended in future writings on this topic.
The cultural historical and activity theory (CHAT) approach has received minimal attention in mainstream mental health disciplines in psychology relative to other fields such as developmental and educational psychology. However, because counseling and psychotherapy are essentially educational activities, some of the work concerning the application of essential concepts in the model has already been initiated (Miltenburg & Singer, 1995; Portes, 1993; Ryle, 1991; Wilson and Weinstein, 1990). Counseling, as well as psychotherapy, are specific types of educational activity that have emerged in many parts of the world through institutionalized, formal cultural practices. Counseling and therapy represent essentially re-mediational practices that as a rule, aim to socialize the client anew, particularly when other socialization practices have failed or when stressful events overwhelm the individual. Re-mediation can and does takes place ordinarily in both, individual and group levels. At the individual level, self-help books and practices, as well a sessions with experts form part of what is essentially mediated learning (Karpov & Haywood, 1998) involving others, activities and tools. Societal change and individual development are also intertwined, as are the definitions and practices in the profession which often remain unexamined in the profession.
Cultural-Historical Connections to Mental Health
Counseling per se was not of concern to Vygotsky and the theory's co-founders, and from a historical standpoint, this is quite understandable for a number of reasons. Counseling, as a cultural practice, had not been well established except for psychodynamic theories and analysis during the early part of the century. Luria's pioneering work with head injury and psychotic patients and Vygotsky's analysis of thought in schizophrenic adolescents and focused mainly on the relation between the regulatory functions of language, inner speech, and cerebral organization of verbal structures and comprehension. This work was significant yet far removed from the secondary intervention focus associated with the more formal, institutionalized practices in counseling psychology today. In those early times, the counseling profession, as it exists today, was only beginning to emerge from practices found in psychoanalysis and psychiatric institutions.
It should be noted that Luria, and to a lesser extent, Vygotsky, had an interest in psychodynamic theory (Van der Veer & Valsiner, 1994; Wertsch , 1990) but both became disillusioned with it's adequacy as a general model for the field. This was not because of its adequacy in dealing with mental health problems specifically but rather, because it did not present a unified model for the study of mind. It was concern for the latter that later led them to found the cultural historical school in response to a deeper crisis in psychology as a discipline (Cahan & White, 1992). This crisis has prevailed in Western psychology and inadvertently, long after psychodynamic and behavioral theories moved away from the core of the discipline of psychology in the U. S. and other parts of the world.
There are other reasons for the void between the sub-discipline of counseling and the CHAT approach besides the fact that the model was founded to address fundamental theoretical issues and to develop general principles for the field. First, only after methods are developed and integrated with research findings could there be any meaningful efforts devoted to the applied subdisciplines. Secondly, the model encompasses questions that concern ontogenesis, sociogenesis and phylogenesis (see Werstch, 1990), that are most relevant to the field of counseling. Whereas ontogenesis is relevant in examining developmental change in the individual client, the socio-genetic line of inquiry would be concerned more with the social context in the construction, classification and practices surrounding various psychopathologies. These two areas are more concerned with the line of cultural development (Vygotsky, 1978). Similarly, the phylogenetic line concerns the biological bases of psychopathology, and the mind's natural development from a comparative psychological standpoint. From a CHAT viewpoint, these lines must be included in any developmental analyses as they might interact with each other.
The CHAT model requires attention not only to the means through which the client can be helped to change, as in the case of acquiring new problem solving skills or perspectives. It also requires attention to the relation between the client and therapist level and that of the larger cultural context that defines mental health and learning problems, the roles of the therapist and those of particular institutions. The means through which and individual acts are a central issue for counseling. This model attends to the contexts of activity that are mediated culturally and in turn, influence human development.
One final reason is related to the above distinction between two lines of inquiry. That is, any advancement in the application of the model at the individual level would have to simultaneously situate it in the larger, societal context. This is an unfamiliar practice in counseling since psychopathology has ordinarily been situated in "the head" of the client, as have been the case with other traits and (dis)abilities . In cultural historical theory, the unit of analysis cannot be reduced simply to heredity, behavior, thought, nor the environment. Rather, it is mainly the person acting and thinking with cultural tools and with her environment and heredity. The latter, of course, have been forged over time in particular contexts. In this model, what a person chooses to do with a given set of socially and biologically influenced conditions and activity matters, from both a subjective and objective standpoint. Of course, efforts to understand the social construction of psychopathology from a psycho-social standpoint (e.g., Erikson, 1968; Goffman, 1966), have been noted in the field. Yet, these efforts have served mainly as critical observations of cultural practices without much direct impact on the counseling field as standard theoretical perspectives.
