This book is about the three kinds of plots that run the lives ofpatients--subservience, bureaucratic delay and overpowering. It isalso about the three kinds of psychotherapy that attempt to deal withthese plots: objective psychiatry, which deals with the outsidesurface; subjective psychiatry, which deals with the inside; andnarrative psychiatry, which attempts to deal with both.

Objective: The COVID-19 pandemic is negatively impacting the mental health of COVID-19 patients and family members. Given the restrictions limiting in person contact to reduce the spread of the virus, a digital approach is needed to tackle the psychological aftermath of the pandemic. We present the development of a brief remote psychotherapy program for COVID-19 patients and/or their relatives.Methods: We first reviewed the literature on psychotherapeutic interventions for COVID-19 related symptoms. Based on this evidence, we leveraged ongoing clinical (...) experiences with COVID-19 survivors and family members to design an intervention model that could be disseminated and integrated into the workflow of the mental health system.Results: This 8-session model –inspired by constructivist and hermeneutic-phenomenological therapies– serves COVID-19 patients during hospitalization, remission and recovery. This model can also be delivered to people dealing with the COVID-19 hospitalization/discharge of a family member, or the loss of a family member due to COVID-19.Conclusion: We described a remote psychotherapeutic approach to tackle the COVID-19 pandemic psychological aftermath. To date, the approach seems feasible and highly customizable to patients’ needs. Studies are underway to test its preliminary efficacy. Once proven efficacious, this treatment model could provide a blueprint for future tele-psychology wide-scale interventions. (shrink)

Argues that psychotherapy's claim to be a universal scientific practice that objectively treats ahistorical illnesses is untenable. PT is a cultural product, so it both reflects and reproduces its cultural context. Because cultural context is in part composed of moral traditions embedded in political structures, PT is unavoidably a moral practice with political consequences. Implicit moralities in current practices are discussed. Philosophical hermeneutics in PT practice are offered as an alternative. In a discussion of intersecting traditions, it is suggested (...) that a hermeneutic perspective can portray the keeping of family secrets as a commitment to a particular moral code, rather than the products of a "dysfunctional family." If PT theories can be changed so that they are more historically situated, and if PT practices can be changed to use hermeneutics, then a different moral frame can be put forth. 2012 APA, all rights reserved). (shrink)

The area of psychotherapy has grown considerably in Ireland since the original edition of this book was published in 1993, and in this revised edition twelve leading practitioners of psychotherapy working in Ireland offer an overview of the approach or school of psychotherapy that is within their area of competence. Among the topics covered are: psychoanalysis, child psychoanalytic psychotherapy, Jungian analysis, psychosynthesis and transpersonal theory, constructivist psychotherapy, family therapy, cognitive-behavioral therapy, gestalt theory, the person (...) centered approach, and an integrative approach to psychotherapy. (shrink)

Psychotherapy holds out the promise of help for people who are hurting and in need. It can save lives and change lives. In therapy, clients can find their strengths and sense of hope. They can change course toward a more meaningful and healthy life. They can confront loss, tragedy, hopelessness, and the end of life in ways that do not leave them numb or paralyzed. They can discover what brings them joy and what sustains them through hard times. They (...) can begin to trust, or to trust more wisely. They can learn new behaviors in therapy and how to teach themselves new behaviors after therapy ends. They can question what they always believed was a given. They can find out what matters most to them, and how to stop wasting time. They can become happier, or at least less miserable. They can become better able, as Freud noted, to love and to work. They can learn how to accept and love themselves just as they are and accept others who are different from them. Our ethics acknowledge and affirm our profession's responsibilities. This book was written to help strengthen, deepen, and inform ethical awareness and the sense of personal ethical responsibility. Its job is to help you hold onto the ideals-including ethical ideals-that called you into the profession to begin with, to help you develop and fulfill those ideals. There will be so much-trust us on this-that tends to dull ethical awareness, to make ethics drift out of focus, to create barriers between you and your ideals, to replace ethics with pseudo-ethics and ethics placebos. Fatigue, endless paperwork, unrealistic expectations, illness, family crises, not being able to make ends meet, burn out, threats of job loss, insurance coverage that doesn't come close to meeting the needs of our clients, biases that have not been addressed, and so many other forces can pressure us into cutting ethical corners. This book is intended to help you develop a strong and healthy resistance to such forces, to help you weather them without losing your ethical awareness and ideals. (shrink)

Dans cet article, l’auteur, psychologue exerçant en Institut thérapeutique, éducatif et pédagogique (itep) et en point-rencontre, traite la question de l’articulation entre la place du secret autour des maltraitances intrafamiliales en psychothérapie de l’enfant et la distorsion du rapport à la dette symbolique chez ce dernier, au regard de son vécu. Le sujet est abordé à partir d’une réflexion théorique associée à des apports cliniques issus de rencontres thérapeutiques. L’objectif est d’amener le lecteur à porter un regard plus nuancé sur (...) les situations de révélations de maltraitances par l’enfant, en considérant avec plus d’attention la perte de la place qu’il occupe au sein de son système familial. En parallèle à la question du positionnement de l’enfant, l’auteur interroge également le positionnement du thérapeute et rappelle l’importance de l’investissement affectif dans la relation thérapeutique, aussi anxiogène qu’il puisse être parfois pour les deux partenaires du dispositif. (shrink)

Mental health professionals face many complex questions in the course of their work with clients and patients. Among the most difficult are dilemmas that involve ethical issues. This book presents a forthright exploration of these dilemmas and the ethical considerations they raise. Drawing on extensive interviews, the author identifies common ethical problems that practitioners encounter. What happens, for example, when personal interests intrude into therapy? How can the therapist make an accurate assessment of his or her appropriateness as a care (...) provider for a particular patient? What about confidentiality? How are problematic financial arrangements best addressed? The author goes on to show how these dilemmas may be intensified by the unique assumptions of different therapeutic orientations--individual, group, family, marital, and organizational--and how professionals can learn from such experiences to better understand and apply their particular approach. This analysis--and the words of the therapists themselves--provide both a guide to practice and a unique store of experience for the growing number of researchers and students concerned with ethical problems in psychotherapy. (shrink)

This study explores how therapists deal with ethical dilemmas in psychotherapy with older adults. Semi-structured interviews were conducted with 14 therapists and analyzed using grounded theory methodology. Findings clustered around three themes: (i) respecting autonomy when interacting with family of vulnerable and dependent older patients; (ii) prioritizing respecting autonomy in risk situations and in suspected financial abuse without impaired judgment; and (iii) prioritizing protecting the patient in risk situations of patients with dementia and of suspected physical abuse or (...) neglect. These findings highlight several important issues regarding the management of ethical dilemmas in psychotherapy with vulnerable and dependent older adults. (shrink)

Cet article décrit le développement de l’approche psychanalytique de la thérapie de couple au Tavistock Centre for Couple Relationships (auparavant Tavistock Marital Studies Institute). Il donne un aperçu de quelques concepts théoriques clés et de la pratique consistant à recevoir les couples en co-thérapie. La notion de « faits cliniques » est utilisée en lien avec un fragment de recherche clinique pour éclairer différentes perspectives de cette thérapie psychanalytique.

