The difficulty of understanding a borderline patient

SUMMARY

For much of the time during my work with Mr A, a borderline patient whom I saw for twice-weekly psychotherapy over a period of one year. I had difficulty understanding and communicating with him. I felt despairing and impotent and that therapy was not progressing at all. A few weeks prior to termination a shift occurred and I realised that there had been some improvement in Mr A's functioning. Although I was aware that behind the polite façade was an angry, disturbed man, I felt that he was a little more in touch with reality than he had been at the beginning of the treatment.

In this paper I will focus on the factors that contributed to my difficulty in understanding and communicating with Mr A. I will also attempt to account for his apparent improvement.     

Theological Reflections of an Adopted Daughter

Abstract

For as long as I can remember I had a sense of not belonging, of being a misfit. When, therefore, at the age of six, it was casually mentioned over the dinner table that I was adopted it was no surprise. I felt I had always known. As I grew up I dreamed of who my real mother might be, the circumstances of my birth and where I had come from. It was many years before I found some answers to my questions and, in the process, discovered more about myself and the nature of relationships.     

Understanding of moral emotions and social exclusion in pre-schoolers and third graders

Abstract

This study examined whether children use information about moral emotions when judging peer exclusion. Japanese pre-schoolers and third graders (N = 110) listened to stories featuring characters who felt happy or sad after engaging in immoral behaviour or avoiding immoral behaviour (pushing a child off a swing and stealing another child’s doughnuts). In study 1, participants judged the extent to which characters who felt happiness, guilt, and pride would be socially excluded. In study 2, participants judged whether characters who felt guilt, no guilt, pride, and no pride would be socially excluded. Participants believed that characters would be socially excluded based on moral emotions. Characters who did not feel guilt or pride were excluded more frequently relative to those who did; however, children found it easier to judge exclusion based on guilt rather than pride, especially in the case of pre-schoolers. Moreover, pre-schoolers had difficulty explaining their reasoning.     

The emperor's new clothes: A study of narcissism and delusional greatness,denial, splitting and projection in a centre for people facing the challenge of HIV and AIDS

Abstract

Last January I began work as an untrained volunteer counsellor at a drop-in centre for young adults in London. It was the first time I had done any counselling with adults, though I had worked with children, and I found myself to be extremely anxious. I was acutely aware of my untrained and inexperienced status, not to mention any other flaws in character and health I might possess, and acutely concerned about whether I could possibly discharge my responsibilities to any client who might come to me for help. I was in therapy myself, but it was not clear to me how this could help me on the spot, so to speak.     

The essence of being stuck: It takes one to think you know one or work on the therapist's own family

Abstract

I would like to tell you about certain strategies I used to change my relationship with my family of origin, particularly my mother and dad. I did this in order to become more me, more differentiated from them. In doing so, paradoxically, I established a closer, more rewarding relationship with each of them and with my own children, especially my second child, Mark, and a more effective relationship with families in treatment.     

Effects of children's emotional state on their reactions to emotional expressions: A search for congruency effects

Abstract

Three groups of 30 six-year-old children were tested to examine whether one's own happy or sad mood state causes a specific preference for happy or sad expressions in others, a systematic bias in the labelling of ambiguous expressions, and a selective memory for happy or sad expressions. In two of these groups, a happy or sad mood state was induced by a mental imagery procedure. The third group served as control subjects. It was found that all groups showed a distinct preference for happy faces. Happy children, however, tended to opt for extremely happy faces, whereas sad children chose mildly happy expressions. Furthermore, children (especially the children that received a happy mood induction) were inclined to interpret ambiguous expressions as being congruent with their own mood state. Finally, the “sad” group recalled fewer expressions correctly than the other two, irrespective of the nature of these expressions. Overall, the happy face was more often correctly identified than the sad one.     

Healing presence in the psychotherapist

Abstract

Throughout graduate school I felt compelled to become a fine psychotherapist. Implicit in that motivation was my curiosity about what makes a psychotherapist effective. My curiosity was inspired by my experience with one therapist who helped me activate profound transformation. After identifying intuitive inquiry (Anderson, 1998, 2000, 2004) as my research method, I explored that experience through meditation, reading, and conversation and eventually identified her healing presence as the core quality that differentiated her from other therapists I had known. Though technique and experience are important, I sensed that it was her healing presence that allowed her to use technique and experience skillfully. Throughout Cycle 1 of intuitive inquiry, the “text” that claimed me was my personal experience of her healing presence, her ability to be present, to connect with me, to see me, and even, to love me. Through intuitive inquiry, I was able to expand my understanding of the healing presence of a psychotherapist to incorporate the experiences of many others.     

