The Power of the Immediate Moment in Gestalt Therapy

This article discusses the gestalt therapy concept of the paradoxical theory of change and a method combining a dialogic relationship with active phenomenological focusing and experimenting. Fundamental change results from self-acceptance and not attempts to change based on self-rejection. This is supported by the characteristics of dialogic contact: inclusion, confirmation, authentic presence, and a commitment to what emerges between therapist and patient. The patient is taught how to be aware, including awareness of the awareness process, facilitating autonomous use of the method by the patient. Suggestions and cautions for practice are discussed. My thanks to Lynne Jacobs for help in writing this article     

The hidden meanings of metaphors in family therapy

This study investigates how two therapists' beliefs and practices influence the therapeutic process when they organize social interaction according to a metaphor of a royal family. The therapeutic process is described through the case of a boy called Pelle. He comes to therapy together with his family. It is shown how the therapists collaborate in the process of implementing the worldview of the predefined normative standard for family life. In the short term the therapists' use of the metaphor can be seen as an intervention to accomplish immediate change in a non-threatening way. In the long term the cost of using the metaphor was that the mother got a confirmation about herself as a less powerful parent and the child got an image of being a failure. This study points out that metaphors as therapeutic tools have to be analyzed critically before they are used or more specifically the therapists have to examine what kind of values and meanings are hidden in the metaphor and who will gain and loose if it is used as an intervention.     

The personal and the political

The term 'counselling' is used liberally to convey paedagogical, casework and clinical meanings. The indiscriminate use of the term by institutions of health, welfare, and education often conceals the intention to appear more solicitous to clients than the institution can in fact afford to be. The central fact of counselling is the use of the counsellor's total and global personality in effecting changes in the personality of the client. This factor is shown to be potently present even in behaviour therapy where it would be explicitly disclaimed. Counselling, therefore, is a personalistic process. To-day energetic political attacks are levelled against individualistic, piecemeal, and privatist solutions of man's problems. The political accusers charge counsellors, social caseworkers, psychotherapists and others with a desertion of their moral duty to change evil systems and with distracting attention from the really important public miseries inflicted on man by these systems. Politicisation of the personalists and a kind of hybridisation of the two kinds of social concerns is suggested by these critics. In this paper, the incompatibilities of the personal and political roles are stressed, and a continued protection of the integrity of these meliorist roles is advocated.     

Change through paradox: using self-verification to alter beliefs

Past research has shown that conventional strategies of persuasion tend to be ineffective against people who are highly certain of their beliefs. To change the beliefs of such individuals, we devised a paradoxical strategy that consisted of posing superattitudinal leading questions (questions that encouraged respondents to make statements that were consistent with, but more extreme than, their own viewpoints). We expected that individuals who were high in belief certainty would resist such questions and, therefore, change their beliefs in the opposite direction. To test this reasoning, we used either a conventional or a paradoxical strategy to change people's beliefs about women's roles. As suggested by earlier research, the conventional strategy was effective in changing the beliefs of targets who were low in belief certainty only. In contrast, the paradoxical strategy was effective in changing the beliefs of targets who were high in belief certainty only. A follow-up investigation replicated this effect and indicated that paradoxical injunctions change people's positions on belief dimensions rather than their perception of the dimension itself. The implications of these findings for an understanding of the interpersonal mechanisms that generate stability and change in people's beliefs are discussed.     

The Will to Truth,the Death Drive and the Will to Power

This paper claims that Freud’s idea of the death drive is analogous to the will to truth in traditional philosophy and can be better understood as a truth drive. The argument is based upon Nietzsche’s interpretation of the will to truth as a concealed will to death. This interpretation emphasizes the opposition between truth and life; truth is a concept of constancy while life is a concept of change. Freud’s recognition of the conservative nature of the drives brings him to the paradoxical conclusion of the existence of a death drive. It is paradoxical, for Freud, since it considers death as a fundamental principle of life and as its aim. The paper suggests that by replacing the concept of death by the concept of truth and using Nietzsche’s idea of “the will to power” this paradox can be resolved without losing Freud’s insight of the dialectic nature of psychological life.

     

Rigid general terms and essential predicates

What does it mean for a general term to be rigid? It is argued by some that if we take general terms to designate their extensions, then almost no empirical general term will turn out to be rigid; and if we take them to designate some abstract entity, such as a kind, then it turns out that almost all general terms will be rigid. Various authors who pursue this line of reasoning have attempted to capture Kripke’s intent by defining a rigid general term as one that applies to the objects in its extension essentially. I argue that this account is significantly mistaken for various reasons: it conflates a metaphysical notion (essentialism) with a semantic one (rigidity); it fails to countenance the fact that any term can be introduced into a language by stipulating that it be a rigid designator; it limits the extension of rigid terms so much that terms such as ‘meter’, ‘rectangle’, ‘truth’, etc. do not turn out to be rigid, when they obviously are; and it wrongly concentrates on the predicative use of a general term in applying a certain test offered by Kripke to determine whether a term is rigid.     

