An interview with Prof. Dr. Mehmet Zihni Sungur conducted by Ceylan \u00d6zge Kunduz: Who is Prof. Dr. Mehmet Zihni Sungur?<\/p>\n
He completed his secondary education at Tarsus American College and graduated from Hacettepe University Faculty of Medicine in 1982. In 1984, he began his residency training in the Department of Psychiatry at Ankara University Faculty of Medicine. Her career began in 1985 when she went to England as a Council of Europe fellow and worked on "Community Psychiatry". The report she prepared as a result of her studies was deemed successful by the Council of Europe, and she was given another scholarship opportunity. In 1986, she won a British Council scholarship and worked as an assistant at the Institute of Psychiatry and Maudsley and Bethlem Royal Hospitals in England until 1988. During this time, she received training particularly in the fields of "Behavioral therapies", "Sexual dysfunction \u2013 sex therapies", "Marriage therapy" and "Anxiety disorders" (phobias, obsessions, panic, trauma, etc.) and served as a therapist for the British team in collaborative studies conducted by British, American and Canadian teams. In 1988, she returned to her position at Ankara University Faculty of Medicine and became a Specialist in Psychiatry in 1990. He received the title of Associate Professor of Psychiatry in 1992. Following his professorship, he focused his research particularly on "Cognitive and behavioral therapies," "Sexual dysfunction," "Sexual treatments," "Marriage therapy," and "Anxiety disorders." In 1996, he served as the Founding President of the Cognitive and Behavioral Therapies Association, and in 1998, he became a founding member of the Sexual Education, Treatment, and Research Association and the coordinator of the Cognitive-Behavioral Psychotherapies Working Unit of the Turkish Psychiatric Association. He currently serves as the President of the Cognitive and Behavioral Therapies Association and the coordinator of the Family and Couple Therapies Working Unit of the Turkish Psychiatric Association. In 2000, he was elected President of the European Association for Behavioral and Cognitive Therapies. During this tenure, he organized the 31st European Congress of Behavioral and Cognitive Therapies in Istanbul in 2001. In 2011, he had the great honor and pleasure of chairing the 7th International Congress on Cognitive Therapy and organizing it in Istanbul. Professor Mehmet Zihni Sungur, who became a professor in 2001, is currently a faculty member at the Department of Psychiatry, Marmara University Faculty of Medicine. What are the most important features that distinguish cognitive behavioral therapy from psychoanalysis? Actually, let's call it psychodynamically oriented therapies rather than psychoanalysis, because I can say that cognitive behavioral therapy has no similarities with classical psychoanalysis. If we talk about the differences with dynamically oriented therapies, the most important difference is that the therapist focuses directly on the target maladaptive behavior, going beyond hypotheses or assumptions. Freud put forward some very good, but hypothetical, views in his time. These hypotheses have undoubtedly provided great benefits in understanding patients. They are good hypotheses based on observations in terms of understanding. However, it should not be forgotten that science is based on the principle of falsifiability. Some hypotheses are so general that you can neither prove their truth nor their falsity. Within the framework of Popper's approaches, there are two things you cannot disprove: firstly, things that are entirely true cannot be disproven; secondly, definitions that are too general to be proven true or false cannot be shown to be either true or false. Therefore, the fundamental problem in dynamically oriented approaches is that while hypotheses may seem plausible, they cannot be supported by scientific data. This is because dynamic approaches speak to the unconscious. It is impossible to measure and evaluate the unconscious. Where measurement and evaluation are impossible, it becomes difficult to speak of science, because the first rule of being scientific is the ability to measure and evaluate. Analytical theory or psychodynamically oriented therapies essentially say this: Every seemingly conscious behavior has an unconscious motivation, and if you understand that, you will understand the behavior better. By saying this, they try to work with the unconscious and bring it to consciousness using special techniques, and ultimately, the client is expected to gain insight into their problem. Even if we assume for a moment that this is true, awareness and insight are often not the final stage of therapy. Even practitioners of the dynamic approach don't define gaining insight as the final achievement, but rather as a significant goal. However, providing insight is often the beginning of treatment, not the end; because what matters is change. People come to us for change. The fundamental aim of psychotherapy has always been change, therefore concepts like awareness and insight are necessary for change, but not sufficient. This is where the difference becomes clear. Providing awareness is also an important goal in cognitive behavioral approaches, but when it comes to achieving change, quite different techniques are used compared to dynamic therapies. In fact, today, technology related to treatment has reached a point where it can be used in research through manuals. Actually, the main goal of behavioral therapies, which were