Psychotherapy; Its Relation to Biblical and Rabbinic Judaism

Some facets of the relationship between psychotherapy and Judaism are analyzed. The issue of a framework for therapy that is congruent with Jewish biblical and rabbinic sources is examined in detail. The thesis advanced is, that the healing-helping model promulgated by psychotherapeutic theorists and practitioners is amenable to Jewish thought. Some implications of this model are explored. Attention is focused on the issues of inner conflict, self-knowledge, and complexity unique to human behavior. It is argued that these are basic premises fundamental to both depth psychology and Jewish thought. The Jewish and Christian variations of the healing model are compared and analyzed.     

Religion, Ethnicity, and Attitudes Toward Psychotherapy

Many presume that White culture supports psychotherapy utilization. However, cultural analyses suggest that many aspects of White culture are antithetical to the values and practices underlying psychotherapy, which appear more congruent with Ashkenazic Jewish attitudes and values. The current research empirically tested this possibility by comparing older Jewish White people, non-Jewish Whites, and Black participants on attitudes relevant to psychotherapy. Results indicated that Jews had greater confidence in a therapist's ability to help, were more tolerant of stigma, and more open to sharing their feelings and concerns than participants in the other groups. Furthermore, initial differences between Whites and African Americans were lessened when Jewish identity was included in the analysis. Results suggest that Jewish culture is relatively accepting of psychotherapy, and that previous reports of different rates of mental health seeking attitudes and utilization by Whites and Blacks may be due, in part, to the inclusion of Jewish individuals in these samples.     

Evidence‐based practice: Accounting for the importance of the therapeutic relationship in UK National Health Service therapy provision

It is argued that different models of therapy result in broadly similar outcomes and that the therapeutic relationship is the most important factor in relation to outcome. This paper presents some of the main findings from over 30 years of psychotherapy research. We discuss these findings in relation to current provision of therapy within the UK National Health Service (NHS) and express our fears that despite a culture of evidence‐based practice, this evidence is in danger of being ignored. We conclude by discussing some of the implications and challenges that this evidence presents to therapy researchers, policy makers, trainers and practitioners.     

Ethics of Globalization and the AIDS Crisis from a Jewish Perspective

This essay explores what Jewish ethics has to say about globalization in relation to the AIDS crisis. Special attention is paid to the consequences in affirming current intellectual trends to transcend traditional limits in both society and thought for rethinking traditional Jewish values. The discussion proceeds from two presuppositions. The first is that there is an intimate connection between ethics, science, and politics. The second is that the history of Jewish ethics involves three distinct forms that are generally correlated but rarely identical in content and moral judgment. These three forms are law, wisdom or virtue, and covenant. The discussion considers related issues of accidental connections in time between the bubonic plague and Zionism and between AIDS and homosexuality in relation to moral–theological issues related to divine providence and distributive justice.     

Psychotherapie mit Migranten

After an introduction and presentation of the influence of immigration on psychological health, the present overview focuses on several models of psychological development in immigration. Cross-cultural psychodynamics and culturally conditioned transference in ethnically mixed cultural psychotherapy settings are explored. The effectiveness of Western therapy methods based on Christian – Jewish values is discussed with regard to the therapy of patients from different ethnic backgrounds, i. e. so-called traditional societies. In Western cultures, proximity in object relations is based on autonomy whereas in traditional societies proximity is based on relatedness. Knowledge of specific cultural issues are considered to be an important instrument in cross-cultural therapies. Joining, activation of ethnic resources, and culture-sensitive interventions are considered to be helpful psychotherapeutic interventions. Specialized therapy settings, e.g. integration of ethnic therapists in established institutions, mono-cultural ethnic settings and collaborative projects are described. Last but not least, the authors point out the necessity of cross-cultural therapeutic competence because of an expanding cultural heterogeneity of society.     

Does Religiosity Predict Attitudes Toward Psychotherapy?

