Showing papers in "American Journal of Psychotherapy in 2007"
TL;DR: Weight Bias successfully demonstrates that although overweight and obesity are linked to a long list of diseases, what is generally not recognized is the extent to which stigma, bias, and discrimination affect the health of obese individuals.
Abstract: K.D. BROWNELL, R.M. PUHL, M.B. SCHWARTZ, L. RUDD, (eds): Weight Bias: Nature, Consequences, and Remedies. The Guilford Press: New York. 2005, 320 pp., $35.00, ISBN 1593851995 Weight Bias focuses on what the authors suggest is the last accepted arena of discrimination, obesity. The field of obesity research has come a long way since Theodore B. Van Itallie produced his original research on metabolism and Albert Stunkard's oriented the profession, as well as the public, to the unspoken emotional pain of the obese in the Pain of Obesity. These historic giants in the field laid the groundwork for the present-day centers of excellence in the field of obesity research. With Weight Bias, Brownell et al have taken on the enormous challenge of producing a substantial work on the stigma and bias surrounding obesity. The book successfully demonstrates that although overweight and obesity are linked to a long list of diseases, what is generally not recognized is the extent to which stigma, bias, and discrimination affect the health of obese individuals. This is an important book. It's wide scope, which provides a history of the field of obesity research from the 1960s to the present, may be its weakness as well as its strength. That being said, it is a thought-provoking work, which will inform the public as well as anyone working in this field. The twenty-two chapters in the book are divided into four Parts: "The Nature and Extent of Weight Bias"; "Origins, Explanations and Measurements"; "Consequences of Weight Bias"; and "Remedies". Part I demonstrates the prevalence of weight bias in employment, health care settings, the media, and among children and teens. Janna Fikkan and Esther Rothblum supply ample evidence of weight bias in hiring, pay equity, and other work-related areas, and the book provides an extensive examination of the legal ramifications of making "excess fat" a legal disability. In a discussion of health care workers in health care settings, Anthony Fabricatore, Thomas Wadden, and Gary Foster describe the inadvertent, insidious collaboration between patient and physician surrounding weight loss issues, which occurs in the transference and countertransference of the relationship. The suggested scenario goes something like this: A patient is told to lose weight. When the patient does not follow through, the health care provider becomes less invested in the patient, who in turn becomes discouraged. Fabricatore & Wadden emphasize that it is inappropriate and inaccurate to assume that obese individuals must also have some form of psychopathology, raising the age-old question: Is obesity a psychosomatic illness? They argue that top experts in the obesity field deem genetic, rather than psychological factors, and lack of physical activity to be the primary causes of obesity. The latter chapters of Part I grapple with the emotional fallout of obesity in children and teens in a society where thinness is cherished. Part II is a rather lackluster, if informative, examination of the origins of the stigma in obesity. …
155 citations
TL;DR: The psychotherapy of persons with schizophrenia may be conceptualised as a "dialogical prosthesis" that helps individuals recover past selves then kindle internal and external dialogue, which partially enables a sense of the self to emerge.
Abstract: Phenomenological analyses suggest that persons with schizophrenia have profound difficulties with meaningfully engaging the world and situating a sense of self intersubjectively, which leads to the experience of self as absent. In this paper we explore the implications of this view for understanding the workings and potential of individual psychotherapy. Following an examination of individual psychotherapy transcripts for over 60 persons with schizophrenia-spectrum disorders we offer four principles for psychotherapy and provide clinical vignettes to exemplify these points. We suggest that the psychotherapy of persons with schizophrenia may be conceptualised as a "dialogical prosthesis" that helps individuals recover past selves then kindle internal and external dialogue, which partially enables a sense of the self to emerge. The therapeutic process consists of assisting persons to move towards recovery by providing an intersubjective space where they can evolve the first-person perspective of themselves and the second-person perspective when encountering others.
96 citations
TL;DR: The author develops the concept of lived space as the totality of an individual's spatial and social relationships, including his "horizon of possibilities", which may be regarded as a "fusion of horizons" of the patient's and the therapist's worlds.
Abstract: Using phenomenological and ecological psychology as a base, the author develops the concept of lived space as the totality of an individual's spatial and social relationships, including his "horizon of possibilities". The lived space may also be regarded as the individual's ecological niche, which is continuously shaped by his exchange with the environment. Mental illness may then be conceived as a limitation or deformation of the patient's lived space, inhibiting his responsivity and exchange with the environment. Unconscious dysfunctional patterns of feeling and behaving act as "blind spots" or "curvatures" in lived space and lead to typical distortions, thereby further restricting the patient's potentialities and development. Accordingly, the task of psychotherapy is to explore and understand the patient's lived space in order to reopen his horizon of possibilities. The main agent for this purpose is the interactive field of psychotherapy, which may be regarded as a "fusion of horizons" of the patient's and the therapist's worlds.