introduced long before cognitive therapies, was to test the validity of the assumptions of dynamic-oriented therapies, which were the dominant psychotherapy approach until then, and to provide people seeking help with a short-term therapy opportunity towards treatment goals determined together with them. Then, to be able to measure and evaluate the change that occurs. Imagine a spectrum. At one end is analysis. At first glance, cognitive therapy seems very appealing, exotic, and based on seemingly profound assumptions and valuable observations. At the other extreme are behavioral therapies, which appear extremely dry but are goal-oriented and built on a solid theoretical foundation, such as learning theories, attempting to test the reality and accuracy of hypothetical observations. Cognitive therapy, which emerged years later, can be considered a therapeutic approach that takes elements from both schools of thought that can benefit the patient, incorporating them to create a reform in both understanding and change. Behavioral therapies use learning theories to make observable and measurable changes in human behavior. Therefore, it is based on learning theories instead of hypothetical and observational things. The fact that it is based on learning theories automatically increases the power and value of this approach. It represents a treatment approach based on experimental and empirical data obtained not only from animal experiments but also from studies on volunteers, and where measurement and evaluation gained importance and were used for the first time. Measurement and evaluation both brought scientific methodology to psychology and allowed us to concretely measure the help we provide or fail to provide to a person. The effectiveness of a treatment approach is proportional to how beneficial it is to people in clinical practice. Since the emergence of behavioral therapies, various studies have aimed to both measure their own effectiveness and test the hypotheses of previous psychological theories. Eysenck was one of the first to realize that psychotherapeutic approaches before behavioral approaches were not based on scientific data. Eysenck points out that there were no studies (randomized controlled trials had not yet been defined in those years) showing that psychotherapies were effective and states that research was needed to be able to say that widely used psychotherapies were effective. Measurement and evaluation gain importance in this context, and the hypotheses of analytic theory begin to be tested. For example, the view of analytic theory that agoraphobia stems from separation anxiety is questioned. In the study, one group included only agoraphobia patients, while the other group included patients with all anxiety disorders other than agoraphobia (what was then called neuroses). Both groups were retrospectively examined for separation anxiety, and it was found that separation anxiety was indeed present in agoraphobia, but the same was true for other anxiety disorders, and there was no significant difference between the two groups. Therefore, the observation was correct but not very specific. In other words, the hypothesis was not specific or did not possess defining characteristics for a particular group of diseases. In short, the theory based on observation is correct but too general. Behaviorists began to consider whether these general hypotheses based on observations could be made less authoritarian, more flexible, and more individualized. The most important innovation brought about by behavioral therapies is the findings that emerged while testing the self-criticisms of analytical approaches and increasing the value of this new approach. Analysts summarize by saying, "We examine the unconscious because every behavior that seems conscious has an unconscious motivation, and only by understanding this unconscious motivation can a more holistic treatment be achieved." Therefore, they believe that treatments that do not address the unconscious will be superficial (symptomatic) and that such treatment will have two complications. First, "that symptom goes away and another symptom takes its place." Analysts call this symptom substitution (change) and see symptom change as an inevitable consequence of symptomatic treatment. The second complication is the expected relapses in symptomatic treatments. In other words, the patient may recover today, but will relapse tomorrow. Instead of rejecting these hypotheses, behavioral therapists decide to test and see the validity of the hypotheses with a scientific methodology and begin to follow patients who have recovered with behavioral therapies for up to 7 years. Even in the field of psychopharmacology, let alone psychotherapy, there are almost no follow-up studies lasting up to 7 years. At the end of this study, it is revealed that symptom change does not occur and relapses are much lower than predicted. Thus, all assumptions that behavioral therapies are mechanical and superficial, that their effect is not permanent, and therefore that the disease will recur or new symptoms will emerge, are disproven. The greatest beauty of behavioral therapies is that they allow for the investigation of all hypotheses, including self-critical ones, without judging them as true or false. Research findings, while increasing the value of behavioral therapies, also reveal that psychoanalysis, the dominant treatment approach until then, needs to reconsider its own fundamental hypotheses. In other words, it becomes clear that behavioral therapies are not a mechanistic and superficial approach as analysis claims. Why are relapses so rare? Indeed, relapses are far less than expected, and there is no symptom change. In mechanistic or symptomatic treatments, symptoms are suppressed or temporarily eliminated. However, the goal of behavioral therapies is not to suppress or eliminate symptoms, but to teach how to cope with them. When an agoraphobic patient comes to us, they talk about certain handicaps in their life. Behavioral therapists ask them these questions: "If you didn't have this problem today, what would you be doing now that you can't do?" Or, \u201cAt the end of this treatment, what things will you be able to do that you can\u2019t do now so that we can say you\u2019ve been cured?