Several studies have demonstrated that Jewish people have positive attitudes toward psychotherapy. This study differentiates among Orthodox, Conservative, and Reform Jewish groups to test whether there are differences in the level of religiosity and practice among these different affiliations to Judaism and whether these differences may influence attitudes toward seeking psychological help. Despite significant differences in religiosity and level of practice, results indicate that positive attitudes are present among all affiliations. However, Orthodox Jews are significantly more likely to use their rabbi as a source for psychological counseling and perhaps as a conduit to professional treatment.     

‘Does class count?’ Social class and counselling

This article explores the importance attached to social class by experienced practitioners taking part in a co‐operative inquiry group. A review of the literature from the last thirty years indicates that there is very little research on class in relation to counselling and psychotherapy reported in the UK. Both authors position themselves as coming from working class origins. Nine co‐researchers from both middle and working class origins joined the group. Eight meetings took place over a period of nine months. Extracts from the group's discussions are represented and integrated with ‘presentational knowing’ drawn from contemporary culture, including poetry and popular music. This study suggests that social class is a neglected aspect of diversity in the counselling field. Implications of the study have relevance for the language of counselling and psychotherapy and class based values; social class and its impact on initial education; and ongoing counselling practice and access to therapy for working class people.     

Psychiatry,Cultural Competency,and the Care of Ultra-Orthodox Jews: Achieving Secular and Theocentric Convergence Through Introspection

Several socio-cultural factors complicate mental health care in the ultra-Orthodox Jewish population. These include societal stigma, fear of the influence of secular ideas, the need for rabbinic approval of the method and provider, and the notion that excessive concern with the self is counter-productive to religious growth. Little is known about how the religious beliefs of this population might be employed in therapeutic contexts. One potential point of convergence is the Jewish philosophical tradition of introspection as a means toward personal, interpersonal, and spiritual growth. We reviewed Jewish religious-philosophical writings on introspection from antiquity (the Babylonian Talmud) to the Middle Ages (Duties of the Heart), the eighteenth century (Path of the Just), the early Hasidic movement (the Tanya), and modernity (Alei Shur, Halakhic Man). Analysis of these texts indicates that: (1) introspection can be a religiously acceptable reaction to existential distress; (2) introspection might promote alignment of religious beliefs with emotions, intellect and behavior; (3) some religious philosophers were concerned about the demotivating effects of excessive introspection and self-critique on religious devotion and emotional well-being; (4) certain religious forms of introspection are remarkably analogous to modern methods of psychiatry and psychology, particularly psychodynamic psychotherapy and cognitive-behavioral therapy. We conclude that homology between religious philosophy of emotion and secular methods of psychiatry and psychotherapy may inform the choice and method of mental health care, foster the therapist-patient relationship, and thereby enable therapeutic convergence.     

Psychotherapy process and research: Missing persons and missing values

The task of ‘understanding’ in psychotherapy is compared with the mundance basis of interpersonal understanding. This implicates a discussion of three ‘principles’ which are put forward as distinguishing features of psychotherapy: ‘empathy’ (as a process, not a technique); ‘interpretation’ (particularly with regard to its relation to values); and the ‘faded person of the psychotherapist’ (related to empathy and interpretation, but particularly the power and remoteness of therapist). This allows a critical evaluation of psychotherapy research. Process research, particularly the innovative work of Robert Elliott, which seems best able to meet criticisms related to the sensitivity of research methodologies, is given particular attention. However, epistemological limitations are identified which are likely to unnecessarily distort the meaningfulness of the ‘events’ of psychotherapy.     