84 citations
TL;DR: Six treatment principles that guide therapists in carrying out PE-EFT are summarized: achieving empathic attunement, fostering an empathic, caring therapeutic bond, facilitating task collaboration, helping the client process experience appropriately to the task, supporting completion of key client tasks, and fostering client development and empowerment.
Abstract: Process-Experiential/Emotion-Focused Therapy (PE-EFT) is an empirically-supported, neo-humanistic approach that integrates and updates person-centered, Gestalt, and existential therapies. In this article, we first present what we see as PE-EFT's five essential features, namely neo-humanistic values, process-experiential emotion theory, person-centered but process-guiding relational stance, therapist exploratory response style, and marker-guided task strategy. Next, we summarize six treatment principles that guide therapists in carrying out this therapy: achieving empathic attunement, fostering an empathic, caring therapeutic bond, facilitating task collaboration, helping the client process experience appropriately to the task, supporting completion of key client tasks, and fostering client development and empowerment. In general, PE-EFT is an approach that seeks to help clients transform contradictions and impasses into wellsprings for growth.
75 citations
TL;DR: Higher alliance levels were found to be related to improved outcome and a more global high-low-high pattern predicted in the literature would not be present.
Abstract: We examined the relevance of the level and pattern of the therapeutic alliance in 44 cases of three different, manualized 30-session treatments using patient ratings of the Working Alliance Inventory after each session. It was hypothesized that both high-alliance level and either a linear increase in alliance rating or a series of brief rupture-and-repair episodes would be found in successful treatments. We also hypothesized that a more global high-low-high pattern predicted in the literature would not be present. Consistent with the literature, higher alliance levels were found to be related to improved outcome. As predicted, we did not find a global, high-low-high pattern. Local rupture-and-repair patterns were found in 50% of the cases; linear trends were found in 66% of the cases. There was no relationship between outcome and either pattern. We found no differences among the treatments.
72 citations
TL;DR: Bromberg as discussed by the authors posits a set of psychoanalytic theories and techniques that place special emphasis upon the relational and intersubjective phenomena in the treatment of psychotherapy, and takes proper heed of the possible pitfalls of biographical self-disclosure on the part of the analyst and makes cautionary references to them.
Abstract: Philip M Bromberg: Awakening the Dreamer The Analytic Press, Mahwah, NJ, 2006, 223 pp, $5500, ISBN 0-88163-441-7 Since its inception, the profession of psychoanalysis has exhibited many guises It is alternately perceived, by both the lay public as well as the psychotherapy profession, to be humane, intellectually profound, stilted, austere, brilliandy enlightening, curative, outmoded and anachronistic, and unnecessarily impersonal The attribute of professional impersonality, to the extent that it is accurately applied, is usually attributed to Freud's famous use of the metaphors of analysts as surgeons or reflecting mirrors in his seminal papers on technique There is, of course, an irony to this attribution in that Freud, as some of his biographers have pointed out, was unsystematic, lively, advice-giving, gossipy, and very self-disclosing with some of his patients; in other words the antithesis of a detached surgeon or reflecting mirror The author of this book, Philip Bromberg, is a Training and Supervising Analyst, William Alanson White Institute, and a Clinical Professor of Psychology, New York University Postdoctoral Program in Psychotherapy and Psychoanalysis Dislodging himself from the impersonal stance that has characterized the work of many of his psychoanalytic forebears, Bromberg posits a set of psychoanalytic theories and techniques that places special emphasis upon the relational and intersubjective phenomena in the treatment This more "personal" approach is taken in order to deal with patients as they intermittently dissociate themselves from threatening memories and emotions to achieve a state of stabilization Recognizing that analysands, and virtually everyone else, including psychotherapists, live their emotional lives in multiple and fluid self-states, and are prone to dissociation, Bromberg is vigilant in his attempts to be highly attuned to the here-and-now self-state of his patients And wherever he detects alienation from aspects of the self, he courageously enters into those gaps with timely and tempered disclosures of his own affective state By enlisting the disclosure of the analyst's affective state in response to the patient's ongoing dissociations, a new relational vista is explored and negotiated collaboratively If this process is successfully implemented, over time the patient will gain, according to Bromberg, a new sense of self and a greater wakefulness to life Bromberg takes proper heed of the possible pitfalls of biographical selfdisclosure on the part of the analyst and makes cautionary references to them, such as the potential for self-revelations to feel to the patient like an intrusive indoctrination or ploy for gaining control …
70 citations
TL;DR: Results of a MANOVA and follow-up ANOVAs indicate that psychotherapists displayed significantly stronger feelings of being dominated (i.e., exploited, manipulated, talked down to) by clients with Antisocial Personality Disorders when working with clients having Schizophrenia.
