Promoting Recovery Identities Among Mothers with Histories of Addiction: Strategies of Family Engagement

Changes in identity are critical to managing transitions to recovery from substance and alcohol addictions. Identity change is particularly important for mothers, whose recovery processes are often in the context of critical but complex family relationships and societal expectations. But research and practice often underestimate the relational dimensions that promote or inhibit changes in one's identity during recovery. Here we analyze data from a study that involved interviews with 30 formerly incarcerated women participating in a community-based substance use treatment program in the Midwest. Drawing from Constructivist Grounded Theory Methods, our analysis identified three factors shaping levels of engagement with family members: (1) the relational consequences of a shared past; (2) ascribing permanence to the old identity of “addict” versus the ability to see women's capacity to change; and (3) the current provision of caregiving support to participants’ children. Our analysis supports and extends existing research by highlighting how family can both promote and inhibit a recovery identity process. We discuss potential implications for theorizing “recovery” and “identity” as relational and identify key elements to support practices more attuned to the hidden complexity of family support.     

Familientherapie

In the field of family therapy besides the emphasis on the autonomy of the different schools (behavioral, psychodynamic, systemic), partly motivated by professional politics, a growing openness for concepts developed in other approaches can be observed. Approaches and results of attachment and affect theory and research find their way into the conceptualization of family processes and family therapy. Processes in the “self” of the therapist are taken into the discussion of therapeutic processes in systemic therapies. Furthermore, new fields of application of family therapy approaches have developed: parents-infant therapy and counseling, therapy of the elder, family medicine and coping with the consequences of the “human genome project”. New research on the empirical validation of relational dynamic concepts and on the evaluation of family therapies show a trend to see the claim for making treatments as short as possible in very relative terms. It is assumed that the family therapeutic approach will become more important in the future.     

L'influence de l'activation des rapports intersexes sur les choix en faveur de la famille,du travail,du bénévolat ou des loisirs personnels

The aim of this paper was to study how the activation of intersexes relations affected the choices of activities linked to “relational” or “market” individualism. Firstly, as in Marro's research (1998), stories were presented in which the protagonists, being female or male, for different reasons (personal, professional, etc.) must decide or not to modify the time allocation that they devote to various activities, such as family, work, leisure, or voluntary help. Next, the subjects had to point out which choice they would personally advise. In addition, an activation of intersexes relations was carried out. The results have shown: 1) that personal advice in favour of “relational” or “market” individualism are found in both sexes ; 2) that the activation of intersexes relations modified more personal advice of female subjects than of male subjects (then more oriented, to family and work for women, to leisure for men).     

Examining the link between institutional and community violence: Toward a new cultural paradigm

New explanations of cultural processes are sought, in part, because existing hypotheses are at odds with new wave contemporary empirical findings. Namely, a growing body of scholarship calls into question the “racial invariance” hypothesis proposed by Sampson and Wilson (1995), particularly as it applies to Latinos. Based on these findings, it stands to reason that culture, in addition to structure, may be a property of communities that helps to explain racial/ethnic involvement in crime. This article explores the link between institutional and community violence, and then compares traditional perspectives on the influence of culture on violence (e.g. Wolfgang and Ferracuti’s subculture of violence) with newer, more dynamic conceptualizations of the cultural influence of violence in both institutional and community settings (e.g. Sampson and Bean’s relational theory of culture). The authors consider how both institutional and community violence may be explained using a new cultural paradigm, which moves beyond traditional views of “culture as values” to a new relational theory of “culture in action”. They present a model for understanding, and researching, culture that is based on the notion that value systems in institutions and neighborhoods influence one another. Offering examples from recent research on prison culture, they examine the key dimensions of this new cultural paradigm, which describes culture as “intersubjective, performative, cognitive, relational, and world-making”. The authors conclude that further examination of the reciprocal relationship between institutional and community culture is needed before we can begin to consider the policy implications of the “culture in action” paradigm.     

