The therapist's body

Abstract

War Memoirs, W.R. Bion, ed. Francesca Bion, London: Karnac, 1997, 312 pp., £32.50 hb., £24.95 pb.

Freely Associated: Encounters in Psychoanalysis, ed. Anthony Molino, London: Free Association Books, 1997, 211 pp., £15.95 pb.

The Politics of Attachment, ed. Sebastian Kraemer and Jane Roberts, London: Free Association Books, 1996, 254 pp., £15.95 pb.

Psychotherapy and Society, David Pilgrim, London: Sage, 1997, 176 pp. £37.50 hb., £12.95 pb.

Handbook of Counselling in Organizations, eds. Michael Carroll and Michael Walton, London: Sage, 1997, 358 pp., £47.50 hb., £17.95 pb.

The Future of Counselling and Psychotherapy, ed. Stephen Palmer and Ved Varma, London: Sage, 1997, 208 pp., £37.50 cloth £12.95 pb.

Supervision of Psychotherapy and Counselling: Making a Place to Think, ed. Geraldine Shipton, Buckingham: Open University Press, 1997, 159 pp., £16.99 pb.     

The therapist's pregnancy: Evocative intrusion

This paper is concerned with addressing the complex impact of the therapist's pregnancy on the analytic treatment process. The pregnancy is seen as intensifying the transference and countertransference material so that the therapeutic work becomes more strenuous as well as more fluid, with the potential for significant therapeutic change. The paper is divided into two parts. The first section attempts to conceptualise the meaning of the experience for the therapist and patient within the framework of psychoanalytic theory. Problems of technique and management resulting from the pregnancy are examined. One of the issues considered is the manner and timing of the patient's recognition of the pregnancy. The second section of the paper contains extensive clinical material illustrating the enriched transference and countertransference processes, and the access these allow to psychotic pockets of the personality, hitherto largely unavailable for exploration.     

The therapist's poetry as a therapeutic incident

Poetry can be understood as an intrapsychic record of introspection, and as a means for interpretation in the therapeutic situation. In this installment (the second of a series to be eventually published at book-length) the authors examine from their personal research the uses, as well as dangers, of utilizing poetry in therapy. Poetry should not be used as a gimmick to direct the process of therapy, but as a point of spontaneous interaction, insight, and empathy. Used appropriately, poetry may bring to the client and to the therapist insight and meaning. The therapist may also use his or her own poetry as a creative means for recognizing countertransference in the therapeutic setting.Dr. Moss is an Episcopal Priest and the Executive Director of The Seabury Institute for Pastoral Psychotherapy, Atlanta, Georgia. He is also the co-author ofThe Organization and Administration of Pastoral Counseling Centers and Book Review Editor ofThe Journal of Religion and Health. Dr. Christensen is Senior Consulting Psychiatrist to the Pastoral Psychotherapy Institute, Park Ridge Illinois. In 1981 he was the recipient of the American Association of Pastoral Counselors' Distinguished Contributions Award. This paper was initially presented at the Southeast Regional Conference of The American Association of Pastoral Counselors, Hendersonville, N.C., 1983. Reprint requests should be directed to: The Seabury Institute, 2997 Piedmont Road N.E., Atlanta, 30305.     

The therapist's self in dialogical family therapy: some ideas about not-knowing and the therapist's inner conversation

In this article, the focus is on the therapist's self, which will be in line with Bakhtin's thinking, viewed as a dialogical self. First, the dialogical view of the self is situated in the context of psychology's traditional focus on the individual self. Then, leaning on Bakhtin and Volosinov, the self is described as a dialogue of multiple inner voices. Some of the implications of this concept for family therapy practice are examined, focusing especially on the therapist's participation in the therapeutic process and on the therapist's inner conversation. The author argues that not-knowing does not only refer to the therapist's receptivity and respect but also implies that the therapist is aware of his or her experience and reflects on how his or her inner conversation might inform and enrich the therapeutic conversation. Finally, these ideas are illustrated with a brief clinical vignette.     

The therapist's anxiety and resistance to group therapy

When therapists contemplate starting groups, consider placing an individual patient within an existing group, or respond to the group reconfigurations when members are added or replaced, it raises their anxieties and resistances. Under these circumstances, the therapist must contend with many intersubjective factors: dread, fear, and idealization of groups; contagion and amplification of psychological phenomena; absorption in the group mentality; magnification of the therapist's centrality and importance; exposure and disturbance of existing relationships, and utilization of one's own emerging and evolving thoughts, feelings, and fantasies, along with the group's. Therapists learn about themselves and their groups by reviewing their countertransference, being alert to possible enactments, and listening to their patients, whose anxieties and resistances to group often reflect their own.     

The group therapist's absence and the substitute leader.

When a group is led by a single individual the therapist's absence creates a management problem. This article presents several options for the solo leader. The author has used a substitute leader, and this experience is presented and evaluated. Discussion includes selection of a substitute, group preparation, on-going use of the substitute, and benefits of this alternative for the management of the leader's absence.     