Abstract: Contemporary theoretical and clinical literature asserts that countertransference reactions are common and may be specific to clients' presenting concerns and interpersonal styles. Although this phenomenon has broad implications for psychotherapy training and practice, little empirical research is available to support these claims. This study investigated the phenomenon of client-induced countertransference toward two client populations that may evoke strong reactions in psychotherapists--persons with Antisocial Personality Disorder and Schizophrenia. Results of a MANOVA and follow-up ANOVAs indicate that psychotherapists displayed significantly stronger feelings of being dominated (i.e., exploited, manipulated, talked down to) by clients with Antisocial Personality Disorders. Counselors manifested significantly stronger positive feelings (i.e., being liked and welcomed and being in charge, that is, being put in a decision-making role) when working with clients having Schizophrenia. We discuss research and clinical implications of these findings.
40 citations
TL;DR: Clinical observations of the expression of depression among Haitian immigrant women living in the United States are discussed, and three distinctive types of depression are examined (pain in the body, relief through God, and fighting a winless battle).
Abstract: Existing research demonstrates that culture has a profound impact on the expression and manifestation of mental illness, especially on depressive disorders among ethnically diverse populations. Currently, little research has focused on the Haitian population, despite the growing number of Haitians living in the United States. This paper discusses clinical observations of the expression of depression among Haitian immigrant women living in the United States. Specifically, this paper examines three distinctive types of depression (pain in the body, relief through God, and fighting a winless battle), explains their symptoms, and provides case examples to illustrate the expression of each type of depression. Additionally, the paper describes treatment processes for each type of depression and makes recommendations to mental health providers with respect to each type of depression. The information provided in this paper highlights the importance of a more systematic and scientific investigation of depression among Haitian women, men, and youths in the United States.
37 citations
TL;DR: Results suggested that the students used reflective listening equally after different lengths of training, however, longer training resulted in the confederates disclosing more emotion, the psychology students remembering the information relayed better, and the evaluators perceiving the therapeutic relationship as better.
Abstract: Psychology students received a 14-, 28-, or 42-hour training course in reflective listening Before and after training, the students participated in role-played counseling conversations with confederates, who rated them The conversations were captured on audio- or videotape, categorized, and rated by external evaluators Results suggested that the students used reflective listening equally after different lengths of training However, longer training resulted in the confederates disclosing more emotion, the psychology students remembering the information relayed better, and the evaluators perceiving the therapeutic relationship as better This was especially true among the evaluators who self-reported high social skills
25 citations
TL;DR: The many beneficial features that employing stories in psychotherapy can have are related, guidelines for presenting, clarifying, and applying them to patients' unique situations are offered, and a sample of therapeutic stories used with a variety of patients are presented.
Abstract: This article (a) relates the many beneficial features that employing stories in psychotherapy can have, (b) offers guidelines for presenting, clarifying, and applying them to patients' unique situations, and (c) presents a sample of therapeutic stories that may be used with a variety of patients. The work is intended to build upon, and is heavily indebted to, the work of many previous authors in the tradition of therapeutic storytelling.
22 citations
TL;DR: Specific cultural factors, such as level of acculturation, cultural conflicts, stigma and interpersonal relationships, were important factors associated with distress and resilience in South Asian women.
Abstract: The rates of self-harm among South Asian women in the United Kingdom are much higher than among their White counterparts. However, the explanation for this is far from clear, and there is a need for more culturally informed assessments for this group. Using literature review we identified cultural factors associated with self-harm in South Asian women. These findings were used to guide the clinical assessment of an Asian woman who had self-harmed using a personal narrative approach. Three independent clinicians analysed the narrative and identified important themes that gave an insight into the problems associated with the incident, arriving at a cultural formulation. Our interview showed that specific cultural factors, such as level of acculturation, cultural conflicts, stigma and interpersonal relationships, were important factors associated with distress and resilience. Literature reviews can help in conducting culturally competent assessments and enable better interventions for this group of patients. The key cultural areas identified are discussed in detail.