Trauma Child on The Couch: Transference,Introjection, Identification

This paper attempts to explore some of the psychic processes at work with patients whom I identify as the “trauma child”. The term is a metaphor rather than a diagnosis of “traumatisation”, to indicate patients particularly resistant to maturational processes. They feel blocked and thereby find it difficult to evolve as creative adults. As opposed to the “traumatised” child no particular distressing event can be identified as a cause for emotional suffering. The malaise is often “low key” or silent but functions as a saboteur, undermining satisfactory existence. The trauma child is constantly seduced by regressive functioning and bound by numerous strategies of resistance of reality and often incapable of relinquishing the boundless pleasure of omnipotence. On the basis of my clinical work with the “trauma child”, I will explore the different processes of introjection in transference and counter transference, paying particular attention to the dynamics of identification between analyst and patient and its implications for object relations. Instead of “healthy” identification with the other, taking account of difference and reality, the mode of object relations can be that of “pathological imitation” based on fantasies of oral incorporation. A kind of regressive defense against “mature” relationships; it is an attempt to acquire a substitute identity through magical imitation. Analytical listening, associative work and interpretation stimulate maturational processes within the patient and help him/her to let go of immature relational modes fixated in childhood.     

Moving from “I” to “We”: A Grounded Theory Analysis of Couple Therapy with Liver Patients and Their Partners

Prior research indicates that couples who cope with chronic illness from a relational “we” orientation experience more positive outcomes than couples that cope individually; however, little prior research identifies clinical processes that promote reciprocity or how societal gender processes are involved. This grounded theory analysis of 25 videotaped therapy sessions with six heterosexual couples coping with chronic liver disease (LD) used a feminist-informed relational lens to focus on the clinical processes involved in shifting from an individual to a relational orientation. Findings identified three contextual barriers to attaining a “we orientation”: (a) autonomy discourse, (b) illness-related power, and (c) gendered power. Analysis detailed therapist actions that decreased the impact of barriers to reciprocity and fostered relational coping. Clinical implications attend to complex intersections among gender, caregiving, and contextual barriers to reciprocity.     

The Death of Resistance

For any conceptual distinction to be useful ( 5 ) within the field of family therapy, it needs to lead to some clear answers to the question: What does this distinction mean for clinical practice? The distinction between (a) the family-as-a-system, and (b) family-therapy-as-a-system leads to a clinical perspective, or stance, that includes a focus on changing. Once this focus is clear, the therapist can help to create the expectation of changing and consequently promote changing. That is, techniques can be developed using positive feedback loops. ¹ 1 It is important to remember throughout this essay that “positive” and “negative feedback loops,”“deviation-amplifying,”“deviation-counteracting processes,” etc., are just heuristic devices or metaphors. Human systems do not have such things. Human systems are described by an observer “as if.”
Moreover, this distinction leads to a therapeutic stance in which not changing is a surprise.     

At the verge of unthinkable anxiety: On the relevance of a neurophysiologically informed relational perspective on meaning-making in psychosis

Abstract

This article examines the relevance of relationally oriented psychoanalytic phenomenology as a frame of reference for understanding psychotic states in schizophrenia. The etiology and structural characteristics of such states are examined from both a neurophysiological, and a relational and interpersonal point of view. Many findings indicate organic abnormalities in schizophrenia, acquired through an exposure to physical risk factors and genetic predisposition, but relational traumas also seem to have an impact on the form and content of psychotic states. This may happen through interruptions in the “use-dependent” maturation of the brain in a relational milieu. In addition, at the level of meaning-making, we find that the emotional and relational contexts—both past and present—give the substance or “raw material” for hallucinations and delusions. In a psychotic state, the person also tries to handle basic affects and relational needs, and to make meaning in states of overwhelming chaos and anxiety. Donald W. Winnicott's theory of “a holding environment”, Stephen Mitchell's theory of the relational matrix, and Stolorow, Atwood, and Orange's concepts of a “shattered world” and annihilation anxiety are used as a framework in the analysis of the phenomenology of psychosis. Two case illustrations, one from child psychotherapy and one from therapy with an adult patient, are used to illuminate the theoretical points of view.     

Love,Sex, Romance,and Psychoanalytic Goals

There are many ways for people to have meaningful relationships and satisfying lives, which may differ from the implicit Freudian psychoanalytic ideal of the couple that sustains love, intimacy, romance, and genital sexual passion throughout life. An alternative is proposed, based on the work of Harry Stack Sullivan, which examines the ability of the person to find love, sexual satisfaction, security, and happiness in a combination and arrangement that feels satisfying and that allows for interpersonal intimacy without coercing or harming another person. Good clinical work also considers what John Money called the “lovemap,” a cluster of relational and sexual patterning for the individual that can be relatively enduring throughout the lifespan.     

WHAT CAN PIAGET OFFER LONERGAN'S PHILOSOPHY OF BIOLOGY?

