A Systems Approach to Sex Therapy with Gay Male Couples

SUMMARY

Sex therapy with gay male couples is difficult for many family and relationship therapists. Family therapists lack knowledge of the nature of sex therapy, gay male culture and sexuality, the dynamics of gay male couples, and the sexual issues gay male couples are likely to bring to sex therapy. Countertransference also makes sex therapy with gay male couples difficult for some family and relationship therapists. This paper addresses those issues and then explains a systems approach to sex therapy with gay male couples.     

Analyse et comparaison de discours de patients douloureux chroniques durant une thérapie de soutien par opposition à l’utilisation de la thérapie Eye Movement Desensitization and Reprocessing (EMDR)

IntroductionThe use of EMDR – Eye Movement Desensitization and Reprocessing – being innovative in the area of chronic pain. If his efficiency as show in the specific litterature, the way its work it is really different than usual therapy.ObjectiveThe main objective of this work is to compare the speech of patients during the use of EMDR vs. supportive therapy in a supported unit of chronic pain to the hospital.MethodsForty-five patients divided into three groups received EMDR therapy (standard protocol), EMDR therapy (pain protocol) as well as supportive therapy. All interviews were transcribed and analyzed using the software Alceste.ResultsThe results show that the semantic classes differ between the three forms of therapy, as well as passive or active posture of the patient during the therapy.ConclusionThese results give us an additional insights into what happens in fine in different types of therapy.     

Frank in mind: a journey to self

Abstract

This paper describes two years’ intensive psychotherapy with an 11 year old boy I shall call Lou, who as a result of traumatic experiences in his early life, struggled to integrate a robust sense of self and in particular to find accord with a sense of himself as male. The impact of maternal depression, paternal gender dysphoria and domestic violence are discussed in relation to this young boy’s capacity to resolve the ordinary Oedipal challenge and find narcissistic value in a male body image to consolidate his gender identity. Concomitant difficulties with separation from his mother and aggression towards himself and others significantly impacted his ability to manage in a mainstream school environment and he was excluded at the time the therapy began. A clinical narrative is presented which illustrates Lou’s journey in psychotherapy, where he began to engage and allow links to be made. He sought to understand his position in a world that did not make sense to him, to face a hitherto ‘unthinkable’ past and to integrate disparate aspects of himself including a male gender identity. Notably Lou’s creation of ‘Frank’ constructed from dead, lost and reanimated objects is described and the actual and symbolic functions of this therapy object are discussed in relation to his internal development and the progress of the work. Parallels are drawn with Mary Shelley’s novel Frankenstein, where the creature strives for psychological birth and understanding. Lou and I struggled in the paradox of the themes of his narrative; a male/female father; potency and castration; corruption and repair and how to be a boy, held and helped in part through the paternal function of a female therapist.     

On Dignity,a Sense of Dignity,and Inspirational Shame

ABSTRACT

The word dignity encompasses more than we can say of it. It is difficult to define, and yet we work with it every day in our offices. I explore various ideas about dignity, and then examine the place of dignity in the process of analysis and therapy. I draw out psychological components of dignity that are often strong themes in our psychoanalytic work. Many patients come to therapy as a result of assaults on their dignity, or from the effects of family situations that are so corrosive that they never developed a sense of their own dignity. For these patients, I think of therapy as a process of either finding or restoring dignity.     

Clinical Issues with Gay Male Couples

SUMMARY

Although gay male couples share with all couples three essential tasks of couplehood-creating boundaries in order to form a couple identity, negotiating closeness and distance, and accommodating to their individual differences-gay male couples face special complications in each task. These complications, examined herein, are largely the result of the marginalization gay men experience from living in a homophobic culture, and male gender acculturation that makes male-to-male intimacy difficult. A model of brief couple therapy for gay men is presented that is designed to honor, as well as challenge, the relationship the men have co-constructed and specifically addresses the difficulties men have in maintaining intimate bonds. A case study illustrates the treatment of clinical issues presented by male couples.     