I. R. Owen. Psychotherapy and Phenomenology. New York: iUniverse,Inc.

Abstract

This study¹ explores the experience of the body for contemporary female mystics. It is an exploration in how women mystics of today—those who have devoted most of their lifetime to prayer, meditation, and spiritual service—make sense of the body. What is the relationship between spirit and body, God and flesh, for such women? Is it a relationship of tension or even opposition, and how does it evolve over time? These are some of the questions that guided my investigation. The impulse to understand how the body is experienced and understood by such women was felt by me as both a longing to challenge, deepen, and refine my awareness and understanding of spirit and the body, specifically for women mystics. I also felt this as a burning in the heart, an urgent desire to connect and bridge the larger world of matter and that of spirit, to inquire into that dimension where flesh and spirit are not two, but one. I believe that this impulse to understand the relationship between body and spirit is both personal and quite possibly collective. My hope is that this research will serve as one step to further our collective understanding of human embodiment.     

‘Adolescent fantasies and the horror-film genre‘: The freud museum 1995 spring conference

Abstract

As I walked towards home across Waterloo Bridge, having left this conference in its apt setting of the National Film Theatre, I realized I had attended the day from two points of interest: firstly, from my professional position of working in a university counselling service where I encounter adolescents and their ‘phantasies’ regularly. Only the other day a young student I had been seeing started the session by telling me she had seen the film Interview with the Vampire the night before, had been sick at the end, and then casually ‘threw up’ to me that she did not think she would need to go on seeing me.     

Reply to Psarros: Popper and Chemistry

In this article I reply to criticism of my published work by N. Psarros (Journal for the General Philosophy of Science 28: 297–305,1997). I show that I had already answered the first criticism in my published work and not overlooked his supposed refutation. However I offer a plausible argument which he could have used to strengthen his claim. Psarros cites my work on Hopkins in his opening paragraph, but then makes no further reference to it in the text. I indicated to Psarros verbally at Ilkley 1994 (and reiterate the message here) that Hopkins' work on Vitamins is the exemplar of a Popperian historical episode and must require addressing by the opponents of critical rationalism. This revised version was published online in August 2006 with corrections to the Cover Date.     

Therapeutic Action in the Work of a Playful Clinician: A Reflection on Dr. Silber’s Reimagining of Humpty Dumpty

ABSTRACT

In my discussion of Dr. Silber’s paper, Reimagining Humpty Dumpty: The Therapeutic Action of Play, I mirror Dr. Silber’s playful posture in her use of the Humpty Dumpty fable to talk about children and their care by society. My reflections on Dr. Silber’s therapeutic work with her two young patients focus on her co-creating meaning with each child’s parents as well as with the child. I discuss that by holding in her mind both the subjectivities of the child and his parents, Dr. Silber is able to practice a fundamentally relational therapy. I would have liked to have heard more about her emotional reactions in her work with both cases as another important dimension of her work. Finally, I emphasize through my play with Humpty Dumpty several ways that society can support children and families that are essential for their development: parental leave, developmentally approptiate expectations for children in school, and the facilitation and protection children’s open ended time and ability to play.     

Memoirs of a Mentor: Using Creativity for Counselors in Coping With the Loss of a Mentor

This article was inspired by my (S.S.) own personal loss. My mentor passed away during spring break of my 2nd year postgraduate school after a short battle with systemic lupus. I remember the deep sadness that I felt when it became apparent that she was coming home from the hospital for the last time. No words can describe the emotions; she had helped me through the toughest times in my academic life. How would I ever get the type of mentorship she provided again? She was there when I almost quit as a young student, back when my anger still got the best of me. She talked me down from the edge so many times; I never expected to be on this journey without her.

I dedicate this article to her and mentors like her. Equally, I dedicate this article to mentees who have lost their mentors. I offer my story (in italicized font) in the hopes that it will help others who are dealing with a similar loss. In this article, we attempt to illuminate the true power of mentorship, honor the significance of the relationship between mentor and mentee, and provide a tool useful to anyone who has lost their guide. I share my story in gratitude for my own mentor; I am so thankful that she was a part of my journey and that I can pass on to others the patience she had with me.     

An Analysis of the Effectiveness of the Intervention

SUMMARY

In this chapter, I examine the specific problem Betty had with her children because, in many ways, it represents the problems most of the volunteers had with their children. Her problem was the most extreme among the participants, and she involved the other volunteers in helping her look for a solution. The vignette that follows comes from my field logs, and it is followed with a layered response from Betty's peers. The vignette offers a close look at Betty's problems with her daughters and the dilemma she experienced in relation to coming to work when her children needed her. Betty told her story to Esther, Dolores, and me one morning in the dayroom.     