The group therapist's shame: a much undiscussed topic

The topic of shame in group therapy has received limited attention in the group therapy literature. When the topic has been addressed, the focus has been on the shame of the group members. The shame of the group leader and its effect on leadership efficacy and group process has received inadequate attention, given what seems to be its power and prevalence. In this article we examine shame and the group therapist with regard to (1) potentially shameful topics and (2) dynamics that evoke shame. Suggestions for both the mitigation of shame and the enhancement of the leader's self-esteem in dispatching the role and functions of group therapist are offered. In discussing this subject, we propose to normalize group therapist shame by emphasizing the challenges and complexity of group leadership. While the examples illustrate an array of emotions, our purpose is to focus on their shameful elements because they are (1) frequently ignored or overlooked; (2) not made explicit; or (3) discussed in other terms, such as narcissism. In doing so, we invite the reader to consider the clinical utility of the hypothesis that shame has a powerful presence and impact on our leadership image and effectiveness.     

A therapist's ritual of respect

A great deal of attention in systemic family therapy has been given to the process and technique ofdeveloping 'therapeutic' rituals for families. In this paper we address the process of the therapist developing the ritual of practising respect. By practising respect the therapist shifts to a position similar to that of an anthropologist who is attempting to understand another culture and its epistemology. The ritual of practising respect has the potential of changing the therapist's tendency to move toward social control and moralist judgements. A case example is presented in this paper which illustrates the therapeutic ritual of practising respect for the client/family.     

The function of the therapist's affect in therapeutic conflict in groups

Group psychotherapy theory and technique are presented with the goals of helping group practitioners working with difficult clients: 1) develop a treatment plan; 2) create a therapeutic alliance; 3) foster a responsive group climate; and 4) utilize the therapist's countertransferential reactions in dealing with therapeutic conflict. Historical modifications of the analyst's role in the development of group psychotherapy are noted. Emphasis is give to the recognition of therapist-client identifications in order to separate feelings induced in the therapist from countertransferential reactions, to enable the practitioner to respond appropriately to the affective and inspirational substratum of therapeutic groups.     

The therapist's responsibility: a systemic approach to mobilizing family creativity

Three techniques, sculpting, geneograms, and family drawing are considered within a systemic approach to therapy. Frequently, emphasis is laid on either the activity of the therapist or the behaviour of the family in treatment. We focus on ways in which the therapist draws on the clients' creativity, relying for this on a correct assessment of their 'language' or 'idiom'. Certain assumptions are proposed, and case illustrations are used in their support. Our approach is that any material, or apparently no material, produced when using these techniques represents essential information which can be turned to therapeutic advantage by means of positive reframing. Although a framework within which to practise is viewed as essential, a 'game-plan' will almost certainly result in sterility and impasses in therapy. Therapist flexibility, it is proposed, is a prerequisite for creativity. We prefer to label resistance to treatment as failure by the therapist to recognize the clients' needs.     

Love in the counter-transference: The uses of the therapist's excitement

SUMMARY

The psychoanalytic tradition has always had difficulty with the question of the therapist's sexual feelings toward the patient. This paper traces that difficulty: from Freud's original struggle to replace moralism with a psychoanalytic mode of understanding, to the more recent literature on countertransference which still seems particularly averse to the possibility of the therapist's sexual experience. By way of a discussion of a psychoanalytic psychotherapy, I argue for the sometimes central therapeutic role of the therapist's experiencing, and then containing, excitement.     

Effect of therapist's title on perceived competence

A videotaped segment of a therapist and student/client was shown to groups of male and female undergraduates under four conditions. One group saw the tape with the title "Doctor (the therapist's actual name was used) and Client" superimposed at the bottom. The second group saw the same tape with "Mr. (blank) Client" superimposed, the third group had "Timothy (blank) and Client," while the fourth group had no title at the bottom. The 204 students rated the therapist on 11 variables. Analysis showed no effect for title and no interaction. Men rated the therapist higher on nine of the 11 variables, than did women.     

A trans-disciplinary study of the therapist's self

Participation in personal therapy during training is required by British accreditation bodies for counselling psychology as well as by most psychotherapy trainings. By contrast, trainee clinical psychologists are not required to undertake personal therapy, although they may elect to. Prior research in Britain and the US suggests that practitioners have a wide range of motives for entering therapy as well as motives for not doing so (Norcross &; Connor, 2005). This study addresses the fact that no research to date has specifically explored what individuals beginning their counselling psychology, clinical psychology and counselling training think and feel about participation in personal therapy during training. Data from open-ended questionnaires was analysed using inductive thematic analysis. Two main themes were identified. These consisted of: ‘Personal therapy helps me to be a better practitioner’, and ‘Personal therapy costs me’. The study results are considered in light of the limited prior research and recommendations for training are made.