\u201d Or, \u201cHow does this problem hinder your work, social, and private life?\u201d Or, \u201cHow has this impaired the functionality of your life?\u201d All these questions are aimed at the same purpose: identifying the goals of treatment. The patient responds, \u201cI\u2019m tired of spending all my money on taxis. I would like to use public transportation.\u201d What does this tell us? They take taxis because they can pull over and get out if there\u2019s a crowd, but they can\u2019t stop a bus whenever they want (reduced sense of control). Or they say, \u201cI would like to travel intercity. I haven\u2019t been able to for 10 years,\u201d because intercity travel is not safe for them. \u201cI would like to be able to go to cinemas and theaters, and if necessary, be able to sit somewhere not near the exit. Besides cinemas and theaters, I would also like to be able to go to supermarkets without my husband.\u201d Why do I say \u201chusband\u201d? Because two-thirds of agoraphobics are women. When a therapist asks, \u201cSo, if you can comfortably travel between cities, use public transportation, sit wherever you want in the cinema or theater without panicking about where to find a seat, and go to supermarkets on your own, can we say you're cured?\u201d the patient will most likely reply, \u201cOf course, doctor, I can't even imagine.\u201d Now, goals have been set, and the patient has set these goals themselves. The therapist only provided guidance in setting these goals, acting as a facilitator. After the goals are determined, a rationale about the treatment is conveyed to the patient. This rationale teaches the patient how to cope with the anxiety symptoms that arise when entering the environment they fear. In short, anxiety symptoms appear when individuals are put in the environment they avoid, and we teach them how to cope with these symptoms. What's the beauty of this? We are actually giving the patient a skill. Skills acquired are not forgotten; what is forgotten is knowledge. The patient can learn to use the skills they have acquired in other areas of their life. Therefore, it has become a widely used and accepted approach in treatment because it is never a symptomatic treatment, but rather an approach that teaches how to cope with the existing problem and develops individual skills. But what if it were analytical? We are actually giving the patient a skill. Acquired skills are not forgotten; what is forgotten is knowledge. The patient can learn to use the acquired skills in other areas of their life. Analyst colleagues would respond better to this. However, if it were analytical treatment, the main goal would probably be to try to create awareness starting from childhood experiences, to examine the roots of the problem in childhood, and to try to gain insight by getting to the core of the unconscious conflicts related to the problem. Of course, then a process aimed at achieving change would be initiated. As you can imagine, such an approach would require many therapy sessions at short intervals. I always say: "Intelligent people don't question well-being. What people question are states of ill health. When you treat patients, the past origins of the problem lose their value and importance, because you are now healed, and investigating the reasons for past negativity would only cause anxiety." Moreover, even if an effort to understand the origin of something is valuable, the findings can be misleading. Because no disease has a single cause. Behavioral therapies that analyze the root cause often approach it with some hesitation: a person's personal experiences in childhood. However, childhood or past learning experiences may not necessarily be solely personal experiences. In other words, these experiences may not necessarily be our own. We may have learned from the experiences of others. Furthermore, if two people raised in the same way and having the same experiences develop a disorder, but one does not, it is difficult to say that the sole cause is childhood experience. Twin children go through the same experiences, grow up in the same family. This means there is a range of individual sensitivities. That's one point. Secondly, intelligent people don't question well-being. What people question are states of ill health. When you treat patients, the past origins of the problem lose their value and importance. Even if we experience things similarly, we don't perceive them similarly. Thirdly, even if we live and perceive things similarly, in later years of life, with the learning, maturation, and growth that these years bring, we re-examine our experiences, and some of us can repair those experiences while others cannot. Therefore, there is never just one cause for illnesses. Furthermore, as therapists, we need to clearly define where