The Value of Research Methods in Psychotherapy Research: A Reply to the Commentary of Dr Norton

Norton's commentary on our article has prompted us to think further about the purpose of psychotherapy research. We agree with his suggestion that researchers have much work to do to understand when and for whom interventions are most efficacious. We hope that our field will make progress in this regard. In this reply, we further describe why we believe careful attention to research methods, such as those highlighted in our article, is key to making progress in psychotherapy research.     

B.F. Skinner and the auditory inkblot: The rise and fall of the verbal summator as a projective technique

Behaviorist B.F. Skinner is not typically associated with the fields of personality assessment or projective testing. However, early in his career Skinner developed an instrument he named the verbal summator, which, at one point, he referred to as a device for "snaring out complexes," much like an auditory analogue of the Rorschach inkblots. Skinner's interest in the projective potential of his technique was relatively short lived, but whereas he used the verbal summator to generate experimental data for his theory of verbal behavior, several other clinicians and researchers exploited this potential and adapted the verbal summator technique for both research and applied purposes. The idea of an auditory inkblot struck many as a useful innovation, and the verbal summator spawned the tautophone test, the auditory apperception test, and the Azzageddi test, among others. This article traces the origin, development, and eventual demise of the verbal summator as an auditory projective technique.     

Changes in studying abilities as perceived by students attending psychotherapy

In rehabilitative psychotherapy, the goal is to support and improve the person's working and studying capacity and to secure his/her staying in or entering the workforce. In this qualitative study, the aim was to describe the changes students experienced in their studying ability and the advancement of their studies as a result of the therapy process. The results of this study showed many kinds of positive changes in the psychological resources and studying ability of students participating in psychotherapy. The results also show that when psychotherapy is arranged with the aim to support the study process, good connections between psychotherapy, study tutoring and career guidance are needed.     

Mother – infant group psychotherapy as an intensive treatment in early interaction among mothers with substance abuse problems

In this article we present a novel method of outpatient care: brief, dynamic mother – infant group psychotherapy with mothers who have substance use problems. In this therapy, substance abuse treatment is part of mental health and parenting interventions. The focus is on preventing disturbance in the mother – infant relationship in this high-risk group. The clinical material is taken from 16 mother – infant dyads from six psychotherapy groups, which met weekly over six months from pregnancy to post-partum. The therapy process consists of 20 – 24 three-hour sessions. The basis of the therapy is to offer mothers experience of care, which they, in turn, can give to their infants. In this paper we analyse the core therapeutic elements that may contribute to better mothering and child development. They involve: the group providing a symbolic maternal lap, and the meeting of the mothers' and the infants' needs. It is hoped that this may offer the mothers a new experience within which to reappraise their early memories. This may help prevent them from projecting traumatic past experiences onto their infants. Our analyses show that in the therapy, mothers, feeling safe within the group, gradually experienced pleasure with their infants and their peers. These effects, according to the mothers, were the most noticeable. Brief dynamic mother – infant group psychotherapy seems to be a promising form of treatment for those substance-abusing women able to commit to outpatient care and examine the causes of their drug dependence. The groups may also be used as a diagnostic tool to detect problems in early mother-baby interaction.     

Considering methodological integrity in counselling and psychotherapy research

Within the field of counselling and psychotherapy research, qualitative methods have been a longstanding tradition of inquiry due to the mutual interest of therapists and researchers in both internal experiences and intersubjective processes. Methodological integrity is a conceptual framework that has been advanced to increase the rigor of these methods. In this paper, we consider the value of this concept for counselling and psychotherapy researchers and reviewers. This framework guides investigators and reviewers to consider how procedures can be adapted to meet the goals of specific studies, given their characteristics and approach to inquiry. In this brief article, we exemplify the relevance and application of this concept to this field by describing the decision‐making process within the designing of a qualitative research project to investigate clients' needs within rape crisis counselling. Through this exemplar, we also provide guidance to counselling and psychotherapy researchers on considerations during the process of research review and reporting.     

Effective Psychotherapy With Low-income Clients: The Importance of Attending to Social Class

The purpose of this article is to explore some of the issues associated with conducting psychotherapy with low-income clients. Throughout the article, we draw from our specific clinical experiences working with low-income Latina mothers in a depression prevention program. The themes that we address regarding class and psychotherapy are in the areas of assessment of social class, integration of class issues into the therapy process, and managing differences in social class between therapists and clients. As we discuss these themes, we provide concrete recommendations in order to advance awareness and effectiveness in working with economically disadvantaged populations.     

