Narrative of “Here-and-Now”: Cancer Survivors in a Group Psychotherapy Using SCT® (Systems-Centered Therapy)1,2

This study focused on “here-and-now” narrative and examined the process of group psychotherapy for cancer survivors using systems-centered therapy (SCT). In contemporary society, cancer survivors have a vital need for psychological support, and group psychotherapy and peer support are used as part of this need. In most of these interventions, participants are encouraged to speak freely and share their experience of cancer. This generally means speaking about “there-and-then” experience. It has been argued that one reason that narrative therapy produces a psychological effect is that the meaning of an experience changes when the experience is spoken about. SCT differs significantly from other group interventions in that it requires participants to talk about their here-and-now experience through the format of SCT's “functional subgrouping.” Functional subgrouping requires participants to listen, reflect, and build on similarities in their experience. In this study, we qualitatively examined how participants' experiences unfolded in the SCT group by directly addressing the group process. The study findings revealed that even though the participants did not directly share their cancer experiences in the group, they experienced an inexplicable sense of connectedness that had a positive psychological effect on them. They also experienced deep emotions through talking while using the SCT narrative style. In the process, the effects of the SCT narrative were discussed.     

Bilinguals who stutter: A cognitive perspective

PurposeBrain differences, both in structure and executive functioning, have been found in both developmental stuttering and bilingualism. However, the etiology of stuttering remains unknown. The early suggestion that stuttering is a result of brain dysfunction has since received support from various behavioral and neuroimaging studies that have revealed functional and structural brain changes in monolinguals who stutter (MWS). In addition, MWS appear to show deficits in executive control. However, there is a lack of data on bilinguals who stutter (BWS). This literature review is intended to provide an overview of both stuttering and bilingualism as well as synthesize areas of overlap among both lines of research and highlight knowledge gaps in the current literature.MethodsA systematic literature review on both stuttering and bilingualism studies was conducted, searching for articles containing “stuttering” and/or “bilingualism” and either “brain”, “executive functions”, “executive control”, “motor control”, “cognitive reserve”, or “brain reserve” in the PubMed database. Additional studies were found by examining the reference list of studies that met the inclusion criteria.ResultsA total of 148 references that met the criteria for inclusion in this paper were used in the review. A comparison of the impact of stuttering or bilingualism on the brain are discussed.ConclusionPrevious research examining a potential bilingual advantage for BWS is mixed. However, if such an advantage does exist, it appears to offset potential deficits in executive functioning that may be associated with stuttering.     

Discussion of “I’mprovisation–Therapists’ Subjective Experience during Improvisational Moments in the Clinical Encounter”

The first part of this article discusses Romanelli, Tishby, and Moran’s qualitative research on the impact of training clinicians’ “skill-sets” derived from improvisational theater. Categories of experience were discerned from the data, along with findings of the impressive positive effects from the training on the clinicians’ ability to better respond to unpredictable “improvisational moments” in psychotherapy. The second part elaborates on how the authors' research represents a welcome addition to a larger conversation about how drama theory “puts” “flesh and blood” on the “bones” of Relational Metapsychology, which entails theories of process and change, rooted in an information theory based epistemology in contrast to Freud’s archaic and deeply flawed Metapsychology ensconced in a psychic energy theory epistemology. Finally, the authors’ lends to advocacy for clinical training in drama and improvisation being added to clinically based curriculums.     

The Crossroads of Countertransference and Attribution Theory: Reinventing Clinical Training within an Evidence-Based Treatment World

Social Psychological research on Person Perception/Attribution Theory has concluded that an individual responds to interpersonal situations based upon their interpretation of the “nature” of that situation. For example, physically attractive people are often attributed niceness and capableness even without any basis in reality. The observer, guided by percepts cum attributions, may treat the attractive participant “as though” these qualities are about them rather than about the observer's internal bias. In psychoanalysis, this social phenomenon takes on individual meaning as countertransference. Therapists seem to experience irrational feelings during the psychotherapy exchange, which remain, whether or not the therapist is conscious of these responses or whether their technical objective includes or ignores their own transference. The attributional tendency to act upon these feelings “as though” they were wholly about the patient may lead to therapeutic disasters. Therefore, clinical training of psychotherapists needs the early inclusion of this concept to prevent subsequent dogmatic and untherapeutic attitudes. This paper will discuss the possibility of disarming the damage rendered by medicalized parsimonious “healing” and the latest fashion, Evidence-Based Treatment, via a translation of assumedly unmeasurable psychoanalytic tenets into multiply measured, investigated areas of social research.     