In the first collection of his essays to be published, Jeremy Holmes discusses the wider application of psychotherapy within psychiatry and suggests that psychoanalysis needs to escape from its esotericism by taking into account contemporary advances in cognitive science, family therapy and the realities of psychiatric work in a public health setting. Illustrating his arguments with literary as well as clinical examples, he emphasizes the importance of creativity in psychotherapy and the connections between the artistic and psychotherapeutic (...) impulse. (shrink)

This edited volume comprehensively examines the critical ethical challenges that arise in the practice of counselling and psychotherapy. It translates philosophical positions and professional ethical guidelines in a way that can be applied to practice. The various chapters focus on specific ethical issues that emerge in working with a range of different client groups; for example, children, couples and families. While some ethical imperatives are common across the board, others could be more closely associated with certain client groups. Practitioners (...) might experience uncertainty in working with vulnerable client groups; for example, lesbian/gay/transgender/intersex (LGBT) clients, or persons who report intimate partner violence. Several chapters raise questions, provide information and additional resources to enhance ethically informed practice. Chapter contributions also highlight the ethical dilemmas that might be unique to certain contexts; for example, private practice, schools and consultation-liaison settings. This volume also addresses contemporary and relatively less understood playing fields like 'digital ethics' related to therapist-client interface in the internet space and the navigation of ethical dilemmas in the newly emerging field of employee assistance programmes which address mental health needs in the corporate sector. Written by experienced practitioners of psychotherapy, and culturally contextualized, this is a valuable resource for academics and practitioners interested in psychotherapy and counselling. (shrink)

Many therapists can attest to the fact that adolescents can be difficult and frustating clients-problems are seldom well defined, clearly delineated symptoms are more exception than the rule, and troubling situations often involve the entire family. Gestalt therapist Mark McConville draws on his more than twenty years of professional experience to offer clinicians an effective model for understanding and treating adolescents. He outlines the Developmental Tasks Model, which describes adolescents' struggles, "temporary insanity," and ultimately, triumph of development. He clearly (...) demonstrates that the Gestalt therapeutic model bridges the theoretical and clinical gap, and offers an indepth exploration of the various aspects of clinical work. _Adolescence_ offers valuable nuts-and-bolts advice on initiating therapy with adolescents who are not yet ready to do the self-reflective, exploratory work. In addition, the book examines the therapeutic method of engaging and cultivating the adolescent's emerging inner world. With perception and sensitivity, McConville explains how the clinician can guide the adolescent in the very personal and subjective process of birthing and existential self. The book details the process of the creative reorganization of the self during adolescence and explores the changes that take place in the adolescent's relationships with peers, parents, and others in the adult world. The author also tracks the interplay of intrapsychic and interpersonal boundary development and shows how this interplay manifests itself in relationships and evolves from early through late adolescence. The Gestalt model of therapy allows the clinician to make sense of the confusion of the adolescent world and map out the multiple possibilities of clinical interventions. (shrink)

IntroductionCouple violence (CV) affects many, and the consequences of those actions are grave, not only for the individual suffering at the hand of the perpetrator but also for the other persons in the family. Violence often happens among more than just the adults within one family. Even if CV has been thoroughly investigated in the general population very few studies have investigated this objective on a clinical sample, and none of these have included family violence.AimThis article identifies (...) and describes the group of clients that have issues of physical couple and family violence. It analyses a model that can help to discover physical violence and help therapists to assess what actions to take in therapy to prevent further physical violence.MethodologyDescriptive analysis, t-tests, and structural equation modeling (SEM) are used on a sample of clients receiving couple and family therapy (CFT) in Norway (N = 830). Family violence is modeled by the partner’s expectations toward each other, levels of anger, sexual satisfaction, and self-control.ResultsOne-in-five clients experienced physical CV in their current relationship and one-in-four experienced physical family violence. The group of clients who experienced CV differed from those without such experiences in having lower income, more prior experience with psychotherapy, more experience with alcohol abuse in childhood, and far more physical family violence in their current family. Our model predicting physical coupl... (shrink)

By analyzing session exchanges and questionnaires administered to family therapy clients, this article examines questioning as conversational practice grounded in institutional goals that are therapist-directed and therapist-conceived. In their manifestation in talk and text, therapeutic questions function to replace client accounts with the nosological accounts of institutional psychiatry. The analysis illuminates three ways in which questioning works in the session and then locates these in therapy's professional and institutional logic. A critical reflection on psychotherapy's questioning practices in a (...) social context concludes the article. (shrink)

Conversation analytic research has advanced understanding of the psychotherapeutic process by understanding how psychotherapy is organised over time in and through interaction between clients and therapists. This study progresses knowledge in this area by examining how psychological accounts of experience are progressively developed across a range of helping relationships. Data include: (1) approximately 30 h of psychotherapy sessions involving trainee therapists; (2) approximately 15 h of psychotherapy demonstration sessions involving expert therapists; and (3) approximately 30 h of (...) everyday conversations involving close friends or family members. This article reports an analysis of techniques that are used to bring together two experiences that were discussed separately, to proffer a candidate connection between them. This proffering of candidate connections was recurrently used in psychotherapy. If confirmed by a client, a proffered connection could be used to develop a psychological account of a client’s experiences, which could then warrant some psychological intervention. In contrast, the proffering of connections was observed in only one of the everyday conversations included in the current study, where it was used to develop psychological accounts of experience. This shows that although proffering candidate connections is an everyday interactional practice, it appears to be used with greater frequency in psychotherapy, to advance its specific institutional aims. (shrink)

The roots of much of Western medicine lie in the Christian monastic tradition and its commitment to nonstigmatizing compassionate care throughout the life cycle and to the ideal of empathic personal connection between physicians, patients, and the communities and relationships in which both of these are embedded. In the modern West, these Christianly informed aspects of medicine are increasingly being undercut as medical care becomes ever more specialized, technologized, and depersonalized. At the same time, there exist a variety of efforts (...) to counter these tendencies and to foster a practice of medicine that is more sensitive to the personal, relational, familial, and narrative dimensions of health, illness, and medical care. There are, in particular, considerable numbers of physicians, psychologists, and psychotherapists working at the intersections of biomedical and psychosocial care, of care for individuals and care for families, and of the body and the mind. Given the natural affinity that Christian bioethicists might be expected to have to communitarian, narrative, and family-oriented approaches to health care, it is thus remarkable that there appears to be no work of Christian bioethics that interacts in any discernible way with this psychotherapeutic literature concerning health, illness, families, and the mind-body interface. Instead, Christian bioethicists appear to endorse a narrowly reductionistic biomedical view of health and illness while either ignoring the psychosocial, integrative, and collaborative literature, or actively blaming and shaming those pastors or lay Christians who might have anything to do with psychotherapy or psychosocial care. This is unbecoming and unhelpful. In the fragmented, complex, and potentially dehumanizing world that is modern medical care, those who would think Christianly about the care of the sick cannot afford to despise psychology and psychosocial care. On the contrary, the church needs psychotherapy. In this article, I will thus consider, first, what the state of the conversation is where Christian bioethics and psychosocial and psychotherapeutic care are concerned. I will then turn to some of the principal landmarks in the professional literature concerning psychotherapeutic work with the sick, the disabled, the dying, and the bereaved, particularly as these are considered in contexts that include families and lay and professional caregivers. I will then identify a few opportunities for practical and theological reflection that present themselves in this literature, and will conclude with a few comments on the substance and relationship of salvation and health. (shrink)

We know from the research literature that psychotherapy is effective, but we also know that hundreds of diverse therapies are being practiced that have not been subjected to scientific scrutiny; thus, in some circumstances iatrogenic effects do occur. Therefore, it is crucial that we recognize and implement therapeutic interventions that are evidence based rather than succumb to ethical dilemma, frustration, and complacency. Recommendations for family therapists are discussed, including the need to (a) keep abreast of research findings, (b) (...) translate research findings and developments as they apply to clinical practice, (c) prioritize techniques and intervention models, and (d) reexamine funding priorities and research foci. (shrink)

Ce texte a déjà paru dans Thérapie familiale, Genève, 2002, Vol. 23, n° 1, p. 21-34. Nous remercions Anne Courtois de nous avoir autorisé à le reproduire ici. Résumé : Le temps familial, une question de rythmes ? Réflexions épistémologiques et cliniques. – La dimension temporelle a, pendant de longues années, été complètement évacuée par les différentes écoles de thérapie familiale. Aujourd'hui, l'histoire du groupe familial, l'évolution dans le temps de la relation thérapeutique est prise en compte. (...) - Psychanalyse (...) et psychothérapie – Nouvel article. (shrink)

