Working with dreams in a bereavement therapy group

There is ample theory and research about group therapy, dream work, and bereavement as separate subjects. However, there is little written specifically about utilizing dream work in bereavement therapy groups. Using the Foulksian group analytic model, dreams in one particular bereavement group (for parents of children killed in a terrorist action) were interpreted in such a way as to help members access deep unconscious feelings. This helped facilitate a fuller and more complete mourning process. The analytic, dream interpretive activity also helped overcome resistance in the group-as-a-whole and thereby facilitated movement through group development phases.     

Student essay competition prize winner basket weaving: Sharing stories in a group setting

Abstract

Participating in a self-awareness group (in this case for counsellors in training) is an exercise in give and take - an interweaving of stories - through which we share ourselves with our peers. This paper explores some personal discoveries about the processes at work in (a) listening to others, (b) relating my own story - and assessing thereby the extent of my belonging, role and investment in the group. A dream alerted me to our shifting to another dimension of story-sharing by the end of forty sessions. The imagery I use is of basket weaving and creating a mandala.     

The Deaf and Their Problems by Kenneth W. Hodgson

Abstract

This article is an attempt to develop a coherent, unified, and consistent conceptualization of dreaming and dreamtelling in the clinical setting. Dreams told in a therapeutic setting are challenging events: fantastically rich in content, but often overwhelming in their implications for peoples’ relationships. When told in therapy groups, dreams provide additional challenges for all participants. Learning to work with dreams not only enhances understanding of unconscious intrapsychic and group processes, but may also have a strong impact on the therapeutic culture and working relationships in the group. After differentiating dreaming from dreamtelling, I briefly describe three uses of dreams in groups—the classical “informative” and more familiar “formative” uses, and a new perspective that focuses on the “transformative” aspects of a dream told. According to this perspective, a dream told has an interesting past, an important present, and a worthwhile future because of its interpersonal, intersubjective influence on the dreamer–audience relationship.     

Laying mother to rest: Working with grief-related nightmares through exposure therapy and imagery

Cognitive behavioural therapy of unresolved grief is usually presented as a fairly rapid approach for reducing psychological problems. The present case study shows how behavioural cognitive and symbolic approaches can be integrated to foster griefwork at several levels. The counselling adopted a behavioural exposure technique specifically for eliminating a significant anxiety-provoking obstacle to mourning, namely the experience of recurrent death-related nightmares that surfaced every time the bereavement was recalled in depth. The client was also encouraged to explore the symbolic meaning of the dream images and in drawings modified these images in ways that helped to alleviate her feelings of long-standing guilt. Drawing as well as verbal representation could also be regarded as an effective form of exposure therapy, helping the client to stay with the anxiety-provoking death-related images. The client once relatively free of nightmares could mourn the loss of the mother more deeply in subsequent less directive counselling sessions.     

Does worry affect adjustment to bereavement? A longitudinal investigation

Background and objectives: Repetitive thought is a trans-diagnostic risk-factor for development of psychopathology. Research on repetitive thought in bereaved individuals has focused primarily on clarifying the role of rumination, repetitive thinking about past negative events and/or negative emotions. While detrimental effects of rumination have been demonstrated following bereavement, surprisingly few studies have aimed to clarify the role of worry, repetitive thinking about potential future negative events, in adjustment to loss. This study sought to fill this gap in knowledge. Methods/Design: One hundred eighty-three bereaved individuals (85.3% women) filled out questionnaires on sociodemographic and loss-related characteristics, worry, and symptom measures of depression, anxiety, and prolonged grief. After six months, 155 participants completed worry and symptom measures again. Using multiple regression analyses, concurrent and longitudinal associations between loss-related variables, worry, and symptoms of psychopathology were examined. Results: Main results were that worry was strongly positively associated with symptoms of anxiety, depression and prolonged grief concurrently and also predicted higher levels of anxiety, depression and prolonged grief longitudinally. Conclusions: Findings suggest that worry influences adjustment to bereavement negatively and may be a potential target in grief therapy, especially when aiming to reduce anxiety.     

Therapists' views of the relative benefits and pitfalls of group work and one-to-one counselling for bereavement

Aim: To explore therapists' perceptions of the relative benefits and pitfalls of group work and individual counselling for bereaved clients. Method: Semi-structured interviews with nine experienced bereavement therapists from a range of different contexts generated data which was analysed using grounded theory methodology. Findings: Groups were perceived as having a normalising influence, helping members make new social contacts and practice social skills. Individual counselling was seen as facilitating the initial telling of the story and the expression of extreme emotion. Discussion: The findings suggest that individual counselling may be useful as a primary intervention easing ‘emotional loneliness’ caused by the death of a spouse or attachment figure. Group work may be of more benefit later in the bereavement process, facilitating an engagement with the outside world and alleviating ‘social loneliness’. Implications for practice: This suggests that bereavement services might usefully combine group and individual provision. Initial assessment could help clients clarify their needs and facilitate their choice of service. This would be more cost effective and potentially ease clients' bereavement experience.     