Buber's interpersonal theory as a hermeneutic

Martin Buber is remembered as a philosopher, existentialist, Zionist, and Jewish theologian. The purpose of this article is to demonstrate that his theory of interpersonal relations forms a useful tool for categorizing some of the theoretical perspectives and therapeutic techniques within psychiatry. It is neither the intention nor purpose of the authors to judge the relative merits of competing modalities of treatment but to clarify their therapeutic mechanisms in such a way as to identify their purposes more precisely. Additionally, the authors wish to categorize the various schools of psychotherapy and their subdivisions according to the realm in which they are operative. Finally, they hope to demonstrate that Buber's system can be modified or elaborated upon by this connection with some of these approaches to personality theory.T.L. Brink, Ph.D., did his graduate work at the University of Chicago. He taught psychotherapy at Instituto Tecnologico y de Estudios Superiores del Occidente in Guadalajara, Mexico. Currently he has a private practice in geriatric counseling in the San Francisco Bay area. He serves as a consultant for Midpeninsula Health Services and San Mateo County Mental Health and is on the faculty at College of Notre Dame and Palo Alto School of Professional Psychology.Connie Janakes leads a dream therapy group for the aged at Little House in Menlo Park, and counsels alcoholics at WRA in San Mateo, California.     

Psychotherapy research: an interplay between inner and outer and a succession of meanings

Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual’s experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the ‘Centre for research on the psychodynamics of personality’. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re‐authoring one’s life narrative is accepted as part of a productive therapy as well as discovering one’s inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.     

Psychotherapie®

Psychotherapy has not escaped the societal changes of the last decades, which are labelled by sociologists as “reflexive modernization”. Nevertheless, psychotherapists occasionally are supposed to avoid a discussion of issues related to modern societies. This article discusses economization, connected with reflexive modernization, in relation to psychotherapy focussing on the question if psychotherapy has already become a “product” (or is imminent to that). This question is discussed in connection with three specific issues: parallels between psychotherapy and industrial production related to terms such as quality assurance and quality management, the question of a monopoly within psychotherapy, similar to monopolies of industrial companies, and, finally, some phenomena connected with a boom of specific psychotherapies of the recent years that indicate the product-character of psychotherapy.     

The Life and Work of Sigmund Freud. Vol. III: The Last Phase by Ernest Jones

This paper describes the ward group, a modified version of group psychotherapy, designed for use in conjunction with comprehensive long-term treatment for severely disturbed adolescents and young adults. The authors examine the structural features of the ward group and discuss the group in relation to the unit and the hospital regarding such issues as membership, confidentiality, space, time, and ward group identity. The complex issues of task boundaries, the ward group as both an administrative unit and as a therapy group, are given special attention. The ward group transmits unit and hospital values and expectations, maintains behavioral controls over patients, exercises administrative decision-making authority, operates as a reflective–explorational therapy group, and represents an important means through which patients can achieve a sense of significance within the institutional setting.     

Clinical Approaches to Conflicts Between Religious Values and Same‐Sex Attractions: Contrasting Gay‐Affirmative,Sexual Identity,and Change‐Oriented Models of Therapy

The literature germane to the care of clients presenting for psychotherapy with conflicts between their sexual orientation and religious values typically addresses the topic from within a particular therapeutic approach. This article addresses the issue from a broader perspective that takes into account 3 different paradigms: gay‐affirmative therapy, sexual identity therapy, and change‐oriented therapy. The authors describe the 3 approaches, compare and contrast them across several different key dimensions of theory and practice, and identify some strengths and potential limitations of each approach for assisting clients who are attempting to navigate the resolution of their conflict.     

Sailing between Scylla and Charybdis1: Incorporating qualitative approaches into child psychotherapy research

Starting from the acknowledged gap between research and practice in child psychotherapy, this paper offers an historical perspective on the relation between these two activities, and suggests that qualitative approaches to research may offer new ways of bringing them together. After introducing the fundamental concepts of qualitative analysis, three areas where qualitative forms of research may be useful to child psychotherapists are explored: relevant but non-psychotherapy research; accounts of therapy research; and therapy process research. Examples of all of these types of research are presented, and some of the challenges to incorporating qualitative approaches into child psychotherapy research are discussed.     

