Responding to the embodiment of distress in individuals defined as obese: Implications for research

This article examines the evidence for a relationship between body image distress (BID) and obesity, and between emotional eating and obesity. The need is highlighted for treatment programmes that are responsive to these complex issues and combine this with diet and physical activity. Weight loss programmes so far have had a poor success rate. They have often sought to capitalise on BID as a motivation to lose weight, but there is some evidence that such an emphasis may be self‐defeating, as seriously overweight individuals may eat either to self‐punish or self‐comfort and may also avoid social situations that could support healthy lifestyles. The case is made for new research that addresses the highlighted psychological aspects of obesity. There is a need for both a randomised controlled trial (RCT) that will enable a statistical inference of causality relating to new treatments and qualitative, interview‐based research to elicit information regarding individual responses to treatment. Dance Movement Therapy (DMT) is proposed as one new treatment option for those individuals whose obesity is linked to emotional eating. Theoretical support and empirical research evidence for DMT are explored. However, since this treatment has not so far been applied with obese individuals, a pilot study is proposed prior to a RCT.     

(Emotion-centered) problem-solving therapy: An update

Problem-solving therapy (PST) is a psychosocial intervention, typically considered to be a member of the cognitive and behaviour therapies family, and is based on a biopsychosocial, diathesis-stress model of psychopathology. The overarching goal of this approach is to promote the successful adoption of adaptive problem-solving attitudes and the effective implementation of certain behaviours as a means of coping with life stressors in order to attenuate the negative effects of such events on physical and mental well-being. Over the past several decades, in addition to accumulating strong support for its efficacy as a clinical intervention, similar to many other forms of psychotherapy, PST has undergone various evolutionary changes. Developed primarily as a more cognitive-based approach, due to the large body of literature in the field of affective neuroscience that underscores the importance of the impact of affect on problem solving, PST has evolved into emotion-centered problem-solving therapy (EC-PST). This article provides for a brief excursion into the historical roots of PST and why it has evolved into EC-PST, as well as providing support for its characterisation as a transdiagnostic approach. In addition, several meta-analyses that underscore its efficacy are described, as well as the most recent clinical guidelines that comprise EC-PST.     

Blowing in the Wind: ‘70s Questions for Millennial Therapists

ABSTRACT

Psychotherapy came in for a drubbing by the Women’s Liberation Movement of the 1960s. Indeed, some movement members declared that Feminist Therapy was an oxymoron. Despite the antipathy, feminists in the mental health professions borrowed practices, ethical ideals, principles, and goals from the Women’s Liberation Movement to create innovative models of therapy. This progressive impetus came to an abrupt halt with the sweeping re-medicalization of psychiatry in 1980s and the corporatization of medicine that followed thereafter. As the landscape of psychotherapy changed, so too did the founders’ vision of Feminist Therapy. Drawing on interviews with feminist therapists, I examine some of these changes. I close by asking about the conditions of possibility for feminism in therapy today.     

具身心理治疗:原理与技术

具身心理治疗是以身体心理治疗、舞动治疗为代表的,理论上契合具身认知观点、实践中注重身体作用的一种当代心理治疗取向。它将“身体”与“躯体”区分开来,赋予身体解剖学的、感觉运动的、认知的与嵌入环境等不同层面的意义。当前,已有不少研究证实身体有助于改善治疗关系,促进来访者认知、情绪的改变,并发展出一系列注重身体内外感知、姿势或运动的非言语治疗技术。具身心理治疗重构了身体在治疗过程中的概念与角色,发展了新的技术,是传统心理治疗的有益补充; 但也存在实证证据不足、理论框架尚未完全整合、容易过分强调身体作用等问题。今后需自觉整合其他治疗流派、开发独特的核心技术,推进循证的具身心理治疗的发展。     

Contemporary Psychotherapy: Moving Beyond a Therapeutic Dialogue

Psychotherapy was developed as a means of using words to heal emotional pain. Although a therapeutic dialogue can be helpful to many clients, some people need a more action-based intervention. Psychotherapy may be enhanced by adapting several therapeutic procedures that have been found effective in physical therapy. Where physical therapy can help clients learn to manage chronic physical pain, psychotherapy can help clients learn to manage chronic emotional pain. Both physical therapy and psychotherapy can help to facilitate awareness, flexibility, strength and endurance in order to maximize the clients functional ability.     