Graduate programs: The Boulder Graduate School

Abstract

The motion picture is conceived of as a modern‐day avenue for providing humans with mythological, metaphorical and symbolic imagery. Human subjects were interviewed to determine how film imagery was processed on a cognitive basis. Subjects were also interviewed about their dream imagery to elicit any matching or resonating with the imagery from their felt film experience and dream experience. Utilizing a mythic method, the researcher examined the narratives to discover emergent patterns and configurations of symbolic imagery, metaphorical and mythological content as related to personal mythologies.     

Prolonged grief disorder symptoms in bereaved internally displaced Tiv persons in Nigeria: associations with rumination,rebirth concerns and gender

ABSTRACT

There is burgeoning research on prolonged grief disorder (PGD) among several vulnerable populations but PGD symptoms have been scarcely examined among bereaved internally displaced persons (IDPs). This study investigated the associations of rumination, rebirth concerns and gender with symptoms of PGD following conflict-related bereavement. Participants were 379 Nigerian IDPs who were of the Tiv ethnic group. They provided demographics and completed self-report measures grief and rumination, while concern about rebirth status of the deceased was assessed using a single item which requested participants to indicate whether they had any concerns about the re-incarnation of the deceased. Results showed that gender was not associated with PGD symptoms. High intrusive rumination and high deliberate rumination were associated with increased PGD symptoms in males and females. Rebirth concern was associated with high PGD symptoms in males but not in females. Findings highlight the need for socio-culturally-informed screening/intervention in the wake of conflict-related bereavement.     

The critical dream incident in pastoral psychotherapy

Pastoral psychotherapy needs to re-cover one of the most authentic tools of its trade ... the healing dream encounter. A brief outline of operational prejudices and theory prepares discussion of the use of such dream work within a marital system. It is stressed that the dream came aspart of a careful and multi-focused therapy which used the best of psychotherapeutic methodologies. The dream incident reported came as part of the climactic end-stage environment of this counseling experience. A few concluding comments are made about the ongoing schools of thought on dream function and their relationship to pastoral psychotherapy.Dr. Gibson is Counseling/Education Minister at the Christian Counseling Service, 424 South K Street, Tacoma, Washington, 98405. His clinical interest focuses on the dream and similar modes of altered states of consciousness as a direct form of religious experiencing and healing.     

The yom kippur war: The soldier on the front and his family

Abstract

The present report illustrates how uncertainty, continued stress and the transient “commuter” role of the soldier in the Yom Kippur War led to psychological disequilibrium on both the individual and familial level. On the individual level such phenomena as anger outbursts, apathy, depression and secondary impotence were observed and reported. These were often relieved through group discussions in the soldier's unit about the universality of such reactions to stress. On the familial level regressive behaviors, disciplinary problems, spouse conflict and diffuse anxiety were among the phenomena reported. In group discussions with soldiers and their spouses, it was suggested that candid and clear communication about the father-soldier's whereabouts and the nature of his military duties were necessary to prevent regression and permit active coping behavior. Conflicting expectations and role change resulting from the war situation were discussed in terms of how these might affect the family's functioning in such realms as child rearing, spouse relations and other familial matters. Death, mourning and bereavement were also discussed and it was suggested that family and friends are often more effective than professionals in helping relatives of the deceased do their mourning work.     

Terror,Trauma, and Bereavement

Abstract

How is interpersonal loss incurred in a terror event similar and different from loss under non-terror conditions? Because terror and bereavement are located in the individual's experience of the event, this has important implications for assessment and intervention. In the Two-Track Model of Bereavement (TTMoB), the relationship between life threat, symptomatic response, and the ongoing relationship to the deceased allow therapy to target difficulties in functioning as well as relationship to the deceased. Two case vignettes are presented to ground the discussion.     