In sum, the CHAT model's seeming renaissance is due partly to it's main founder's early death and his work being banned for a time. Although translations of one of Vygotsky's works appeared as early as the mid-1950's, it was primarily through the model's co-founder, Alexander Luria, that interest was awakened in Western psychologists. For historical reasons, counseling seems to have remained insulated from the CHAT's broader approach to the study of mind, one which differs radically from those that have reigned in twentieth century psychology. Whether CHAT will rank among the other major schools of thought or seep into the area of counseling remains to be seen. This is because, while it carries numerous implications for counseling, its meta-paradigmatic aspects can also deconstruct the practice of counseling as culturally-situated activity. For example, this model's analysis of most mental health problems would included both objective and subjective stances that are not likely to fare well within the dominant practices in the fields of mental health. The influence of insurance companies, or HMO's, as another example, is reflected in the mental health practices today to a considerable extent. The dilemma of dealing with prescriptive, individual level practices in psychotherapy and the recognition of the cultural presses from which those practices and categories stem must be first recognized and dealt with in any attempt to extend CHAT meaningfully in this area. The model is interdisciplinary by definition with its inherent "cultural anthropology" lens. The latter inevitably would create tension in the training and education of mental health professionals.
Mediation of Development Through Language and Other Tools
To the extent that psychological adjustment is influenced by cognitive development, it can be seen that the mind the client brings to therapy has been constructed largely through the activities characterizing the micro and macro culture it originated from, particularly through language and other means. The emergence of language as a way to mediate and contrast experience is a most critical area for further study in counseling. The way language is employed in a given setting and mediates development is relevant to understanding psychopathology developmentally in terms of how psychological functions emerge or fail to develop. This point is relevant to some of the techniques currently found in the field such as neuro-linguistic programming, brief solution, reality or rational-emotive therapy. The work of Vygotsky, Luria, Leont'ev and others would seem critical for counselors who strive to understand how communicative processes and activity shape the mind's higher psychological functions. The same is particularly important as it applies to the counseling process where much of the re-socialization efforts are generally attempted via verbal communication. The "talking cure" concerns directly the social regulation of thought and behavior and their internalization.
Why then is it so difficult to obtain meaningful change in the client? Why is the "talking cure" so evanescent? From a CHAT view, it is not just insight by the client that leads to change. When permanent change occurs, several important concepts might require attention; for example, the zone of proximal development, the first law of cultural development in the development of complex functional systems, and the double stimulation method. Each of these cornerstones of CHAT will be briefly discussed in subsequent sections.
Overview of CHAT Premises
A semiotic relationship exists between mind and culture that is generally overlooked by models that presume culture to be either a constant in the individual or an external factor. The lack of continuity in the types and use of meanings and mental tools found in the counseling context is characteristic of some clients' adjustment problems. Clearly, a mismatch between the client's set of meanings and those of others is related to subsequent motivational, affective and behavioral difficulties.
The CHAT approach addresses developmentally (historically) many of the ways through which environmental processes influence cognition, learning and behavior. It distinguishes the natural from the cultural line of development. The development of executive processes, voluntary attention and cognitive skills appear largely structured by external, inter-psychological relations, communication, and routines in culture. This appears relevant to research on social learning, self-regulation (Bandura, 1991; Rotter, 1954; Schunk. 1984). The shift from overt speech, to that of speech for oneself (Vygotsky, 1986), shows the gradual internalization of interpersonal communications that originate and govern mental functions. The person's cognitive structure regulates reasoning and depends on social?interactive processes for development. The implications here are most helpful in understanding how culture forms the higher functions of mind. The CHAT model allows for both subjective and objective analysis of both between group and within group differences in values, attitudes, mental health and intellectual ability. It addresses social formation of institutional and professional definitions that may be arbitrary and situated in a particular context
Cultural processes and patterns of communication influence the transition from simple to complex functions through speech and other symbolic means (semiotic) devices. They influence the type as well as the timing of such psychological transitions that represent the foci of the CHAT approach. The term cultural in this model stands for tools or other means that mediate development and cognitive-behavioral changes in particular. One implication from the CHAT model is then that maladjustment often leads to the development of "different" meanings and mediational schemas that are likely affect the person's potential development early. These differences sometimes occur in strategic areas related to social norms and mores. Such differences vary in terms of tolerance afforded and the severity associated with behavior and/or symptoms.