Feminist Issues in Couple Therapy

Abstract

The authors reviewed the feminist couple therapy literature from 1995 to 2006. They summarized this large body of work into several key themes. The first revealed that feminist couples therapists are continuing to discuss and deconstruct gender issues in couple therapy. The second showed that feminists believe that therapists should be educated both academically and personally about culture and diversity so as to support couples in their therapy around their own issues of diversity as well as learning to deal with issues of social justice as a couple. In the third theme, the authors introduced readers to feminists' emphasis on connection and empathy within couple and sex therapy. And, in the fourth, the authors explored feminists' work with power in couple therapy as they applied to couple therapy in general as well as around the specific topics of: balancing family and work and therapy for familial violence.     

Tools for Change

Abstract

This paper discusses the ways in which one may incorporate political action into a client's therapy process so the client may incorporate it into her/his life. A framework for defining this as ethical, therapeutic and necessary to the client is presented. A number of suggestions for helping clients and therapists to become more politically active, as well as vignettes demonstrating how this might work with clients in the therapy process are provided.     

Some Recollections of Virginia Satir

SUMMARY

The following excerpts are taken from several hours of conversation with Virginia Satir in which Virginia shares her personal reminiscences of herdevelopment as a therapist and the intellectual environment that stimulated some of her most creative work. She reflects on her association with Gregory Bateson and other prominent theorists in the field. In deceptively concise language, she puts forth her own seminal ideas on the complex nature of change and the processes that underlie family therapy and group therapy.     

Male leaders with paternity leaves: effects of work norms on effectiveness evaluations

ABSTRACT

With the growing relevance of work–family balance and gender equality at work, researchers have extensively recognized the importance of men’s greater home involvement. Yet, little is known about how people evaluate men and particularly male leaders with involved fathering behaviours, such as taking a long paternity leave. Using a social normative perspective, we explore whether cultural standards providing social approval for work–life balance influence competence evaluations of male leaders who request a paternity leave. Results from three experimental and field studies suggest that perceptions of a supportive work-family culture favour more positive evaluations of male leaders with a paternity leave. Associations were stronger for people with leadership aspirations and roles. Several main effects emerged too: male leaders taking a leave beyond the standard (from 2 weeks to 3 months) received more negative evaluations than male leaders with a shorter, statutory leave (from 2 days to 2 weeks), and employees’ sexism predicted negative evaluations. Also, slightly lower status was attributed to male compared to female leaders who requested a leave. Findings are discussed in terms of how male managers’ domestic behaviour should be further reinforced with organizational discourses and practices.     

Outpatient Group Therapy with Convicted Pedophiles

Abstract

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.     

Couples Relationships of AFDC Mothers

SUMMARY

Virtually nothing is known about AFDC mothers and their relationships with their male friends. Yet such men are clearly an influence in their lives. Findings from a sample of 275 Baltimore AFDC mothers provide important exploratory data about the characteristics of these relationships and about how women who have a long-term male friend differ from AFDC mothers who do not. Implications for work with these couples are also presented.     

Learning about empathy with unconscious states of mind 1

2008 Ellen Noonan Annual Counselling Lecture, Birkbeck College, University of London

It was a very special privilege to give this lecture in honour of my dear colleague and friend Ellen Noonan. The lecture is based on one of the new chapters of my book about therapy with older people. Ellen was a most helpful mentor to me when I was preparing the first edition of this book and I have dedicated the new edition to her memory. The lecture is essentially about learning to use one's feelings in therapeutic work and to illustrate this theme I shall be drawing on experiences of supervising clinical psychology trainees on placement with me in my NHS work. The theme of this lecture applies as much to counselling as to psychotherapy and I use therapy to refer to counselling and psychotherapy.     

Radical therapy: A research note on the use of ideological work in maintaining a deviant subculture

A social protest movement which survived the demise of the New Left is explored in terms of ways in which a countercultural group preserved a particular kind of deviant subculture. Radical therapy developed from an opposition to American middle class values as they were institutionalized in psychiatric practice. While identifying themselves as Marxist revolutionaries, members reacted to the decline of social activism by adopting a hidden agenda of psychological transformation activities and duplicating traditional structures in their “radical” therapy. The longevity of radical therapy is explained in terms of its effectiveness in benefitting from the dominant culture while preserving members's deviant identities through various forms of ideological work.     