in the patients' lives or current problems we are intervening. Remember that in illness, especially in psychiatry, it is difficult to talk about a concept called etiology. In psychiatry, illnesses are examined in three dimensions: predisposing causes, triggering causes, and maintaining causes. The causes that trigger an illness are not the same as the causes that maintain it today. Let's say you are married, and your first problem in the marriage arises from a mother-in-law issue that started even before the marriage. What is the problem? Problems starting with the mother-in-law\u2026 What is the problem 10 years later? Communication problems between husband and wife\u2026 Arguments that started because of the mother-in-law lead to communication problems, and over time these communication problems spread to many areas, and the couple can no longer talk to each other. Individuals are increasingly forgetting how to communicate, but the problem seems to start with the mother-in-law. Today, instead of focusing on the mother-in-law issue, we need to solve the existing communication problem. This means that the contributing factors and the maintaining factors are different. The most important factor that perpetuates an illness is the strategies patients use to cope with the problem. Whatever your strategy is, that's your life. Therefore, it's unlikely you'll change your life without changing your strategy. I want to understand the strategies that play a role in the continuation of the illness today. The same applies to cognitive therapy. People don't get sick because they don't think intelligently or because they think incorrectly. Inexperienced therapists often want to correct all thinking errors. However, intervention is needed when the same thinking error is used as a pattern. Otherwise, you, I, and all of us can make many cognitive errors. The important thing here is to be able to see the recurring pattern. This is determined by the strategies the patient uses to cope with the problem. If you were to ask me today what madness is, I would say, "Using the same strategy and expecting tomorrow to be different." In other words, you'll use the same strategy every day and then expect your life to change one day. That's impossible. Because your life is what your strategy is. If you're using the same strategy, every day is Monday. Looking at it this way, we see something. What do patients do when their strategies don't work? Not just patients, but all of us\u2026 We increase the dose of our strategy. It's like giving a patient medication, and when they don't get better, instead of thinking, "Is my diagnosis wrong?", we increase the dose. In this case, the patient gets nowhere. So, we need to look at it this way: What isn't working in my strategy, and how can I change this strategy? Therefore, instead of asking "why did it happen?", we need to ask "what is happening today and what will happen tomorrow?". So, what were the shortcomings in behavioral therapies that cognitive therapies filled? Behavioral therapy is based on the stimulus-response relationship, and the important thing in treatment is to bring about change. Years ago, inexperienced therapists generally wanted to correct all the error in thinking. However, intervention is necessary when the same cognitive error is used as a pattern. If you asked me what the fundamental aim of psychotherapy is, I would say "change." Now I wouldn't say that. In my opinion, one of the fundamental aims of psychotherapy is to learn acceptance as well as change, but to be able to accept, we need to know what we are accepting, that is, we need to understand the phenomenology, what it is. In my view, cognitive therapies are, in one sentence, "giving meaning to the incomprehensible." Behavioral therapies have changed certain things within the stimulus-response framework, but they have not given importance to the events and processes between stimulus and response. Behavioral therapies, with their effective interventions and strategies aimed at achieving positive results in a short time, have indeed achieved effective results in the treatment of a range of disorders in a short time; they have produced hundreds, thousands of publications, emphasizing their own power, and have become enslaved by that power. The important thing is to be able to control that power. Because that power becomes meaningful when we understand its phenomenology. When you don't understand it, it's magical. Understanding the mechanisms of change and defining the content to be changed is, in my opinion, very important. In recent years, it seems that CBT has also heeded the criticisms directed at it and begun to focus on the childhood traumas of the patient\/client. How do you explain this situation? Cognitive therapy has provided content for behavioral therapies to work on. Initially, cognitive therapy saw that behavioral therapies were an effective approach, but noticed a deficiency. Patients get positive results from behavioral therapies, but some patients are not very receptive to exposure-based therapies. In my opinion, one of the fundamental aims of psychotherapy is to learn acceptance as well as change, but in order to accept, we need to know what we are accepting, that is, we need to understand phenomenology, what it is. So, putting patients in the environment they avoid and fear, and teaching them how to cope with such environments, situations, images, and objects, is very effective in one sense, but in another sense, it is an approach that many patients do not welcome. When