What sets off the termination of analysis and psychodynamic therapy from the variety of endings that enter into all human relationships? So asks Herbert J. Schlesinger in _Endings and Beginnings: On Terminating Psychotherapy and Psychoanalysis_, a work of remarkable clarity, conceptual rigor, and ingratiating readability. Schlesinger situates termination - which he understands, variously, as a phase of treatment, a treatment process, and a state of mind - within the family of "beginnings and endings" that permeate one another throughout (...) the course of therapy. For Schlesinger, therapeutic endings cannot be aligned with the final phase of treatment; ending-phase phenomena are ongoing accompaniments of therapeutic work. They occur whenever patients achieve some portion of their treatment goals and supervene when therapy stagnates. Small wonder that an assessment of the patient's relationship to time and capacity to end therapy are key aspects of diagnostic evaluation. By linking beginning and ending phases not to the chronology of treatment but to the patient’s experience of it, Schlesinger brings revivifying insight to a host of psychodynamic concepts. Nor does he shy away from a trenchant critique of the instrumental “medical model” of psychiatric and psychotherapeutic training, which militates against the therapeutic exploration of treatment endings. Schlesinger's exemplification of how to begin treatment from the point of view of ending; his sensitive delineation of the mid-treatment "ending" crises characteristic of "vulnerable patients"; his richly woven case vignettes illustrating various "ending" contingencies and permutations - these inquiries are gems of pragmatic clinical wisdom. _Endings and Beginnings_ distills lessons learned over the course of a half century of practicing, teaching, and supervising psychotherapy and psychoanalysis and is a gift to the profession. (shrink)

Cet article s’intéresse aux méthodes psychothérapeutiques utilisées dans la déparentification : la reconnaissance de l’empreinte de la parentification à l’âge adulte, l’évaluation et son élaboration lors des psychothérapies individuelles ou familiales. La déparentification consiste à mettre au travail la position paradoxale du sujet parentifié, celle de prendre totalement en charge l’autre, une position salvatrice au départ qui se révèle trop lourde dans un deuxième temps, car en contradiction avec les propres intérêts du sujet. Un des objectifs de la déparentification est (...) d’élaborer la position de sollicitude extrême, celle du « sauveur » qu’on aperçoit dans les relations lorsque l’adulte perçoit un infantile traumatique chez l’autre comme il l’avait perçu chez son parent en souffrance. La déparentification met en évidence une parentalité précoce construite sur du vide ou à partir du négatif de la parentalité, nous faisant penser à une parentalité défensive d’emprunt, réparatrice, compulsive et agissante. (shrink)

This book explores the puzzling phenomenon of new veiling practices among lower middle class women in Cairo, Egypt. Although these women are part of a modernizing middle class, they also voluntarily adopt a traditional symbol of female subordination. How can this paradox be explained? An explanation emerges which reconceptualizes what appears to be reactionary behavior as a new style of political struggle--as accommodating protest. These women, most of them clerical workers in the large government bureaucracy, are ambivalent about working outside (...) the home, considering it a change which brings new burdens as well as some important benefits. At the same time they realize that leaving home and family is creating an intolerable situation of the erosion of their social status and the loss of their traditional identity. The new veiling expresses women's protest against this. MacLeod argues that the symbolism of the new veiling emerges from this tense subcultural dilemma, involving elements of both resistance and acquiescence. (shrink)

Although touch frequently occurs in psychotherapy with children, there is little written on the ethical considerations of therapeutic touch. Because physical contact does occur, therapists must consider if, how, and when it is used, for both their clients' safety and their own. In this review, I further develop the issues suggested by Aquino and Lee (2000) in the use of nurturing touch in therapy by considering many types of touch that occur in psychotherapy with children; the possible positive (...) role of touch; clients' perception of touch in therapy; considerations related to the therapist, the child's safety, and any history of abuse in the child's and family's background; and other practical considerations. I list guidelines. (shrink)

Theology offers an account of how a person grows in the love of God or fails to do so; this account is needed for understanding the role of mental health treatments. An overview of the elements of character formation is given, including moral and theological virtues, vices, emotions, reason, commandments, and the influence of family and the community. The diagnosis of mental disorders and illnesses is reviewed, along with the basic kinds of psychotherapist and methods of therapy. A few (...) principles regarding human dignity are highlighted, and the similarities of and differences between the counselor and the confessor are explained. (shrink)

The case of Xiang as described by Jane Carroll is indeed disconcerting well beyond the immediately apparent factors contained within the article. While Xiang’s direct medical expenses are excessive and his inability to pay for those expenses and further support his noncustodial family seem to be the main issues up for debate, Xiang, however, is likely going to need much more psychosocial support if he is to regain his previous independent functionality or retain any aspect of a quality of (...) life whilst continuing his indefinitely isolated treatment. In this response, I briefly outline the probable effects of Xiang’s current situation on his social identity and mental health as well as a potential way that we can minimize these adverse effects. (shrink)

Mental health professionals frequently work with family caregivers in the provision of psychotherapy services to individuals with serious mental illness. To address the need for ethical guidelines for working with family caregivers, an analysis of relevant ethical and legal issues is provided within the context of dynamic mental health care and legal systems. When working with family caregivers, practitioners utilize the American Psychological Association’s Ethics Code (2010), legal codes, and a complex decision-making plan; identify and communicate (...) ethical obligations to family caregivers; consider the unmet needs of this population; avoid harm resulting from multiple relationships; and balance ethical duties of beneficence and respect for autonomy. (shrink)

From the Couch to the Circle: Group-Analytic Psychotherapy in Practice is a handbook of group therapy and a guide to the group-analytic model - the prevailing form of group therapy in Europe. The book draws on both John Schlapobersky’s engagement as a practitioner and the words and experience of people in groups as they face psychotherapy’s key challenges - understanding and change. This book provides a manual of practice for therapists’ use that includes detailed descriptions of groups at (...) work; accounts of therapists’ own experience and the issues they face in themselves and in their groups. The book is devoted to the Group-Analytic model but the other principally psychodynamic models of group therapy - the Tavistock, Interpersonal, Psychodynamic, Modern Analytic and Structural/Systemic models - are brought into a comparative discussion and drawn upon to create an integrated and coherent approach. The book is divided into three sections: Foundations – aimed at practitioners using groups of any kind and working at every level, including those providing supportive psychotherapy and providing groups for psychosis, trauma, the elderly, people at risk, the elderly and children; The Group-Analytic Model – defines the group-analytic model at a basic and advanced level; The Dynamics of Change – aimed at group analysts, psychotherapists and psychologists providing short-term psychotherapy and long-term group analysis The book is illustrated with clinical vignettes including incisive, instructive commentaries to explain the concepts in use. It is intended for those seeking psychotherapy, whether to resolve personal problems or to find new sources of meaning in their lives. It is also intended for policy-makers in mental health, students of different models of psychotherapy and the psychosocial field. The comparative discussion running through the text about methods and models of practice will likely be of interest to the wider mental health and psychotherapy fields. The author draws together the inherited wisdom of group analysis since Foulkes’ time and makes his own lasting contribution. From the Couch to the Circle will be an invaluable, accessible resource for psychotherapists, psychoanalysts, psychologists, family therapists, academics, psychologists, mental health practitioners, academics and teachers in psychotherapy. (shrink)

Difficulties in various cognitive functions are common observations in people experiencing anxiety. However, limited research has investigated the effects of psychotherapy on abnormal cognitive functioning. This study assessed whether psychotherapy-related reductions of anxiety result in improvements of cognitive functioning as well. Fifty-four participants with high self-reported anxiety, divided into two experimental groups (N = 28 and N = 26), and 27 non-anxious control participants (N = 27) completed a battery of memory tasks and anxiety questionnaires in three consecutive (...) time points. In experimental group 1, participants started systemic family therapy immediately after the first time point, while, in experimental group 2, participants begun the same type of therapy three months later at the second time point. The results showed that, compared to control participants, at the beginning of the experiment, participants in the experimental groups had significantly lower memory performance, along with higher anxiety. Psychotherapy had a beneficial effect on anxiety symptoms and cognitive performance, with significant changes occurring only after intervals of treatments. These results show that psychotherapy is effective not only in reducing anxiety symptoms but on cognitive functioning as well. This improvement might be linked to the release of cognitive resources previously absorbed by worrisome thoughts, facilitated by a heightened protection from interference. (shrink)