EMDR therapy: An overview of its development and mechanisms of action

IntroductionThis article examines the history and development of Eye Movement Desensitization and Reprocessing (EMDR), from Dr. Francine Shapiro's original discovery in 1987, to current findings and future directions for research and clinical practice.Elements of the literatureAn overview is provided of significant milestones in the evolution of EMDR over the first 20 years, including key events, research and scientific publications, and humanitarian efforts. The authors also describe the Adaptive Information Processing (AIP) model, which is the theoretical basis of the therapy; they address the question of mechanisms of action, and EMDR's specific contribution to the field of psychotherapy.DiscussionEMDR is an integrative psychotherapy, which sees dysfunctionally stored memories as the core element of the development of psychopathology. In its view of memory, it integrates information that is sensory, cognitive, emotional and somatic in nature. The EMDR protocol looks at past events that formed the presented problem, at the present situations where the problem is experienced, and at the way, the client would like to deal with future challenges.ConclusionEMDR is a 25-year-old therapy that has accumulated a substantial body of research proving its efficiency, and is now part of many professional treatment guidelines. The research is pointing to its potentially large positive impact in the fields of mental and physical health.     

Self-Healing Aspects of EMDR: The Therapeutic Change Process and Perspectives of Integrated Psychotherapies

Eye Movement Desensitization and Reprocessing (EMDR) (Shapiro 1989a, 1989b, 1995) is an innovative, comprehensive approach to psychotherapy. While EMDR's use of eye movements has attracted a great deal of attention, the efficacy of the EMDR method can be explained parsimoniously in terms of many different types of therapy. Lang's (1985) information processing networks provide a way to understand the Accelerated Information Processing model proposed by Shapiro to explain EMDR. A representative EMDR session is presented to illustrate the integrative components of EMDR's procedural elements and the range of clinical effects. Therapeutic changes seen as a result of self-healing using EMDR are discussed from the perspectives of other psychotherapeutic approaches in order to understand the contribution of EMDR to the psychotherapy integration movement.     

Mediating factors in chick social pecking: II. effects of exposure to movement

Unfamiliarity with movement may lead isolated chicks to respond aggressively when tested with live, moving conspecifics. This hypothesis was tested by comparing the number and locus of pecks by isolated chicks to a stationary or moving model of a chick, and to a live chick. In a second test of the hypothesis chicks that viewed a moving object during isolation and chicks isolated without movement were tested with a live con-specific and their number and locus of pecks were compared. Neither experiment supported the hypothesis. Movement alone failed to excite aggressive pecks and prior experience with movement failed to suppress aggressive pecks. In the first experiment imlated chicks treated the live testmate more aggressively than the moving or stationary model. In the second experiment aggressive pecking of chicks was unaffected by prior experience with movement, These fmdmgs do not support the hypothesis that movement excites aggression in isolated chicks. Nonetheless the results focus attention on the generally neglected problem of emotional and motivational states produced by isolation.     

The group psychotherapy movement at the millennium: some historical perspectives

Although almost a century old, group psychotherapy has experienced an unprecedented expansion over the last 50 years. By the 1970s, human helping groups had found application in virtually all the human services, including the media. The growth of professional organizations for group work specialists was accompanied by a burgeoning literature and by accelerated research endeavors. The recent advent of the managed health care "revolution" has shaken the very foundations of this prospering group psychotherapy movement. Undue pressure from third-party payers for greater accountability and for cost-containment has come to threaten the traditional autonomy and dedication to quality of care by group therapy practitioners. Professional organizations have begun to meet these challenges by educational endeavors addressed at insurers, legislators, and the public. Current training programs and literature for clinicians have focused on the need for a new "business orientation" and on less costly group treatment measures (i.e., short-term and combined). Given group therapy's proven effectiveness, coupled with its practitioners' flexibility, the movement is bound to regain its secure footing at the dawn of the new millennium.     

Inhaltsdeutung und Prozessdeutung

In successful psychotherapy pathogenic psychological contents (e.g. thoughts, dreams, emotions, perceptions of the body, etc.) are subject to an emotional process of transformation. This process can be observed, described and conceptualized independently of the contents at work in the particular case. Interestingly, several non-linear properties of this process of self-organization become apparent by clinical observation. Typical patterns can be discerned in the interplay of the various levels of representation (physical, emotional, cognitive), in the regulation of emotional intensity, and in the alternating prominence of negative and positive emotional material (bipolar pattern). The transformation process has rhythmic, almost musical, qualities. This paper describes this processual pattern, discusses various psychoanalytical process models, and proposes a process-oriented therapeutic method. In this type of process-oriented therapy, to the traditional interpretation of contents interpretations of the process are added, whenever necessary.     