Authority,Psychotherapy and the Authority of the Therapist in the Religious Haredi Community

This article considers the meaning and significance of authority, and its relevance to the transference process, within the framework of psychotherapy in the orthodox Jewish (Haredi) community in Israel. In this community, deeply-rooted habits of obedience to the commandments of the Torah and the authority of the Rabbi are integral to maintaining an orthodox way of life. Clinical vignettes with Haredi patients are presented to illustrate the complexities that arise when both patient and therapist belong to the orthodox community, and highlight the authority-related issues that are central to the therapy. This combination of factors requires a sensitive and finely-tuned approach which will enable the therapist to maintain the treatment framework while still accommodating the orthodox way of life.     

A Cross-Contextual Construction of Clients' Therapeutic Practice

This study demonstrates how gathering data from a different context can significantly change how an object of study may be viewed. Data from a qualitative diary study of psychotherapeutic practice were used to construct a cross-contextual view of psychotherapy. Data about clients’ everyday lives as well as psychotherapy sessions were analyzed. Examples of how extra-therapeutic factors are significant to client change are presented. Six types of extra-therapeutic information sources that clients use to develop their personal stances while in therapy were identified. The case of one client's abundant use of extra-therapeutic sources of information offers a different construction of how psychotherapy works, emphasizing client activities outside sessions. The implications of the study for psychotherapy research are addressed.     

Transference and the idea of God

While many factors influence the course of therapy, based on empirical evidence a strong case can be made for the importance of religious beliefs influencing the process of transference. During a ten-year period of private psychiatric practice, the senior author saw 353 patients suffering from anxiety and neurotic depression. The form of treatment was individual, dynamic, psychoanalytically oriented psychotherapy with occasional use of psychotropic drugs. Forty percent of the patients who were seen were Catholic; forty percent were Protestant; and twenty percent were Jewish.Protestants, Catholics, and Jews bring differing conceptions of God to the transference phenomenon in individual psychotherapy. Basing findings on extensive clinical evidence, this study seeks to explain why this occurs, and the need for the psychotherapist to be aware of religious factors that influence the course of psychotherapy.He is Associate Clinical Professor of Psychiatry at the Medical College of Wisconsin in Milwaukee and Associate Professor at the Institute of Psychology of the Pontifical Gregorial University in Rome, Italy.     

Between the street and the consulting room: The role of therapeutic frame in working with homeless clients

This paper explores the context of psychotherapy with people who are homeless and the kinds of dynamics and challenges that typically arise in this work. The paper specifically considers the process of therapy as it takes place with clients who have been recurrently homeless and who have difficulties with sustaining shelter that has its roots in deficits in early containment. Clinical case material from psychotherapy conducted with two homeless men is presented and the implications of the approach adopted are explored both in relation to policies around the provision of services for homeless people and the more specific issue of psychotherapy intervention.

It is argued that a clear, well-articulated set of expectations has to be developed around this work in order to protect it and to provide it with the greatest opportunity for providing the kind of safety that is required for the development of this work. It is argued that the most important issue here relates to the provision of a consistent therapeutic framework and a care around the development of the specific psychotherapeutic frame within, and in relation to, the other frames present in the person's life.     

Assessing and treating sexual dysfunctions in Orthodox Jewish couples: a summary of 41 consecutive cases

ABSTRACT

Orthodox Jews are a distinct subgroup with specific beliefs and values towards sexuality, reproduction, modesty, and openness to mental health treatment. This paper reviews the treatment of 41 Orthodox Jewish couples who presented for sex therapy. Most couples were referred by a rabbinical leader. The most common presenting problem was an unconsummated relationship; present in 27 couples. In 34 couples the initial presenting complaint was a male sexual problem yet in 20 of 41 couples both partners described having some sexual problem. Almost 50 per cent of both men and women were also diagnosed with a comorbid psychiatric disorder, which was almost always previously undiagnosed. The most common presenting problems were vaginismus, male inhibited arousal, and/or inhibited male orgasm. Two case examples illustrate some adaptations to assessment and treatment that can be helpful in treating sexual problems in Orthodox Jewish couples.