Evidence-based treatment of stuttering: IV. Empowerment through evidence-based treatment practices

Assertion-based treatments for stuttering have historically been more popular than evidence-based treatments. In this paper it is argued that the use of evidence-based treatments for stuttering is professionally empowering for clinicians, but that the use of assertion-based treatments is a circular process that inhibits professional development. The arguments in favor of evidence-based treatment are elaborated under headings of "professional investment," "professional development and diversity," and "optimizing treatment efficacy." EDUCATIONAL OBJECTIVES: The reader will understand and be able (1) to describe the distinction between assertion-based and evidence-based treatment practices (2) to present a series of arguments that evidence-based treatment practices are professionally empowering.     

Moving Toward a Secure Attachment Style: Can Repeated Security Priming Help?

Despite the abundant literature on attachment processes and the development of a secure or insecure attachment orientation during childhood, it is still unclear whether adult attachment style can be changed through systematic interventions, and if so how the change process works. One way to learn more about such change is to create it, on a small scale, in the laboratory. It is already known that a person's sense of security can be momentarily changed in the laboratory ( Mikulincer & Shaver, 2007a ). But there is clearly a difference between very short‐term and longer‐term change. According to Bowlby (1982) , the development of an attachment orientation in childhood is based on many encounters and interactions with caregivers, which gradually create a mental network of relatively stable expectations and concerns. Thus, it may take many episodes of security priming in a laboratory to begin to affect a young adult's attachment style in a lasting way. Here, we explore this possibility, review existing evidence from our own and other researchers’ laboratories, and discuss directions for future research.     

Working with countertransference

The transference-countertransference relationship is only one of five modalities of relationship that research has identified as potentially present in the therapeutic encounter. This paper gives the background and definition to one aspect of this - the countertransference - and traces the development of the concept from Freud's first use of the term in 1910 to the contemporary view that it is a useful tool of psychotherapy. The first part explains its connection with the Kleinian concept of projective identification and discusses its elaboration by the object relations school. There is general acceptance nowadays that the countertransference contains a great deal of information about the client's psychological world. It is therefore important to understand this process and the authors have identified three main dimensions to countertransference. These are its vector (or direction and force), its variance (the quality it represents), and its valence (its effect on the client). The second part of the article illustrates, through the use of example and metaphor, how these three dimensions are defined and can be recognized. Common themes and paradigms of countertransference are identified and discussed along with some ways in which experience has shown how these might be contained and worked with constructively. Finally, a clinical vignette is presented in which some of the dimensions of countertransference are identified and used to understand the client's psychic world and foster therapeutic change.     

Paradox as Epistemological Jump

Recent articles on paradoxical interventions tend to view them as something given by a therapist to a patient, thus unintentionally adopting a unidirectional view of causality and an outmoded epistemology. It is postulated that change takes place in the context of a patient-therapist relationship and that when that relationship becomes paradoxical it becomes more difficult for the patient to view himself as a reified "thing." Paradox effects change, then, by altering the meaning of experience and modifying epistemological assumptions.     

‘The newspaper reader’: On the meaning of concrete objects in a psychoanalytic treatment1

The author investigates the meaning of concrete objects in the psychoanalytic treatment of a severely disturbed patient for the development of his inner world and the analytic process. She includes a survey of relevant theoretical concepts with an emphasis on Winnicott and Bion. It is shown that the objects served basic defensive functions both within the analytic relationship and for the precarious intrapsychic state of the patient. The author describes the technical dealing that led to a structural change. From the comparison of the initial dream and a later dream, Mr N's inner development from total inclusion in the object to triadic reality of separated, repaired objects becomes discernible. The author shows how this progress was facilitated by his use of concrete objects as links between his psychotic and non‐psychotic parts, as well as by the specifi c way the analyst handled the paradoxical transference‐ countertransference. She also illustrates the thesis that the developmental steps described are crucial for the capability to digest psychic pain by symbolization instead of discharging it in a destructive‐violent way.     

A longitudinal analysis of the role of task-specific knowledge in the subjective impact and structure of performance

It is widely accepted that the structure of performance depends on the relationship between task demands and information processing resources. This relationship is affected by many factors including practice. For instance, it is claimed that while use of task-specific knowledge, an information-processing resource, may benefit performance in the long term, the costs of its use in the short term are quite high. It is dificult to find any studies which can be used to test this claim, as those which have been undertaken typically measure gross performance only, lack any measure of the subjective costs of resource investment, and are of relatively short duration. In this paper an experiment is reported which looks at the effects of task-specific knowledge on gross and process performance, and on a number of subjective indices over a longitudinal time frame. The results are discussed in terms of the relationships between the context of performance, the perception of control, and strategies of resource management. Finally, the argument that the data suggest a need for the reconceptualization of demands and resources is mooted and some methodological implications are discussed.     

