"I have entitled this book _For Love of the Imagination_. Long ago, I fell in love with the imagination. It was love at first sight. I have had a lifelong love affair with the imagination. I would love for others, through this book, to fall in love, as I once did, with the imagination." _Michael Vannoy Adams_,_ _from the Preface. ___For Love of the Imagination__ _is a book about the imagination – about what and how images mean. Jungian psychoanalysis is (...) an imaginal psychology – or what Michael Vannoy Adams calls "imaginology," the study of the imagination. What is so distinctive – and so valuable – about Jungian psychoanalysis is that it emphasizes images. For Love of the Imagination is also a book about interdisciplinary applications of Jungian psychoanalysis. What enables these applications is that all disciplines include images of which they are more or less unconscious. Jungian psychoanalysis is in an enviable position to render these images conscious, to specify what and how they mean. On the contemporary scene, as a result of the digital revolution, there is no trendier word than "applications" – except, perhaps, the abbreviation "apps." In psychoanalysis, there is a "Freudian app" and a "Jungian app." The "Jungian app" is a technology of the imagination. This book applies Jungian psychoanalysis to images in a variety of disciplines. _For Love of the Imagination_ also includes the 2011 Moscow lectures on Jungian psychoanalysis. It will be essential reading for psychoanalysts, psychotherapists, students, and those with an interest in Jung. (shrink)

Extensively updated to include clinical findings over the last two decades, this third edition of A Practitioner's Guide to Rational-Emotive Behavior Therapy reviews the philosophy, theory, and clinical practice of Rational Emotive Behavior Therapy. This model is based on the work of Albert Ellis, who had an enormous influence on the field of psychotherapy over his 50 years of practice and scholarly writing. Designed for both therapists-in-training and seasoned professionals, this practical treatment manual and guide introduces the basic principles of (...) rational-emotive behavior therapy, explains general therapeutic strategies, and offers many illustrative dialogues between therapist and patient. The volume breaks down each stage of therapy to present the exact procedures and skills therapists need, and numerous case studies illustrate how to use these skills. The authors describe both technical and specific strategic interventions, and they stress taking an integrative approach. The importance of building a therapeutic alliance and the use of cognitive, emotive, evocative, imaginal, and behavioral interventions serves as the unifying theme of the approach. Intervention models are presented for the treatment of anxiety, depression, trauma, anger, personality disorders, and addictions. Psychologists, clinical social workers, mental health counselors, psychotherapists, and students and trainees in these areas will find this book useful in learning to apply rational-emotive behavior therapy in practice. (shrink)

Erving Goffman’s “Asylums” is a key text in the development of contemporary, community-orientated mental health practice. It has survived as a trenchant critique of the asylum as total institution, and its publication in 1961 in book form marked a further stage in the discrediting of the asylum model of mental health care. In this paper, some responses from a range of disciplines to this text, 50 years on, are presented. A consultant psychiatrist with a special interest in cultural psychiatry and (...) mental health legislation, two collaborating psychotherapists in adult and forensic mental health, a philosopher, and a recent medical graduate, present their varying responses to the text. The editors present these with the hope of encouraging further dialogue and debate from service users, carers, clinicians, and academics and researchers across a range of disciplines. (shrink)

Since the emergence of psychology, its relation with religion has been inconsistent. Their different sources and methodologies but common aims made them close or distanced. Today these disciplines acknowledged and learned to benefit from each other. The affect of religion/spirituality on human’s lives raised the attention of psychology and required the integration of these into psychotherapy. In order to approach the psychology-religion relation via the traces of religion within psychotherapy the paper deals with the necessity, the knowledge needed, the principles (...) when integrating religious/spiritual principles and practices into psychotherapy; finally the religious traces in psychotherapy. The paper comprises few Turkish examples together with the huge body of theoretical and practical examples on the topic. These theories and practices should be important examples for Turkey. By addressing the religious traces in psychotherapy the aim of the paper is to show that the cliff between psychology and religion is in fact not that deep.SummaryIt can be argued that psychology and religion have common interests relating the well-being of individuals. There is a huge body of research that emphasizes the implementation and necessity of cultural, religious, spiritual principles in professional psychology. The proprium of these models is to integrate the client’s religious/spiritual sources into therapy. Especially religious clients benefit from therapies that define their treatment goals around their religious views. However, it must be considered that if the disorder has a biological dimension and/or is severe psychopathologic pure religious interventions will not be sufficient. This paper traces the religious/spiritual principles within psychotherapies and shows that the cliff between religion and psychology is not that deep.At different places in the world therapy is done according to western standards. However, determining mental health or disorders according to western criteria might be problematic. In societies in which religious/spiritual life is an essential part of culture, religion plays a crucial role in people’s perception of disease and treatment. In mental health, spirituality is an important and primary source for coping. Empirical studies reveal the positive outcomes of religious practices such as personal prayer, repentance, meditation, and dhikir on mental and physical health. In light of this data it becomes clear that psychotherapies should be revised socio-culturally and culturally sensitive psychotherapies that cover belief and religious practices should be developed. Another need for the integration of religion, belief, and spirituality with psychotherapy is the significant effect of these experiences on individual’s lives. With regard to the broad impact of religion, psychological interventions solely might not be sufficient to fulfill human psychological needs. As studies show, religious clients expect religious practices in treatment as well as a therapist who is open and respectful to religious principles, ready to talk about own religious beliefs, willing to integrate religious matters into therapy. To fulfill these expectations therapists, need to be trained and educated in religious/spiritual matters. Additionally, the therapist must acknowledge and be conscious about her/his own worldview, religious commitment, and spiritual life. However, the therapist needs not to be religious him/herself or share the same religion as the client. It is sufficient that the therapist is open and receptive to the client’s beliefs so that these can be used as effective sources in therapy. Spiritual psychotherapy considers spirituality as one of the main sources of clients. Thus, it might be critical when the therapist has poor knowledge about religion when the client considers it as significant. This source might be helpful for the client in coping with his/her problems and limitations. Having knowledge about the client’s religion and culture might also be important to acknowledge his/her perceptions and beliefs. Because individuals’ understanding of disease, their beliefs about reasons for mental disorders, their expectations from the health system are important factors in seeking help and choosing therapy.Therapists who decide to integrate spiritual/religious principles into psychotherapy have to adhere to some ethical principles. The source and the degree of the psychological disorder are important, too. Even though the efficacy of religious rituals and spiritual interventions are extensive in each case it has to be investigated whether religiosity/spirituality is part of the problem or the solution. Certain aspects will guide the therapist in deciding whether to integrate religiosity/spirituality into the therapy process or not. Additionally, he/she has to gather information about the client’s religious/spiritual life (spiritual anamneses) in order to choose the most appropriate religious method and intervention. Today psychotherapy deals with coping, questions about the meaning, purpose, and way of life. Actually, these are issues with which religious traditions has dealt and proposed solutions for thousands of years ago. For example, ethical principles for mental health professionals correspond to those of religious teachings. The attitudes and the type of relationship recommended by the client-centered approach are also commended by religious teachings for all human relations. Beginning with the 1960’s an increasing interest in Buddhist teachings is observable among psychotherapists. Mental exercises (especially meditation) cause transformations in the self-perception and lead to enduring changes in consciousness. Religions such as Islam, Judaism, and Buddhism recommend meditation technics like contemplation, dhikr, and yoga. Confession in the Catholic Church has similarities with psychotherapeutic catharsis. Many cultures own one kind of forgiveness rituals of confessions. As studies report people benefit from these rituals. Forgiveness is a multifaceted issue with psychological and spiritual dimensions and involves cognitive, emotional, relational, and spiritual processes. Research indicates the religious and psychological functions of forgiveness. Many subjects such as personal prayer, hope, empathy, love, and tolerance are common issues of both, psychotherapy and religion/spirituality. Different psychotherapeutic approaches and especially positive psychology integrate these values that are valued by religion/spirituality into their theories and practices.In conclusion, the cliff between psychology and religion/spirituality is not that deep at it seems at first sight. They have many subjects in common. Individuals turn to religion and spirituality in times of crises. This makes it inevitable to include religion and spirituality into the therapeutic process. Because religions provide ways of coping, hope, and meaning in difficult times. This fact is recognized and accepted abroad and lead to the religious/spiritual psychotherapy movement, which will hopefully an inspiration for Turkish psychology as well. (shrink)