CHAT and Psychotherapy
Among the various theoretical currents in human development, the cultural-historical activity theory (CHAT) approach inspired by Vygotsky, Luria, Leontiev and others is one that has yet to be fully considered in the area of mental health. Although earlier during the development of this approach, efforts were made to integrate it with psychoanalytic theory, by the late 1920's both Luria and Vygotsky had abandoned the monism inherent in psychoanalysis as a theoretical system in favor of a more comprehensive approach that would consider socio-cultural factors more directly. While various threads have evolved in other fields since that time (mainly in education and developmental psychology), implications from the CHAT approach has been rather silent in counseling and psychotherapy for reasons that will be examined, in part, next.
Vygotsky was influenced by Adler, Kretschmer, Jaspers, and Freud (see van der Veer & Valsiner, 1994). Luria had been an enthusiastic follower of Freud until several critiques (see van der Veer & Valsiner, 1991; Wertsch, 1990) led him to reject the psychodynamic model altogether. The founders of CHAT were only indirectly concerned about developmental aspects of various mental health conditions and the dynamics of psychopathology as noted. Their search for a unified theory of mind, which gradually has been described as cultural historical, focused on activity, tools mediation and social practices. It has not been until now that the development of CHAT has accrued sufficient force to provide some foundations for practice in psychology and other applied areas.
Cultural-historical activity theory offers a paradigm that is perhaps too broad, complex and thus might be regarded as a metaparadigm relative to others in the field, such as cognitive-behavioral, psychodynamic , existential, humanistic or other models. Because it focuses on the development of mind socio-culturally from three bases simultaneously; phylogenetic, socio-genetic and microgenetic, CHAT is constantly extended by practice. Notwithstanding, it is only recently that it is being articulated in this field. It has yet to appear in standard counseling textbooks. Its potential has been exploited in a number of related disciplines, such as special education (Fuerstein & Fuerstein, 1991), developmental (Valsiner, 1987) and educational (Portes, 1996) psychology. Only recently, have there been several writings that attempt to link Vygotsky's work to mental health, which vary considerably in interpretation and application. Some stem from the psychoanalytic thread (Leinman, 1992; Ryle,1991 ), others from activity theory ( Drier, 1997, Miltenburg, 1998).
Abandoning the Psychoanalytic Framework
In the 1920's, both Luria and Vygotsky were still influenced by psychodynamic theories. In the case of Luria, the influence was more intense (see Luria, 1925)/1978) initially although later, its rejection was much greater than that found in Vygotsky's writings (van der Veer & Valsiner, 1994). Both appeared to endorse psychoanalysis as a great advance in their introduction to Freud's publication, Beyond the Pleasure Principle. By 1926, psychoanalysis was no longer regarded in the Soviet Union as sufficiently materialistic, and as some critics noted, it suffered actually from an idealism that was inconsistent with efforts to forge a Marxist psychology. It was repudiated after critiques from Bakhtin, Jurinets and Vygotsky himself, although the latter respected the originality and heuristic value of Freud's work in advancing the cause of a scientific psychology. Vygotsky strongly disagreed with Luria's and others' early, enthusiastic effort to integrate Marxism and psychoanalysis. From Vygotsky's perspective, Freud probably would have not agreed that his system was monistic nor that he followed historical materialism. Vygotsky felt such efforts to marry the two models were filled with distortions and that psychoanalytic theory was much closer to a conglomeration of insights, beliefs and facts than a complete model (van der Veer & Valsiner, 1994, p.99). Vygotsky's analysis and critique of psychoanalysis must be understood thus in context of searching for a general, unified psychological science that went beyond the positivist and idealistic restraints, and which would be anchored in practice. In spite of appreciating the analysis of various areas and principles (pleasure, death, e.g.,), he felt that a number of premises such as pansexualism and the blanket explanation of form and content according to primordial drives to the exclusion of social factors compromised the model. He felt Freud's focus on the biological or phylogenetic line tended to exclude attention to the socio-genetic dimension. Nevertheless, he did not condemn psychoanalysis entirely and focused positively on some of its contributions to psychology as it strove to become a more complete science. He considered Freud's work on the unconscious reaches of the mind highly creative.
