SUICIDALITY IN MEN IN PSYCHODYNAMIC PSYCHOTHERAPY

Based on the evidence of empirical gender differences in attempted suicide and suicide, this paper develops psychodynamic hypotheses on gender‐specific biographic, intra‐psychic and treatment aspects of suicidality among men. ‘Forming Types by Understanding’ is a qualitative method, based on a systematic analysis of similarity and differential reference points to develop ideal types of suicidal men. A random sample of 20 suicidal men who were receiving out‐patient psychodynamic psychotherapy was studied.

Four ideal types of suicidal men were identified: (1) ideal type ‘disconnected’: a predominance of disconnected feelings that is associated with rejection experiences; (2) ideal type ‘hurt’: aggressive conflicts and the realization of disillusioned life reality combined with experiences of real loss and real trauma; (3) ideal type ‘stormy’: an attached‐symbiotic transference offer mobilizes unrealistic wishes to help against a background of unresolved dependency conflicts; and (4) ideal type ‘object dependent’: concrete facts are important in relationships; in case of separation, real repossession of the woman must occur, a lack of emotional experience is compensated. The danger of suicidality, especially in the early stage of psychotherapy, is particularly acute for patients who cannot reach their therapists emotionally and vice versa. Disturbance of the early experience of inseparability from the mother, gender‐specific conflicts in the development of separation and individuation, and failed triangulation are of central psychodynamic importance.     

CREATIVITY IN EXPERIENTIAL PERSONAL CONSTRUCT PSYCHOTHERAPY

We propose that experiential personal construct psychotherapy demands therapist creativity in engaging clients, beginning with the initial diagnosis and continuing through the entire therapy process. We suggest a number of ways of enhancing therapist creativity in the therapy room. We discuss making time for aloneness, seeking particular kinds of interactions with others, fantasizing, having a passion for one's work, trying on roles, exposing oneself to literature and the arts, leading a balanced life, reducing time pressures, making judgments, focusing on process, and seeing client growth. Finally, we consider creativity in the life of the therapist beyond the therapy room. We explore how the therapist's desire to be a part of lifechanging psychotherapy mandates the personal pursuit of creativity.     

GREAT IDEAS AND DUMB LUCK IN PSYCHOANALYTIC PSYCHOTHERAPY

Both Dr. Kuriloff’s initial contribution to the Roundtable, and her later response to her fellow discussants focus on the social construction of psychoanalytic theories of therapeutic action. She notes the promise of the enlightenment/ modern era as impetus for an initially positivist “science” of psychoanalysis, and then implicates the scourge of the Shoah as that which galvanized the largely Jewish seminal community to cling to universal, versus contextual theories and technique. That the deconstruction of truth and authority, beginning with the post-war “baby boom” and student movements in the United States and Europe, put an end to one metapsychology is yet another example of the power of context upon ideas and praxis. This seemingly haphazard pairing of context and content determines the degree to which theories are embraced or ignored within any particular body politic, or within our tiny community at one time or another, prompting Kuriloff to warn against over valuing and/or excluding any theory, theorist, or technique from what we need to know and do to be helpful to people. This tension—between immersion in, and observation of the field—is what psychoanalytic theory and praxis ought to allow.     

HISTORICAL ASPECTS OF MINDFULNESS AND SELF-ACCEPTANCE IN PSYCHOTHERAPY

We describe some of the historical conditions that made possible Kabat-Zinn’s [(1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte] very successful use of mindfulness in his stress management program. The ground had been prepared by the nonjudgmental acceptance of people and symptoms by Humanistic psychotherapists, and by the increasing assimilation of Buddhist ideas into Western psychology and psychotherapy. In addition the word “mindfulness,” as the translation of the Pali sati, came to refer to both the manualized practice that provides the evidence for its efficacy in the hands of Kabat-Zinn and others, and the more complex process of clear comprehension and recollection that is described in his more discursive writings, and is similar to Ellen Langer’s use of “mindfulness” in her book of that name.