Written by a former corporate manager pursuing counseling as a 2nd career, this article offers pointed views on managed mental health care. Values of practitioners that are a mismatch for managed care are noted, and more specific disadvantages and advantages are examined. Loss of client confidentiality is addressed and procedures and technologies for its reclamation are noted. Negative effects on therapy are acknowledged and potential for better accountability and research are pointed out. Economic disadvantages of a small provider's practice as (...) well as opportunities for creating new value and additional income are reviewed. The relatively sudden emergence of managed care is credited with a natural time lag preceding regulatory responses. Acknowledging that most new practitioners have little choice about the clients they serve, the article concludes that it would be shortsighted to rule managed care out of one's practice. (shrink)

_On the Lyricism of the Mind: Psychoanalysis and Literature_ explores the lyrical dimension of the psychic space. It is not presented as an artistic disposition, but rather as a universal psychic quality which enables the recovery and recuperation of the self. The specific nature of human lyricism is defined as the interaction as well as the integration of two psychic modes of experience originally defined by the psychoanalyst Wilfred Bion: The emergent and the continuous principles of the self. Dana Amir (...) elaborates Bion's general notion of an interaction between the emergent and the continuous principles of the self, offering a discussion of the specific function of each principle and of the significance of the various types of interaction between them as the basis for mental health or pathology. The author applies these theoretical notions in her analytic work by means of literary illustrations showing how the lyrical dimension may be used to teach psychoanalytic readings of literature and explore the connection between psychoanalytic and literary languages._ _ On the Lyricism of the Mind presents a new psychoanalytic understanding of the capacity to heal, to grieve, to love and to know, using literary illustrations but also literary language in order to extract a new formulation out of the classic psychoanalytic language of Winnicott and Bion. This book will appear to a wide audience to include psychoanalysts, psychotherapists and art therapists. It is also extremely relevant to literary scholars, including students of literary criticism, philosophers of language and philosophers of mind, novelists, poets, and to the wide educated readership in general._ _. (shrink)

In this paper I continue to probe the roles of philosophy and psychology in moral education. In a previous article published in this journal, I criticized the moral views of various schools of psychotherapy, and argued that philosophers are the sole professionals equipped to teach normative morality in a pluralistic, critical, and reasoned way . In this paper, I argue that effective moral education involves emotional education; that philosophers’ views of emotions tend to be reductive, and when they are not, (...) they point to an irreducibility of affectivity which is not amenable to philosophical investigation. While emotional and moral education should go hand in hand, philosophers seem poorly equipped for the former. Psychotherapists are trained in educating emotions and in attending the irreducible affectivity of individual emotions. Interested as we might be in psychotherapists’ specialization in emotional education, we cannot dissociate it from moral education, as emotional education is not value-free. Recalling that psychological theories involve views of morality which do not withstand critical examination , we are reluctant to entrust psychotherapists with moral education. Turning once again to psychology, we realize that we have added a new complexity to the initial problematic status of psychological moral education. While emotional and moral education should go hand in hand, the untenable situation that obtains is that philosophers educate us morally while psychologists educate us emotionally. Moral education is impaired whether it is left to psychotherapists or to philosophers. I conclude by sharing some thoughts on the possibilities of amending this situation. (shrink)

Do psychotherapists' unethical practices influence how they are perceived? The 202 Israeli lay and professional psychology participants rated systematically varied descriptions of effective therapists and potential clients under conditions of no difficulties, practice without a license, and a previous sexual boundary violation on indexes of evaluation and willingness to refer. Participants completed a measure of important variables in therapist selection. Effective standard therapists were rated most favorably, unlicensed therapists were rated favorably, and therapists who violated sexual boundaries in the past (...) were rated least favorably. When results were analyzed by respondent characteristics, laypersons rated unlicensed professionals and sexual boundary violators more positively than did clinical psychologists. Men rated the violators more favorably than did women. Factor analysis of therapist selection measures identified professional and personal factors, but only the former were associated with ratings of "problem" therapists. The results underscore the gap between ethical standards and applied decisions made by professionals and laypersons. Further investigation is needed to ensure quality care in both professional and consumer approaches to psychotherapy. (shrink)

This essay describes possible futures that may result from accelerating technological advances and the challenges these futures present to psychotherapists. In the next 100 years, human beings will be likely to increasingly use computers and artificial intelligence and become extremely dependent on this relationship. Chip and stem cell implants may provide people with greater memory capacity, computational capacity, and skill sets. Genetic engineering, cryonics, and cloning may allow dramatic increases in the human life span these developments occur, they will challenge (...) what it means to be a human being and have a soul. Although psychotherapists will acquire new tools for assessment and intervention, they will face the daunting task of addressing these changes and challenges to personhood with their clients. (shrink)

Basics of awareness : knowing yourself -- Basics of awareness : privilege and social responsibility -- The process of acculturation : developing your professional ethical identity -- The ethical culture of psychotherapy -- "I can't believe it's not therapy" : boundaries of the psychotherapy relationship -- Confidentiality : a critical element of trust in the relationship -- Informed consent : the three-legged stool -- Making the most of supervision -- Ending psychotherapy : the good, the bad, and the ethical -- (...) Putting it all together : toward ethical excellence. (shrink)

Perhaps no other population exposes the clinician to more moral and legal dilemmas than clients with an HIV-positive diagnosis. What does the therapist do about the HIV positive patient who is having sex with unnamed partners and refuses to stop? What should be said in end-of-life decisions? What of the adolescent who is HIV positive but whose guardian does not wish the youth to be informed of his status?