Mein Konzept der Supervision

The reflections on supervision presented in this paper were written against the background of a psychoanalytic training. The paper describes what – in the author's view – characterizes a patient in psychoanalytic psychotherapy, a psychoanalytic therapist, and a supervisor. In addition, the author reports on his personal experiences which he has made with supervision in the course of his activity as a psychoanalyst in the roles of supervised and supervisor. In this context, he presents some actual memories from supervisory experiences with M. Balint, H. Argelander and F. Morgenthaler.     

Cognitive-Perceptual Theory and the Projective Use of Autobiographical Memory

Most clinicians know little about the operation of autobiographical memory. Yet as assessment people, clinicians are frequently called upon to make important decisions about the individuals they evaluate. It is not surprising that clinicians are ignorant regarding many aspects of autobiographical memory because most have not been trained to understand how autobiographical memory functions. This article focuses on a vital domain of autobiographical memories—early memories—and discusses from a clinical perspective the purpose, function, and organization of autobiographical memory as seen by cognitive-perceptual theory.     

Relationality and Existence: Hermeneutic and Deconstructive Approaches Emerging From Heidegger's Philosophy

In this article I discuss the concept of relationality from a philosophical perspective. I focus, in particular, on the philosophy of Martin Heidegger, exploring how his relational concepts of worldhood, being-with, solicitude, and Befindlichkeit were central to his early philosophy, before he extended his ideas and related them to psychotherapy in his later work. I then proceed to focus on the work of other philosophers, influenced by Heidegger, who developed and extended his relational ideas further. In particular, I discuss Hans Georg Gadamer's notions of Horizon and Dialogue, Paul Ricouer's notion of Dialectics with Otherness, and the writings of Emmanuel Levinas and Jacques Derrida concerning Otherness, Difference, and Ethics. I develop this philosophical discussion as a foundation for further consideration of the relevance of relational ideas in philosophy to the domains of developmental psychopathology and clinical approaches in the field of psychotherapy.     

Eltern-Säuglings-Psychotherapie

In this article the treatment of a 1-year-old girl with eating disorder and of her mother is presented. First, the theory of the disturbance constituting the basis for the work of the psychological counseling service named ?Vom Säugling zum Kleinkind“ (From infancy to early childhood) at the Potsdam College is presented as well as the treatment technique of parent-infant psychotherapy. The focus of the article is the case study. Its particular characteristic is the non-interpretative handling of the transference. The connection between the specific transferential disposition of the parents and the operating factors of the parent-infant therapy is described. The author distinguishes three levels of parental transference which are used in parent-infant psychotherapy. She reflects about the psychodynamics of the infantile pathology and discusses the factors which in this case have allowed a positive development.     

SPONTANEOUS REMISSIONS: NORMAN REIDER'S FORGOTTEN PAPER,PART I

Almost sixty years ago, Norman Reider published a paper about spontaneous “remissions” he had observed. He discussed the manner in which psychoanalytic theory provided a way to partially explain these otherwise mysterious remissions or improvements in symptoms, some without benefit of either psychoanalysis or psychotherapy. Especially important were his comments about the negligible role of interpretation or insight in these examples. His conjectures reflected controversies that were current at the time and that remain unsettled. Of special interest is his introduction of some highly original ways to think of applying psychoanalytic ideas to supportive psychotherapy. But few analysts today have heard of this paper. A reconsideration of his paper allows us to be vividly reminded about our enduring and profound confusion about exactly what constitutes a “cure” at all. Spontaneous shifts in the severity of symptoms may be viewed as experiments of nature that we have neglected to investigate as valuable restraints on our immodest therapeutic claims.     

On the object relational texture of affects

Marty Mayman will be remembered as a uniquely gifted clinician, diagnostician, supervisor, and teacher. In this article, I link his distinctive capacity for empathic understanding to his reliance on self-representational and object representational concepts as a vehicle for accessing the inner life of his participant. Mayman's special brand of empathy was remarkable for its sensitivity to nuance as well as its ability to strike a chord with vivid resonance. His understanding of ego development included the notion that self-representation and object representation make up part of the internalized structure of all ego functions. Self- and object representations can be thought of as embedded in the individual's subjective experience of the very performing of those ego functions. Self- and object representations can also be thought of as embedded in the individual's attitudes toward the exercising of particular ego functions, for example, where the individual struggles with whether or not he or she feels a sense of permission to "own" or exercise specific ego capacities. In this article, I apply the use of self- and object representation as a way of "texturizing" the ego to the way object relations are embedded within affects. I use some Early Memory Test (Mayman, 1968) material to elucidate the role of object relational themes in the specific way in which affects are experienced.     