Exploring How Parents Make Sense of Change in Parent-Child Psychotherapy

Understanding how change occurs in psychotherapy is imperative in informing clinical practice. Increasing attention has been given to the role that qualitative research could play in enhancing our understanding of therapeutic change. Although quantitative research suggests that parent-child psychotherapy is effective in facilitating change, no research to date has focused on how parents make sense of their change experience. In this study, interpretative phenomenological analysis was used to analyze semi-structured interviews of eight parents who had completed parent-child psychotherapy about their understanding of change. Five master themes emerged that encapsulated participants’ understanding of change. These included constructing a survivor narrative, the experience of being understood enabling further understanding, adjusting expectations and practicing acceptance, and feeling empowered to relinquish control. The final theme summarized how despite psychotherapy being conceptualized as a “precious” resource, there was a sense that its limitations could negatively impact participant’s well-being.     

Why using “consciousness” in psychotherapy? Insight,metacognition and self-consciousness

Since its early development, clinical psychology has questioned the impact of “consciousness” on the determination of human responsibility across psychiatric disorders. In recent years, specific clinical approaches have focused on “consciousness” work that could play a key role in psychotherapy. We focused our research on clinical psychology's consciousness-related concepts of insight, self-consciousness, and metacognition. Insight and metacognition, for example, have prompted increased interest in schizophrenia (SZ), bipolar disorder (BD), and, more recently, borderline personality disorder (BPD) treatments as representative of the latest advances in the cognitive and behavioral therapy field. Here we review cognitive, social, and clinical psychology research measuring “consciousness” in BPD, SZ, and BD, exploring the implications of different conceptualizations of consciousness-like concepts for treatment adherence, symptom evolution, and related aspects of psychotherapy. Our results show the overall relevance of using measures of clinical and cognitive insight, emphasizing the more central role of cognitive insight and metacognition in psychotherapy, as it appears that consciousness can remain useful if understood as a cognitive skill. The inclusion of a conceptualization of self-consciousness is important in order to address the social component of psychotherapy, as it does in biopsychosocial approaches. We discuss the implications of such results for global efficacy, for the relevance of the “consciousness” concept to clinical psychology, and for the potential need to keep operationalizing different conceptualizations of it in psychotherapy. We open the debate on the definition of consciousness to motivational aspects of change and to general considerations of both legal and ethical aspects.     

„Homo ambivalens“

For many individuals, under the present social conditions the processes of constituting, developing and articulating the self, i.e. a dynamic personal identity, imply experience of ambivalences. The reference to ambivalences is also an important topic in the social diagnostics of a “globalized postmodernity” and its contradictions. Psychotherapy has accumulated a rich stock of knowledge about the analysis of ambivalences and ways to deal with them. This wisdom can be used to stimulate the repeatedly claimed interdisciplinary discourses between psychotherapy and social, cultural and biological sciences. For this purpose a concept of human nature (“Menschenbild”), labelled “homo ambivalens” is proposed. This concept is to be thought of as a general heuristic orientation. It postulates not only the ability of human beings to experience and reflect ambivalences but also to judge them in an ambivalent way, namely as disturbances and burdens as well as possibilities for openness, creativity and freedom.     

Traumaadaptierte tiefenpsychologisch fundierte und analytische Psychotherapie

The authors discuss the question which criteria should apply to the depth psychologically oriented psychotherapy (TP) and to the analytic psychotherapy (AT) in order to guarantee a state-of-the-art treatment for traumatized patients on the basis of latest scientific research. Specific demands and modifications of the two guideline treatment methods arise from the scientific findings of interdisciplinary research projects bringing together psychobiological research results and models with concepts and results from empirical psychotherapy research.When TP and AP were conceived, an interdisciplinary concept was still out of reach. In the meantime there exist elaborated traumaspecific concepts for TP/AP and show promising empirical research findings.The adaptation of TP/AP to the demands of trauma patients should proceed in the opinion of the authors under the following term: “As much reform as necessary, as much tradition as possible”, so as not to endanger valuable and proven treatment principles of both methods.     