TL;DR: The authors report the case of a 22-year-old woman who presented with intrusive thoughts of demonic possession and flashbacks of the film The Exorcist, a form of psychological crisis shaped by exposure to a film narrative that is emotionally and culturally significant to the individual.
Abstract: The authors review the literature of cinematic-related psychiatric case reports and report the case of a 22-year-old woman who presented with intrusive thoughts of demonic possession and flashbacks of the film The Exorcist. Cinematic neurosis may be considered a form of psychological crisis shaped by exposure to a film narrative that is emotionally and culturally significant to the individual. The structure of horror films are examined from the perspectives of trauma theory, narrative theory, and borderline personality organization theories, using the film The Exorcist as an example. Within this framework, the horror film can be seen as a cultural tale that provides a mechanism for attempting mastery over anxieties involving issues of separation, loss, autonomy, and identity. An individual will identify with narrative elements that resonate in personal life experiences and cultural factors embedded within the film, which carry levels of either stress that will be mastered, or act as a trauma to the viewer. The outcome of this exposure is related to how the individual's personality structure is organized in combination with the stresses they are experiencing.
TL;DR: This paper will explore the possibility that an extramarital affair is not a joint venture between partners, and that cheated partners are often victims of a psychological setup by their partners.
Abstract: According to some systemic thinkers, extramarital affairs are a joint venture between spouses. In an attempt to revitalize an emotionally depleted marriage, partners choose to triangulate a third party, and thus generate a crisis in the marriage. From a systemic point of view, cheating spouses represent the fear of engulfment while cheated partners represent the fear of abandonment, both fears being associated with the process of individuation. From the systems theory point of view, both partners are responsible for creating this scenario, in which there are no victims. This paper will explore the possibility that an extramarital affair is not a joint venture between partners, and that cheated partners are often victims of a psychological setup by their partners. In order to justify extramarital relationships, cheating partners induce their spouses into playing a very negative role in the marriage. In a systemic scenario, cheated partners are not only betrayed, but are also made partly responsible for the betrayal, which makes recovery very difficult for them. A clinical case will be discussed.
TL;DR: This pilot study indicates that psychodynamic group psychotherapy is feasible as a component of treatment for bipolar disorder diagnoses, and results suggest benefits on depressive, but not manic symptoms.
Abstract: Background: This study examines the effectiveness of long-term outpatient psychodynamic group psychotherapy for individuals with bipolar disorder who may have psychiatric comorbidity. Method: The I...
TL;DR: An experiential process-directive approach is presented in which the therapist is guided by the Rogerian core attitudes for offering a therapeutic relationship and for intervening in a process-enhancing way, and it is elaborate on how interventions that originate in the therapist's empathic-resonance process influence the client's experiencing in a thought-leadership way.
Abstract: In this paper, an experiential process-directive approach is presented in which the therapist is guided by the Rogerian core attitudes for offering a therapeutic relationship and for intervening in a process-enhancing way. I elaborate on how interventions that originate in the therapist's empathic-resonance process influence the client's experiencing in a process-enhancing way. A process-diagnostic model, based on distinctions among different aspects of the experiential exploration process, forms the framework in which the various interventions are classified according to dominant process intention. Three major process intentions are distinguished: becoming aware of experiencing, regulating (increasing or decreasing) the intensity of experiencing so that it becomes possible to hold the experience in attention, and exploring that leads to further unfolding and change. Therapy excerpts illustrate this approach.
TL;DR: Many specific examples of what a therapist may say to the client to encourage the bodily felt sense are presented, including dealing with three obstacles to forming a felt sense, intellectual speculation, drowning in emotions, and self-attacking.
Abstract: Experiential Psychotherapy originated in Gendlin's Philosopy of the Implicit. Some of its main concepts are bodily felt sense, fresh emergence of words from the felt sense, and carrying forward the implicit with small steps of change. Presented in this paper are many specific examples of what a therapist may say to the client to encourage the bodily felt sense. Dealing with three obstacles to forming a felt sense, intellectual speculation, drowning in emotions, and self-attacking are discussed. The philosophical concepts in the focusing-oriented school of therapy enable therapists to relate any psychological theory to the client's ongoing experience, allowing therapists from any theoretical orientation to practice in a focusing-oriented way.
TL;DR: Mahrer's Experiential Psychotherapy provides a valuable alternative to conventional sex therapy with individuals and couples and is ideally suited to dealing with forbidden, haunting, and disturbing sexual feelings, fantasies, and urges.