FEMINIST THERAPY WITH MAINLAND PUERTO RICAN WOMEN

This article discusses the use of feminist therapy with mainland Puerto Rican women. Sociocultural factors such as the experience of cross-cultural translocation, the process of transculturation, and the colonial background of Puerto Rico with its deleterious effects are examined. Special emphasis is given to Puerto Rican sex roles, the paradoxical condition of power and powerlessness, and Puertorriqueñas' complex sense of identity. These issues are illustrated with a clinical population, and as such, may represent an extreme position within the range of reactions to these sociocultural variables. Clinical vignettes present the use of feminist therapy with this client population. Feminism—with its emphasis on empowerment, adaptation and flexibility in role relationships, promotion of competence, and commitment to social change—is particularly relevant for Puerto Rican women. However, in order for feminist therapy to be effective with this population, it must be embedded in a sociocultural context.     

Sensational Thinking A Teaching/Learning Model for Creativity

Change, the acknowledged constant: The paradox of two seeming opposites contained as one. In the world today we find ourselves challenged by a multitude of paradoxical problems and our need to resolve these issues drives a change process, the nature of which is dynamic and complex. Dynamic change is recognized as a process of moving from one state or form to another, in ways that appear chaotic, non-linear, and unpredictable (Gleick, 1987). This results from the interactions between and among individual component parts of a system (Gleick, 1987; Bohm & Peat, 1987; Goodwin, 1991), and studies to understand how and why this type of change occurs have found that dynamic change is a creative process that occurs naturally in physical, biological and social systems.     

Context change and retention interval can have additive, rather than interactive, effects after taste aversion extinction

Spontaneous forgetting is often attributed to retrieval failure caused by natural changes in the background context that occur over time. However, some investigators have argued that the context-change account of forgetting is paradoxical, because context-change effects themselves decrease over time. To resolve the paradox, we have suggested that organisms may merely forget the physical context as the temporal context in which it is embedded changes; this explanation accepts a fundamental similarity between time and physical context. The present experiment tested an implication of this analysis by examining the interaction between retention interval and context change in rats after a taste aversion was conditioned and then extinguished. Importantly, subjects tested at the longer (24-day) retention interval received reminder exposure to the physical contexts before testing. Under these conditions, retention interval and context change both caused relapse of the extinguished aversion (spontaneous recovery and renewal, respectively), and the strongest overall relapse was observed when the two treatments were combined. Such additivity (rather than interactivity) is consistent with a context-change account of forgetting and sets the stage for resolution of the context-forgetting paradox.     

Universal Selection Theory: Implications for multidisciplinary approaches to clinical psychology and psychiatry

Universal Selection Theory claims that the increases in the fit of a system to its environment are achieved through a process of blind variation and cumulative selection that is analogous to evolution by natural selection. The process is proposed to occur in many domains, including the gene, behavior, cognition, and culture (meme). This paper reviews the background for the theory and explains how it may contribute to clinical psychology and psychiatry. It is suggested that the theory provides: A framework for integrating biological, psychological and cultural perspectives; an account for why problem-solving and cognitive reappraisal prove to be effective interventions; and an understanding of why psychological disorders can be resistant to change. Implications for psychological treatments, theoretical integration, and future research are discussed.     

Paradox and polarity: the Tao of family therapy

Taoism is a Chinese spiritual tradition whose central metaphors concern polarity, paradox, and the natural process of change. Taoist ideas offer a particularly useful framework for understanding paradoxical interventions, the stance of the paradoxical therapist, and the new epistemology emerging in the field. The relevance of three Taoist metaphors for family therapists is discussed: polarity, cyclical change, and Wu Wei (noninterference).     

Rites of passage in families with adolescents

In previous generations society defined expectations and constructed events to promote individual development, a functional family organization, and cultural continuity. Culturally defined and accepted rites of passage that were previously observed in families with adolescents have given way to a more vague and meaningless set of adolescent expectations and affirmations. It is proposed that this change has interfered with the mission of the family to promote functional adolescent development and with the ability of the family during this life cycle stage to operate with a sense of community attachment. This paper addresses the importance of rites of passage as they pertain to family development and change and presents ideas about making them explicit in family therapy to change family interaction and structure. Prescribed family rituals that are straightforward, developmentally relevant, and interactional can be effective without consideration to whether they are paradoxical. Three clinical illustrations are presented to highlight this therapeutic approach.