In Insight, Bernard Lonergan provides, albeit schematically, a unique philosophy of biology which he takes as having “profound differences” with the world view presented by Darwin. These turn on Lonergan's idea of “schemes of recurrence” and of organisms as “solutions to the problem of living in an environment.” His lapidary prose requires some deciphering. I present the broad lines of his philosophy of biology and argue that Jean Piaget's structuralism can shed light on Lonergan's intentions in virtue of his use of cybernetics and the isomorphism between biology and knowledge. In turn, Piaget draws on Waddington's restatement of epigenesis and I suggest that the result, “process structuralism,” is a viable alternative to the modern Darwinian synthesis.     

Healing Intergenerational Wounds: An Integrative Relational–Neurobiological Approach

Old resentments and unfinished business from the family of origin can constrain adults in current relationships with parents or siblings and negatively affect relationships with partners or children. This article explores how old wounds get reactivated in current relationships and contribute to the intergenerational transmission of painful legacies and trauma. Building on intergenerational family theory and interpersonal neurobiology, the dynamics of reactivity and pathways for growth are explored. While much of the time the human brain is on autopilot, driven by habits and emotional reactivity, we are capable of bringing prefrontal thoughtfulness and choice to close relationships. Rather than being victims of parents or our past, we can become authors of our own relational life. Interventions are offered to help adult clients “wake from the spell of childhood,” heal intergenerational wounds, and “grow up” relationships with family of origin. The damage caused by parent‐blaming in therapy is explored and contrasted with Ivan Boszormenyi‐Nagy's emphasis on rejunctive action and cultivating resources of trustworthiness in intergenerational relationships. The family is considered both in its cultural context—including stressors and resources for resilience—and in its life cycle context. Aging in the intergenerational family is discussed, focusing on ways adult children and their parents can grow and flourish with the challenges at this time of life. Throughout, the theme of relational ethics—how we can live according to our values and “reach for our best self” in intergenerational relationships—informs the discussion.     

Reflections on relational readings of organizational learning

In this concluding article we further reflect on relational readings of organizational learning and how they can contribute to organization studies and organizing practices. As has been seen, the root metaphor of “organizational learning” takes a variety of forms. These include “product-oriented” pictures such as learning curves, strategy, and business processes, and the generative metaphor of organizational learning as conversations-for-new-possibilities. This special issue highlights the contribution of learning-as-conversations, especially in those organizational instances where the organizing is “in-the-making” and where the creation of a transitional space can be a new meeting ground for participants. In an increasingly globalized world we are more and more in need of the ability to construct such transitional and possibility-enabling practices. It can be a task of work and organizational psychology to contribute ideas and practices for this endeavour.     

“The Gift of an Apple or the Twist of an Arm”: Negotiation in Couples and Couple Therapy

This paper explores the role of negotiation in couples and couple therapy from a relational perspective, situated at the interface of psychoanalytic and systems theories, that emphasizes intersubjectivity. We consider the clinical processes through which members of a couple may be helped to develop competence in basic elements of intimate communication and negotiation, including reflective listening, mentalization, and recognition. Clinical examples illustrate therapeutic movement from projective-introjective “transference” repetitions within a couple's relationship toward a growing ability to transcend the intrapsychic “demons” that haunt the couple. Specific technical measures are described, including the use of communication “exercises” and “homework” in the context of analytic couple therapy—what we term working from the outside-in and the inside-out—as well as the potential functions of a cotherapist team for particular couples.     

Neurowissenschaften und Psychotherapie

The rapid development of the cognitive neurosciences is based on interdisciplinary efforts and on a broad repertoire of research methods ranging from molecular biological to functional neuroimaging procedures suitable for the study of complex, ongoing intrapsychic processes. Selected recent results that are relevant for psychotherapy are discussed. They are based on genetics, on animal studies about the impact of early relational experience on brain development, further on memory research, on functional neuroimaging (PET, fMRI), and on first studies about the impact of psychotherapy on the brain. Neuroscience studies confirm some major psychoanalytic hypotheses (crucial role of early experience, unconscious processing) and question others (e. g. structural models). They help to overcome the split between “somatic” and “psychological” theories and treatments and open new, interdisciplinary research perspectives for psychotherapy.     