Abstract: Mahrer's Experiential Psychotherapy provides a valuable alternative to conventional sex therapy with individuals and couples. Experiential Psychotherapy uses the sexual complaint as it would any situation or scene described at the outset of therapy, as an entry point to the client's deeper experiencing. Several of the advantages of the methods employed are listed. Specifically, the ways in which Experiential Psychotherapy is ideally suited to dealing with forbidden, haunting, and disturbing sexual feelings, fantasies, and urges are highlighted. Clinical illustrations are presented of experiential dream work with a sexual assault survivor and of a couple referred for treatment of his erectile dysfunction and her low sexual desire. Experiential Psychotherapy effects profound changes in the person(s), connections within and with others, and in bodily phenomena. These outcomes, including freer choices, heightened pleasure and embodiment, extend beyond the predominant treatment paradigm's amelioration of sexual symptoms and disorder.
TL;DR: The therapeutic relationship is described as a curative factor in its own right as well as facilitative for other tasks and experiential tasks that facilitate working on the intrapsychic, interpersonal, and existential domains are distinguished.
Abstract: The therapeutic relationship is described as a curative factor in its own right as well as facilitative for other tasks. Experiential tasks that facilitate working on the intrapsychic, interpersonal, and existential domains are distinguished. Focusing is an intrapsychic task of paying attention to one's bodily felt experience. Clearing space helps clients finding a right distance for exploring their experience when they are too close or too distanced from their emotions. Interpersonal work takes the lead when maladaptive interactional patterns are hindering the relational life of the client. Metacommunicative feedback and interpersonal experiences in the therapeutic encounter act as an invitation to develop new ways of communicating. Existential processes are challenged when the client struggles with the givens of life. Finally, the "inner guide" found in accessing experiencing may involve an awareness of a transcendent dimension that leads one to spiritual growth. Vignettes from short term psychotherapy illustrate how this approach is established in practice.
TL;DR: The power of romantic love and passion was explored in the work of Dr Person as mentioned in this paper, who described the experience of falling in love, the excitement, the passion, the idealization, and the vulnerability.
Abstract: ETHEL SPECTOR PERSON: Dreams of Love and Fateful Encounters: The Power of Romantic Passion American Psychiatric Publishing, Inc, Washington, DC, 2007, 379 pp, $2995 ISBN 158562-240-0 Dr Person is Professor of Clinical Psychiatry at the College of Physicians and Surgeons, Columbia University, and Training and Supervising Analyst at the Columbia University Center for Psychoanalytic Training and Research, in New York City Dreams of Love and Fateful Encounters is a revision of Dr Person's original work from 1988 I often read works that have a clinical application with an eye on how well their words might apply to my current patients In this case, I found myself dwelling as much on my own experience of romantic love and passion as that of my patients' While reading Dreams of Love, I was compelled to consider my relationship with my wife of 17 years, Leslie, who is my own great romantic passion Such was the resonance I felt while engaging with this text Dr Person divides her work into five parts Part 1 is titled, The Experience of Romantic Love I found myself reading this section with the passion of a man who is deeply in love My own experience resonated strongly with the description of falling in love-the excitement, the passion, the idealization, and the vulnerability The description and examples of this phase of infatuation and passion captured the essence of this perfecdy normal insanity Part 2 is titled, The Aims of Love I found myself reading this section with the passion of an educator of psychotherapists This section discusses the development of love, its place throughout the life cycle, and the positive, growthpromoting creativity that romantic love generates The experience of love is presented in a developmental context This section will find a home in the lecture hall where students of psychotherapy may make use of it to situate love in the passage of life Part 3 is titled, The Paradoxes and Struggles Inherent in Love I read this section with the passion of a clinician who spends much clinical time dealing with perversion (in the Freudian sense) Dr Person discusses transcendence and enslavement, love and power, disillusionment, and that anathema of love, the triangle Of particular interest was her discussion of enslavement and of power The strength of this section was in its ability to frame the normal failings of love in relation to the potentially pathological distortions of obsession, masochism, and perversion …
TL;DR: The complexities of marriage are explored from historical, anthropological, legal, and sociological perspectives and it is incumbent on clinicians to be sensitive to the many dimensions of this extraordinary institution as it relates to their patients.
Abstract: The institution of marriage has received renewed interest and even appreciation in the context of the controversy regarding same-sex marriage. Paradoxically, though, as marriage has become more valued, it has become, in the minds of some, just another life-style choice. This paper presents an overview of marriage and explores the complexities of the institution from historical, anthropological, legal, and sociological perspectives. Marriage has many practical implications, including psychological and physical benefits for men and for women, and particularly for children and adolescents, as well as direct benefits to society itself. It is incumbent on clinicians to be sensitive to the many dimensions of this extraordinary institution as it relates to their patients.