Many of the fundamental problems and issues in psychology today were anticipated by Vygotsky's search for a causal, objective psychology that would evolve from application and its scientific study (Cahan & White, 1992). And interestingly enough, among the areas that lend themselves most directly to practices guided by theory are special education and psychotherapy. Since practice is the most exacting test of theory, Vygotsky argued that the traditional theory down-to-practice order should be changed to a recursive order where practice routinely informs the development of theory. As van der Veer and Valsiner (1994) note. For Vygotsky;
The growth of branches of applied psychology, such as psychotherapy, paedology (including intelligence testing), and educational counseling forced researchers to be explicit in their assumptions and to re-examine their theoretical concepts. It was against this background of rapid social reforms and the need for scientists to contribute to these reforms, that Vygotsky agreed with those who consider practice to be the supreme court of science, the ultimate judge of truth. (P.150)
II. Alfred Adler
Another very important influence from the psychodynamic camp, which is relevant to clinical work and Vygotsky's work, is found in Adler's theory (see Ansbacher & Ansbacher, 1964) which focused on individual action and social motives. His views on the purposiveness of behavior and ideas about compensation appear to have influenced Vygotsky's work in defectology and other areas. Adler believed that behavior is goal directed and understanding thus, the future course of behavior allows for a prospective analysis of the human mind. In a way, one might even link the metaphor of the zone of proximal development to this type of analysis, which is becoming integrated in the main of psychology. This functional, goal directed point of view allowed for a more sophisticated understanding of how individual's negotiate the complexities found in a future full of options, contradictions and possibilities. Adler's own thinking about human behavior appears to have been influenced by both philosophy and fiction. Among his favorite authors were Goethe, Shakespeare, Marx, Dostoevski, Conan Doyle and Edgar Allen Poe. They contributed in varied ways to the investigation of basic principles underlying behavior that included both unconscious and social motives. Adler believed that all psychological phenomena can be related to the preparation for some future goal which is generally social in nature, - that of reaching a superior or advantageous position in life relative to others. The feeling of inferiority, on the other hand, represents a basic principle for motivation, which is of particular importance for children who wish to become adults, or children and adults with physical or psychological challenges. Physical deficits at the organic level compromise functioning in ways that are parallel to psychological disorders that compromise social and psychological functioning. However, while the organic contribution to the abnormal condition is of primary importance, often the problem becomes most difficult because of particular social treatments that exacerbate the condition in question. The treatment of such conditions requires not only attention to the organic bases that compromise psychological functions but also attention to the social response(s) that is afforded to the afflicted parties whose functioning is regarded as problematic. The individual's effort to compensate may lead to successful adaptation and even superior development, or might fail, which might be linked to various types and degrees of psychopathology.
Where Vygotsky and Adler agreed most was that both argued for an open system where problems in one area could reconfigure the structure of the psyche and allow for compensation in functioning in another area (Vygotsky, 1993d). Both were hopeful in terms of the prognosis of those with defects or psychological problems. Adler's is known for his insistence on encouragement. Vygotsky stressed the vital need for developing new means and practices for those with "defects" or problems in order to adapt socially and to minimize the change caused by any problem in terms of social relations. One may extend his ideas concerning mainstreaming or (social) moral education (Vygotsky, 1997) as well as those concerning special education or "defectology" to specific areas in mental health. In the mental health area, the model is relevant to explaining client change, issues in diagnostics with respect to the natural and cultural factors in etiology, and treatment. It is a model that is also pertinent to culture-specific practices in the profession as well as outside the profession.