Becoming a client, becoming a practitioner: student narratives of a dance movement therapy group

This paper documents one of several themes arising from a larger research study which invited trainees' views on their experience in a weekly, 2 year, dance movement therapy (DMT) personal development group. This group formed part of their post-graduate training. The study used a phenomenological, grounded theory and collaborative methodology followed by an interpretive framework. The research sought to discover participants' views on the experience of this personal development group in relation to their clinical practice with DMT groups during and following their training (the latter is not the subject of this paper). The study identifies a gap in the literature on trainee experience, particularly in relation to group process. Following a brief introduction and overview of methodology employed, the theme entitled 'becoming a client, becoming a practitioner' is presented, as it manifested for the students in the DMT group over time. The personal development component of therapists' training is directly relevant to most counselling/psychotherapy and arts therapies practitioners; consequently, the study has broader implications.     

EMDR and Emotionally Oriented Couples Therapy

When reviewing past and current research on the role of emotion in couples therapy, there appeared to be a lack of articulation concerning how emotional expressions and relational dynamics are affected by emotional trauma that has not been accessed. The authors demonstrate how emotionally and experientially oriented therapy with couples can be enhanced by accessing stored trauma through the use of Eye Movement Desensitization and Reprocessing (EMDR). This approach is called Eye Movement Relationship Enhancement (EMRE) therapy and includes key clinical areas such as accessing and tolerating previously disowned emotion, reprocessing emotional experiences, and amplifying couple intimacy. These key areas are discussed and illustrated with case examples.     

Does movement proficiency impact on exergaming performance?

There is growing interest in the use of consumer level exergames in movement skill acquisition. The purpose of this study was to investigate the relationship between movement proficiency and performance in virtual exergaming. Twenty seven children, aged 10–15 years participated in an experiment completing the Movement Assessment Battery for Children 2 (MABC-2) and a series of XBOX360 Kinect Sports exergaming tasks. Significant correlations were observed between MABC-2 aiming and catching percentile and exergame javelin and target kick, where the more proficient movers tended to perform better in the exergame. Statistically significant correlations were observed between MABC-2 balance percentile and exergaming sprint and target kick performance. In this study children who scored better in real life gross motor movement tasks performed better in most related exergaming activities. This suggests current exergaming technology has advanced to a point where body movement unencumbered by a physical or remote game device tether can extract movements resembling real life tasks, translate them into game play and reward proficient movers with higher in-game performance. It is possible that benefit gained in an exergaming environment by more proficient movers was a result of either their more proficient movement, or a greater ability to adapt to the exergame.     

Popularizing American psychotherapy: the Emmanuel Movement, 1906-1910

As late as 1907 Americans knew little of psychotherapy. The word itself was virtually nowhere to be found in either professional or popular literature. Talking cures were not talked about. Despite growing medical and cultural awareness of mental suffering, few physicians made any effort to treat such states by appealing to mind. Indeed, for more than 3 decades, American physicians--particularly those who specialized in the treatment of nervous and mental disorders--had scoffed at anything even remotely resembling mental therapeutics. By 1910 this situation changed dramatically. Whereas decades of vigorous internal professional debates had failed to generate a consensus among American physicians and academic psychologists regarding the scientific legitimacy and clinical efficacy of mental therapeuitcs, in 2 short years the Emmanuel Church Healing Movement had forced both physicians and psychologists to confront squarely and publicly a subject that they had long avoided. Lasting from 1906 to 1910, this popular mevement was the primary agent responsibile for the efflorescence of psychotherapy in the United States.     

Alfred Adler's Treatment as a Form of Brief Therapy

Alfred Adler was largely overlooked during his era because he viewed people as creative beings in control of their own mental health and resisted the then-standard practice of treating human beings from a pedestal with a normative body of laws. His progressive style of treatment has become more popular in an age when efficient and collaborative treatment is valued for the sake of cost-effectiveness. This article positions Adlerian psychotherapy as a form of brief therapy, effective psychotherapy that takes place in 20 sessions or fewer. The article summarizes the fundamentals of Adlerian theory, outlines the general criteria of brief psychotherapy required by managed care companies, and specifically highlights how Adlerian psychotherapy qualifies as brief psychotherapy.     