TL;DR: This article investigated the construct validity of a revised version of the Countertransference Rating System (CRS) by means of convergence with Referential Activity (RA), which operationalizes three mental activity dimensions (rational-objective, reactive, and reflective) as processes of transformation of countertransferential contents elicited in a therapist by a patient's object-relations units.
Abstract: This study investigates the construct validity of a revised version of the Countertransference Rating System (CRS) by means of convergence with Referential Activity (RA). The CRS operationalizes three mental activity dimensions (rational-objective, reactive, and reflective) as processes of transformation of countertransferential contents elicited in a therapist by a patient's object-relations units. The participants were 36 novice psychotherapists who shared their spontaneous reactions toward parental descriptions provided by conduct-disordered male adolescent patients. Globally, the reflective dimension was positively correlated with RA, whereas the other two dimensions--rational-objective and reactive--showed no association. Dominant categories within each dimension displayed patterns of correlation with RA that are consistent with the constructs. These results are discussed with reference to potential impact on intervention and training.
TL;DR: A cultural model of cognitive-behavior therapy based on the clinical, as well as theoretical, knowledge of the practitioners and researchers working in different cultural settings is needed.
Abstract: Contemporary cognitive-behavior therapy underscores the importance of the culture-specific variables in the treatment of psychological problems. The flexibility and strengths of cognitive-behavior therapy provide us with an excellent opportunity to build a cultural model of cognitive-behavior therapy based on the clinical, as well as theoretical, knowledge of the practitioners and researchers working in different cultural settings. As a first step, we need to share our experiences with the other colleagues working in different cultures.
TL;DR: It is argued that poor limit setting caused by powerful projective identification dynamics were central to the pathology of the boy and his family and the establishment of solid limits by addressing projective Identification forces was necessary for the improvement in the disruptive behavior of the child.
Abstract: Dealing with children who have disruptive behavior disorders can evoke feelings of frustration and anger in their therapists. D.W. Winnicott discussed the complexities in the treatment of enraging patients in his article "Hate in the Countertransference" (1949). In the following paper, I will depict the relationship between limit setting, projective identification dynamics, and enraging behavior in the treatment of a provocative latency-aged boy. I will argue that poor limit setting caused by powerful projective identification dynamics were central to the pathology of the boy and his family. These dynamics partially repeated in the boy's treatment--an outcome of which Winnicott had warned. The repetition contributed to the boy becoming physically out of control in my office and led to a disruption in his treatment. The establishment of solid limits by addressing projective identification forces was necessary for the improvement in the disruptive behavior of the child.
TL;DR: A case history of treatment with a client with retardation and psychosis is presented with a discussion of the therapist's innovative technique.
Abstract: Contact Reflections are the primary method of Pre-Therapy. There are five formalized techniques: situational, facial, word-for-word, body, and reiterative. Together they form a web of psychological contact enabling the development of therapeutic relationships. A case history of treatment with a client with retardation and psychosis is presented with a discussion of the therapist's innovative technique.
TL;DR: The role of clinical inference in the construction of psychoanalytic case formulations is examined and several clinical examples are presented to highlight the operation of these factors and how they can lead to alternate theoretical formulations.
Abstract: This article examines the role of clinical inference in the construction of psychoanalytic case formulations. The principles of analogy, especially in the context of contiguity, the repetition and convergence of themes, the theoretical predilections of the observer, and the assumptions one makes about the operation of the mind are among the major factors that influence the nature of the clinical inferences generated by psychodynamically oriented clinicians. Several clinical examples are presented to highlight the operation of these factors and how they can lead to alternate theoretical formulations.
TL;DR: The author advocates immersion learning of CBT, arguing that theoretical learning must be supplemented by supervision and active use of the method in one's patients.
Abstract: Would-be learners of cognitive-behavioral therapy (CBT) may be hampered by learning traps that impede effective acquisition of the skills necessary to provide this type of therapy to clients. Among these pitfalls are the possibility of isolation, therapeutic fanaticism, lack of seriousness, therapeutic drift, and thinking CBT is antipsychodynamic or antipsychoanalytic. The author advocates immersion learning of CBT, arguing that theoretical learning must be supplemented by supervision and active use of the method in one's patients. Presented are two case vignettes demonstrating therapeutic drift and therapeutic fanaticism to highlight potential therapeutic impasses that may ensue from these pitfalls.