This book addresses selected central questions in phenomenological psychology, a discipline that investigates the experience of self that emerges over the course of an individual’s life, while also outlining a new method, the formal indication, as a means of accessing personal experience while remaining faithful to its uniqueness. In phenomenological psychology, the psyche no longer refers to an isolated self that remains unchanged by life’s changing situations, but is rather a phenomenon which manifests itself and constantly takes form over the (...) course of a person’s unique existence. Thus, the formal indication allows us to study the way in which ipseity relates to the world in different situations, in a way that holds different meanings for different people. Based on this new approach, phenomenological psychotherapy marks a transition from a mode of grasping the truth about oneself through reflection, to a mode of accessing the disclosure of self through a work of self-transformation that requires the person to actually change her position on herself. By putting forward this method, the authors shed new light on the dynamic interplay between a person’s historicity and uniqueness on the one hand, and the related physiopathological mechanisms on the other, providing evidence from the fields of genetics, cardiology, the neurosciences and psychiatry. The book will appeal to a broad readership, from psychiatrists, psychologist and psychotherapists, to researchers in these fields. (shrink)

The Internet and electronic communication technologies have taken the psychological field by storm. From the innovations of new web interventions for easier access to care to the increased ease of client scheduling and communication, these developments have greatly advanced mental health care. However, these advantages are also laced with ethical implications that warrant attention. Without judicious consideration, social media use by psychotherapists can lead to inadvertent self-disclosures to clients that risk damaging the therapeutic alliance, interfering with therapeutic processes, and placing (...) both the client and clinician at risk. A better understanding of the ethical implications of social media use is warranted so that guidelines for appropriate use can be developed and implemented. This article highlights the potential risks associated with social media use by psychotherapists and, in absence of formalized guidelines, offers recommendations for best practices. (shrink)

Media representations of illnesses, particularly those associated with stigma such as non-suicidal self-injury (NSSI), not only define health conditions for mass audiences, but generally do so in ways that are consistent with dominant ideologies. This article examines the construction of non-suicidal self-injury as practiced by female adolescents and young adults in four US films: Girl, Interrupted, Painful Secrets, Prozac Nation, and Thirteen. The methodology used to examine the films’ narrative structure is Kenneth Burke’s dramatism, while Julia Kristeva’s concept of abjection (...) informs the analysis. On one hand, a paradigmatic reading suggests that the films frame self-injury as resistance to repressive maternal domination of female adolescents. On the other hand, syntagmatic analysis reveals a privileged response to NSSI in the form of pacification administered by psychotherapists functioning as the return of the phallic-mother fantasy. (shrink)

Context: For Graham Barnes, the starting point of his research was the observation that most psychotherapists are trained in a theory-centered style of practice, neglecting epistemological and ….

Demonstrating a relational, dialogic way of thinking and writing, this book offers an innovative perspective on the human potential for intersubjective engagement and on the nature of true encounter. The authors engage in creative, associative dialogues and trialogues inspired by psychoanalysis and Buddhism, poetry and religion, theory and case studies, academic and free styles of writing - each enriching the other. Reflecting on the essence of relating, they convey a flow between inner, private reveries and shared ones, and between individual (...) expressions of thought and evolvements of newly born thirds. Through this interdisciplinary, experimental setting, the authors explore the possibility to reach truths and meanings that each individual would not have achieved on their own. Offering new concepts and formulations that may nourish psychotherapists' thought and be usefully implemented in their practice, this book presents a pressingly unique and essential viewpoint for psychoanalysts and psychoanalytic psychotherapists in training and in practice. (shrink)

Only by the method of free-association could Sigmund Freud have demonstrated how human consciousness is formed by the repression of thoughts and feelings that we consider dangerous. Yet today most therapists ignore this truth about our psychic life. This book offers a critique of the many brands of contemporary psychoanalysis and psychotherapy that have forgotten Freud's revolutionary discovery. Barnaby B. Barratt offers a fresh and compelling vision of the structure and function of the human psyche, building on the pioneering work (...) of theorists such as André Green and Jean Laplanche, as well as contemporary deconstruction, feminism, and liberation philosophy. He explores how ‘drive’ or desire operates dynamically between our biological body and our mental representations of ourselves, of others, and of the world we inhabit. This dynamic vision not only demonstrates how the only authentic freedom from our internal imprisonments comes through free-associative praxis, it also shows the extent to which other models of psychoanalysis tend to stray disastrously from Freud's original and revolutionary insights. This is a vision that understands the central issues that imprison our psychic lives - the way in which the reflections of consciousness are based on the repression of our innermost desires, the way in which our erotic vitality is so often repudiated, and the way in which our socialization oppressively stifles our human spirit. Radical Psychoanalysis restores to the discipline of psychoanalysis the revolutionary impetus that has so often been lost. It will be essential reading for psychoanalysts, psychoanalytic psychotherapists, mental health practitioners and students and academics with an interest in the history of psychoanalysis. (shrink)

_What is psychotherapy about?_ _What are the similarities and differences of its many forms?_ _What are the most recent developments in the field?_ _Introduction to Psychotherapy_ has been an essential reference book since its publication in 1979, and is regularly included in reading lists for trainee psychotherapists, psychiatrists and other professionals. It is often recommended to interested lay people and prospective patients. This third edition takes into account recent changes in psychotherapy theory, practice and research. The authors are all psychoanalysts. (...) The first edition arose from the experiences of Dennis Brown and Jonathan Pedder working and teaching together as Consultant Psychotherapists at St Mary's Hospital and Medical School, London. (shrink)

This fourth edition of _Introduction to Psychotherapy_ builds on the success of the previous three editions and remains an essential purchase for trainee psychotherapists, psychiatrists and other professionals. It has been revised and extended to capture some of the current themes, controversies and issues relevant to psychotherapy as it is practised today. Bateman has added new chapters on attachment theory and personality disorder and has developed further the research sections on selection and outcome. His new chapter on further therapies covers (...) a variety of therapeutic movements and establishes links between these and classical psychoanalytical therapies. _Introduction to Psychotherapy_ is a classic text that has been successfully updated to provide a relevant and essential introduction for anyone interested in psychotherapy. (shrink)