Le complexe fraternel mettant en scène la jalousie participe à l’organisation de la subjectivation de l’individu et préfigure l’intersubjectivation par le biais d’un pacte narcissique de fratrie. Dans des configurations familiales où la problématique de la filiation traumatique est présente, le complexe d’intrusion devient désorganisateur du fait d’un fonctionnement incestuel et de la puissance de l’emprise, engendrant une logique fratricidaire à l’origine de violences. Les auteurs proposent à partir de l’expérience de l’un d’entre eux de revisiter l’expérience fraternelle dans le (...) cadre de la psychothérapie familiale. À travers des exemples cliniques, et en prenant appui sur des moments fondateurs du lien fraternel en thérapie familiale, ils mettent en évidence l’importance de l’espace fraternel comme lieu d’interfantasmatisation permettant une reconstruction des liens de filiation. (shrink)

Confronté à des éprouvés d’étrangeté dans la rencontre avec le jeune enfant autiste et à la fragilité de constitution de son image du corps, le thérapeute peut perdre de vue la question de la construction de ses identifications sexuées. Il risque alors de se priver d’une ressource créative dans le transfert avec l’enfant et sa famille. À partir d’études de cas d’enfants reçus en psychothérapie au long cours, cet article propose d’explorer quelques ressorts thérapeutiques offerts par l’attention que porte le (...) thérapeute aux voies de construction parfois insolites des identifications sexuées dans l’autisme. Cette attention soutient la qualification des recherches sensorielles des enfants et facilite la relance des identifications réciproques entre l’enfant et son entourage. Elle favorise ainsi l’élaboration des douleurs de transmission dans le lien parents-enfant. (shrink)

Résumé L’article interroge l’approche familiale des adolescents nouvellement immigrés ayant subi de nombreux traumatismes de guerre. Il montre que la consultation familiale peut être une voie d’accès aux soins. Au travers de cas cliniques, la question du fraternel est interrogée dans cette période de reconstruction d’un passé difficile, pendant l’adolescence où confrontation au réel et à la loi symbolique du père et recherche identitaire peuvent s’exacerber. Les difficultés d’apprentissage, les problèmes identitaires, les symptômes multiples au sein de la même famille (...) sont étudiés. (shrink)

In these seven letters, practising psychiatrist Vincenzo Di Nicola offers wisdom to a young therapist from 25 years of experience conducting relational therapy. Ranging from what to read and how to begin therapy, the letters cover therapeutic temperaments and technique, how to create a relational dialogue, the myths of individual psychology and the need for relational psychology, the evolution of therapy in the past century and when therapy is over-all the while looking forward to the relational practices of the coming (...) community. This book complements Di Nicola's model of working with families presented in A Stranger in the Family: Culture, Families, and Therapy (New York and London: W.W. Norton). -/- Awarded the prestigious Prix Camille-Laurin of the Association des médecins psychiatres du Québec - the Camille Laurin Prize of the Quebec Psychiatric Association. -/- From the Foreword: -/- "It's a beautiful idea, this project of turning to young people... The relational dialogue offers an important new direction of study to discover the deep basis of the therapeutic alliance, in order to understand the still too-little known phenomenon of 'change'... This is what you have brought together in your book: the search for the whole regarding the person and, at the same time, the network of primary affective relationships that we call the family and of social relationships ..." --from the Foreword by Maurizio Andolfi, M.D. Director of the Academy of Family Psychotherapy Professor of Psychology, University of Rome -/- Advance Review: -/- "Di Nicola is a true master of constructive inquiry, synthesis, and brilliant creativity. Memorable aphorisms leap from every page of this very wise, thoughtful, and beautifully written book in which the healing process of discovering and making meaning to help reorder the lives of troubled persons is clarified. I highly recommend this book for all who are or would be therapists!" --Armando Favazza, M.D., M.P.H. Emeritus Professor of Psychiatry University of Missouri-Columbia Author of Bodies Under Siege. (shrink)

