Psychotherapie und die Anerkennung des Fremden

The aim of the present paper is three-fold: it reveals the inherent limitations of the concept of disorder in psychopathology and psychotherapy. It argues that characteristics of the person such as individuality, subjectivity and identity, have to be considered in psychiatric and psychotherapeutic concepts. And it shows that psychotherapy is dependent on cultural, social and socio-economic factors that are neglected in many theories. The paper uses clinical and epistemological arguments. It arrives at the conclusion that the above mentioned limitations have a common ground. They could be overcome, if psychiatry and psychotherapy were self-reflective and self-critical in respect to the inherent limitations of theory and practice and if they integrated concepts of being different in their basic theories so that symptoms, persons and cultural or societal peculiarities could be recognised and acknowledged.—The paper has been written as a comment to D. Orlinsky's statements considering disorder-specific psychotherapies from the viewpoint of psychotherapy research.     

Mentalizing in psychotherapy: patients’ and therapists’ reflective functioning during the psychotherapeutic process / Mentalizando en psicoterapia: funcionamiento reflexivo de pacientes y terapeutas durante el proceso psicoterapéutico

Abstract

There has been a growing interest in mentalization in clinical research given its relationship with normal and psychopathological functioning and its explanatory potential as a mechanism of psychotherapeutic change. This study uses the Reflective Functioning Scale (RFS) to identify and characterize mentalization manifestations in psychotherapeutic interaction. Method: the RFS was applied to a sample of relevant episodes — 44 sessions from five different psychotherapy processes carried out with adult patients who had different diagnoses. Results: we observed a higher probability of reflective functioning (RF) passages in relevant events than in neutral segments. There were no differences in the RF passages according to episode or actor type, but there were in RF Failures, which is more likely in patients and during rupture episodes. Discussion: although certain modifications are necessary, the RFS can be applied to clinical material, and it is a promising strategy for the study of mentalization within psychotherapy.     

The Phenomenological Approach to Art Therapy

The present paper discusses the phenomenological approach to art-therapy and suggests an operational terminology for its main theoretical concepts. First we present the general assumptions that underline art therapy. Definitions, leading approaches, and the therapeutic effect of artwork are considered. Next we indicate the need for relevant and particular theories of art therapy. Phenomenological theory is examined as a case in point because of its popularity among art therapists. Despite its philosophical appeal, however, we find phenomenological theory lacking the operational terminology that is essential to form a coherent and distinct school of therapy. In the present paper, we extract from phenomenological theory operational principles, which can be followed and applied by art therapists. In this analysis, we take into consideration Betensky's pioneer attempt to create the bridge between phenomenological theory as applied in verbal psychotherapy and art therapy. We end by discussing the urgent need to operationalize other verbal psychotherapeutic theories so they are relevant for art-therapy practice and may help create greater similarities among art therapists of the same school of psychotherapy.     

Neurodynamics inside therapeutic interaction: a case study with simultaneous EEG recording / La neurodinámica en el contexto de la interacción terapéutica: un estudio de caso con una grabación simultánea de EEG

Recent research on processes of psychotherapy has focused on the study of patient-therapist regulation. Evidence concerning verbal and nonverbal coordination as predictors of therapeutic alliance and outcome in psychotherapy has been cumulating. These, along with others results in the field of social neuroscience, suggest that behavioural coordination may have neurophysiological correlates, which play a role in the regulatory process in psychotherapy. Here we introduce an observational paradigm and analytic method to assess the joint neurodynamic activity of patient and therapist. Additionally we report results from ongoing psychotherapy sessions. Our work highlights the involvement of brain activity in the psychotherapeutic process and provides novel insights on how psychotherapy works, in order to further the understanding of the embodied characteristic of the therapeutic interaction.     

Multiple personality disorder and the choice of self: Change factors in a brief therapy case

A person who identified herself as having a multiple personality disorder made remarkable changes after seven psychotherapeutic sessions and two batteries of tests, one on the alter. The case raises such problematic issues as the diagnosis of MPD, the unitary versus discrete theories and treatment of it, change factors in brief psychotherapy and for all psychotherapy, and the use of psychological tests.     

Virginia Satir's Process of Change

SUMMARY

This article describes Virginia Satir's theoretical base out of which grows the theory and practice of her process of change in psychotherapy. Her theory is set in a context of other psychothcrupeulic theories and is described with case examples of application. Virginia's process of change is applied to individual, couple and family therapy particularly its application to cultural change is discussed.     

Suggestion,persuasion and work: Psychotherapies in communist Europe

Abstract

This article traces what recent research and primary sources tell us about psychotherapy in Communist Europe, and how it survived both underground and above the surface. In particular, I will elaborate on the psychotherapeutic techniques that were popular across the different countries and language cultures of the Soviet sphere, with a particular focus upon the Cold War period. This article examines the literature on the mixed fortunes of psychoanalysis and group therapies in the region. More specifically, it focuses upon the therapeutic modalities such as work therapy, suggestion and rational therapy, which gained particular popularity in the Communist countries of Central and Eastern Europe. The latter two approaches had striking similarities with parallel developments in behavioural and cognitive therapies in the West. In part, this was because clinicians on both sides of the ‘iron curtain’ drew upon shared European traditions from the late nineteenth and early twentieth centuries. Nevertheless, this article argues that in the Soviet sphere, those promoting these approaches appropriated socialist thought as a source of inspiration and justification, or at the very least, as a convenient political shield.     