Borderline Personality disorder is a severe personality dysfunction characterized by behavioural features such as impulsivity, identity disturbance, suicidal behaviour, emptiness, and intense and unstable relationships. Approximately 2% of the population are thought to meet the criteria for BPD. The authors of this volume - Anthony Bateman and Peter Fonagy - have developed a psychoanalytically oriented treatment to BPD known as mentalization treatment. With randomised controlled trials having shown this method to be effective, this book presents the first account of mentalization (...) treatment for BPD. The first section gives an overview of BPD, including discussion of nosology, epidemiology, natural history, and psychosocial aetiology. It additionally summarises the present state of our research knowledge about effective psychotherapeutic treatments and use of medication. The second section outlines the authors' theoretical approach and contrasts it with other well known methods, including DBT, CAT, and CBT. In the extensive final section, the authors outline their clinical approach starting with how treatment is organised. A detailed account of the transferable features of the model is provided along with the main strategies and techniques of treatment. Numerous clinical examples are given to illustrate the core techniques and detailed information provided about how to apply aspects of the mentalization based treatment approach in everyday practice. Aimed at mental health professionals, along with counsellors, psychotherapists, and psychoanalysts, the book will be a valuable tool, providing an effective means of treating those suffering from Borderline Personality Disorder. (shrink)

Unconscious Incarnations considers the status of the body in psychoanalytic theory and practice, bringing Freud and Lacan into conversation with continental philosophy to explore the heterogeneity of embodied life. By doing so, the body is no longer merely an object of scientific inquiry but also a lived body, a source of excessive intuition and affectivity, and a raw animality distinct from mere materiality. The contributors to this volume consist of philosophers, psychoanalytic scholars, and practitioners whose interdisciplinary explorations reformulate traditional psychoanalytic (...) concepts such as trauma, healing, desire, subjectivity, and the unconscious. Collectively, they build toward the conclusion that phenomenologies of embodiment move psychoanalytic theory and practice away from representationalist models and toward an incarnational approach to psychic life. Under such a carnal horizon, trauma manifests as wounds and scars, therapy as touch, subjectivity as bodily boundedness, and the unconscious 'real' as an excessive remainder of flesh. Unconscious incarnations signal events where the unsignifiable appears among signifiers, the invisible within the visible, and absence within presence. In sum: where the flesh becomes word and the word retains its flesh. Unconscious Incarnations seeks to evoke this incarnational approach in order to break through tacit taboos toward the body in psychology and psychoanalysis. This interdisciplinary work will appeal greatly to psychoanalysts and psychoanalytic psychotherapists as well as philosophy scholars and clinical psychologists. (shrink)

This book encapsulates John Beebe’s influential work on the analytical psychology of consciousness. Building on C. G. Jung’s theory of psychological types and on subsequent clarifications by Marie-Louise von Franz and Isabel Briggs Myers, Beebe demonstrates the bond between the eight types of consciousness Jung named and the archetypal complexes that impart energy and purpose to our emotions, fantasies, and dreams. For this collection, Beebe has revised and updated his most influential and significant previously published papers and has introduced, in (...) a brand new chapter, a surprising theory of type and culture. Beebe’s model enables readers to take what they already know about psychological types and apply it to depth psychology. The insights contained in the fifteen chapters of this book will be especially valuable for Jungian psychotherapists, post-Jungian academics and scholars, psychological type practitioners, and type enthusiasts. (shrink)

Immigration in Psychoanalysis: Locating Ourselves presents a unique approach to understanding the varied and multi-layered experience of immigration, exploring how social, cultural, political, and historical contexts shape the psychological experience of immigration, and with it the encounter between foreign-born patients and their psychotherapists. Beltsiou brings together a diverse group of contributors, including Ghislaine Boulanger, Eva Hoffman and Dori Laub, to discuss their own identity as immigrants and how it informs their work. They explore the complexity and the contradictions of the (...) immigration process - the tension between loss and hope, future and past, the idealization and denigration of the other/stranger, and what it takes to tolerate the existential dialectic between separateness and belonging. Through personal accounts full of wisdom and nuance, the stories of immigration come to life and become accessible to the reader. Intended for clinicians, students, and academics interested in contemporary psychoanalytic perspectives on the topic of immigration, this book serves as a resource for clinical practice and can be read in courses on psychoanalysis, cultural psychology, immigrant studies, race and ethnic relations, self and identity, culture and human development, and immigrants and mental health. (shrink)

Why do counsellors and psychotherapists practice? What is the purpose? What real benefit does the client gain and what benefit accrues to society as a whole? Do liberal and postmodern values leave counselling and psycho-therapy vulnerable to being devalued by consumerism, individualism and relativism? This unique text subjects counselling and psychotherapy to a proper and thorough moral and ethical analysis. Using radical new theories, the author opens up the field of counselling to rational debate, giving it a thorough analysis that (...) is political, sociological and philosophical in outlook. Drawing on the communicative ethics of Habermas, he provides a new basis for understanding the purpose of counselling and psychotherapy. Using an argument that is both challenging and stimulating, the liberal and postmodern approaches are decisively investigated and rejected. Of interest to specialists and non-specialists alike, this work offers a new vision for counselling, which is both appealing and soundly argued. (shrink)

Living in the Borderland addresses the evolution of Western consciousness and describes the emergence of the "Borderland," a spectrum of reality that is beyond the rational yet is palpable to an increasing number of individuals. Building on Jungian theory, Jerome Bernstein argues that a greater openness to transrational reality experienced by Borderland personalities allows new possibilities for understanding and healing confounding clinical and developmental enigmas." "Living in the Borderland challenges the standard clinical model, which views normality as an absence of (...) pathology and which equates normality with the rational. Jerome S. Bernstein describes how psychotherapy itself often contributes to the alienation of Borderland personalities by misperceiving the difference between the pathological and the sacred. The case studies included illustrate the potential this has for causing serious psychic and emotional damage to the patient." "This challenge to the orthodoxies and complacencies of western medicine's concept of pathology will interest Jungian Analysts, Psychotherapists, Psychiatrists and other physicians, as well as educators of children. (shrink)

Documented ethical violations and empirical research have demonstrated that, despite professional standards and formal training in ethical principles, some psychotherapists engage in unethical behaviors that compromise the welfare of clients. It appears that competing values and interests that emerge in the therapeutic endeavor can interfere with therapists' considerations of ethical standards and their willingness to act ethically. Expanding current models of ethical decision making, this article offers a hermeneutic model that recognizes that in addition to moral reasoning, the context of (...) the therapeutic relationship and the therapist's subjective responses are fundamental considerations in the interpretation and application of ethical interventions. Implications for understanding and training of ethics in psychotherapy in this broader context are explored. (shrink)