Family Therapy in China

This paper aims to provide an overview of the family therapy in mainland China, by analyzing its development, current situation and future directions. The authors argue that the history of family therapy can be understood as three stages: introductory stage from 1985 to 1994, “blossoming” stage from 1995 to 2004, and “fast growing” stage from 2005 to present. In every stage, we can see clear differences in each of the following fields: training (including training programs in universities and workshops held by companies or institutes), academics (including research articles, professional books and conferences), and general public environment (including media and policies). We also outline the development of China’s first university system family therapy training program as an example and evidence of family therapy’s significant present and future development in mainland China. Based on this, we highlight some points for future improvement in family therapy in mainland China, including developing indigenous theories and practice models, reinforcing training and research programs in university systems, and improving accreditation standard for all family therapists.     

Making Probabilistic Relational Categories Learnable

Theories of relational concept acquisition (e.g., schema induction) based on structured intersection discovery predict that relational concepts with a probabilistic (i.e., family resemblance) structure ought to be extremely difficult to learn. We report four experiments testing this prediction by investigating conditions hypothesized to facilitate the learning of such categories. Experiment 1 showed that changing the task from a category‐learning task to choosing the “winning” object in each stimulus greatly facilitated participants' ability to learn probabilistic relational categories. Experiments 2 and 3 further investigated the mechanisms underlying this “who's winning” effect. Experiment 4 replicated and generalized the “who's winning” effect with more natural stimuli. Together, our findings suggest that people learn relational concepts by a process of intersection discovery akin to schema induction, and that any task that encourages people to discover a higher order relation that remains invariant over members of a category will facilitate the learning of putatively probabilistic relational concepts.     

The “death of freud”; and the rebirth of free psychoanalytic inquiry

The relevance of Grunbaum's recent critique of psychoanalytic theory is explored as it relates to relational/interpersonal theories. Griinbaum finds no scientific evidence for repression, the cornerstone of psychoanalysis. I argue that studies demonstrating the effects of motivated, unconscious processes are beginning to emerge in psychological research. This research, as well as interpersonal theory, refers to these processes as dissociated, not “repressed.”; I agree with Griinbaum that scientific validation of psychoanalytic theories of the mind, personality, and change cannot be gleaned from case studies alone. In relational theories the analytic situation is admittedly “contaminated”; with the analyst's participation by its very nature. There is beginning to be support for some relational hypotheses, but measures to validate these hypotheses are only now being developed. Grunbaum's criticisms have come at a time when the convergence between relational theories and theories in social/clinical psychology makes it more likely that relational hypotheses will be articulated in a more precise manner by researchers, if not by analysts.

The issues of the difficulty of measuring unconscious processes and the quest for knowledge seemingly beyond human limitations are addressed. Psychoanalysis is not only less than scientific, but more encompassing, in that it is also a creative activity that cannot be understood through science alone.

Science is not enough, nor art: In this work patience plays a part [Goethe].

The most beautiful and deepest experience a man can have is the sense of the mysterious.... To me it suffices to wonder at these secrets and to attempt humbly to grasp with my mind a mere image of the lofty structure of all that there is [Albert Einstein, quoted in Pagels, 1985].     

Relational Psychoanalysis Potential Usefulness with Black South African Clients

The aim of this article is to suggest that relational psychoanalysis may be a useful approach for working with clients from indigenous African cultures. In particular, the article considers the utility of relational psychoanalysis to understanding and enacting the therapeutic relationship with clients from an indigenous African cultural background. The notion of “we” self from the perspective of African cultures is a case in point for possible compatibility between relational psychoanalysis and black clients who come from background that place a high value on communal or “we” selves. An integrative therapy that combines African worldviews and relational psychoanalysis is possible.     

Moments of Therapeutic Impasse: Commentary on Jody Messler Davies's “Whose Bad Objects Are We Anyway? Repetition and Our Elusive Love Affair with Evil”

Davies contributes to the development of relational theory by formulating and illustrating what occurs during especially difficult moments in an analytic exchange. In understanding enactments, Davies importantly underscores the contribution of both the analyst's and patient's “bad objects.” This author attempts to build bridges between Davies' language and concepts anchored in object relations theory and this author's language and concepts based in contemporary or relational self psychology, including the integration of cognitive psychology. In addition, this author delineates the use of the “empathic,” “othercentered,” and “analyst's self” listening/experiencing perspectives to explicate the case material and to provide alternative understandings and pathways for psychoanalytic work. The thesis set forth is that the use of different listening/experiencing perspectives expands choice for the analyst when working in difficult moments of the clinical exchange.