Behandlungsmotivation und Indikation von Psychotherapie

Concepts and results of research into treatment motivation under psychotherapy are discussed with regard to the question whether decisions for indications on the basis of the motivational characteristics of patients are reasonable. Established concepts and broader theories of treatment motivation as well as diagnostic tools for the assessment are presented. Subsequently, empirical results for the effects of motivational factors on the maintenance and success of psychotherapy are briefly sketched. Approaches aimed at the enhancement of treatment motivation before and during psychotherapeutic processes are then illustrated. Finally, it is emphasized that, in turn, features of individual therapeutic processes may provide a basis for the indication of motivational enhancement interventions, thus supporting the notion of a dynamic nature of treatment motivation.     

Section IV: Group Psychotherapy with Adults a Review of Recent Trends and Practices

The group psychotherapy of a population of cognitively intact men, aged 70–95 years, resident in a home for the aged is described. Although this age group is often thought to be nonresponsive to psychotherapeutic intervention, it appears that group psychotherapy is a valuable modality in addressing the common clinical picture of social isolation, depression, and demoralization. The paper describes certain technical modifications in the conduct of the group by the leader—high activity and support, therapeutic transparency, translation, and integration—that facilitate this process. Psychodynamic aspects of aging and of living in an institution are also elaborated, with particular reference to the role of the life review, current theories of narcissism, and the consequences of the men's efforts to maintain their self-esteem and sense of self in the face of recurrent narcissistic injuries and losses.     

Mental Health Matters

Abstract

This article discusses the epistemological biases and therapeutic risks of overly-medicalized and deterministic approaches to women's psychological problems. Constructivist and feminist perspectives are used to illuminate the essentially political enterprise of naming psychological distress, and to argue the necessity of feminist theories of psychotherapy. These too, however, must be critically examined for deterministic assumptions which emphasize pathology or victimization, thereby limiting recognition of women's agency, and capacity for resistance and change. One alternative model is Adler's Individual Psychology. This humanistic approach is neither medicalized nor deterministic, assumes human freedom and pur-posefulness, emphasizes the dialectic interaction of the individual and society, and is philosophically committed to gender equality.     

Existential psychotherapy and the therapeutics of activism*

This paper considers the socio-political perspectives of Sartre, de Beauvoir and Fanon and their relationship to existential psychotherapy practice. It argues that their existential analyses of oppression must play a greater part in informing existential psychotherapeutic practice and pedagogy. In this current neo-liberal political age, in which therapy is increasingly being utilised as a form of psychological coercion and mystification, an understanding of the structures and systems of alienation and oppression that construct experience must translate to a broadening therapeutic concern beyond individual to social change. The author suggests that engaging with a politics of alienation and actively responding to the oppressive social conditions which generate distress and marginalisation should be intrinsic to existential psychotherapy practitioners and their representing institutions.     

Israeli Psychotherapy,Politics and Activism: Is There a Way Out of the Trap?

This article examines psychotherapy in context—political, social, cultural and historical. It does so by taking a close look at the Israeli psychotherapeutic community and how it changed over the years. Through this narrative and analysis the author wishes to illustrate how social-political context and professional practices plug into each other. It will be demonstrated how at difficult times when their country faces internal and external hardship and threats, Israeli psychologists have tended to withdraw and, whether unwittingly or not, affirm and support the status quo. This is paradoxical: when mostly needed psychotherapists may become silent and socially or politically passive. A possible way out of this trap, through a change in psychotherapists’ professional position and views, will be discussed. In addition, a politically sensitive alternative will be presented, one that may enable psychotherapists to maintain an independent praxis, which models a proactive and optimistic stance while serving society as agents of personal, social and political change.     

Taking a Historical Turn: Possible Points of Connection Between Social Pyschology and History

The article confronts methodological differences between (and among) social psychologists and historians about how far the social psychologist should be interested only in contemporary or very recent history and how far general conclusions can be drawn about human behaviour across time and space. The article suggests that social psychology need not be present-centric and might take different forms of a ??historical turn??. In turn, it is suggested, historians can benefit from approaches developed by social psychologists. Seven possible points of connection with the discipline of history are put forward in the hope of fostering future collaborations. These are: the nature of modernity; collective memory and the uses of the past; political discourse and ideologies; partisanship; the public sphere; stereotypes; and languages and images. Indeed, just as they can encourage closer collaboration between historians and social psychologists, these themes might also open a wider inter-disciplinary discussion with anthropologists, sociologists, literary scholars, art historians and scholars of political discourse.     