The author presents a varied menu of ideas and experiences in many areas - in research, in diagnosis, and in psychotherapy, each using art media with patients of all ages. She integrates art, phenomenology and gestalt psychology, describing specific techniques and findings. Part I of the book lays out the theoretical foundations and the techniques; Part II addresses the formal components used in art therapy - line, shape and colour in their interrelated dynamics and discusses other aspects and modes of (...) symbolic expression found in clients' work. Part III looks at symbolic expression through the scribble, offering a system of classification, diagnostic possibilities and case studies of work with eating disorders. Part IV focuses on art expression for art therapy diagnostics, including a method for qualitative diagnostics, and a first full diagnostic battery for adolescents. Part V is devoted to Holocaust children's art expressions, highlighting the power of art expression in children under ultimate stress, the intensity of their inner experience, and its visualization in the structure of the pictures. The book is for art therapists and advanced students. It can be used as a textbook on phenomenological art therapy; for therapeutically-oriented art teachers, educators and social workers; and for practicing psychotherapists, to see that art is a source of expression demonstrating how a person is. (shrink)

This essay aims to morally evaluate psychotherapy as it is currently practiced through the lens of sales/exchange ethics. The main focus of the essay is on psychotherapists’ claims to special expertise at diagnosing and treating mental illness. I review the research evidence relevant to these claims and conclude that these claims are not supported by the available evidence. Psychotherapists do not appear to be any better than actuarial tests at diagnosing mental illnesses, and meta-analyses of psychotherapy outcome studies casts serious (...) doubt on the existence of treatment expertise. Given that the expertise that psychotherapists claim to have is lacking, those seeking psychotherapy are not adequately informed about the quality of the product that they are seeking. Using Holley’s principles of sales ethics as a springboard, I argue that this situation is morally unacceptable; thus the current practice of psychotherapy is morally impermissible. I provide and evaluate some suggestions for rectifying this problem. The most important of these is Dawes’s suggestion that psychotherapists be licensed according to their use of experimentally confirmed diagnostic and treatment methods. (shrink)

Psychoanalysts working in clinical situations are constantly confronted with the struggle between conservative forces and those which enable something new to develop. Continuity and change, stasis and transformation, are the major themes discussed in _The Work of Psychoanalysis_, and address the fundamental question: How does and how can change take place? _The Work of Psychoanalysis_ explores the underlying coherence of the complex linked issues of theory and practice. Drawing on clinical cases from her own experience in the consulting room Dana (...) Birksted-Breen focuses on what takes place between patient and analyst, giving a picture of the interlocking and overlapping vertices that make up the work needed in psychoanalysis. Some of the key topics covered include: sexuality; aspects of female identity; eating disorders; time; dreams; disturbances in modalities of thought; and terminating psychoanalysis. This book draws different traditions into a coherent theoretical position with consequences for the mode of working analytically. _The Work of Psychoanalysis_ will appeal to psychoanalysts and academics in psychoanalysis, psychotherapists, as well as postgraduate students studying courses in these fields. (shrink)

In this book, David M. Black asks questions such as 'why do we care?' and 'what gives our values power?' using ideas from psychoanalysis and its adjacent sciences such as neuroscience and evolutionary biology in order to do so. _Why Things Matter_ explores how the comparatively new scientific discipline of consciousness studies requires us to recognize that subjectivity is as irreducible a feature of the world as matter and energy. Necessarily inter-disciplinary, this book draws on science, philosophy and the history (...) of religion to argue that there can be influential values which are not based exclusively on biological need or capricious life-style choices. It suggests that many recent scientific critics of religion, including Freud, have failed to see clearly the issues at stake. This book will be key reading for psychoanalysts and psychotherapists as well as counsellors with an interest in the basis of religious feeling and in moral and aesthetic values. The book will also be of interest to scholars of psychoanalysis, philosophy and religion. (shrink)

_Aims:_ Italy was one of the first countries to be significantly affected by the coronavirus disease 2019 (COVID-19) pandemic, determining a unique scenario for Italian psychotherapists to consider changing the modality in which they deliver treatment. The present study aimed at studying which factors related to psychotherapists and their clinical practice had a major role in predicting two main outcomes: (1) the rate of interrupted treatments during lockdown and (2) psychotherapists’ satisfaction with the telepsychotherapy modality. _Methods:_ An online survey was (...) administered to licensed psychotherapists ( n = 306), who worked mainly as private practitioners, between April 5 and May 10, 2020 (i.e., the peak of the pandemic in Italy). _Results:_ Psychotherapists reported that 42.1% (SD = 28.9) of their treatments had been interrupted, suggesting that Italy faced an important undersupply of psychotherapy during the lockdown. Using the Akaike information criterion (AIC) model selection, we identified three predictors of the rate of interrupted treatments: (1) psychotherapists’ lack of experience with telepsychotherapy prior to the lockdown, (2) their theoretical orientation (with cognitive behavioral psychotherapists reporting a higher rate of interrupted treatments), and (3) patients’ lack of privacy at home, as reported to the psychotherapists. Furthermore, we found four predictors of psychotherapists’ satisfaction with the telepsychotherapy modality: (1) the rate of interrupted treatments, (2) psychotherapists’ previous experience with telepsychotherapy, (3) their beliefs about the compatibility of telepsychotherapy with their theoretical orientation, and (4) their use of a video-conferencing modality, rather than telephone. _Conclusion:_ The following recommendations can help policy makers, professional associations, and practitioners in promoting the continuity of psychotherapy treatments during the COVID-19 outbreak and in future emergencies: (i) disseminating training programs for practitioners on telepsychotherapy, (ii) supporting patients to pragmatically access a private space at home, (iii) encouraging practitioners to use video-conferencing (instead of telephone) to deliver remote therapy, and (iv) increasing the acceptance of telepsychotherapy among both clinicians and the general public. (shrink)

Sandplay is a growing field of interest for Jungian and other psychotherapists. _Sandplay - Silent Workshop of the Psyche_ by Kay Bradway and Barbara McCoard, provides an introduction to sandplay as well as extensive new material for those already using this form of therapy. Based on the authors' wide-ranging clinical work, it includes: in-depth sandplay case histories material from a wide range of adults and children over 90 illustrations in black and white and colour detailed notes on interpretation of sand (...) trays an examination of symbols and concepts used in sandplay. Clearly written and soundly based in theory, this book provides historical background for understanding sandplay as well as helpful discussion of how it works in a clinical context. Kay Bradway and Barbara McCoard bring their indispensable personal experience to the subject to stress the healing potential of sandplay. They also reflect on the nature of a therapy where the psyche works largely in silence. (shrink)