“She was on my side,and grounded me when I needed it:” Research supervision in the field of therapy,based on counsellors’ and psychotherapists’ views on their engagement with research

Research‐supported practice is increasingly emphasised within counselling and psychotherapy at all stages of training. Guided by an interest in how to support therapists in their efforts to develop research knowledge during doctoral training, this paper focuses on research supervision. Research supervision is a surprisingly under‐researched area. Little is known to date about how supervisors “go about their supervision” (Bruce & Stoodley, 2013, p. 5), despite the fact that “high failure rates for research dissertations in the social sciences have been partly attributed to student dissatisfaction with supervision and poor student–supervisor relationships” (Armstrong, 2004, p. 134). Between 2016 and 2019, we explored accredited counsellors' and 'psychotherapists engagement with research during or after their doctoral training. This paper explores research supervision with these two previous studies serving as the backdrop (Bager‐Charleson et al., 2018; Bager‐Charleson et al., 2018b), together with a literature review into research supervision within social sciences and psychotherapy. Supervision is discussed as a crucial coping/support strategy to (a) link research with practice in therapy work, practically and epistemologically; (b) contain and make sense of the use of transformative learning; (c) balance “enculturation” with critical thinking and emancipation; and (d) support reflective and reflexive development. This paper discusses an adaptive research supervision model, akin to a “holding bond” (Stevens, 2016) which supports the student to reflexively position her/himself personally, intersubjectively, theoretically and socio‐culturally, whilst “negotiating the tension” (Lee, 2008) during a process of enculturation into the discipline, and also fostering critical thinking and emancipation to contribute to new knowledge.     

A few thoughts about the mind,the brain,and a child with early deprivation

Infant brain research is having an increasing impact on child psychotherapy and our understanding of the neurobiological effects of trauma and neglect. This paper outlines the 'experience-dependent' nature of brain development in infancy and the concept of critical periods in such development. The effects of deprivation on child development are illustrated and case material from a child who was institutionalized during his second year is used as a basis for posing questions about the nature of the mind and the brain. In spite of his deprivation, he was able to communicate imaginatively. Schore's proposal for the use of early interventions is put forward to counter discouragement that can be engendered by work with severely deprived children.     

Psychoneuroimmunology: A bio‐psycho‐social approach to health and disease

Since the early 1980s, the interdisciplinary field of psychoneuroimmunology has explored the complex bi‐directional interactions between brain, behavior, and the immune system. Taken together, this research has expanded the limits of the questions we can ask about the organism by challenging the biomedical paradigm of the immune system as predominantly “autonomous”. Psychoneuroimmunology has played a key role in establishing a biological basis for the ancient idea that the mind can play a role in health and disease. This article describes the development of psychoneuroimmunology and reviews a number of key findings concerning psychological phenomena of potential relevance to understanding brain‐behavior‐immune interactions, including learning, emotions, stress, and the role of sensory processes.     

The impact of Primacy/Recency Effects and Hazard Monitoring on attributions of other drivers

The present study examined the impact of Primacy/Recency Effects and Hazard Monitoring on driver attributions. Participants viewed a simulated near collision from the perspective of a trailing motorist. The amount of error free driving prior to the near collision varied between two groups, where the near incident occurred either early or later in their viewing experience. They were then given the opportunity to provide judgments of the offending driver based on how safe, dangerous, risky, and skilled the driver was in general, and to evaluate their overall performance. Results showed a Primacy Effect dominance in that judgments of the driver were most negative in the early group, but this was moderated by high Hazard Monitoring for ratings of “dangerous” and “safe”. This suggests that judgments of other drivers are likely to be quick and based on early information, but are impacted by personal factors such as a tendency to monitor for hazards.     