Traumatic Loss: Conceptual and Empirical Links Between Trauma and Bereavement

Abstract

This article focuses on conceptual issues and empirical studies regarding the topic of traumatic loss (i.e., loss that occurs suddenly and under violent circumstances) as a method for linking the field of trauma, and that of grief and bereavement. Several definitions of trauma are presented that include the concept of loss, and additional concepts are suggested that may be helpful in thinking about the two areas together. Also, modes of death associated with poor recovery are noted, and it is argued that these modes are those that make a bereavement more “traumatic”. Some empirical studies on the psychological outcomes associated with traumatic loss are reviewed, and preliminary findings from a new study of traumatically bereaved women are briefly presented     

Dreamwork beyond psychoanalysis

Abstract

Dr. Montague Ullman's work with dream groups is the main subject of this paper. After detailing his method there follows an account of the author's experience in a dream workshop run by Dr. Ullman. The theoretical issues involved in this work are discussed, particularly the ideas of Trigant Burrow, an early American analyst who believed in species connectedness, and David Bohm's theory of implicate order. Dr. Ullman's intention to return to the healing process in dreams to ordinary people is connected with the author's paper “Thoughts on the Healing Process.” The implications for psychoanalysis of these holistic ideas are considered.     

Male Cross-Dressers in Therapy: A Solution-Focused Perspective for Marriage

This paper offers techniques on how to work with male cross-dressers using solution-focused therapy. An overview about issues crossdressers often face is addressed which shows they have many of the same concerns as other clients seeking therapy. Solution-focused therapy is discussed as a way to work with male-cross dressers and their partners. A case study of a male cross-dresser and his wife is presented and possible directions are suggested for marriage and family therapists.     

Young Freud's linkage with Persia

Abstract

Sigmund Freud's hands helped to mutilate a volume containing a series of “colored plates” like the one replicated in Figure 1 in the text. As a young adult, his personal library included a fairytale whose German text was entitled Die Träumleiter: Ein Marchen. No one has yet been able to authenticate the author's identity beyond the following imprint: “S. Andreas (1832).” The poetic play centers upon a celestial meeting featuring Shakespeare, Goethe, and Dschami. It has been translated into English (The dream ladder: A fairy tale), but still awaits a psychoanalytically informed exegesis.     

The Power of Feelings

Abstract

The relationship between myth, the dream, narrative and career are explored in order to understand better the underlying factors that influence career development and will thus inform the work of career counsellors. A case study is used to illustrate how these insights can be used in practice.     

Dramatology in life,disorder, and psychoanalytic therapy: A further contribution to interpersonal psychoanalysis

Abstract

Action and interaction, and emotion and thought as the inner wellsprings of action, play a central role in the lives of individuals, families, and society, spanning the continuum between everyday life and disorder. Until now, the narrative tradition has been the main methodology for portraying and formulating human action and interaction, and little has been written about the dramatic approach to life, disorder, and therapy. Since the essence of drama is action, dialogue, character, and emotion, it is time to give drama its due. The author proposes a methodological concept – dramatology – analogous to narratology, to highlight the dramatic method of investigating action and interaction in life, disorder, and therapy. Breuer and Freud presented both aspects of dramatology: dramatization in dream and fantasy, and dramatization in act, focusing on the person. This approach was elaborated by psychoanalysts with an interpersonal orientation, focusing on the person and speech as action. Dramatology is applied to exploring ongoing patient–therapist interactions as reality and as transference. Analyzing unconscious and latent dramatization in dream, fantasy, and enactment with free association is enhanced by utilizing clarification and confrontation, focusing on the manifest and mutually observable expressive form and style of actions and enactments, defenses and resistances, and the discharge and meaning of emotions. Dramatology puts forward a new paradigm for psychiatry, psychotherapy, and psychoanalysis.     

The Ego in Love and Sexuality by Edrita Fried

This paper presents a rationale and step-by-step procedure for the interpretation of dreams in a specifically dream-oriented group. Traditionally, dreams have been used across a broad spectrum of approaches to individual psychotherapy. As group methods have evolved, the group context has emerged as a particularly favorable medium for the analysts of dreams. Adherence to the Jungian approach to dream interpretation, together with theoretical insights from dream and imagery research, group research, and behavior modification form the basis of this four-step dream group model. This systematized procedure has utility for the training of professionals in basic psychodynamic dream work, for psychotherapeutic practice, and for research into the efficacy of the model.     

DSM‐5 and Bereavement: The Loss of Normal Grief?

The mood disorder work group has proposed to eliminate the bereavement exclusion criterion from the diagnosis of major depression in the 5th edition of the American Psychiatric Association's (2012) Diagnostic and Statistical Manual of Mental Disorders. The proposal would break tradition with the long‐held distinction between depression and normal bereavement. This article reviews the development of the bereavement exclusion, discusses evidence for and against the proposal, and offers some relevant implications for counselors in light of the research on depression and bereavement.