The Adult Attachment Interview and observed couple interaction: implications for an intergenerational perspective on couple therapy

One of the assumptions of intergenerational family therapy is that how a person thinks and talks about family-of-origin experiences has important implications for current family relationships. The Adult Attachment Interview (AAI) is a measure of attachment security based on how coherently the person can discuss attachment experiences in childhood. This study examined the relationship between attachment security, as measured by the AAI, and couple interaction, as measured by the Georgia Marriage Q-Sort (GMQ), in a sample of 28 couples in therapy for relationship problems. During a conflict resolution discussion, those individuals who were less coherent in discussing their family of origin expressed more negative affect, less respect, less openness, more avoidance, and less willingness to negotiate when interacting with their partner. No evidence of intra-couple effects or "buffering" was found. The findings support a key assumption of intergenerational approaches to family therapy and suggest that applying attachment theory is a promising direction for refining and developing new interventions for couples.     

Improving cognitive therapy for depression with functional analytic psychotherapy: Theory and case study

A behavioral reconceptualization of cognitive therapy is presented to illustrate that clinical behavior analysis (CBA) has much to offer traditional cognitive behavior therapy. Particular attention is given to the distinction between cognitive structures and products and the theoretical dilemma facing cognitive therapists when they attempt to devise interventions aimed at changing nonbehavioral entities. The distinction between rule-governed and contingency-shaped behavior and the implications of functional analytic psychotherapy (Kohlenberg & Tsai, 1991) are used to resolve the dilemma and to suggest methods for enhancing cognitive therapy. In a case study, a CBA-enhanced version of cognitive therapy was introduced after 7 weeks of standard cognitive treatment for a 35-year-old depressed male. The client-therapist relationship provided opportunities during the therapy session for learning new behavior called for in the behaviorally reconceptualized cognitive therapy. The enhanced treatment improved clinical efficacy and increased the client's focus on his deficits in interpersonal repertoires. Because the present case study involved only one of several enhancements suggested by CBA, the possibility of increased efficacy from a more comprehensive application is discussed.     

A factor analytic study of structural family therapy constructs

The lack of empirical work on therapists' use of Structural Family Therapy (SFT) concepts is discussed. The important SFT dimensional models are briefly reviewed. Three groups of therapists were required to make judgements of video-taped interviews using a set of SFT concepts. The data were factor analysed and the results discussed in terms of the relationship between the therapists' produced factors and theoretical models of SFT.     

Rhetoric and psychiatry: A Szaszian perspective on a political case study

Conclusion  The study of rhetoric and the assumption that rhetors generate the grounding for persuasion have been at the root of Thomas Szasz’s psychiatric critiques for almost two generations. His corpus has consistently pointed to a psychiatric rhetoric which creates, rather than discovers, “mental illnesses,” a metaphorical pseudo-medical labeling which, when accepted, confounds the attribution of adult responsibility and substitutes instead an infantilizing dependency.     

A gender-informed model of couple and family therapy: Relationship enhancement therapy

The key elements of gender-informed couple therapy are discussed with an emphasis on the significance of empathy and dialogue and the structuring of a context in which both can occur. Relationship Enhancement therapy, a psycho-educational and client-centered approach developed by Guerney (1977) is described and illustrated as one method of operationalizing a constructivist-systemic approach to couple therapy in which a conversation toward profound changes in gender relationships can take place.     

A psychodynamic perspective on early childhood trauma in an adult: A case study

Abstract

This paper uses a long-term case to illustrate, from a psychodynamic perspective, a number of issues arising in working with an adult survivor of early childhood trauma. The paper takes an overview of the case study, identifying issues which are inextricably interwoven in the client's experience of trauma, and which impact on the working alliance. The therapeutic relationship forged with the client is discussed in terms of its intrinsic successes and failures together with the implications of early traumatic experiences for the termination of counselling.     

Between the analytic and the arbitrary: A case study of psychological research

It is argued that psychological theories must be seen as attempts to explicate the conceptual network embedded in ordinary language and that psychological data must be seen as historically constituted. Hence, psychological theory is regarded as, potentially, a system of logically necessary (analytic) theorems, analogous to, e. g., Euclidean geometry, and psychological data are seen as determined by the historical (arbitrary) circumstances that happen to prevail. An instance of published psychological research is shown to contain many unrecognized analytic and arbitrary elements. Its pretensions to generality are contradicted by its highly situation- and culture-bound assumptions, and its pretensions to being empirical are contradicted by the prevalence of necessarily true and necessarily false assumptions. The level of theoretical precision is seen as very low.     

The Hofgeismar Lectures: A Contemporary Overview of Horneyan Psychoanalysis

Part I of this paper describes Karen Horney's theory of neurosis. In the 1930s, Horney repudiated Freud's view of female developmental psychology. She argued that cultural factors rather than anatomy or innate biological drives were the primary determinants not only of female development but of personality, as well. When genetic and environmental circumstances together lead to basic anxiety early in life, she believed a deep inner conflict emerges in the individual leading to the need for elaborating layers of rigidified protective defenses. She called this the neurotic process. This process can result in discrete symptoms of mental disorder as well as the more generalized problems of alienation from the person's real self and reliance on neurotic solutions. In Part II, the practical application of Horney's theory to clinical work is demonstrated in a case presentation of a notably timid and perfectionistic man. Part III points up elaborations of Horney's theories by later workers of her school, the American Institute for Psychoanalysis, and provides a history of her school within the broader context of American psychoanalysis. The author's emphasis on postmodern and narrativist elements of Horneyan psychoanalysis are illuminated, as well.     

A married couple in separate therapy groups

Abstract

A behavioral contract was used to change several behaviors in a married couple's relationship. A multi-assessment “package” was used to determine the effect of the behavior change on the couple's relationship. A multiple baseline, single-subject design demonstrated that the treatment “package” was responsible for producing behavior change and changes in levels of satisfaction. Further research should concentrate on which components of the “package” may be the most critical. Multi-assessments provide the therapist or researcher with concrete data on a couple's progress in behavioral marital therapy.     

A case study of borderline anxiety andthe process of analytic transformation

Borderline patients present particular treatment problems and require close, devoted understanding of their often chaotic and shifting intrapsychic conflicts. Many of these patients act out, making it difficult to maintain an analytic process. In fact, many terminate early on. When they do stay for longer periods, they exhibit particular constellations of defense, anxiety, and conflict. One extensive case report is used to examine the overlapping cycles of treatment with this population. Frequently, self-destructive acting-out is present in the transference and extratransference. This acting-out is often followed by the self-destructive, antichange attitude of the death instinct. These ways of relating to the self and the object are mobilized within the vehicle of projective identification and are best understood as primitive defenses against core fantasies of loss and persecution. These issues of loss and fear are the final and vital phase of treatment with borderline patients, who are often able to make major fundamental changes in their internal sphere, but only if patient and analyst can tolerate and understand these three levels of intrapsychic experience.     

The Search for Glory in Madame Bovary: A Horneyan Analysis

The American Journal of Psychoanalysis -