patients are forced into a situation they avoid and try to escape from, either in the presence of a therapist or at the therapist's suggestion, some withdraw and refuse because it is an unfamiliar situation for them. Therefore, we are effective with those who accept the treatment. Based on the logic that increasing the rate of treatment acceptance leads to a more beneficial outcome, cognitive therapies began to be used in some disorders to increase the patient's motivation for treatment, provide information about the illness, and involve the patient more in behavioral therapies. This led to the identification of key cognitions that play a crucial role in understanding and treating illnesses. A key cognition can only be defined if its change alters the course of the illness. For example, the key cognition underlying panic disorder is "catastrophizing." That is, the catastrophizing of existing symptoms\u2026 The existence of this cognition has been so clearly demonstrated that even classification systems like the DSM define panic attacks as "intense anxiety resulting from the catastrophizing of innocent bodily symptoms." Is your arm numb? What's the worst thing that could happen from numbness? A stroke\u2026 What's the worst thing that could happen from palpitations? A heart attack\u2026 What's the worst thing that dizziness could lead to? Fainting\u2026 A headache? A brain hemorrhage\u2026 I catastrophize the existing symptoms and take precautions to protect myself from these catastrophes. If catastrophizing is a key cognition in panic disorder, then the following hypotheses can be put forward: 1. If I reduce catastrophizing, the severity of my panic disorder will decrease. 2. If I eliminate catastrophizing, panic disorder will disappear. 3. As long as catastrophizing doesn't return, panic disorder will not relapse. 4. There is a correlation between the amount of catastrophizing and the frequency of panic attacks. These hypotheses have been tested in various studies, and almost all of them have been shown to be correct. When you identify key cognitions, a treatment that directly addresses the key cognition, rather than circumventing it, will naturally be completed in a shorter time. That's why our treatment time is much shorter in some diseases where we know the key cognition. Many panic disorder patients can be easily treated in three to five sessions by directly addressing key cognitions. Cognitive therapy also tells us that childhood experiences are extremely important for understanding present behavior. Learning in childhood is crucial in cognitive therapy because an individual's basic schemas are formed during this period. Schemas are the fundamental beliefs an individual has about themselves, the outside world, and the future, formed in childhood, and these same schemas function like a hard drive that determines what kind of meanings we will assign to our experiences in later years. Cognitive therapies value and emphasize the role of childhood experiences in understanding what is happening today, but when examining the past to understand the present, they do not deal with hypothetical concepts such as the unconscious or symbolic representations of internal conflicts. In other words, when examining the present, they do not go back to the past and ask "why did it happen?" after establishing the connection between the present and the past, even though what we experience today is a product of what we experienced yesterday. Trying to find the answer to the question "why did this happen?" may not always be necessary. Past experiences are never ignored, but what matters is where we focus in therapy. Of course, what we experience today is a product of what we experienced yesterday, but after establishing the connection between today and the past, it may not always be necessary to go back to the past and try to find the answer to the question "why did this happen?" in therapy. The fact that our current lives and behaviors continue unchanged is often due to our automatic thoughts that we are unaware of, and the resulting unchanging strategies. That is, strategies that ensure the continuation of basic schemas formed in childhood, that are consistent with these schemas, and that protect us from the disturbing effects of these schemas. For example, let's consider someone who thinks, "I am worthless." The schema is "I am worthless." The child develops the perception of "I am worthless" as a result of their parents' critical, easily dissatisfied behavior. Because the child thinks, "I am equal to what I have been given." \u201cIf I am valued, I am valuable; if not, I am worthless. Since they criticize me, I am worthless. Who criticizes me? My mother and father. What do they represent? The outside world. Therefore, I am worthless, and the outside world is extremely cruel and dangerous to those who are worthless.\u201d This is how schemas are formed. I also have a future schema: \u201cIf I continue to live like this, that is, while I am worthless and the outside world is cruel to the worthless, the future will be dangerous. To protect myself from the dangerous consequences of these schemas, I must develop intermediate beliefs (strategies) so that I do not face worthlessness. I must always be valuable. To be valuable, I must be loved by others, successfully complete everything I do, and please others. If I cannot do something completely, I should not start at all.