Sex with ex-clients: theoretical rationales for prohibition

Two decades of literature and discussion on the topic of therapist-client sexual relationships have revealed much about the nature and consequences of these relationships and have produced an explicit prohibition against such relationships in American Psychological Association (APA) Ethical Principle 6a. This article reviews the literature as it relates to the ethically gray area of sex with former clients. The relative lack of an empirical basis for extending the prohibition of Principle 6a to posttermination relationships is noted. This article describes concepts from three theoretical perspectives about psychotherapy that support an extension of the prohibition to sexual relationships with ex-clients.     

Acceleration of the therapeutic process with group

This paper deals with the impact of adding group to individual treatment of patients with neurotic character problems and attempts to illustrate the efficacy of this dual approach. The formidable task for the individual therapist is to make these patients see that their habitual ways of reacting are pathological and stem from repressed intrapsychic conflicts. This task is facilitated in a group in a number of ways since the group setting becomes an arena that affords wider therapeutic scrutiny. Having become aware that behavioral characteristics disguise anxiety, other group members initiate independent efforts to extract the underlying meanings for their fellow members. Their interventions are often more effective and acceptable because they are less likely than the therapist to be perceived in the projected image of the bad parent.Copyright, 1980, Washington Square Institute for Psychotherapy and Mental Health, which published this paper in No. 7 of the Group Psychotherapy Monograph Series, after the paper had been presented at the Seventh Annual Conference of the Group Psychotherapy Department.     

Love and the therapeutic process

This paper deals with the nature of love that can be present in the person of the therapist as well as how it can express itself in the therapeutic effort. It also takes up certain errors that can occur as a result of the misunderstanding of the terms as well. There are those who lean toward making therapy an overintellectualized process. The point of view is presented that for psychotherapy to have its full value, the emotions need awakening and structuring for the benefit of the patient's individual life contributions as well as for the benefit of those he will associate with during his lifetime.     

Embodying analysis: the body and the therapeutic process

This paper considers the transfer of somatic effects from patient to analyst, which gives rise to embodied countertransference, functioning as an organ of primitive communication. By means of processes of projective identification, the analyst experiences somatic disturbances within himself or herself that are connected to the split‐off complexes of the analysand. The analysty’s own attempt at mind‐body integration ushers the patient towards a progressive understanding and acceptance of his or her inner suffering. Such experiences of psychic contagion between patient and analyst are related to Jung’s ‘psychology of the transference’ and the idea of the ‘subtle body’ as an unconscious shared area. The re‐attribution of meaning to pre‐verbal psychic experiences within the ‘embodied reverie’ of the analyst enables the analytic dyad to reach the archetypal energies and structuring power of the collective unconscious. A detailed case example is presented of how the emergence of the vitalizing connection between the psyche and the soma, severed through traumatic early relations with parents or carers, allows the instinctual impulse of the Self to manifest, thereby reactivating the process of individuation.     

Memory transfer process: an extension of the Sternberg paradigm.

Research conducted by Sternberg (1969) has suggested that there is a transfer process, a cognitive process for activating stored knowledge. His research and that of those who have replicated and extended it have concentrated on distinct declarative lists of information. In two experiments, we have sought to extend this area by studying the cognitive processes for activating an action plan, a sequence of mental operations executed to achieve a goal. Results showed that (a) longer action plans took more time to activate, and (b) when the activation process was interrupted before completion, the process had to be restarted from its beginning after the interruption had been dealt with. These results were interpreted as evidence for a time-consuming transfer process in which the elements of action plans are transferred from long-term store to short-term store. These results are compared with other current data on the transfer process, and implications for the use of controlled knowledge in cognitive tasks are discussed.     

Beneficial factors in family discussion groups of a psychiatric day clinic: perceptions by the therapeutic team and the families of the therapeutic process

This paper reports a pilot investigation of the perception of helpful events by the therapeutic team and the families in two family discussion groups (FDGs) of a psychiatric day clinic. All participants of the FDG, including therapists and observers, filled in questionnaires measuring events helpful for the individual, for the family and for the group after each FDG session. The results showed that the therapeutic team and the families diverged in their overall perception of which factors were important in family discussion group therapy. The therapeutic team saw the relational climate and the structural aspects of the group (including group involvement and support from the group), and specific therapeutic interventions as more helpful than the families. The process aspects in the group members (including the experiencing of communality and gaining insight) were, on the other hand, more frequently mentioned by the families than by the therapeutic team. The clinical implications of these findings and suggestions for future research are discussed.     

Internalization of the therapeutic process: differences between borderline and neurotic patients

Intersession process in psychotherapy refers to the thoughts, memories, and feelings about each other and about their therapy sessions that participants experience during the intervals between sessions. This study compared the intersession process experienced by patients who had been diagnosed with severe borderline personality disorders (BPD) with others who had not. A total of 76 patients with neurotic disturbances and 20 patients with BPD were treated in a therapeutic day clinic and completed the Intersession Experience Questionnaire (IEQ) before sessions of individual psychotherapy and the Session Questionnaire (Stundenbogen) after those sessions. Comparison of the two groups on these measures of intersession process and postsession outcome showed markedly different patterns in patients' evaluations and internalizations of in-session therapeutic experiences: most prominently, that BPD patients internalize therapy sessions with much more negative and contradictory emotions.     

Conditional reflexes and sensory-evoked epilepsy: The nature of the therapeutic process

Studies of conditional reflex therapy for patients with sensory-evoked epilepsy are reviewed and experimental studies in animals reported. The behavioral methods employed in the therapy are reviewed. They are of a conditioning nature and are defined as clinical therapeutic conditioning. Sensory-evoked epilepsy can be induced in animals by conditioning techniques, provided the animal brain has been rendered epileptogenic. Sensory-evoked epilepsy in patients can be made worse by conditioning, and can be changed from one type to another. However, sensory-evoked seizures in humans are not the result of conditional reflexes.     

Obsessional slowness: a replication and extension

The treatment of an obsessionally slow patient is described. A combination of pacing and self instruction was used in order to speed up behaviour. This method is adopted and extended from that reported by Rachman (1974). Suggestions as to the maintenance of the treatment effects are discussed.