Independent on Sunday October 2nd One of the country's lead­ing philosophical counsellers, and chairman of the Society for Philosophy in Practice (SPP), Tim LeBon, said it typically took around six 50 ­minute sessions for a client to move from confusion to resolution. Mr LeBon, who has 'published a book on the subject, Wise Therapy, said philoso­phy was perfectly suited to this type of therapy, dealing as it does with timeless human issues such as love, purpose, happiness and emo­tional challenges. `Wise (...) Therapy, is part of a series aimed at promoting an integrative attitude as its ethos. Among all the many perspectives of psychotherapists and counselors, philosophy needs to take its place and needs to find its voice. Tim LeBon has provided an effective means by which counselors can bring philosophy into their work with clients' - APPA journal `Tim Le Bon's Wise Therapy is a comprehensible and well argued book dealing with the practical therapeutic applications of philosophical research that may well be of interest to philosophers but -- as the author himself intends -- will be of most obvious benefit to therapists and counselors, both by informing their dialogue with clients in new ways and by helping them become more informed about ways to resolve the ethical dilemmas arising within the context of their own work' - Metapsychology `A fascinating workshop for therapists and clients, backed up a thorough degree if philosophical acuity' - Journal of the Society for Existential Analysis `I strongly recommend the book for philosophers as well as practitioners, teachers, students and supervisors in counselling and psychotherapy' - Self and Society `Provides some additional and valuable arrows for the therapist's quiver' - Irvin Yalom, author of Love's Executioner `Like Aristotle, Tim LeBon examines what is said and extracts what is best from it…. There are many fascinating exercises designed to bring out and enlighten the client's values, conception of the good life, well-being, happiness, pleasure, and the proper place of reason in life…. Wise Therapy is well written and engaging. The case histories are illuminating examples of therapeutic techniques at work, the thought experiments are well designed, and the philosophical position adapted from the internal debates of the philosophers is level headed…. I recommend it highly to philosophers with an interest in counselling, and psychological counsellors with an interest in philosophy' - Jeff Mason, The Philosophers' Magazine `Tim LeBon has… authored a text which should become a staple on the philosophical counsellor's bookshelf…. Wise Therapy is a concise, well-written book…. His ability to relate philosophical concepts to counselling concerns is admirable and attests to the skill and knowledge he possesses as a working counsellor. But, by far the most important part of Tim LeBon's book to PC is the last chapter, "The Counsellor's Philosophical Toolbox"' - Craig Munns in The Examined Life ` Tim LeBon has done a good job of offering practical approaches to some of the most important and vexing issues that arise in counselling…. Tim LeBon's book contains helpful suggestions, practical information, and useful examples, and would make a good addition to the library of any counsellors willing to allow philosophy to turn mere client sessions into wise therapy' - Peter Raabe, Practical Philosophy Wise Therapy is an original and practical guide to how philosophy can benefit counselling and psychotherapy. Tim LeBon argues that therapy, informed by philosophy, can help clients make better decision and achieve emotional wisdom. He uses philosophical approaches to explore issues of right and wrong, the emotions and reasons, well-being and the meaning of life, and develops a 'counsellor's toolbox' of techniques that can help practitioners apply the wisdom of philosophy to good therapeutic practice. For counsellors who may find philosophical approaches to therapy useful, this work addresses key philosophical topics - the emotions, free will, the meaning of life and ethics. It is jargon-free where possible and assumes no previous philosophical training. From The Independent, 16th November 2004 Plato is my agony aunt It was the end of a love affair that broke her heart. Could the wisdom of the great philosophers show her how to be happy again? Claire Smith tries a novel form of therapy "The unexamined life is not worth living," Socrates said. Nor is the life you're left with after your boyfriend has left you for another woman - at least, that's how it felt in October last year when mine broke rank and went off with an art student from Cleveland, Ohio. We were over there for the opening of his new art exhibition. He'd flown over four days before me and had met her at a party. Supposedly, they "connected". The five months that followed were a roller-coaster of confusion, vitriol and despair. I knew there'd been problems in our relationship. We saw the world very differently; he delighted in the charm of the ordinary, I wanted maximum divinity. He walked; I galloped. He drank tea; I loathed the stuff. But, along the banks of the Thames, we'd made a promise to always stick together. Our love was something unique: "transcendental", I called it. And besides, we recycled. Surely a commitment to save the world would save our relationship? Alas, no. So there I was, a woman scorned. Hell truly hath no greater fury. And what made it worse was that I still believed in our transcendental love. If I wanted to change the way I was feeling, I needed to alter the way I was thinking. But how? A few bottles of wine and a sharp blow to the head might have done the trick. Fortunately, there's an older, more trusted way of turning your head on its head that counsellors are starting to use: philosophy. The idea of employing Plato as an agony aunt was begun in 1981 by the German philosopher Gerd Achenbach. Although philosophy spends a lot of its time asking real-life questions that affect real-life people - What is happiness? And is it always wrong to lie? - most of the debate goes on in ivory towers. What Achenbach and subsequent philosophers including Tim LeBon, the chairman of the UK's Society for Philosophy in Practice, wanted to do was "give practical application" to this gigantic library of great thoughts. So how does it work? Like most types of therapy, you sign up for a set of sessions. "Two would give you a new perspective on one issue; six would help you to make a major life-decision, like a career change; with 12 you can start to rethink your entire life philosophy," explains LeBon. Each session lasts 50 minutes and costs £50 - and, no, you don't have to have any previous knowledge of philosophy. "If you think of Friends, it would suit Ross and Chandler more than Joey," LeBon says. "It's for anyone who wants to make their emotions more intelligent. Or for those who have tried other kinds of therapy, and want something more cerebral." The first session begins with the patient venting off about whatever's troubling them. The rant over, the counsellor then picks out some key concepts that are crucial to the problem - in the case of heartbreak, it is love and happiness that come hurtling to the fore - and then gets the patient to define what they mean. So, what is love? What is happiness? To kick-start the patient's thinking, LeBon describes what a great philosopher had to say about it. In my case, he tells me what Plato wrote about love in his Symposium: that to stop man fighting the gods, Zeus decided to cut each human in two, so they would lose their strength. "This, then, is the source of our desire to love each other," Plato said. "Each of us is a 'matching half' of a human whole, because each was sliced like a flatfish, two out of one, and each of us is always seeking the half that matches him." This method of probing what we might think are "obvious" ideas, such as love and happiness, was devised by Socrates in the squares of Athens. "The only I thing I know is that I know nothing at all," he boasted. What Socrates showed was that although many of the thinkers of his time thought they knew what justice, happiness and goodness meant, their understanding was tied in to their personal agenda and world view, and, what's more, when pushed, their ideas often contradicted themselves. A bit like me on love. Whereas part of my understanding of love was something that gave life meaning, made it worth living and bound us together, I also believed that true love was "transcendental": that it was out of this world, and it didn't matter if the two people who loved each other couldn't get along in the day-to-day. Love was bigger than the mundane. But when it came to the next stage of the therapy, critical thinking - "to check out whether your assumptions stand up to examination" - I walked head first into a contradiction. If I think love's purpose is to make life worth living, but then say it's irrelevant to daily life, surely my two ideas of love are not compatible? As the cogs in my brain start to creak into motion, I feel myself taking a step back from my predicament: thinking about how I've been thinking. This idea I had of transcendental love might have started off as a romantic dream. But when the relationship stopped working, and I found myself feeling trapped and frustrated, I used it to justify the mechanics of a relationship that just didn't work in the daily grind. I used it to lie to myself. In the final stage, LeBon gets me to start thinking about how to go forward. "You can't change what has happened," he says. "You can't change that he's left you, or how you behaved in the relationship. So, as the Stoics did, let's work on controlling the controllables: the things that you can change." To work out what can be changed, he gets me to try out a thought experiment, a method often used in philosophy to imagine other worlds where people can have different codes of behaviour. Thought experiments shatter your preconceived ideas of how the world should be and let your imagination run wild to how the world could be. "I find Viktor Frankl very useful here, the Austrian psychiatrist and concentration-camp survivor who actually believed that everything in life happens for a purpose," LeBon says. "Suppose this break-up did happen for a reason that will work to your benefit," he suggests. "What might that be? The answer might be that you can now focus on something important that was denied in the relationship. Or - the Hollywood version - so you'll meet someone who is really right for you." Temporarily freed of any sense of responsibility for the relationship that was, and its sorry demise, the list came fast. I could now travel more; he didn't like me travelling on my own, but too often he didn't want to go anywhere, preferring to stay in his studio and make art. I'd love to meet someone with a similar sense of adventure to mine. For the first time in two years, I was being honest with myself about what I really wanted - listening to those voices that we all have inside our heads, and too often try to muzzle. So did philosophy save me? Well, I'm now dating a travel writer I have to run to keep up with. I still haven't got over the fact that my replacement came from Cleveland, Ohio. But I guess I never will. Tim LeBon can be reached by e-mail at [email protected] A FEW WORDS FROM THE WISE Compiled by Ed Caesar · "At the touch of love, everyone becomes a poet" - Plato · "There is always some madness in love. But there is also always some reason in madness" - Friedrich Nietzsche · "That man shall live as his own master and in happiness who can say each day 'I have lived'" - Horace · "The good of man is the active exercise of his soul's faculties in conformity with excellence or virtue... Moreover this activity must occupy a complete lifetime; for one swallow does not make spring, nor does one fine day; and similarly one day or a brief period of happiness does not make a man supremely blessed and happy" - Aristotle · "There is nothing on this earth more to be prized than friendship" - Thomas Aquinas · "Whatever you do... love those who love you" - Voltaire · "Happiness is not an ideal of reason but of imagination" - Immanuel Kant · "Happiness is a state of which you are unconscious. The moment you are aware that you are happy, you cease to be happy" - Jiddu Krishnamurti · "Love is an ideal thing. Marriage is a real thing" - Johann Wolfgang von Goethe I shrink, therefore I am Therapy has many answers, but some questions require the help of a philosopher, says Clint Witchalls Sunday November 21, 2004 The Observer Danny had worked in the City of London for 10 years. As a research analyst, stockbroker and fund manager, he'd made a lot of valuable contacts, earnt a lot of cash, and learnt some important business skills. However, as he approached his mid-thirties, he no longer felt good about himself or what he did for a living, and he found his colleagues cold and unfriendly. A chronic illness made him realise his mortality, and he began to reassess his priorities. Danny had been struggling with his career conundrum for nearly five years when he met David Arnaud, a philosophical counsellor. After a few soul-searching sessions, Danny arrived at a decision. Today, he teaches economics to sixth-formers, and he loves it. 'It's a much better lifestyle,' he says. Many people are turning to philosophical counsellors to get answers to questions such as: 'How do I make sense of myself?' 'What is important to me?' 'Where am I going?' These are perhaps not the sort of questions that require psychiatric intervention, but Arnaud, who recently completed the first empirical study of philosophical counselling in the UK, has found that within just five sessions the majority of clients, with important decisions to make, tend to move from a state of concern and confusion to a resolution. Modern philosophical counselling can be traced back to 1981, when the philosopher Gerd Achenbach opened the first practice near Cologne. Achenbach referred to the new discipline as 'therapy for the sane.' Today, there are hundreds of philosophical counsellors around the world, with the movement particularly strong in the US, Britain and the Netherlands. 'The dilemmas people face aren't always primarily psychological,' says Alex Howard, a philosophical counsellor from Newcastle. 'If people face problems that are social or economic, it doesn't make sense to define their problems in purely psychological terms.' Tim LeBon, a founder member of the Society for Philosophy in Practice (SPP) and author of Wise Therapy, adds: 'We are faced with far more life choices than our grandparents, yet have far fewer resources to deal with them. Our grandparents may have gone to a priest or to other family members for advice; most people don't trust these solutions any more and so want to make their own well-informed, well thought-out choices. Philosophical counselling can help these people - people in mid-life crises who are wondering how to make the most of the rest of their life. People who want to take stock of their values.' Where stressed executives might once have been prescribed a course of tranquillisers or antidepressants, they can now get a dose of Bertrand Russell instead: 'Success is too dearly purchased if all the other ingredients have been sacrificed to obtain it.' While some philosophical counsellors do recommend books for their clients to read, most sessions are about helping the client identify faulty thoughts. For example, a briefing in Aristotelian logic might show a client why their beliefs are erroneous. The person might infer that they're a screw-up because they've screwed up. The counsellor could point out that they're making an error called 'fallacy of composition' - that is, what's true of the part isn't necessarily true of the whole. In philosophical counselling, problems aren't pathologised as they are by the psychiatric profession, and the dialogue between client and counsellor is more like a meeting of equals, compared to many therapies where the client is treated like a patient and seen as someone who is, in some way, inadequate. 'Anybody can benefit from philosophical counselling,' says Howard. 'But it does require someone who is willing to take stock.' Lou Marinoff, author of international bestseller Plato Not Prozac! has done much to promote philosophical counselling. 'Some people who have stabilised their neurochemistry and validated their emotions now wish to examine or re-examine the criteria of their beliefs, the principles of their conduct, or the meaning of their lives,' he says. 'With whom shall they do this? Psychologists and psychiatrists can shed light on such issues - as can rabbis, priests, imams and gurus. Philosophers are now rejoining the ranks of helpers.' LeBon believes certain therapies (such as cognitive behavioural therapy) don't go far enough in helping their clients. 'For instance, if you are anxious about your relationship, a cognitive therapist would try to dispute your catastrophising and jump to conclusions to make you feel less anxious,' says LeBon. 'A philosophical counsellor would do this, but would also look for existential meaning in your anxiety - perhaps you really don't want to be in the relationship and that is what your anxiety is telling you.' LeBon also gives short shrift to psychoanalysts. 'There's very little evidence for the Freudian unconscious, and it's time to move on to more intellectually satisfying and helpful therapies,' he says. However, Alain de Botton, the man who popularised philosophy as self-help, isn't ready to bury psychologists and their ilk just yet. 'The truth is that psychoanalysis grew out of philosophy - it's not some completely new idea, and in fact, done properly, psychoanalysis is philosophical anyway. It may even be dangerous to the mental health of some people to suggest a philosopher rather than a properly trained analyst. The knowledge of analysts when it comes to many emotional problems is now much greater than that of most philosophers.' Guardian Unlimited © Guardian Newspapers Limited 2004. (shrink)