TL;DR: L'Abate as mentioned in this paper described three theoretical models that help illustrate how individuals develop interpersonal relationships and illustrated how individuals become competent in key areas of interpersonal functioning, including emotional intimacy, sexuality, and conflict resolution.
Abstract: LUCIANO L'ABATE: Family Psychology III: Theory Building, Theory Testing, and Psychological Interventions University Press of America, Dallas, TX, 2003, 374 pp, $5600 ISBN 0-7618-2302-6 Over the past two decades, family psychologists have contributed greatly to our understanding of how individual adjustment is related to family dynamics and other social interactions The family psychology literature has mushroomed during that time, as is evident from the publication of many new journals and a large number of books Family Psychology III: Theory Building, Theory Testing, and Psychological Interventions is the third in a series of volumes from University Press of America composed of reprinted articles by Luciano L'Abate, a prolific writer and pioneering family psychologist As in the first two volumes (published in 1983 and 1987, respectively) of this series, the articles in this volume provide a description of the author's program of research and clinical experiences What is unique about this volume is the author's effort to include articles that connect seemingly disparate models of personal and interpersonal development and to present the reader with "an integrative and all-encompassing theory of intimate relationships" (p 14) The book includes 23 chapters that are loosely organized into five sections The first section consists of three chapters and highlights the major theories and concepts in family psychology L'Abate begins by describing three theoretical models that help illustrate how individuals develop interpersonal relationships The first model, attachment, proposes that an individual's assumptions and beliefs about emotional security and nurturance have an important influence on the quality of his or her intimate relationships Selfhood, the second model, emphasizes that an individual's personality traits (eg, optimism, altruism), not his or her assumptions or beliefs, are the primary determinants of relationship quality Finally, the elementary pragmatic model deemphasizes the role of individual characteristics in determining relationship quality and highlights the bidirectional and sequential nature of influences between people in relationships L'Abate points out that the three models, although rooted in the academic field of family psychology, are also relevant to the applied field of family therapy However, he fails to explain how each of the models might be applied to the treatment of families or their individual members In the second section (five chapters), L'Abate expands on some of the theoretical concepts in family psychology He first describes how individuals become competent in key areas of interpersonal functioning, including emotional intimacy, sexuality, and conflict resolution Within each of these areas, L'Abate suggests that an individual's "ability to love" and his or her "ability to negotiate" (ie, to be flexible) determine how well he or she functions in relationships L'Abate then explains that while the attachment, selfhood, and elementary pragmatic models are derived from different theoretical traditions (ie, object relations, systems, and personality theories, respectively), these models describe the same patterns of healthy interpersonal relationships For example, a relationship that is defined as "secure" from an attachment perspective has many of the same qualities as a relationship characterized by "selfulness" in the selfhood model or by "sharing" in the elementary pragmatic model …
TL;DR: The authors are very specific with their differential diagnosis between anorexia (AN) and bulimia nervosa (BN), and point out that differential diagnosis for binge eating disorder (BED) is complicated by its uncertain status in the DSM-IV, where it is still not an official diagnostic category.
Abstract: JAMES E. MITCHELL AND CAROL B. PETERSON (EDS.): Assessment of Eating Disorders. The Guilford Press, NY, 2005, 242 pp., $35.00, ISBN: 1593851960 Assessment of Eating Disorders covers a wide terrain, and does it flawlessly. The book's twelve chapters address the most difficult and controversial issues in the eating disorders field today in a salient, cogent, and understandable manner. The volume opens with Timothy Walsh's and Dana A. Satir's review of the diagnostic issues of the eating disorders, followed by Chapter 2, which further clarifies the classification of eating disorders. Dr. Walsh et al thoughtfully expand on the general psychiatric interview of the DSM-IV, pointing out additional assessment information that clinicians ought to obtain from patients with eating disorders. Their information is clear and will be especially useful to the clinician who has little or no experience with eating disorders. The authors are very specific with their differential diagnosis between anorexia (AN) and bulimia nervosa (BN). They point out that differential diagnosis for binge eating disorder (BED) is complicated by its uncertain status in the DSM-IV, where it is still not an official diagnostic category (it is relegated to the appendix), raising the question as to where the boundary is between a non-purging BN and BED. The discussion helps to clear up some of the confusion as to whether obesity is a psychiatric illness. The other non-official diagnostic category in the obesity repertoire is night eating syndrome (NES). To date, only anorexia and bulimia nervosa are official eating disorders in the DSM-IV statistical manual, with a mention of childhood eating disorders. Dr. Peterson's "Conducting the Diagnostic Interview", Chapter 3, is most instructive and to the point, from establishing rapport to getting important information whkh may be hidden or forgotten by the patient. The tables and interview samples are clarifying. James E. Mitchell, in Chapter 4, reviews the standardized database, clarifying its use for non-testers, and provides a convenient Eating Disorder Questionnaire in full form. Chapters 5 and 6 address themselves to structured instruments and measures. Both chapters cover difficult but essential material for the researcher, and share terminology that would be worthwhile for the practicing clinician to note. Chapters 7 and 8 cover medical and nutritional assessments, informing the non-medical practitioner of the most salient points to be alert to, including signs of morbidity, in this most difficult patient population. In "The Family Assessment", Chapter 9, Daniel Ie Grange provides an interesting review of the different schools of thought on working with the families of those with eating disorders, from Bruch and Touraine to Palazzoli, Minuchin and Vandereycken. …
TL;DR: SOPHIE FREUD: Living in the Shadow of the Freud Family as discussed by the authors is a book about Freud's granddaughter, who was a speech therapist at a Parisian hospital and an internationally known Professor Emeritus of Social Work at Simmons College.