Psychotherapy and neuroscience: Towards closer integration

The original aim of psychology was to study and understand the spirit—from the Latin spiritus, literally “breath.” The limitations of scientific methods in the past favoured psychology's aloofness in terms of studying the “intangible,” while medicine developed methods of examining the body (Latin corpus: essential part). Until 20 years ago, knowledge of the localization of brain functions was limited to inferences from clinical observation of brain‐lesioned patients or parallel studies of primate brains. Current neuroscience, with its integrative approach, is bringing together research from molecular through cognitive levels, and psychotherapy has benefited from these findings. Functional neuroimaging studies may make specific and more far‐reaching contributions in this respect, since cerebral dynamics may be observed in vivo and in controlled situations. Methods such as single photon emission tomography, positron emission tomography, and functional magnetic resonance imaging have been able to evaluate the neural correlates involved in psychotherapy for individuals with obsessive‐compulsive disorder, major depression, social phobia, specific phobia, and post‐traumatic disorder. Researchers have found that psychotherapy has the potential to modify dysfunctional neural circuits associated with these disorders. However, precautions are required in constructing feasible designs for neurofunctional investigations. This article reviews the 21 studies that have been published on the subject, and sets out the main advantages and limitations of the technologies used most frequently in protocols involving psychotherapies, and prerequisites for experimental designs. We also pose ways in which the findings from neuroimaging may produce knowledge to guide psychotherapeutic interventions by specifying what should be stimulated in these individuals in order to normalize deficient neural activities.     

聋人早期手语经验对脑功能及结构的塑造作用

语言经验对脑功能和结构发展有重要的塑造作用。然而, 目前的相关证据主要来自对脑损伤导致的失语症病人的语言康复、第二语言学习以及针对成人读者进行的语言训练等方面的研究。幼儿时期的早期语言经验对脑结构与功能发展的影响更加重要, 但直接的研究证据却相当缺乏。本文提出一个研究设想, 拟综合使用多种脑成像技术, 系统探讨有早期手语经验和无早期手语经验的聋人个体在脑皮层语言功能的组织及脑结构发育的差异, 包括语言任务中大脑语言区的激活模式, 静息状态下脑功能联结的默认网络特征, 脑皮层灰质密度, 以及神经纤维束发育状况等, 揭示早期语言经验对大脑功能和结构发育的塑造作用。     

Is the Impact of Psychotherapy Processes on Outcomes Already Quacking and Waddling? Comment “A Primer on Psychotherapy Process Research (Pfeifer & Strunk, 2015)”

The article by Pfeifer and Strunk on psychotherapy process research offers a highly thoughtful review on the state of psychotherapy process research in cognitive therapy for depression, and the inherent challenges in establishing causal relationships between process and outcomes. In this commentary, I argue that the goal of internal validity in psychotherapy process research may be unattainable, and possibly unnecessary. Finally, I suggest that psychotherapy process research should shift from “does it affect change?” to “how does it affect change?”, “when does it affect change?”, and “for whom does it affect change?”     

Influence of personal therapy on learning and development of psychotherapeutic skills

The aim of the present study was to investigate psychodynamic psychotherapists’ experience of the influence of personal therapy on professional growth during training with a focus on the acquisition of knowledge and the development of psychotherapeutic skills. Thematic analysis was conducted on interviews with former students (N=10) at two training institutes for psychoanalytic psychotherapy. The resulting theme “professional subjectivity” indicated that personal therapy was experienced as having a positive effect on learning and growth of professional skill by facilitating the development of a theory- and knowledge-based professional subjectivity, a personally founded, professional attitude. Important elements of this development are “shared experience,” “personal influence,” and “knowledge integration.” The emergence of professional subjectivity proved to be an important factor in terms of professional advancement for future psychotherapists. Finding and relating to their own subjectivity was crucial in the process of developing a personally founded, professional attitude in the clinical work.     

HUMAN PHENOTYPIC MORALITY AND THE BIOLOGICAL BASIS FOR KNOWING GOOD

Co‐creating knowledge takes a new approach to human phenotypic morality as a biologically based, human lineage specific (HLS) trait. Authors from very different backgrounds (anthropology and biology, on the one hand, and astronomy, philosophy, and theology, on the other) first review research on the nature and origins of morality using the social brain network, and studies of individuals who cannot “know good” or think morally because of brain dysfunction. They find these models helpful but insufficient, and turn to paleoanthropology, cognitive science, and neuroscience to understand human moral capacity and its origins long ago, in the genus Homo. An unusual narrative capturing “morality in action” takes the reader back 900,000 years, and then the authors analyze the essential features of moral thinking and behavior as expressed by early and later species on our lineage. In what has primarily been the province of philosophers to date, the authors’ morality model is presented for further scientific testing.     