Title in English: Pastoral Counseling Psychology: Premarital, Marriage, and Family Contexts. "Pastoral counseling" is different from "Christian counseling". Pastoral counseling is a counseling orientation (not a theoretical school) that emphasizes openness to exploration (including tolerating mystery or ambiguity) of spiritual and religious issues (e.g., the concept of God) on clients and between clients and counselors, in which case the issue might be viewed as the root of daily life problems. Pastoral counseling still uses the concepts of counseling psychology or (...) psychotherapy in general, such as the helping relationship or therapeutic relations. Pastoral counseling psychology is demanded to be pro-active, continuous challenging itself to perform critical reflection and to contribute thoughts and praxis "in concreto" in solving psychological problems. (shrink)

Conversation analysis (CA) of children-adult—interaction in various contexts has become an established field of research. However,child therapyhas received limited attention in CA. In child therapy, the general psychotherapeutic practice of achieving empathy faces particular challenges. In relation to this, our contribution sets out three issues for investigation and analysis: the first one is that practices of achieving empathy must be preceded by efforts aiming to establish which kind of individualized conversation works with this child (Midgley,2006). Psychotherapy process researchers in (...) adult therapy (Stiles et al.,2015) have found that therapists “invent” a new therapy for each patient (Norcross and Wampold,2018). The second issue is that it can be difficult for adults to understand the ways in which children express their conflicts and issues. In particular, play activities in therapy, e.g., with dolls, can open up additional scenarios of interaction. The play scenario can be used to disclose unformulated problems masked in everyday and family interactions. The third issue is how to respect the child's higher degree of vulnerability, compared with adult patients. How is it communicated and dealt with in therapy? We present an interaction analysis of a single case study of the first 20 min of a child therapy session with an adopted girl aged 4 years brought to treatment because of “unexplainable rage.” The session was videotaped; parents granted permission. We analyze this session using an applied version of CA. In our analysis, we describe “doing contrariness,” as a conversational practice producing epistemic and affiliative disruptions, while “avoiding doing contrariness” and “remedying contrariness” are strategies for preserving or restoring the affiliative dimension of a relationship (in child therapy). We show how these practices operate in various modes and how they are used by both parties in our case study to variously aid and impedethe achievement of empathy and understanding. (shrink)

I have practiced psychotherapy, family therapy, and hypnotherapy for over 25 years without a single board complaint or lawsuit by a client. For over 3 years, however, a group of proponents of the false memory syndrome (FMS) hypothesis, including members, officials, and supporters of the False Memory Syndrome Foundation, Inc., have waged a multimodal campaign of harassment and defamation directed against me, my clinical clients, my staff, my family, and others connected to me. I have neither treated (...) these harassers or their families nor had any professional or personal dealings with any of them; I am not related in any way to the disclosures of memories of sexual abuse in these families. Nonetheless, this group disrupts my professional and personal life and threatens to drive me out of business. In this article, I describe practicing psychotherapy under a state of siege and place the campaign against me in the context of a much broader effort in the FMS movement to denigrate, defame, and harass clinicians, lecturers, writers, and researchers identified with the abuse and trauma treatment communities. (shrink)

Dans cet article, l’auteur reprécise les critères analytiques de la psychothérapie de couple telle qu’elle est enseignée et transmise au sein de l’AFCCC. Ysont présentés le dispositif, le cadre et le processus analytiques, puis la formation du psychothérapeute de couple. L’ensemble de cette présentation est encadré par de multiples citations de psychanalystes appartenant à divers es sociétés membres de l’API (Association psychanalytique internationale).

This essay explores some relationships between social structures or systems and the internal psychological structures or systems of individuals. After defining evil, pastoral counseling, and structures or systems, I present examples of persons affected by social systems of power who have sought counseling. I present a form of counseling known as Internal Family System Therapy (IFS) and show with an extended example how I have worked with clients using this approach. In this process the client is guided to use (...) "Self-leadership" in healing and transforming inner conflict between various subpersonalities or "parts." I then compare the IFS approach to one used by mediators in community conflict transformation and peacebuilding. (shrink)

Psychoanalysis was introduced to Greece in 1915 by the progressive educator Manolis Triantafyllidis and was further elaborated by Marie Bonaparte, Freud’s friend and member of the Greek royal family, and her psychoanalytic group in the aftermath of the Second World War. However, the accumulated traumas of the Nazi occupation (1941–1944), the Greek Civil War (1946–1949), the post-Civil-War tension between the Left and the Right, the military junta (1967–1974) and the social and political conditions of post-war Greece led this project (...) and all attempts to establish psychoanalysis in Greece, to failure and dissolution. The restoration of democracy in 1974 and the rapid social changes it brought was a turning point in the history of Greek psychoanalysis: numerous psychoanalysts, who had trained abroad and returned after the fall of the dictatorship, were hired in the newly established Greek National Health Service (NHS), and contributed to the reform of Greek psychiatry by offering the option of psychoanalytic psychotherapy to the non-privileged. This article draws on a range of unexplored primary sources and oral history interview material, in order to provide the first systematic historical account in the English language of the complex relationship between psychoanalysis and Greek society, and the contribution of psychoanalytic psychotherapy to the creation of the Greek welfare state. In so doing, it not only attempts to fill a lacuna in the history of contemporary Greece, but also contributes to the broader historiography of psychotherapy and of Europe. (shrink)

The profound changes in personality, mood, and other features of the self that neural interventions can induce can be disconcerting to patients, their families, and caregivers. In the neuroethical debate, these concerns are often addressed in the context of possible threats to the narrative self. In this paper, I argue that it is necessary to consider a dimension of impacts on the narrative self which has so far been neglected: neural interventions can lead to a loss of meaning of actions, (...) feelings, beliefs, and other intentional elements of our self-narratives. To uphold the coherence of the self-narrative, the changes induced by neural interventions need to be accounted for through explanations in intentional or biochemical terms. However, only an explanation including intentional states delivers the content to directly ascribe personal meaning, i.e., subjective value to events. Neural interventions can deprive events of meaning because they may favor a predominantly biochemical account. A loss of meaning is not inherently negative but it can be problematic, particularly if events are affected one was not prepared or willing to have stripped of meaning. The paper further examines what it is about neural interventions that impacts meaning by analyzing different methods. To which degree the pull towards a biochemical view occurs depends on the characteristics of the neural intervention. By comparing Deep Brain Stimulation, Prozac, Ritalin, psychedelics, and psychotherapy, the paper identifies some main factors: the rate of change, the transparency of the causal chain, the involvement of the patient, and the presence of an acute phenomenological experience. (shrink)