Psychotherapy as Special Education
For Vygotsky, the treatment or the analysis of a handicap (i.e., in special education), or of psychotic and neurotic disorders, should be based on the analysis of functions or principles of human psychological development. Compensatory "psychotechnics" could help the organism compensate for a defect by building a superstructure, which would permit sufficient compensation to deal with social demands. My reading of his work is that whether particular tools are internalized or remain external, is a relative issue. The main concern is centered on the cultural consequences of the problem. Vygotsky suggests that often the main problem concerning a biologically based problem or defect is not just the resulting limited functioning and action but how social relations are generally changed in ways that exacerbate the problem and can actually further debilitate the functional potential of the individual. One of Vygotsky's main contributions lies in a latter insight, which implies a different approach to the treatment of any acceptionality. He envisioned more than just an individual effort to compensate for structural problems such as those found in a natural experiment as in the case of the blind or deaf, which can lead to compensation involving the replacement of one instrument with extension of another. He saw the opportunity to aid the development of a protective, adaptive superstructure around the problem by altering the social relations around the person in ways that would allow progress in the development of cultural tools and mediated action. For example, the treatment afforded to autistic children can be improved in relative fashion by incorporating work-related activities (off-hours restaurant help) into the daily routine. (i.e., they can help set tables before customers arrive). In sum, his interaction with Adler's ideas appears to have led him to the insight that just as blindness is not only the lack of vision, any psychophysiological problem causes "a deep restructuring of all the forces of the organism and the personality" (1928a, p. 86-89). The thinking here is systemic, ecological, and dialectical in the understanding of psychopathology and most other abnormal conditions.
It was not until the latter part of the 1920's when cultural historical theory began to be defined in ways that would carry more direct implications for psychotherapy and clinical work. However, it is clear that the core of the implications is based on the analysis of defectology or what may be termed abnormal psychology, in the broad sense, particularly with attention to the interplay of biological and cultural constraints on individual development. As a starting point, the analysis begins with the traditional experimental method (or tool), that of assessing and contrasting some of the effects or influences of organic defects on development and how these are generally reacted to in ways that discourage effective re-mediation from occurring. Part of the problem with the deaf, blind and others whose faculties are challenged, lies precisely in the difficulty of developing a second (signal) functional system of communication and/or operations. Secondly, how the development of such an alternate system affects a higher level of cultural adaptation and development is an important aspect of the problem. The second signal system for the deaf is sign language and for the blind Braille, and with each case, cultural development can proceed relatively well. Without it, development and cultural adaptation are constrained. In a sense, this is a two-factor model that could be applied not only to learning disabilities but also to a variety of mental health problems. For example, Ritalin is the Braille of the ADHD child; Lithium is the sign language that allows the manic-depressive to function in society. However, chemical tools or other external treatments may not form a superstructure in the mind of the person like some social tools or treatments. However, the social treatment and competencies they empower may foster structural change. On the other hand, RET Gestalt or the insight of psychodynamic or other models, over time, may do so as well. Sometimes they may also change or foster, via dialogic communication patterns that are inherent in the activity of counseling, a similar change. So would a self-help group where specific psychological skills can be co-constructed. In effect, this is a basic explanation for how any type of re-mediation works in most cases. In family systems, healthy development can occur once the blocks of anger and conflict are resolved in the family or social group. A hysteric or histrionic personality improves once insight is achieved mutually between therapist and client. A phobic may be cured after systematic desensitization changes the structure or at least replaces some structures with more functional ones.
In general, abstract skills and concept formation is the preferred mode in helping most clients, even those with more severe psychopathology. Improvement was sometimes achieved through word-meanings as an essential mediational tool but in other cases (aphasia, Alzheimer's and other diseases) not. One point here is that other tools or units of analysis besides word meanings can be employed to extend our understanding of development. The connections made here are based, of course, on one interpretation of the various original writings that suggest only some working hypotheses and insights that require much elaboration in this applied field. The above serve as examples of how cultural tools are appropriated by the individual and converted into means for goal-oriented actions.