\u201d Such thoughts begin. My intermediate beliefs tell me, "Don't get involved in this because you won't be able to do it perfectly; please them, and if you do, the danger will lessen. You are worthless; if they realize your worthlessness, they will crush you, so do things that will camouflage your worthlessness." Therefore, to protect myself from the dangerous consequences of schemas, I develop intermediate beliefs and strategies. These, in my opinion, protect me from falling into the situations I fear, so our lives are determined by these strategies we use. These also stem from childhood experiences. In therapy, we provide insight into the connection between schemas and current behaviors. We give as little importance as possible to speculative concepts outside of that. That's the difference. In recent years, it has been observed that analysis has also renewed itself, is striving to become more structured, and has begun to clarify some concepts within itself and conduct some important research in the field. This is a very positive development for analysis. It means that basic psychotherapy approaches use similar principles more, but continue to describe themselves with different terms, which is one of the most important problems today. Sometimes we give different names to the same process. I call this "serving old wine in new bottles." This is one of the biggest obstacles to science. Then it's said that "all psychotherapies are the same." No, they are not. It's necessary to distinguish between non-specific factors, which are an important part of every therapy, and the treatment technologies specific to each therapy. Will therapeutic schools become similar, even identical, after a certain period, or will they maintain their unique structures and differences? For example, schema therapy, which defines itself as an extended form of CBT, takes certain things from psychoanalytic theory, while Kernberg's transference-focused therapy takes certain intervention techniques from CBT. What are your thoughts on this? The efforts to bring together the most effective components of various therapeutic schools in the service of humanity are extremely valuable and meaningful. However, despite all well-intentioned efforts, I have doubts about whether a standard (single) way of helping people can be found. The important thing is to be able to develop treatment methods tailored to the individual's needs, taking into account the unique characteristics of each individual. Schools of thought can develop independently or integrated with each other. What matters is that the chosen treatment approach can take us to the top of the mountain, because the view remains the same at the summit. I hope that in the coming years, many treatment approaches will prove effective in helping people. The more ways there are to help people, the more options we have. All therapies are the product of valuable effort. I believe that identifying more effective ways to ensure that this effort achieves its purpose, and finding the conflicting and overlapping aspects of therapeutic approaches that have proven effective, will be one of the fundamental goals of the coming years. One positive development in this regard was the interview at this year's American Psychiatric Association congress in Philadelphia, where Gabbard, who presented dynamic approaches, and Beck, a representative of cognitive therapies, appeared together on stage. Gabbard's warm and welcoming attitude towards gentle and cognitive therapies, and Beck's usual approach of trying to understand without devaluing, offer clues that common ground can be found between these approaches if desired. Efforts to bring together the most effective components of various treatment schools in the service of humanity are extremely valuable and meaningful. However, despite all well-intentioned efforts, I have doubts about whether a single, standard way of helping people can be found. What is important is not only separation but also integration. When looking at the relationship between therapist and client in cognitive-behavioral therapies, can we say that it is much more democratic and much more egalitarian than in analysis? To avoid doing injustice to analysis, I will answer this question without comparing it to analysis and explain what we do. It would be more appropriate for analysts to explain what analysis does. During my childhood years in psychiatry, analysis and psychodynamic approaches also greatly interested me. Contrary to what might be expected, I did not only receive training in behavioral therapies in England. I participated in every course and training process related to analysis. I have some knowledge on this subject, but it would be unfair to base my conclusions on this knowledge because information is constantly changing. Let me explain what we do, and at least what I do \u2013 and I hope there's a standard between what I do and what we, as the CBT therapists we define ourselves as, do. The attention, empathy, flexibility, impartiality, non-judgment, and human-to-human relationships you build with the patient are all known as non-specific factors in therapy, and the importance of these non-specific factors is assumed to be independent of the therapist's orientation. In other words, non-specific factors are adopted by all schools of therapy. Even here, we see different practices among therapists. We are in a period where it is important to redefine psychotherapies, which are referred to as "talking cures," as "listening cures." We hear the same things, but we don't listen or understand them in the same way. There are also differences among schools of thought regarding which aspects of