心理治療在慢性精神分裂症中的应用

心理治疗在精神分裂症中的应用曾經历曲折的过程。自从1933年胰島素昏迷、卞地查痙攣、电痙攣等一系列所謂“休克疗法”相继問世并大大提高精神分裂症的疗效以后,各国学者对精神分裂症的研究曾重点轉移到神經、內分泌、代謝障碍等方面的病理生理和生化問題上,并且获得了丰碩的成果,因而对心理治疗的兴趣就显著地減退了。然而目前神經、高級神經活动生理或生化机制并不能圓滿地解释病人所呈現的各种特殊的心理現象,所以心理动力学的問題随着神經生理和生化方面研究的深入发展,又引起人們的注     

心理治疗在慢性病綜合快速治疗中的作用

去年以来,北京市医学工作者在中央卫生部及市委領导下展开了一个声势浩大的慢病快治运动。在这个运动中,对70余种慢性病都取得了很高的或显著的疗效。取得这项成績的共同治疗方法是以发揮病人自觉能动性与中西医有效医疗措施相結合的綜合快速疗法。     

心理治疗在神經衰弱快速綜合疗法中的作用(在北京大学学生中进行神經衰弱快速治疗的經驗总結)

一、神經衰弱症过去的治疗情况 神經衰弱一向被认为是一个很难治癒的疾病,例如,某医院精神科門診的統计:在670个神經衰弱患者中,經过一个月至三年的各种治疗,結果仅痊癒3人,显著好轉者祇占20％,50％毫无效果。医学上已經传統地将神經衰弱視作最頑固的慢性病之一,絕非短     

PSYCHOANALYSIS AND PSYCHOANALYTIC PSYCHOTHERAPY

This paper attempts to address the similarities and differences between psychoanalytic psychotherapy and psychoanalysis as practice. Starting from the manifest technical points, which he dismisses as peripheral, the author reaches the position that he considers to be the fundamental area of contention, i.e. the tranference‐countertransference arena. Focusing on the countertransference stance of the professional in this process, the author distinguishes the defining differences of these two approaches, and hopes to show them to be more complementary than antagonistic.     

PSYCHOTHERAPY AS PHASE-SPECIFIC INTERACTION

I am writing this paper to help myself, and hopefully some readers, to a better understanding of why some analysands in certain phases of the analysis develop the idea that they are homosexuals or that their analyst is homosexual. My basic thought is that even if these ideas have their individual roots and differ from case to case, they are also dependent on certain phenomena that are included in the analytic encounter and specified by different gender constellations constituting the analytic couple. I will present two examples from my own practice. From these two vignettes, I will draw some conclusions which are supported by my general psychoanalytic experience. The first example concerns male analysands. I have often seen male patients develop the fantasy that they “in reality” are homosexual. This fantasy is so common that it is a rule in my experience. I see it as a product of the fact that the psychoanalytic constellation consists, as in my case, of two men. The second example concerns female analysands. In a few cases with female analysands, I have seen the fantasy emerge that I, the analyst, am homosexual—a fantasy not seen in my male cases. Another difference is that I can't see this as a rule like the fantasy of the male analysands. In both the male and the female cases, I see the homosexual fantasies as a protection against discovery of the mother-transference to me. However, the fantasies have found different expressions depending on the specific gender constellation of the analytic couple: man and man and woman and man, respectively.     

PREDICTORS OF ENGAGEMENT IN PSYCHODYNAMIC PSYCHOTHERAPY DERIVING FROM PRE‐ASSESSMENT QUESTIONNAIRES

Patients attending the Maudsley Hospital Psychotherapy Unit complete a semi‐structured questionnaire as a matter of standard procedure prior to assessment. Clinical experience suggests that this instrument reveals important aspects of a patient's internal world, regularly borne out at the assessment interview. The questionnaire may thus contribute to predicting engagement in the therapeutic relationship. To evaluate this hypothesis we conducted a qualitative analysis of 40 questionnaires, 20 of patients who attended 20 sessions or more, the other 20 of patients who discontinued at or before the sixth session. We differentially explored characteristics that may indicate the probability of patients' engagement and, hence, help to predict outcome in terms of completion of the treatment. The results indicate that there are no strong discriminating factors discernable in the questionnaires for the prediction of engagement in psychotherapy. Two themes emerged from the analysis that seemed to have a moderate bearing on completion. These are the willingness of patients to observe themselves reflectively as well as the awareness that psychotherapy might be a difficult but necessary and beneficial undertaking.