In sum, as van der Veer & Valsiner (1994) note such views " to a great extent only reiterated Vygotsky's earlier point of view that defects had to be overcome by the word" (p.74). This provides probably the most elegant rationale for the "talking cure". On the other hand, some critique him for having some loose ends and contradictions because he saw development in such cases not as smooth transitions but propelled by conflict between the natural and cultural aspects of development. The implications that social compensation entail in clinical work or in human development have yet to receive full attention in contemporary clinical work. The effects of social groups, and in particular their ideology or social attitudes (as a higher psychological tool) on development, can be appreciated in present day cultural programs such as the 12 steps addictions, weightwatchers, character education and other group-based activities. Current efforts to organize educational activity in ways sensitive to the development of diverse student groups (see Cole, 1999), may be considered in analogous fashion. One may see the cultural contribution to structural change in the establishment of mutual beliefs and values between the client(s) and society. Such changes can help develop a superstructure over both biological (natural) or socio-psychological defective or lacking structures to permit "progress" in cultural development. For Vygotsky, cultural development did not only represent social development, particularly that involving more advanced peers, but development with the tools present in a culture and its history. Conceptual change is implied in the understanding by clients as they acquire, fulfill or co-construct society's fully valued meaning(s), roles, expectations, values and ideology.
A final point to be noted here concerns CHAT's origin in the comparative, experimental method. This method is instrumental in the development of a materialist model where two or more conditions are present. It is also well in line with a positivist approach in science in spite current trends to interpret the theory otherwise.. Whether the phylogenetic line is compared with the cultural, or one cultural context with another, one type of client with others, the CHAT approach essentially points toward an experimental approach in considering various aspects of development in a comprehensive fashion. Elaboration of this point is, however, beyond the limits of this writing.
Vygotsky considered mostly defects that stemmed from the natural line and affected socio-psychological functions. One implication of the above, however, is current theory which holds that problems in social functioning can cause stress and distress that can affect the psyche and body of the individual. Although this is not found specifically in his writings as in modern areas like stress management practices, the dialectic thinking from which he synthesized so much in so short of a period of life would lead one to think he might of eventually. Actually, his first law of Cultural Development, elaborated from Janet's earlier work, points clearly to how the social can be structured psychogenically. Thus, there is reason to believe that he would have agreed that some mental health problems may have originated and been affected more by certain social conditions than others. From this approach, certain current views concerning vulnerability, ecology and expertise development are quite in line, particularly at various levels of prevention (primary to tertiary) which connect social practices to group and individual modifications or change.
In the final period of his life, Vygotsky addressed some clinical problems from cultural historical theory, including Pick's disease (a type of dementia) , Parkinson's and schizophrenia in relation to other types of neuroses. He dealt with the latter topic in adolescence thought disorder (van der Veer & Valsiner, 1994; also in the Cuban translation of Volume V of his collected works), particularly with attention to the role of mediation. For example, early on he was interested in the works of Kretschmer (1928) who noted that schizophrenics responded quite different to life-threatening situations (bombing during the war). Schizophrenics were not among the masses of hysterics who filled area hospitals during the WWI. During that period, a contemporary of Vygotsky, Levenshtein derived an experimental method to determine whether some schizophrenics are susceptible to psychotherapy or not (see next section). This work led Vygotsky to postulate that psychotherapy or remediation of psychosocial relations might counteract some part of the actual, negative effects a biological or endogenous defect or problem has on the socio-psychological functioning. His writings suggest that disturbance in such functioning could be mainly caused by a biological, hereditary predisposition or by disturbances in the social plane like war, unemployment or alienation. In either case, he was optimistic in prognosis in that he saw the potential benefit of providing re-mediation to faltering functions at the psychogenic level and more enlightened social treatment. He agreed that as some in some cases of schizophrenia, defects arise which last a long time and which are not susceptible to psychotherapy. Yet, he thought that if one knew more about the "internal dynamic" or the interplay of sociobiological forces , one could intervene strategically in some cases.
Vygotsky noted from the work of Jung and Bleuler (Bleirer)
that atop the schizophrenic's organic symptoms there exists a
complex (simple elementary functions), or reactive psychic superstructure.
Vygotsky also noticed in Levenshtein's work a psychological test
or experiment in which some schizophrenics manifest hysteric symptoms
or behavior under stress. The results of this test suggested that
in cases where schizophrenics' "superstructure" resembles
or is similar to that of hysteria (neuroses in general) cases,
there appeared to be a greater opportunity for psychotherapy
to have a positive effect.