Die „Technik der Psychoanalyse“ von Otto Rank

In the 1920s, Otto Rank broadened the psychoanalytic treatment space by the prelingual relational and self-experience in the time before, during and after birth. This meant that early prelingual experiences at the level of emotions and sensations is always covertly present in the analytic situation. The special emphasis on the earliest relationship to the mother was perceived in the patriarchal society of the time as inadequate and unjustifiable. But the last decades provided perceptions in different therapeutic settings which seem to confirm the observations of Rank. Just as important are the findings of the empirical research in early brain development and in after effects of early traumatic stress which show the shaping role of early development in a completely new light. There are also new insights into particularities of early human development due to evolution, especially about the psychological consequences of the “physiological premature birth”. From this knowledge a new framework arises for the understanding of early development and for the assessment of the observations and conclusions of Rank. From a contemporary viewpoint this provides valuable contributions to the psychoanalytic research of the last decades into early after birth mother-child relationships. They bear the potential for a deeper understanding of the prelingual level of the psychoanalytic treatment situation.     

Die Therapie-Vorbereitungsgruppe

There are different kinds of pretraining for psychotherapeutic treatment. They have two objectives: to get future patients in the right frame of mind for the imminent psychotherapy by informing them about the treatment, and to support therapists while clarifying the indication and selecting patients. Pretherapy training for group psychotherapy is frequently offered in Anglo-American countries. So far empirical studies have only partly been able to prove the supposed positive effects of pretraining on process and outcome of psychotherapy treatment, particularly as the studies showed profound flaws with regard to methods and pretraining concepts. The “Therapie-Vorbereitungsgruppe” presented here is a pretherapy training group in the run-up to inpatient group psychotherapy at a German university clinic. In Germany, such groups are rarely offered. The “Therapie-Vorbereitungsgruppe” consists of weekly meetings of therapists of a psychotherapeutic ward and applicants for inpatient treatment. Ward members introduce the applicants into the concept of treatment and the treatment setting and they explore the psychological background of each of the applicants. Besides economical the concept has clinical and therapeutic advantages. Future inpatients get a realistic view of the treatment, they can build up a relationship to other inpatients and to therapists, and besides waiting for the admission to the clinic is made more bearable. Therapists are helped with their decision on the admission. The concept has proved itself in clinical practice for many years. The empirical proof of its effectiveness and a comparison with other, similar concepts fall due.     

The dodo bird revisited: A qualitative study of psychotherapy efficacy research

This article is a qualitative study of psychotherapy efficacy research spanning more than four decades. The findings are organized into five temporal categories characterizing the evolution of psychotherapy research. All five categories are integrated in the central phenomenon of two views of human behavior, a reactive or a proactive view. The categories are (1) psychotherapy is no more effective than no psychotherapy (1950s and 1960s), (2) the “core conditions” (empathic understanding, unconditional positive regard, and congruency) are necessary and sufficient conditions for therapeutic personality change (1960s and 1970s), (3) psychotherapy is for better or for worse (early 1960s), (4) the core conditions are necessary but not sufficient for therapeutic personality change (late 1970s and mid-1980s), and (5) specific techniques are uniquely effective in treating particular disorders (late 1980s and early 1990s). The findings concerned with Categories 4 and 5 are (a) that the conclusion that Rogers's attitudinal conditions are necessary but not sufficient has virtually no direct research support, and (b) that the research concerning specificity of treatment, dysfunction, therapist variables, and client variables is characterized by fragmentation, few replications, and lack of generalizability. Implications of the study indicate that specificity research, driven by the unfounded assertion that Rogers' attitudinal conditions are not sufficient, have yielded inconclusive and misleading findings. The pattern of research is one that culminates in the picture of a self-fulfilling model driven and directed by the “scientificating” deterministic view of human behavior, the movement toward narrow and specific application. Over four decades, the major thread in psychotherapy efficacy research is the presence of the therapist attitudes hypothesized by Rogers.