Keeping It Up

SUMMARY

Clients benefit from an eclectic approach. In the case of a presenting problem such as failure to maintain an erection, the assistance of body psychotherapy in the form of Core Energetics brings additional dimensions to couples work. In this case, only the male partner came to the office; but both benefited from the integration of bodywork into the therapeutic enterprise. The client needed access to his body to incorporate the insights and the skills of other therapeutic work. This article offers a sample of the work.     

The Association Between Emotion Work Balance and Relationship Satisfaction of Couples Seeking Therapy

Emotion work refers to the efforts that are made to enhance emotional well-being and provide emotional support in a relationship. Data were collected from 63 couples who were seeking therapy to determine the relation between emotion work balance and relationship satisfaction. On the basis of comparative scores on emotion work, each dyad was categorized as either: (a) balanced; (b) participant performs more emotion work; or (c) partner performs more emotion work. Results indicate that both men and women are most satisfied with their relationship when levels of emotion work are approximately equal. Thus, clinical interventions that aim to establish balance in emotion work may benefit both partners in a relationship.     

Emotionally Focused Family Therapy and Play Therapy Techniques

Emotionally Focused Family Therapy provides a framework for understanding children's behaviors in terms of attachment needs of comfort and support. However, when working with young children, play therapy is often developmentally preferred over “talk therapy.” By integrating play therapy techniques within an Emotionally Focused Family Therapy theoretical framework, therapists can help parents understand and meet their child's needs for affection and comfort. This article will discuss how play therapy techniques can be integrated with an Emotionally Focused Family Therapy theoretical framework for work with young children and their families.     

Gendered Training: Men and Men's Issues in Marriage and Family Therapy Programs

Few studies examine men's experiences in becoming a therapist. Only a modicum of attention appears to be paid to men's professional training needs in MFT training programs as expressed in the family therapy literature. Five recommendations, based on the author's experiences and male student voices, are provided for how to best meet the needs of male students in MFT training programs. These recommendations are (1) be aware of men's experiences and don't assume silence means disinterest, (2) develop depth in clinical training on men's issues, (3) incorporate theories of masculinity into curriculum, (4) engage male students in the training process, and (5) provide support to male students through mentorship and support groups.     

Developing a Psychoanalytic Practice

Abstract

This paper examines two methods of developing a psychoanalytic practice. The first is an “internal” approach that helps a patient make the transition from therapy to analysis with the same analyst. This may be accomplished by attenuating the patient's unconscious fears of analysis as a facilitator of an anticipated regressive loss of control and as a reactivator of feared desires and impulses. Increased motivation for analysis may also result from a therapy that leads the patient to an awareness that an ongoing level of distress is internal, together with the experience of a deepened therapy and of the analyst as safe and potentially providing relief. The second method of developing an analytic practice is an “external” approach that provides others, such as analytic, mental health, medical, and academic colleagues, an experience of the analyst as person and some idea of the type of work he or she does.     

Creativity,Acceptance, and the Pause: A Case Example of Mindfulness and Art in Therapy with an Adolescent

ABSTRACT

Mindfulness, defined as nonjudgmental awareness, has been integrated into a variety of therapeutic approaches. The benefits of mindfulness for adults have been demonstrated, and mindful interventions for youth are increasing. Creating a space for mindfulness to arise can be challenging within the hectic and technology-filled lives adolescents often lead. Art in therapy with adolescents can be a beneficial way of creating a pause, thereby helping clients to connect to a mindful state. The use of art in therapy to promote mindfulness can be especially useful for adolescents who can be reluctant to engage in traditional forms of talk therapy. In this article, we use a case example of therapy with a Mexican-American male youth to exemplify the clinical application of a combination of mindfulness and various art modalities.