This puzzle presented by Kretschmer's observations during the first world war (see Vygotsky, Obras Completas, Vol V. , p263) led Vygotsky and Surajeva to examine more closely why some proportion of that population is so disposed. While they believed that sometimes the biologically-based endogenic schizophrenia is susceptible to psychosocial remediation, there is little clinical data with respect to treatment effectiveness. At this time, treatment or theory applications were not a main concern since such cases, and others, served as cues in the development of the "theory" which was in the making, much as it stills is today. The concern was with the explanation as to why this response to psychotherapy (however defined) was so, is based on a more general logic or synthesis regarding the structuring and deconstructing processes that shape the mind. For example, in electro-schock and other less severe treatments, a similar question arises as to why they might work, and why for some and not others.
It should also be noted that the above logic and theory building is also based on concurrent studies of concept formation from the simple, thinking in complexes found in young children, primitives and psychotics person relative to more advanced formal operations (Luria, 1929/1978; Vygotsky, 1930/1934/1994). With adolescent schizophrenics, as another example, a delay in the protest phase of that developmental stage (which appears in line with Erik Erikson's term of sturm and drang) was noted (Vygotsky, 1934/1994). The analysis of these cases illustrate detective work based on an emerging theory, much of which remains to be tested. At present, there is little evidence to suggest the above thread concerning within group differences in the schizophrenic population has been tested in the fields of psychiatry or clinical and counseling psychology. What is important to note, however, is that even during the initial period of forging a CHAT approach, questions relevant to counseling as psychotherapy were being considered. His work and that of Luria in particular, also remain important to current fields focusing on rehabilitation of persons suffering from physical and psychological trauma.
Implications from CHAT for Counseling: The Zone of Proximal
While the ZPD construct or metaphor has been discussed primarily in the context of learning intellectual skills mostly, the present essay explores the potency of some of Vygotsky's ideas in a number of cultural practices, particularly that of counseling. Many threads are identified in Van Der Veer and Valsiner's book, Understanding Vygotsky. More recently, Elly Singer and Ruth Miltenburg (1995) have explored how this construct and theory can be applied in counseling victims of abuse.
Vygotsky noted an aspect of development that is generally overlooked and that is of equal, if not of greater, importance than that which is reflected by client assessment. It is the zone of proximal development (ZPD) which is defined by mental "functions that have not yet matured but are in the process of maturation, functions that will mature tomorrow but are currently in an embryonic state...". The ZPD concept can be operationalized by "the distance between the actual developmental level as determined by independent problem solving and the level of potential development as determined through problem solving under adult guidance or in collaboration with more capable peers" (Vygotsky, 1986, p. 86). For example, two persons may score similarly on an assessment protocol and might appear comparable in terms of maturity and overall adjustment for their age. Yet, they could differ considerably in terms of learning readiness, motivation or their development in certain areas related to prognosis, depending on their learning history.
Vygotsky argues that learning activates developmental processes that become functional, initially, through social interaction with more advanced agents. For him re-mediation was necessary in both, endogenic disorders such as in mental retardation as well as in more psychogenic cases such as neurosis, although he did not focus on the latter. This view suggests that therapy and education can be helpful by focusing more on current learning potential and secondly how previously completed learning and development concurred in context. Counseling, just like education, needs to focus on the "buds or flowers" as much if not more than on the "fruits" of children's development. This can be accomplished by learning activities that are consistently arranged ahead of a person's actual adjustment level. This theory begins to account for "how culture acts" in regard to development by understanding how development is and can be mediated historically. It lends a dynamic dimension to our research and practice. The stages of change through the ZPD elaborated by Tharp & Gallimore (1988) can be adapted easily in the field of counseling.
Finally, the method of Double Stimulation found in CHAT, deserves some attention in this area. The method was initially employed to investigate concept formation or cognitive change. As Portes (1997) notes, social interaction, particularly educational (teaching & learning) involve the presentation of stimuli, signs that may be employed by the individual in advancing her development, as in the case of counseling. In the latter and psychotherapy process, the acquisition or internalization of skills, beliefs, attitudes on the part of the client if often the goal of the treatment or activity. The stimuli, advice or means directly and incidentally presented by the therapist represent a menu of options, any one of which the client may appropriate and employ to change their future. Therapy, like education, offers a construction zone for meanings and skills to be developed. It may be organized in various ways, yet the principles regarding the creation and maintenance of zones of proximal development, the transitions from external to internal regulation and such appear important in the extending the development of professionals in mental health, as in other related areas. The CHAT approach offers a dynamic grasp of development, which is relevant to understanding how cognition is situated culturally. It challenges the traditional separation of mind from society in ways that require attention to both objective and subjective stances. The latter are reflected in the units of analysis currently being employed in this ever-evolving model (Gallimore,Goldenberg, & Weisner, 1992) . While discussion of these issues are beyond the scope of this paper, they are clearly important to pursue in future efforts that alert the mental health field as to what CHAT may have to offer in terms of professional development, theory and practice.