Tanztherapie

Dance therapy is presented as a processorientated psychotherapeutic method. Its historical roots in the German Expressive Dance and in the Human Potential Movement in the USA are discussed together with current trends in Germany. Phenomena as rhythm, the experience of space, vitality contours, nonverbal attunement and movement analysis are discussed theoretically and backed up by short examples of dance therapeutic sessions. The integration of psychoanalysis and dance therapy is illustrated by the approach of Elaine V. Siegel, speaking about physical transference and counter transference. The therapeutic work with body image and the idea of creative movement and playfulness for the purpose of a new orientation of Stern’s RIG`s (representations of interactions that have been generalized) are fit in a modern and psychodynamic oriented concept of dance therapy. Questions concerning indication and current research are shortly summarized. Dance therapy, as the youngest creative therapeutic method beside music therapy and art therapy, is characterized by its openness for interactive scopes, the integration of behavior observation (through movement analysis) and psychodynamic reconstructions.     

Prognostic validity of the Rorschach

Fifty adult stutterers entering therapy at the UCLA Psychology Clinic were administered the Rorschach, with a Klopfer method inquiry, scoring, form level rating, and calculation of scores on the Rorschach Prognostic Rating Scale (RPRS). On the basis of independent clinician ratings of attitudinal or psychotherapeutic improvement, subjects were divided into groups of Improved Most (n = 21) and Improved Least (n = 29). Subjects were also divided into Continued (n = 43) and Dropped (n = 7). Logistic regression was employed to compare groups on the following Rorschach dimensions: Prognostic Score (RPRS); Human Movement; Animal Movement; Inanimate Movement; Shading; Color; Form Level. The Improved Most group was significantly higher in M, FM, Shading, and Productivity. The finding that M and FM discriminates between improvement groups corroborates results obtained in a previous study (Sheehan et al., 1954). The Rorschach movement variables, particularly M and FM, seem to be stable indicators of capacity for improvement in psychotherapy.     

The Never Land – loss of an idealized pre-birth place and the gain of a thinking mind

This paper describes the main themes in the psychotherapy of a severely epileptic girl, over a period of eleven years, aged 16 at the time of writing. For most of the therapy the girl lacked an ability to differentiate between herself and others, and therefore there was little development of rudimentary Oedipal conflicts. Her severe physical and mental impairments were inextricably linked to this fundamental problem in the process of separating: the physical problems compounding the emotional, and the emotional compounding the physical. Her mother's illnesses were significant factors. Throughout the girl's life she was subject to extreme medical interventions. The paper draws upon psychoanalytic models of mind and body integration, including notions of the 'biopsychosocial dysregulation' model of illness. The clinical material describes the girl's use of the dolls to populate a Peter Pan Never Land, with its many static perspectives, denying growth and the difference between the generations, although therein was the beginning of the use of symbolization. As the child's awareness of her physical impairments grew, so did her despair at her own and her mother's hopeless physical condition. However, she became more able to express her outrage, but with the life-saving awareness of a therapist who was not also ill. This led to the girl's increased ability to acknowledge differentiation between self and other, further painful awareness of her disabilities, losses and possible death, as well as those of her ill mother and, gradually, an ability to acknowledge the passing of time and an appreciation therein of a healthy separate thinking part of her that could use symbolization and allow for some separateness and some emotional growth.     

Neuropsychological functions of hand movements and gestures change in the presence or absence of speech

In order to address previous controversies whether hand movements and gestures are linked to mental concepts or solely to the process of speaking, in the present study we investigate the neuropsychological functions of the entire spectrum of unimanual and bimanual hand movements and gestures when they either accompany speaking or when they act as the only means to communicate in the absence of speech. The results showed that the hand movement activity regarding all types of hand movements and gestures stayed constant with and without speaking. The analysis of the Structure of hand movements showed that executions shifted from in space hand movements with a phase structure during the condition without speech to more irregular on body hand movements without a phase structure during the co-speech condition. The gestural analysis revealed that pantomime gestures increase under conditions without speech whereas emotional motions and subject-oriented actions primarily occur when speaking. The present results provide evidence that the overall hand movement activity does not differ between co-speech conditions and conditions without speech, but that the hands adopt different neuropsychological functions. We conclude that the hands primarily externalise mental concepts in conditions without speaking but that their use shifts to more self-regulation and to endorsing verbal output with emotional connotations when they accompany speech.