Abstract: SOPHIE FREUD: Living in the Shadow of the Freud Family. Praeger Publishers, Westport, CT, 2007, 446 pp., $34.95, ISBN-10: 0-275-99415-5 The recognized author of this book is Sophie Freud, granddaughter of Sigmund Freud, and internationally known Professor Emeritus of Social Work at Simmons College. The term "recognized" is used because the literary centerpiece of this book is the autobiography of Sophie's mother, Ernestine (aka Esti), who, at the age of 79, wrote it. The autobiography was languishing, but not altogether forgotten, in a bookcase for more than two decades, until it reappeared in this publication. As we know, Sigmund Freud has had many critics and detractors-contemporary and posthumous-as well as a vast number of ardent devotees, both lay and professional. The title of this book, as this reviewer interprets it, suggests that his intellectual and emotional legacy to some of his closest descendants was decidedly eclipsing and impeditive. Fortunately, the facts, as related in this book at least, reveal a more balanced and nuanced picture. Esti Freud's autobiography is very much a tale of physical and moral courage. Yes, she was by all accounts, including her own, a notorious kvetch, a squawker, who could slyly induce guilt and defenselessness in her siblings and children by carping ad nauseam about her financial hardships and the failure of others to appreciate her good intentions and deeds. But a closer look at the expansive and rugged terrain of her life's experiences reveals some remarkable, almost transcendent, accomplishments. Esti, as she acknowledges toward the end of her autobiography, was born into a life of comfort, opulence and cultural plenitude. Not insignificantly, she was also blessed with considerable intelligence, pulchritude, and an inborn charm (this last self-ascribed trait, given the harsh aspersions made by her family regarding her character that intersperse the narrative of this book, is moot and therefore, invites skepticism). Esti is barely out of her teens when she meets and is enthralled by Martin Freud, named by his parents after Sigmund's esteemed teacher Jean-Martin Charcot. After all, Martin is a very handsome, dashing and irresistible swain. Esti's amorous letters to Martin while he is a POW in an Italian internment camp during World War I are a heated forerunner to a marriage, whose blazing flames of love are quickly extinguished, doused most emphatically by Martin's penchant for womanizing and his unsound monetary ventures. Before their ultimate separation, Martin and Esti have two children, Walter and Sophie. As World War II approaches, and Germany is militarily aggrandizing itself in preparation for an invasion of Austria, Martin and Walter take refuge in England. Esti and Sophie, who was then a healthy and vigorous teenager, escape to Paris where they gain temporary respite from the war. During this time, Esti finds gainful employment as a speech therapist at a Parisian hospital and Sophie enrolls in a good local school. Their surcease from the threat of Hitler's invading armies was short lived and once again Esti and Sophie must decamp as part of the massive exodus from Paris in 1940, this time instantly, for the still-unoccupied territories of Southern France. Esti discovers that railway travel is no longer a viable means of escape; the railroad stations are clogged with people, the delays are intolerably protracted and life threatening and, in a chaotic scene highly reminiscent of those described in the literary masterpiece Suite Francaise by Irene Nemirovsky, mother and daughter bicycle out of the city, escaping capture by a hairsbreadth. In tandem (Sophie is the stronger and swifter of the two) they wend their way along the less congested byways of the countryside and eventually their travels take them to Nice. Clearly, the success of this hegira is a tribute to Esti's cunning, courage, derring-do and, not to be overlooked, her extraordinary luck. …