Time's wingèd chariot: Short-term psychotherapy in later life

Abstract

This paper is concerned with the appropriateness of short-term psychodynamic psychotherapy with older adults, a client group which has historically been neglected in psychotherapeutic practice. Drawing on the case study of a fourteen-session therapy with a woman in her seventies, it is argued that brief exploratory work can be of particular value to people nearing the end of their lives. The nearness of death gives a special urgency and motivation to the work and a time-limited therapeutic contract mirrors the reality of having only a short time left. Making psychotherapy available to older people also represents an important valuing and validation of their experience.     

Relational ecologies of psychotherapy: The influence of administrative attachment on therapeutic alliance

There is now vast and multi-faceted empirical literature on the impact of relational dynamics in psychotherapy, and relationality is a central theme within contemporary psychoanalytic theories. Yet, there is virtually no literature addressing the relational dynamics around outpatient psychotherapy that influence the wider therapeutic alliance, that is the relational dynamics that unfold between clients and administrative office staff in making initial contacts and appointments, completing paperwork, negotiating payment, discussing insurance coverage, working through crisis calls, and the myriad of other forms of interaction which serve to form the relational ecology of psychotherapy. Milieu therapy or the use of supportive and structured therapeutic environments has been given significant attention in inpatient settings; however, administrative relational factors or administrative staff characteristics have seemingly been ignored in outpatient psychotherapy and psychoanalysis literatures. Many outpatient clinical practice settings involve multiple levels and dimensions of relationality between clients, administrative personnel, and therapists which shape the potential for secure continuous containment and various forms of attachment to psychotherapeutic space. In this paper, we describe several clinical illustrations of relational dynamics between clients and office staff which influence therapeutic alliance and outline the contours of our emerging idea of administrative hospitality based on relational psychoanalysis, attachment theory, symbolic anthropology, and stigma research. In doing so, we draw on our collective experience working in several outpatient clinics and insights from our current context in an urban outpatient training clinic which emphasises psychodynamic practice. Our goal is not a comprehensive analysis of the relational ecology of psychotherapy but to offer an initial exploratory account of some of the administrative relational dynamics in and around outpatient psychotherapy which go beyond the therapist-client dyad. The anthropological concept of liminality is connected to relational psychoanalytic theories to describe the important dynamics of transitional space in an overall process of relational transformation.     

Outcomes of an existential‐humanistic psychotherapy: A tribute to Rollo May

Abstract

Many psychotherapies are formally or informally designated as experiential psychotherapies, and experiencing is increasingly included as one of the common dimensions of psychotherapeutic change. Accordingly, the major purpose is to provide a critical review of the ways in which the term “experiencing” is used in the field of psychotherapy. The provisional conclusion is that there are ten meanings of experiencing, of which only four emerge as defining distinctively experiential processes of psychotherapeutic change. On this basis, it is proposed that a particular group of therapies qualify as distinctively experiential and as comprising the cornerstones of an experiential family of psychotherapies, and it is possible to address the issue of whether or not experiencing qualifies as a common dimension of psychotherapeutic change.     

Crisis counseling: A right and a necessity for members of the underclass

Crisis counseling, short-term, directive psychotherapeutic intervention, is an appropriate form of therapy for the low socioeconomics status (SES) individuals. Poverty, racism, and cultural alienation contribute to making crises a prominent feature of life among poor people. Members of the underclass frequently do not have the time or cultural affinity for many forms of long-term therapy. Oriented toward the solution of practical problems and toward quickly re-establishing emotional equilibrium, crisis counseling does not require the client's long-standing commitment to personal growth. Because it is relatively free of the social biases of most treatment modalities, crisis counseling is a way of introducing many low SES individuals to psychotherapy. For many underclass individuals, crisis counseling can lead them in the direction of overcoming other situations that keep them at a disadvantage.     

Direktausbildung Psychotherapie an der medizinischen Fakultät

Background

There is ongoing political discussion at the Federal Ministry of Health that a university entrance diploma should allow psychotherapy to be studied directly: Graduation leads to a licensure that qualifies for further specialization, e.g. in cognitive behavioral therapy (CBT) or psychodynamic psychotherapy analog to medical specialization. As psychotherapy has its roots in both psychology and in medicine, the question is raised which faculty should be the future home of direct psychotherapy schools.

Material and methods

A theoretical model curriculum of psychosomatic psychotherapy is proposed. Its structure which is oriented to the established structure of medical training and its contents are described. It is argued that the proposed model in the tradition of psychosomatic medicine is suitable to meet ongoing changes in the structure of psychotherapeutic care due to new challenges in the field of public health.

Conclusion

The study of psychotherapy should be associated with chairs in clinical psychology and psychosomatic medicine in order to maintain and further develop the variety and quality which psychotherapy has gained in Germany.     

In Treatment

This article deals with current representations of psychotherapy in movies and television and focuses on the recent TV series In Treatment. It is discussed if and how this and other TV series might contribute to a change in the public image of psychotherapy. This discussion is based on studies investigating the public image of psychotherapy and its image within the media as well as the potential to use movies and TV as a stage for psychotherapeutic processes. Among several TV series dealing with psychotherapy, In Treatment plays a special role because of its conception as an intimate play. The series is described and discussed in relation to the question how realistic psychotherapy is staged and whether the hero of the series ??Dr. Paul Weston?? can be used as a model in psychotherapeutic training.