In sum, the seminal ideas spun by Vygotsky and his co-workers led to an interdisciplinary renaissance in psychology and related fields that is currently known as the cultural-historical model. This model has remained powerful because it addressed fundamental questions in social science that still confront it. Most theories of counseling and psychotherapy have their origin in learning and developmental theories that have become standard paradigms in psychology. Whether this will be the case with cultural-historical theory remains in question due, in part, to it no just being another theory but another psychology (Cahan and White, 1992) or approach to the study of human consciousness.
In retrospect, it is not surprising that Vygotsky's seminal work on the formation of mind would be related to counseling and psychotherapy. His work in defectology, social and biological aspects of development and mediated action are all directly pertinent to the field of counseling and psychotherapy. However, it should be noted that the context in which the practice of psychotherapy was being institutionalized in Vygotsky's era is quite different from that of today, where various communities of practice define psychopathology and treat it according to various standards and methods. It should be noted then that although useful insights may be derived in a historical analysis of his work, one should not expect to find a finished, clearly articulated theory of counseling in this work. At this point, whether a deeper understanding of CHAT in the profession occurs soon seems unlikely because as a meta-theory, it challenges traditional world views and requires considerable study which is unlikely to be integrated into professional training or practices. A related problem concerns methodology in that CHAT would employ a variety of methodologies which may be differ from traditional research practices in various areas of mental health. In the cultural approach to the human mind, one find is likely to find numerous and diverse implications that can be useful to the field of counseling today. In sum, how CHAT is to be integrated with mental health practice is only being gradually defined. Yet the implications are consequential for the next century as a different, second psychology (Cahan & White, 1992) becomes more disseminated in what is becoming known as a cultural psychology (Cole, 1996).
Based on how theoretical knowledge about how humans learn and develop, each major psychological theory has been infused into practices and techniques that range from how to define and assess mental health problems to specific methods to effect change in the client(s). This may occur in the present case as it once did with psychoanalysis and behaviorism if and as it becomes more articulated in psychology. While the CHAT approach may offer some useful tools and concepts for counseling, at a different level, it offers a framework for studying and deconstructing current and future practices historically and in terms of tool-mediation, creating a tension that is likely to remain unresolved for some time. This is largely because present-day psychology still remains in a crisis which dates to the turn of this century and which ultimately extends into the field of counseling. This paper explored in limited measure, what this not so new world view is about and some of the central issues concerning its application to the field of counseling and related areas.
The extent to which this approach will fit the mood of the next century remains in question and is relative to the beliefs and main intellectual systems of a new information age. In Mannheim's (1952) terms, such are conditioned by existing socio-economic structures and by the human activities or experiences in enacting roles within that structure. Perhaps because the CHAT approach does not insist on uncovering objective truth and is sensitive to the manner in which disorders are defined socially, it may be less vulnerable to critiques leveled at behavioristic, intellectual orientations (e.g., Portes, 1971). CHAT focuses more on how the content, rather than the structure of human thought and behavior changes within a intellectual system that predates Weber's (1964) insight regarding the interplay between socioeconomic conditions and intellectual systems. Both appear to recognize what Marx and other sociologists of knowledge missed. The central idea here is that socio-cultural conditions do not produce intellectual orientations directly but they do produce differential receptivities to such intellectual systems. At present, the cognitive-behavioral paradigm still reigns in the field and appears to have the best fit with extant conditions. The crux of the question here thus lies in determining how and to what extent cultural-context factors may change and bring about a change in preference in the mental health field. The interdisciplinary, dialectical nature of CHAT is a double-edged sword in making a prediction with respect to future preference. As the century ends, however, evidence exists that a slow change is occurring towards a cultural-developmental intellectual system, as evidenced perhaps by the rejection of a computational model of mind (Bruner, 1993), the increasing use of terms such as situated cognition, communities of practice and the very notion of a cultural, interdisciplinary psychology.
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