Retrospective reflexivity: The residual and subliminal repercussions of researching war

Stories of the war have been a known part of my story as granddaughter of Polish post-war migrants. Yet venturing into these stories as researcher has been troubling; I found their closeness and their raw emotion difficult to process. Significant sections of my interview schedules entailed participants recounting their own, their parents' or their grandparents' stories of war and migration, with traumatic episodes frequently intersecting into their stories. As a researcher, these traumatic narratives have had a residual quality, lasting in my subconscious long after the interviews themselves and doctorate for which they were conducted had finished.In this paper, I focus on experiences of, and reactions to listening to, analysing and writing about these traumatic cultural memories. Collins (1998: 3.35) has observed that ‘the emotions experienced, whether by the interviewer or interviewee, are as real, as important and as interesting as any other product of the interview’; my powerfully felt experiences with traumatic content have validated this sentiment. With a retrospective reflexivity I now realise that these cultural memories were not the only ‘product’ of my research, but that how they were narrated and how I dealt with them were also a significant part of the research process, and indeed stories in themselves. Here I attempt to retell how these stories impacted me as the researcher; how in the case of particularly harrowing stories, I also needed time to absorb the narratives, to comprehend the participant's experiences and their ability to narrate such stories, and to recover from the experience of listening to such accounts.     

Book Reviews

Abstract

This paper is an attempt to think about the competing factors which shape the nature of university education now. The funders, potential employers and students all approach die university with particular needs and ideologies, and it seems that die actual providers, the university personnel, have the task of managing the conflicts and the anxieties underlying the needs. However, they also have their needs, their beliefs about the purpose of education and their worries. Drawing broadly on psychodynamic concepts and using examples from my experience as a lecturer, counsellor and organizational consultant, I look at the effect of these tensions on the functioning of the university.     

Hidden feelings 1945-95

Abstract

It was a fact learnt early in life: wherever I travelled in Europe as a teenager, it paid me to explain that I was Dutch, not German. And when I left home at 18, in search of the elusive key to good faith and freedom, and came to Britain, crossing the Channel to reach the sole part of Europe untouched by enemy invasion, I felt I was welcomed like a lost daughter; many people told me of the part they played in the liberation of Holland in 1945. And now, fifty years after the historic events of the Second World War have passed, I still like to invoke the ‘magic’ if I can. While staying in a bed and breakfast in Coventry recently, I pointed out to the landlady that a morning call, as written down by the German guest, was requested at 7.15, instead of, as she had read, at 9.15. ‘Oh’, she said, annoyed, realizing the mistake: ‘Do they cross their number seven? We never do’. I was instantly eager to clear my name: ‘The Dutch never do so either’     

A Psychotherapist Retires

Abstract

This article reflects on a year of my personal experience as I prepared to retire from my psychotherapy practice of 40 years. While aware that this might be a poignant experience for bothmyself and my clients, my own surprising emotions and dreams demanded that I pay attention to myself. By acknowledging my feelings I was able to direct sensitive attention to the clients' feelings of loss and sadness. Finding the balance between the sadness that filled the therapy room and my own enthusiasm for what awaited me outside that room, was not a simple task     

Counterfactuals: Ambiguities,true premises,and knowledge

In this paper I explore the ambiguity that arises between two readings of the counterfactual construction, then–d and thel–p, analyzed in my bookA Theory of Counterfactuals. I then extend the analysis I offered there to counterfactuals with true antecedents, and offer a more precise formulation of the conception of temporal divergence points used in thel–p interpretation. Finally, I discuss some ramifications of these issues for counterfactual analyses of knowledge.     

A Model Psychosocial Support Training and Workshop during a Medical Mission for Syrian Refugee Children in Jordan: Techniques,Lessons Learned and Recommendations

ABSTRACT

This article describes a model training and workshop for volunteers that was implemented with child refugees in Jordan, to build empowerment, resilience, and connection with others. The importance of such services for this population is emphasized. The present model, with elements of arts activities and play similar to those used in the Child Friendly Spaces, is based on my extensive experience working with diverse populations under various conditions of crisis, natural disaster, and infectious diseases, mainly in low resource settings. I review activities from my toolbox, their purpose, methods, and processing. The clinical value of such psychosocial support is presented, as has been shown by pilot research in several settings, despite limitations of conducting empirical assessments, which are discussed. Lessons learned and recommended are given. The intervention for refugee children is presented in the context of international policy agreements that provide an important foundation for such projects that clinicians and researchers can use to support their work for this population and others, in efforts to heal children from the traumas of refugeeism and other similar extreme stresses.