The Body in Adolescence: Psychic Isolation and Physical Symptoms examines the affective experience of psychic isolation as an important and painful element of adolescent development. Mary Brady begins by discussing how psychic isolation, combined with the intensity of adolescent processes, can leave adolescents unable to articulate their experience. She then shows how the therapist can understand and help adolescents whose difficulty with articulation and symbolization can leave them vulnerable to breakdown into physical bodily symptoms. This book introduces fresh ideas about (...) adolescent development in the first chapter. Subsequent chapters include clinical essays involving adolescent patients presenting with bodily expressions such as anorexia, bulimia, cutting, substance abuse, and suicide attempts. Attention is also paid to adolescents’ use of social media in relation to these bodily symptoms – such as their use of on-line ‘pro-ana’ or cutting sites. Clinicians can feel challenged or even stymied when presented with their adolescent patient’s fresh cut or recent episode of binge drinking. Brady uses Bion’s conceptualization of containment and the balance of psychotic versus integrative parts of the personality to examine the emergence of concrete bodily symptoms in adolescence. Throughout, Mary Brady offers ways of understanding and empathically engaging with adolescents. This book is essential reading for psychoanalysts and psychotherapists who treat adolescents and other patients with physical symptoms, as well as other readers with an interest in the psychoanalytic understanding of these issues. (shrink)

Our brains are us. But we are neither happy, fulfilled, nor all that we 'should' (or maybe could) be. We have everything previous generations could have dreamed of, but it seems it's never quite enough. What's going on? Has it anything to do with the way those brains have developed, by any chance? Gillian Bridge takes us on a journey through time, history and the mysterious labyrinth that is the brain, investigating strange happenings and unlikely people on the way. The (...) Significance Delusion is a challenging explanation of our species' peculiar vulnerability to disorders of both thinking and social cohesion. It is a power pack of research, ideas, facts and fascinating real life stories which explores our species' obsession with meaning and significance. What does it all mean for me? What do I mean to you? The Significance Delusion is humorous as well as deeply serious, and it is the must read compilation of lifestyle advice for tomorrow's well-adjusted people. It is a book about what it takes to thrive and survive as an individual human and as a society. From it you will learn the meaning of life, and your place in the world. For parents, educators, thinkers, psychologists, psychotherapists and policy makers. (shrink)

None of us will escape the experience of personal loss, illness, aging, or mortality. Yet, psychoanalysis seems to shy away from a discussion of these core human experiences. Existential vulnerability is painful and we all avoid this awareness in different ways. However, when analysts fail to explore the topic of mortality, their own and their patients, they may foreclose an important exploration and short-change patient and therapist. _Entering Night Country_ focuses on the existential condition, and explores how it penetrates professional (...) lives, analytic work, and theoretical formulations. Each chapter explores this topic, shifting the lens from analytic process, to include theoretical assumptions, and professional communities. _Stephanie Brody_ shows how the analytic process is a journey, no less profound than the epic journeys depicted in the classic literature of Homer and repeated in the patient’s own heroic and painful stories. Weaving literary references into the clinical experience of psychoanalysis, Brody reveals the transformative power of the analytic process for the patient and for the analyst. By relating the ancient past to our current struggles, psychoanalyst and patient together are guided to a destination, a life of meaning in the universe of possibilities. Clinical vignettes and personal reflections intersect with motifs from the epic poems and fantasy fiction, where the despair of loss and trauma do not extinguish the wish for change and the search for intimacy. __Entering Night Country__ highlights the common themes that arise for patient and analyst as any person entering an unknown territory. It is intended for psychoanalysts, psychoanalytically oriented psychotherapists, and mental health clinicians. It will also be accessible to those outside the clinical profession, even to individuals who have little understanding of psychoanalysis. (shrink)

_Intersubjective Processes and the Unconscious _looks at how the minds of the therapist and the patient interact with each other in a profound and unconscious way: a concept first described by Freud. This book expands Freud’s ideas further and examines how these have been greatly elaborated by contributions from the Kleinian School as well as from the work of Bion. It explores how, together, patient and therapist co-create a narrative through these unconscious intersubjective processes. Topics of discussion include: the unconscious (...) dimensions of intersubjective processes an historical overview of Freudian, Kleinian and Bionian contributions an integrated theory of the nature of unconscious intersubjective processes the central importance of dreaming in intersubjective processes the clinical implications of this intersubjective model The author offers in-depth clinical examples and case vignettes to illustrate the application of these principles when working with trauma, countertransference dreams and supervision. As such, this book will be invaluable to all psychoanalysts and psychotherapists interested in the topic of intersubjectivity as well as those who want to learn more about the interactional dimensions of Freud, Klein and Bion. (shrink)

_Memory, Myth, and Seduction_ reveals the development and evolution of Jean-Georges Schimek's thinking on unconscious fantasy and the interpretive process derived from a close reading of Freud as well as contemporary psychoanalysis. Contributing richly to North American psychoanalytic thought, Schimek challenges local views from the perspective of continental discourse. A practicing psychoanalyst, teacher, and consummate Freud scholar, Schimek sought to clarify Freud's concepts and theories and to disentangle complexities borne of inconsistencies in Freud's assumptions and expositions. This book is divided (...) thematically into three sections. The first concerns fantasy and interpretation as they play out in the analytic situation, and the manner in which analyst and patient coconstruct meaning and reconstruct and recover memory. The second consists of two seminal papers which provide the sequence of steps in the five revisions in Freud's seduction theory. Schimek's careful scholarship lays out the data of Freud's writing, which allows one to draw one's own conclusions about the implications of the changes in the theory that he made. In the third, more theoretical section, he provides a foundation for understanding many of today's discussions about unconscious fantasy, dreaming, remembering, consciousness, affect, self-reflection, mentalization, and implicit relational knowing. He clarifies and illustrates Freud's original formulations through a careful reading of sections of _The Interpretation of Dreams_, and a study of Freud's famous Signorelli parapraxis. Skillfully arranged and carefully edited by Deborah Browning and including a foreword by Alan Bass, this collection of Schimek's published and unpublished papers will be of interest to practicing psychoanalysts, psychoanalytically-oriented psychotherapists, and students of the history of ideas and philosophy who have a particular interest in fantasy, interpretation, and Freud. (shrink)