what is being said should be emphasized more. Even the physical conditions of the meeting places can have different opinions. When we talk to our patients, we try to avoid having tables between us. When you go to hospitals or clinics, you see a huge table; The seats at the back are smaller, while the doctor's seat is larger. From the very beginning, there are distances between us defined by tables. There are also seats of varying heights symbolizing who is the expert... It seems that a series of situations like this, which we might never have considered or even thought about, but which we symbolically accept beforehand, are part of daily practice. Sometimes we hear that our classic analyst colleagues don't have secretaries and that patients are somehow asked to leave the money directly where they leave it. Some patients even mention that some analysts avoid shaking hands. A patient recently asked me, "Will you shake my hand?" I was very surprised and said, "Why wouldn't I?" She said, "The doctor I went to before didn't shake my hand." "I'm very glad you have a secretary, because when I leave the money there, I worry about whether it's being taken or not. I already have an obsession. And I was terrified that someone else would take the money and it wouldn't reach the doctor. In the end, an argument broke out between me and the doctor. I had put the money there, but the doctor hadn't," she said. Examples like these\u2026 I'm sure each one has a meaning, but the problems begin when the patient can't understand what we're giving meaning to. Putting that aside, when I work with my patients and see what they can do to bring about change, I think, "If they can do it, so can I." Beyond that, I see human suffering. I see how meaningful their complaints actually are. Sometimes I learn how seemingly negative statements can actually have positive connotations. It's impossible for me to see these things without establishing a human-to-human relationship. When someone comes to me and says, "I'm ashamed," I realize that while I used to see shame as a pathology, today I think that shame can also be therapeutic, and that it can be an indicator of the value we place on the opinions of others. For me, realizing that emotion is also a form of knowledge and that our emotions reflect our values is a professional reform. When we talk about working directly with guilt, shame, and anger, we shouldn't perceive all of these as pathologies and approach it as if we're solving a pathology. In interpersonal relationships, it's crucial to remember that these are human emotions experienced by all of us in a similar way. In other words, we should try to normalize them as much as possible, not pathologize them. A patient might say, "These things don't suit me, how could I have done them?" Yet, when we are aware of our ordinariness, we can think, "What could be more natural than the existence of both weaknesses and strengths in all of us?" However, when we manage to become ordinary, we see many things about ourselves. Therefore, being able to become ordinary in our relationships with our patients allows us to understand and normalize their experiences, rather than pathologizing them, thus enabling our growth. The doctor-patient relationship should come after interpersonal relationships. Because today, we have almost forgotten how to build relationships with people by focusing so much on the doctor-patient relationship. Building an interpersonal relationship is at least as valuable as building a doctor-patient relationship. In simple terms, an interpersonal relationship is about working together as a team, assuming that two minds work better than one in the problem-solving process. The fundamental principle of our approach, if we were to rank them, is first to establish a human-to-human relationship, then to build a good therapist-patient relationship, and finally to have a good understanding of the methods of the therapy school being applied\u2026<\/p>","protected":false},"excerpt":{"rendered":"
An interview with Prof. Dr. Mehmet Zihni Sungur by Ceylan \u00d6zge Kunduz: Who is Prof. Dr. Mehmet Zihni Sungur? He completed his secondary education at Tarsus American College and graduated from Hacettepe University Faculty of Medicine in 1982. In 1984, he began his residency training in the Department of Psychiatry at Ankara University Faculty of Medicine.<\/p>","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[3],"tags":[],"class_list":["post-62","post","type-post","status-publish","format-standard","hentry","category-roportajlar"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pavKUa-10","jetpack-related-posts":[],"_links":{"self":[{"href":"http:\/\/mehmetsungur.com.tr\/en\/wp-json\/wp\/v2\/posts\/62","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/mehmetsungur.com.tr\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/mehmetsungur.com.tr\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/mehmetsungur.com.tr\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/mehmetsungur.com.tr\/en\/wp-json\/wp\/v2\/comments?post=62"}],"version-history":[{"count":0,"href":"http:\/\/mehmetsungur.com.tr\/en\/wp-json\/wp\/v2\/posts\/62\/revisions"}],"wp:attachment":[{"href":"http:\/\/mehmetsungur.com.tr\/en\/wp-json\/wp\/v2\/media?parent=62"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/mehmetsungur.com.tr\/en\/wp-json\/wp\/v2\/categories?post=62"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/mehmetsungur.com.tr\/en\/wp-json\/wp\/v2\/tags?post=62"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}