It's time to rework the blueprints: building a science for clinical psychology

The aims in this article are to connect the conceptual structure of clinical psychological science to what the author believes to be the omnipresent principles of evolution, use the evolutionary model to create a deductively derived clinical theory and taxonomy, link the theory and taxonomy to comprehensive and integrated approaches to assessment, and outline a framework for an integrative synergistic model of psychotherapy. These foundations also provide a framework for a systematic approach to the subject realms of personology and psychopathology. Exploring nature's deep principles, the model revives the personologic concept christened by Henry Murray some 65 years ago; it also parallels the interface between human social functioning and evolutionary biology proposed by Edward Wilson in his concept of sociobiology.     

The Birth of Tragedy and The Trauma of Birth

This article examines the early writings of Friedrich Nietzsche and Otto Rank in terms of Harold Bloom's notion of an "anxiety of influence." Like the "strong poets" in Bloom's theory, each of these innovators needed to resolve his ambivalence toward precursors to create new theories and approaches. Nietzsche and Rank are seen as "premature births," thinkers before their time; both went beyond their own early works and attempted self-creation. Through an emphasis on affirmation of life despite death's inevitability, both were able to free themselves creatively. Rank drew from Nietzsche's philosophy and his example in developing an early existential psychotherapy.     

The Developmental Path to Expertise in Group Psychotherapy

This paper describes a trajectory by which an individual achieves expertise in group psychotherapy. Five developmental stages are posited. In the decisional-anticipatory stage, interest is developed in group psychotherapy. In the trainee stage, the individual masters the knowledge base of group psychotherapy and obtains fledgling experiences in a group. In the novice stage, the individual obtains additional experience in running groups and becomes socialized into a community of group psychotherapists. In the proficiency stage, the individual narrows his or her group psychotherapy focus and obtains more specialized experience in that area. At this time, supervisory and consultation skills are often developed. In the final stage of expertise, the expert must engage in a process of recognizing its limits and must devise ways to maintain it. Research that focuses on one aspect of expertise, level of experience, is reviewed. Three dimensions of difference are identified: (a) complexity of conceptualization of members and interventions; (b) fostering openness and engagement; and (c) focusing on process.     

Remembering Early Childhood: How Much, How, and Why (or Why Not)

In this article, we consider recent research on three questions about people's memories for their early childhood: whether childhood amnesia is a real phenomenon, whether implicit memories survive when explicit memories do not, and why early episodic memories are sketchy. The research leads us to form three conclusions. First, we argue that childhood amnesia is a real phenomenon, as long as the term is defined clearly. Specifically, people are able to recall parts of their lives from the period between ages 2 and 5 years, but they recall less from that period than from other periods. Second, we conclude that implicit memories from early childhood may be evident even when explicit memories are not, a finding that suggests early experience may affect behavior in ways that people do not consciously recognize. Third, we argue that although young children are well known to be wonderfully efficient learners of semantic information, they have difficulty in either encoding or retrieving the interlinked aspects of events that lend them their autobiographical character. Although more evidence is needed, the relative lack of episodic memories of early childhood may be linked to maturation of prefrontal cortex.     

Forgetting unwanted memories: directed forgetting and thought suppression methods

Experimental psychopathologists have tested hypotheses regarding mechanisms that ought to be operative if victims possess skills for forgetting material related to trauma. In this article, we review research on directed forgetting and thought suppression paradigms, concentrating on laboratory studies involving attempts by individuals reporting trauma histories to forget emotionally negative material. Most studies have shown that trauma survivors, especially those with post-traumatic stress disorder, are characterized by a breakdown in the ability to forget disturbing material. Studies on individuals reporting repressed or recovered memories of trauma have not confirmed predictions regarding heightened forgetting skills for trauma-related words. However, recent research on suppressing disturbing autobiographical memories suggests that people who report spontaneously recalling childhood abuse outside of psychotherapy may, indeed, possess skills for not thinking about disturbing material.     

Working with Psychosis

This is the first of four papers about working with psychosis in a newly established post of psycho-analytic psychotherapist in an acute psychiatric unit in Australia. In this paper the author gives an account of some early impressions and experiences with staff and patients, particularly connected with an unacknowledged grief in the aftermath of psychosis. The author next discusses some of the psycho-analytic theory about psychosis which he found containing and helped make some sense of his experiences. He then introduces a case study of an exploratory psycho-analytic psychotherapy with a 40-year-old man suffering from a bi-polar disorder. The beginning of the therapy is described when this man revealed feelings of grief and despair about his illness. Being able to face and bear these feelings enabled him to begin to mourn what was irretrievably lost because of his illness and to contemplate what might still be possible. The author describes some of the early themes and one session in detail, and discusses how fluctuations in contact with the client reflect his retreat to a pathological organization in the mind. This psychic retreat was dominated by a psychotic process, and the retreat offered refuge from a dread of fragmentation and the pain of mourning and loss.