2020 Gradiva Award Nominee, Best Edited Book Psychoanalytic Perspectives on Women and Their Experience of Desire, Ambition and Leadership considers how these factors can be understood, nurtured, or thwarted and the subsequent impact on women's identity, authority and satisfaction. Psychoanalysis has long struggled with its ideas about women, about who they are, how to work with them, and how to respect and encourage what women want. This book argues that psychoanalytic theory and practice must evolve to maintain its relevance in (...) a volatile landscape. Each section of the book begins with a chapter that reviews contemporary ideas regarding women, as well as psychoanalytic history, gender bias, and societal norms and deficits. Three composite clinical stories allow our distinguished contributors to discuss the contexts within which individual experience can be affected, and the role that clinical work may have to mobilize and advance passion and vitality. In their discussions, the interplay of clinical psychoanalysis, sociopolitical context, and understanding of gender, combine to offer a unique perspective, built on decades of scholarship, personal experience, and clinical expertise. Psychoanalytic Perspectives on Women and Their Experience of Desire, Ambition and Leadership will serve as a reference for all psychoanalysts and psychoanalytic psychotherapists as well as gender studies scholars interested in the progress of psychoanalytic theory regarding women in the 21st century. Contributors to this book include: Rosemary Balsam, Brenda Bauer, Andrea Celenza, Diane Elise, Adrienne Harris, Dorothy Holmes, Nancy Kulish, Vivian Pendar, Dionne Powell, and Arlene Richards. (shrink)

This article explores the concept of minor or general psychotherapy championed by physicians seeking to popularise psychotherapy in the post-Stalin Soviet Union. Understood as a set of skills and principles meant to guide behaviour towards and around patients, this form of psychotherapy was portrayed as indispensable for physicians of all specialities as well as for all personnel of medical institutions. This article shows how, as a result of Soviet teaching on the power of suggestion to influence human organisms, every interaction (...) with patients was conceptualised as a form of psychotherapy, leading to the embrace of placebo as a legitimate form of therapy, and to the blurring of the boundary between therapy and other activities in the clinic. The principles of minor psychotherapy reveal a concept of psychotherapy that is much wider, and rooted in different priorities, than the dominant understanding of this type of treatment found in Western Europe and North America. This article addresses the ethical principles implicit in the Soviet perspective, demonstrating that despite fighting against the uncaring and dismissive attitude of other physicians, Soviet psychotherapists remained rooted in the paternalistic tradition. Finally, it traces the efforts to establish minor psychotherapy as standard practice in medical institutions, which, like many other plans and ambitions of Soviet psychotherapists, were constrained by a lack of resources in the healthcare system. (shrink)

IntroductionDignity therapy is brief psychotherapy targeting psychological and existential suffering among patients with a life-limiting illness. Studies have been conducted on the use of DT by healthcare professionals. In Italy, the current legislation defines that any form of psychotherapy may be performed exclusively by psychotherapists. Consequently, this intervention is unlikely to be used by other healthcare professionals. Herein, we will describe a training on DT not as a psychotherapy intervention but as a narrative intervention for non-psychotherapists health care professionals. Finally, (...) we will explore the potential enablers/barriers as experienced by palliative care physicians and nurses.MethodsThe study was conducted in the Psycho-Oncology Unit within the Cancer Research Hospital of Reggio Emilia. It consisted of an exploratory qualitative case study. Data were collected employing observations and interview data and thematically analyzed.ResultsThe training was attended by six physicians and ten nurses and took place during two-afternoon sessions for 10 h. Two participants put their training into practice and administered DT under the supervision of a psychotherapist. Data analysis highlighted five overarching themes relating to the training experience and direct use of DT, namely, time required, psychological skills, patient’s disease awareness, patient’s life history, and distinguishing DT from Advance Care Planning.ConclusionPalliative care professionals found DT to be a valuable non-pharmacological hospital-based intervention to address the person beyond the patient and his clinical conditions. In our experience, considering that in Italy, psychotherapy is an intervention that psychotherapists can only perform, it can help organize different training on DT for psychotherapists and other healthcare professionals. (shrink)

Bringing a fresh contemporary Freudian view to a number of current issues in psychoanalysis, this book is about a psychoanalytic method that has been evolved by _Fred Busch_ over the past 40 years called _Creating a Psychoanalytic Mind_. It is based on the essential curative process basic to most psychoanalytic theories - the need for a shift in the patient's relationship with their own mind. _Busch_ shows that with the development of a psychoanalytic mind the patient can acquire the capacity (...) to shift the inevitability of action to the possibility of reflection. _Creating a Psychoanalytic Mind _is derived from an increasing clarification of how the mind works that has led to certain paradigm changes in the psychoanalytic method. While the methods of understanding the human condition have evolved since Freud, the means of _bringing this understanding to patients in a way that is meaningful_ have not always followed. Throughout, _Fred_ _Busch_ illustrates that while the analyst's expertise is crucial to the process, the analyst's stance, rather than mainly being an expert in the content of the patient's mind, is primarily one of helping the patient to find his own mind. _Creating a Psychoanalytic Mind _will appeal to psychoanalysts and psychotherapists interested in learning a theory and technique where psychoanalytic meaning and meaningfulness are integrated. It will enable professionals to work differently and more successfully with their patients. (shrink)

This book addresses a range of fundamental questions around the nature of Psychoanalysis. It distinguishes how Psychoanalysis differs from other forms of therapy, explores the ways in which insights into the unconscious can be used to support and help people, and asks questions around any claim for scientific validity. Informed by Bion's ideas on containment, group functioning and the fundamental need for truth, this book cites research in infant communication to assert that unconscious communication is present from birth. It goes (...) on to explores the dynamics of communication between psychoanalyst and patient, using these findings to distinguish the practice of Psychoanalysis from suggestion. Moreover, the book asserts that Psychoanalysis is uniquely placed to foster the psychological development made possible by this communication. Exploring the relationship between unconscious communication, group dynamics, containment and psychological development in a highly original way, Bion and the Language of the Unconscious: Psychoanalysis, Suggestion, and Thoughts Too Deep for Words will be of great interest to psychotherapists, psychologists and psychoanalysts who are interested in the relationship between psychoanalysis and suggestion. (shrink)

In this book, Robert Caper provides the reader with an introduction to psychoanalysis focusing explicitly on whether psychoanalysis is part of the sciences, and if not, where it belongs. Many psychoanalysts, beginning with Freud, have considered their discipline a science. In this book, Caper examines this claim and investigates the relationship of theory to observation in both philosophy and the experimental sciences and explores how these observations differ from those made in psychoanalytic interpretation. _Building Out into the Dark_ also explores (...) topics including: the origins of psychoanalysis in the art of medicine the therapeutic effect of psychoanalysis the archaic superego psychoanalysis with the individual and groups what makes psychoanalytic work unique. _Building Out into the Dark_ offers a thoughtful consideration of the nature of psychoanalytic knowledge and how it is gained. The book's accessible and concise style makes it a useful introductory resource for students studying psychoanalysis, for psychotherapists who are curious about the distinction between psychoanalysis and other forms of therapy as well as those interested in placing psychoanalysis in the context of current cultural and intellectual developments. (shrink)