Hans Rudi Fischer eröffnet vom Standpunkt einer philosophischen Analyse her einen neuen Zugang zu bestimmten Formen der Geisteskrankheit und damit zu ihrer psychotherapeutischen Analyse und Behandlung. Die Studie ist daher im Zwischenbereich zwischen Philosophie, Sprachtheorie und Psychologie bzw. Psychotherapie angesiedelt und somit für alle drei Bereiche von Interesse. Ihre Zielrichtung ist deshalb eine doppelte: Zum einen sollen Wittgensteins verstreute Bemerkungen zur Psychologie, zum Wahnsinn und zur Psychoanalyse in einer systematischen Interpretation ihres (bisher, wenn diese Bemerkungen überhaupt beachtet wurden, meist unterstellten) (...) kursorischen Charakters entkleidet und in einen konsistenten Zusammenhang mit seinem philosophischen Konzept von Sprachspiel, Grammatik und Lebensform gebracht werden. Zum anderen soll von dieser philosophisch gewonnenen Position her eine (weiterführende) Kritik an einigen Positionen der Psychoanalyse sowie an kommunikationstheoretischen Ansätzen in der Psychopathologie (Bateson und, auf ihn folgend, Watzlawick) geübt werden. Ergebnis ist eine philosophische Erklärung von Schizophrenie als Verschiebung der Grammatik (in Wittgensteins Gebrauch dieses Terminus) aufgrund devianter Lebensformen im sozialen Nukleus der Familie. (shrink)

This book charts Carl Gustav Jung’s 33-year correspondence with James Kirsch, adding depth and complexity to the previously published record of the early Jungian movement. Kirsch was a German-Jewish psychiatrist, a first-generation follower of Jung, who founded Jungian communities in Berlin, Tel Aviv, London, and Los Angeles. Their letters tell of heroic survival, brilliant creativity, and the building of generative institutions, but these themes are darkened by personal and collective shadows. The Nazi era looms over the first half of the (...) book, shaping the story in ways that were fateful not only for Kirsch and his career but also for Jung and his. Kirsch trained with Jung and acted as a tutor in Jewish psychology and culture to him. In 1934, fearing that anti-Semitism had seized his teacher, Kirsch challenged Jung to explain some of his publications for the Nazi-dominated Medical Society for Psychotherapy. Jung’s answer convinced Kirsch of his sincerity, and from then on Kirsch defended him fiercely against any allegation of anti-Semitism. We also witness Kirsch’s lifelong struggle with states of archetypal possession: his identification with the interior God-image on the one hand, and with unconscious feminine aspects of his psyche on the other. These complexes were expressed, for Kirsch, in physical symptoms and emotional dilemmas, and they led him into clinical boundary violations which were costly to his analysands, his family and himself. The text of these historical documents is translated with great attention to style and accuracy, and generous editorial scaffolding gives glimpses into the writers’ world. Four appendices are included: two essays by Kirsch, a series of letters between Hilde Kirsch and Jung, and a brief, incisive essay on the Medical Society for Psychotherapy. This revised edition includes primary material that was unavailable when the book was first published, as well as updated footnotes and minor corrections to the translated letters. (shrink)

Le propos de ce recueil est de développer deux thématiques : raison et folie et déraisons de la raison. D'un côté, on interroge la décision spéculative et politique qui "lie et sépare à la fois raison et folie" dans les termes mêmes employés par Michel Foucault (1961). L'âge classique, le siècle de la raison, commence par constituer un autre de la raison : le fou, renvoyé "au jardin des espèces". Il faut donc revisiter cette archéologie des dualismes mutilants : raison (...) et folie, normal et pathologique, âme et corps, à la lumière des travaux les plus récents. La folie aujourd'hui s'aborde de manière préoccupante dans les politiques de santé mentale qui visent à criminaliser la folie : psychiatrie menacée d'un retour de l'enfermement et de la violence. Psychiatrie sinistrée mais qui est déjà sur la voie de la résistance, notamment dans la culture, comme l'atteste la présence de la mélancolie en son sein, mais aussi dans les développements contemporains de la psychothérapie institutionnelle et de ses équipements comme de ses concepts. Sans négliger d'autres initiatives. Enfin, la rationalité elle-même n'est pas une donnée immédiate de la science. Elle se construit sur fond d'irrationalité. Là aussi, les dualismes familiers et stérilisants sont dissipés. (shrink)

Obstacles in dealing with child sexual abuse can hinder survivors in the process of coming to terms with their experiences. The present study aims to identify and analyze factors that may pose obstacles in the long-term process of dealing with CSA. It is part of a larger research consortium “Auf-Wirkung,” funded by the German Federal Ministry of Education and Research, and was conducted in cooperation with the Independent Inquiry into Child Sexual Abuse in Germany. The IICSAG was appointed by the (...) Independent Commissioner for Child Sexual Abuse Issues and the German Federal Ministry for Family Affairs, Senior Citizens, Women, and Youth in 2016. To determine responsibilities, recognize injustice, and further acknowledge the survivors of CSA in the Federal Republic of Germany and the German Democratic Republic, the Independent Inquiry has held 1,303 private sessions with survivors of CSA by Oct. 17th, 2020. The present study focuses on exploring reoccurring problematic experiences reported by survivors in private sessions regarding the long-term process of dealing with experiences of CSA. A total of 30 transcripts of private sessions, conducted by members and appointees of the IICSAG between September 2016 and June 2019, were analyzed using qualitative content analysis. Attendants of private sessions described a variety of obstacles, including negative social reactions to disclosure, institutions' unwillingness to elucidate occurrences of CSA within their midst, as well as general financial difficulties, and those linked to redress claims. Manipulative grooming by perpetrators and limited access to adequate psychotherapy were perceived as obstructive by survivors dealing with CSA. In the context of criminal proceedings, survivors reported long durations of court proceedings and negative experiences in connection to credibility assessment. Results will be discussed to better support survivors of CSA in the process of dealing with their experiences in the future. (shrink)

Tom Andersen’s reflecting team process, which allowed families to witness and respond to the talk of professionals during therapy sessions, has been described as revolutionary in the field of family therapy. Reflecting teams are prominent in a number of family therapy approaches, more recently in narrative and dialogical therapies. This way of working is considered more a philosophy than a technique, and has been received positively by both therapists and service users. This paper describes how dialogical therapists conceptualise (...) the reflective process, how they work to engage families in reflective dialogues and how this supports change. We conducted semi-structured, reflective interviews with 12 dialogical therapists with between 2 and 20 years of experience. Interpretative Phenomenological analysis of transcribed interviews identified varying conceptualisations of the reflecting process and descriptions of therapist actions that support reflective talk among network members. We adopted a dialogical approach to interpretation of this data. In this sense, we did not aim to condense accounts into consensus but instead to describe variations and new ways of understanding dialogical reflecting team practices. Four themes were identified: Lived experience as expertise; Listening to the self and hearing others; Relational responsiveness and fostering connection; and Opening space for something new. We applied these themes to psychotherapy process literature both within family therapy literature and more broadly to understand more about how reflecting teams promote helpful and healing conversations in practice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Nature of Proof in PsychiatryPaul Lieberman (bio)Keywordspsychotherapy process, knowledge and psychiatry, externalism, WittgensteinThis vivid clinical report illustrates recognizably, and provocatively, a number of routine, but often unexamined, clinical questions. In its few paragraphs, it depicts challenges that each practitioner confronts, and, in the flux of clinical work, addresses, however implicitly and imperfectly, every day: From what data, and by what processes, does a clinical formulation, or way of (...) understanding, come into being? How do we appraise its accuracy and adequacy? Of what value is even a well-substantiated understanding, in the mind of the therapist, to the patient? What is the power of empathy as a treatment tool? How do we assess someone's status as a “good candidate for therapy?” When, typically, only the outlines of a problem are visible, and its origins and implications are largely hidden, by what right do we recommend psychotherapy, and with what conception, at what level of detail, of what its outcome will be? These are among the questions that Dr. Bailey's story challenges us to address.They are clinical questions, of course, because they deal with empirical matters of fact—psychological processes, outcomes studies, and evidence. But they are also philosophical because, as Freud insisted and Dr. Bailey shows, information obtained in the clinical situation often has power and authority that lead us to believe we understand what is going on, understand the other person, even in the absence of scientifically tested hypotheses, or the clear application of research-based evidence. Interactions between people—including clinical interactions—have a life and ability to engage us. Their meanings can seem so transparent and convincing that no doubt or questioning may seem cogent. At their most powerful, such experiences can reawaken us to important realms of experience and feeling which we might, otherwise, forget, ignore, suppress, deny, or in other ways keep out of awareness; they have the potential to arouse us and reconnect us with truths that, once revived, can seem both valid and important—perhaps the kind of experience that we may derive from works of art or literature (in fact, Dr. Bailey's account could be seen as a clinical parable—meant to be neither true nor false, but instructive). But even less dramatic examples are commonplace: we do routinely claim to know and be able to interpret and understand the actions of other people from our everyday interactions with and observations of them.What is less clear is how to account for these convictions and how to appraise their value, because they do not derive from established scientific procedures. Clinical intuition has a role throughout medicine, but we usually expect it to be subjected later to more rigorous tests to establish the correct diagnosis. Yet, as Dr. Bailey's case illustrates, clinical intuition in the psychiatric encounter seems somehow different. When Colin [End Page 225] leads Dr. Bailey to the conclusion that a “painful lack of wounds” has made him depressed, we find this credible. It seems similarly credible that Dr. Bailey might be anxious about his own capacity to defend his young family, because he says he is, that he perceives Colin as testing his manhood or sincerity, because that seems to fit Colin's temperament, that being accurately understood is helpful, because most of us have had that experience and valued it, and that, most generally, an absence of challenge or of activity could be depressing. But suppose a patient believed that a painful lack of wounds produced diabetes instead of depression, or suppose he had developed epilepsy and attributed that to an absence of combat experience. We might see these as ‘pre-scientific’ or ‘hypothesis-generating’ (or worse). By contrast, it seems timid to consider psychiatric formulations to be always and only provisional or hypothetical.In what ways and to what extent should we expect psychiatry to be different, and why? Several considerations suggest that psychiatry's reasons are not, always and everywhere, the same as those of general medicine, nor are its objectives.In general medicine, we distinguish between signs and symptoms, on the one hand, and “underlying” disease processes, on the other. But in psychiatry, this distinction can be... (shrink)