The Unconscious as Space explores the experience of being and the practice of psychoanalysis by thinking of the unconscious in mathematical terms. Anca Carrington introduces mathematical models of space, from dimension theory to algebraic topology and knot theory, and considers their immediate psychoanalytic relevance. The hypothesis that the unconscious is structured like a space marked by impossibility is then examined. Carrington considers the clinical implications, with particular focus on the interplay between language and the unconscious as related topological spaces in (...) which movement takes place along knot-like pathways. The Unconscious as Space will be of appeal to psychotherapists, psychoanalysts, and mental health professionals in practice and in training. (shrink)

The idea of the numinous is often raised in psychoanalytic and psychodynamic contexts, but it is rarely itself subjected to close scrutiny. This volume examines how the numinous has gained currency in the post-modern world, demonstrating how the numinous is no longer confined to religious discourses but is included in humanist, secular and scientific views of the world. Questions of soul and spirit are increasingly being raised in connection with the scientific exploration of the psyche, and especially in the context (...) of psychotherapy. The contributors to this volume are interested in exploring the numinous in the human psyche, in clinical work, world events, anthropology, sociology, philosophy and the humanities. They originate from multi-disciplinary and multi-cultural backgrounds, bringing a variety of approaches to subjects including: · Witchcraft: the numinous power of humans · Jung and Derrida: the numinous, deconstruction and myth · Accessing the numinous: Apolline and Dionysian pathways · The role of the numinous in the reception of Jung The Idea of the Numinous will fascinate all analytical psychologists, psychoanalysts, and psychotherapists interested in investigating the overlap between therapeutic and religious interests. (shrink)

"We often find that the state of not-knowing can be a precursor to moments of rich discovery which possess a dynamic, transformative power that exceeds any prior expectation." From the Introduction In daily life, when we see, hear or touch something that we don't recognise, we are instantly at our most alert. In that condition of 'not-knowing' we are in a state of alive, lithe awareness: asking questions, inviting input, open to learning, looking for significance and meaning... These essays, most (...) by practising psychotherapists, some of them Buddhists, take as their starting point the idea that not-knowing is fundamental to conscious reflection and the desire to know must always arise in the first instance from the self-awareness of not-knowing. Read in any order, on waking, before sleeping or when in doubt... they will be of interest to anyone who has ever sat in either chair in a psychotherapist's or counsellor's room - as well as anyone troubled or intrigued by what it takes to live comfortably and well in a condition of not knowing all (or even any) of the answers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:'Psychiatric Dasein'Christopher Heginbotham (bio)Fulford and Colombo's pioneering work (2004)in linguistic analysis offers valuable insights and 'deconstructs' the often inter-related concepts of mental disorder and treatment. Their paper describes a combined philosophical and empirical research program developed to study "the role models of disorder in the community care of people with long-term schizophrenia" (2004, 130). They claim that the approach supplies a key explanatory insight into the nature of the (...) problem presented by models of disorder, a characterization of models, contributions to research design, a theoretical framework—a 'models-grid,' and a basis for turning theory into practice. These claims are not unreasonable in the context of the specific objectives of the research design, but do not necessarily cover everything of importance in the way models are used to describe mental disorder. In particular, this brief response proposes the need to develop an understanding of psychiatric Dasein—mental disorder as presented in the world.Fulford and Colombo are surely right in their claim that representations of mental disorder are high-level concepts not dissimilar to other high-level concepts such as time. These are concepts that we seem to have little difficulty using in day-to-day practice but have great difficulty defining. In their discussion of this point, they suggest that little progress has been made in relation to models of mental disorder over the previous fifty years, that there is a considerable volume of theoretical literature that has had little impact on practice.This assertion does not appear to do justice to the significant progress that might be argued to have occurred in psychoanalytic theory, psychodynamic therapy, and other metapsychological developments of the last fifty to one hundred years. Many of these developments have changed markedly our perceptions of mental disorder. Some treatments, it is true, may not have direct relevance or applicability to serious psychotic behavior, although that is contentious; there are psychoanalytic psychotherapists working with people with schizophrenia who would claim success. Recent developments in cognitive-behavioral therapy allied to other treatment modalities, such as careful use of low-dosage medication, have had therapeutic impact in enabling people with schizophrenia to 'manage their voices' and to understand the complex nature of their own thought processes.Fulford and Colombo also suggest that after this half century of work much of the development of practice has been largely abortive. Is this correct? It is true that we continue to struggle with an understanding of what we mean by mental disorder, which is made much worse, as the authors say, by the multiplicity of definitions of mental illness, models of mental disorder and practical approaches to treatment and management. Multidisciplinary and multi-agency developments of the last twenty years especially have, on the one hand, been a powerful approach to recognizing the multifaceted nature of mental disorder, but, on the other, have tended to a potential fragmentation of effort that has undermined [End Page 147] the necessary focus on the needs of the individual patient.Threefold ExpansionIt is here that perhaps an addition or expansion can be made to Fulford and Colombo's approach. That addition is, to borrow a phrase used by Hilary Putnam for the title of one of his books, a 'three fold cord.' The term comes originally from Ecclesiastes 4.12: "..a threefold cord is not quickly broken." (Putnam subtitles his book, Mind, Body and World, echoing, probably unintentionally, Heidegger's threefold structure of 'Being-In' [Dreyfus 1991. 163]).First, there have been many attempts 'informally' to understand the interplay of differing mental disorders in the operation of multidisciplinary teams. The development of community mental health teams and more recently Crisis Resolution and Out-Reach teams has required staff from varying professional backgrounds and agencies to find some common ground and to negotiate across their various professional, philosophical, and nosological boundaries. These negotiations have not been easy. A first element of the threefold expansion may be to incorporate (or strengthen) an organizational and group dynamic in the model (see, for example, de Board 1978; Hinshelwood 1987)Second, theoretical and practical work by professionals trained in psychoanalytic disciplines have sought to understand the nature of multidisciplinary community provision for people... (shrink)

Human suffering is a complex and multidimensional phenomenon of special interest for psychotherapy. Psychotherapists deploy various epistemological processes that act as mediators when understanding the human suffering afflicts their clients. However, these issues are scarcely considered by psychotherapists and are rarely addressed in specialized literature. In this sense, and seeking to respond to this problem, this theoretical article aims to analyze the epistemic mediators of the psychotherapist that affect the process of knowledge of the client's human suffering. Three mediators will (...) be analyzed: 1) the general epistemic framework (psychotherapeutic approach of ascription), 2) the specific epistemic framework (personal epistemology of the therapist), and 3) the hegemonic epistemology (positivism) together with its role in the psychopathologization of life, the objectification of suffering and mental health. It is concluded that human suffering is a constant construction phenomenon dependent on the psychotherapist's epistemic mediators, impacting various areas of praxis. Finally, the limitations, implications, and contributions of the issues discussed in the discipline are presented. (shrink)