ObjectiveThe aim of this study was to test the feasibility of telepsychology support for patients with severe cardiorespiratory disease and their caregivers. A secondary objective was to explore pre-post relationships between patients' and caregivers' clinical measures.MethodsA telehealth program incorporating telepsychology support, i.e., an “on-demand” phone service with a psychologist, was provided to consecutive cardiorespiratory patients at discharge from inpatient rehabilitation and to their caregivers. At the start and end of the 1-year program, participants were interviewed “face-to-face,” and their anxiety/depression level, (...) patients' quality of life, and caregivers' family strain and needs were assessed: we analyzed the correlations and evaluated customer satisfaction.ResultsOf 80 eligible individuals, 40 took part in this study: 22 patients and 18 caregivers. Eleven requested tele-psychological support, resulting in 51 consultations focused on anxiety, difficulty in patient management, worry about the patient's emotional state, and need for emotional support; 3 participants underwent a tailored psychotherapy program. All participants expressed high satisfaction with the service. At enrolment, anxiety was less evident in patients than in caregivers, while depressive symptoms were more evident, and correlated with MRF-28 and MQOL. Caregivers' FSQ showed a “strongly recommended” need for support; at enrolment, high levels of anxiety/depression were correlated with high FSQ ; depressive symptoms correlated negatively with age and positively with emotional needs ; anxiety was positively correlated with education level. At follow-up, patients' perception of support tended to increase, while caregivers' strain tended to decline. At enrolment, caregivers' anxiety/depression and strain correlated with patients' quality of life. At follow-up, caregivers' strain correlated with patients' quality of life and cognitive performance.ConclusionTelepsychology support associated with a telehealth service is feasible and satisfying for both participants and psychological management. A suitable support program can benefit both patients and caregivers, particularly those at higher risk of depressive symptoms and anxiety. (shrink)

_What place do Anna Freud’s ideas have in the history of psychoanalysis? What can her writings teach us today about how to work therapeutically with children? Are her psychoanalytic ideas still relevant to those entrusted with the welfare of infants and young people? _ _Reading Anna Freud_ provides an accessible introduction to the writings of one of the most significant figures in the history of psychoanalysis. Each chapter introduces a number of her key papers, with clear summaries of the main (...) ideas, historical background, a discussion of the influence and contemporary relevance of her thinking, and recommendations for further reading. Areas covered include Anna Freud’s writings on: • The theory and practice of child analysis and 'developmental therapy' • The application of psychoanalytic thinking to education, paediatrics and the law • The assessment and diagnosis of childhood disorders • Psychoanalytic research and developmental psychopathology Nick Midgley draws on his extensive experience as a child psychotherapist and a teacher to bring Anna Freud's ideas to life. He illustrates the remarkable originality of her thinking, and shows how analytic ideas can be used not only in child psychotherapy, but also to inform the care of children in families, hospitals, classrooms, residential care and the court-room. __Reading Anna Freud__ will be of interest to child therapists, child analysts and psychoanalysts, as well as others working in the field of child and adolescent mental health, such as clinical psychologists, child psychiatrists and educational psychologists. It also has much to offer to those entrusted with the care of children in a wide range of settings - including teachers, nurses and social workers - for whom Anna Freud was always keen to demonstrate the value of a psychoanalytic approach. _Nick Midgley_ trained as a child and adolescent psychotherapist at the Anna Freud Centre, where he now works as a clinician and as Programme Director for the MSc in Developmental Psychology and Clinical Practice. Nick has written articles on a wide range of topics and is joint editor of _Minding the Child: Mentalization-based Interventions with Children, Young People and their Families_ and _Child Psychotherapy and Research: New Directions, Emerging Findings_. (shrink)

Charlotte Wolff was born in Riesenburg, West Prussia into a middle-class Jewish family. She studied philosophy and then medicine at several German universities, completing her doctorate in Berlin in 1926. Working in various institutions over the next few years, she was also interested in psychotherapy and had a small private medical and psychotherapeutic practice. In 1933 she was forced to leave Germany because of the Nazi regime, and settled for a few years in Paris. As a German refugee (...) she was unable to practice medicine, so she began her research into the correlation between hand traits and personality. In 1936 she went to London to continue her research work and lived there until her death. An active lesbian from an early age, her later research turned to sexology and her writing on lesbianism and bisexuality were influential early works in the field. This is a great opportunity to rediscover her early work, including her first autobiography. (shrink)

In einer Reihe von philosophischen Meditationen setzt sich der Verfasser mit dem im modernen gesellschaftlichen Leben so schmerzlich empfundenen Mangel an Intimität auseinander und mit dem verschiedenen Versuchen, diesem Übel abzuhelfen. Das Buch des Flamen Van Ussel „Intimiteit” bildet seinen Ausgangspunkt. Sorgfältig abwägende kritische Betrachtungen bieten dem Verfasser Gelegenheit, Probleme zu behandeln, die indirekt mit der Initimität zusammenhängen und dabei der Sichtweise einiger bedeutender Philosophen und Humanwissenschaftler Rechnung zu tragen : Probleme, die u. a. die menschliche Leiblichkeit, das Wohnen und (...) die Institutionalisierung menschlicher Beziehungen betreffen. Auch die Frage, ob Scham eine Art Schuldgefühl ist, das mittels Psychotherapie eliminiert werden soll, oder ein natürlicher Schutz der Intimität, wird erörtert. - Mit der letzten Meditation begibt sich der Verfasser auf das Gebiet der Ethik. Van Ussel ist ja auf der Suche nach „alternative Formen des Zusammenleben”, die an die Stelle der „bürgerlichen Familie” treten sollen. Die philosophische Frage wird diskutiert, was in diesem Zusammenhang die Begriffe „ alternativ” und „bürgerlich” eigentlich bedeuten. Ist eine rein ethische Kritik der „bürgerlichen Einstellung” möglich ? Ist eine Ethik denkbar, die die bürgerliche Moral transzendiert, ohne sie zu verwerfen ? (shrink)