Spouse killing: The final abuse

As an alternative to the sado-masochistic interpretation of violent spouse abuse, a quasi-romantic perspective sees abuse as a consequence of intensive intimacy—even love. In this study, abuse is explained as a form of punishment of the partner who is experienced as the spoiler of the expectations, hopes and plans for a fulfilling long term, committed and attuned communion. He/she, who is perceived as the breaker of that intimate context has to be penalized, with the death-penalty being the extreme form of expression of outrage at the offense. Both husbands who killed their wives, and wives who killed their husbands, in their interviews with the author displayed a deep commitment to their marriages. This explains why their leave-takings were so violent and their exits so final. By killing the spoiler they could bury and let go of their romantic dreams! Less lethal forms of spouse abuse-battering, enslavement, etc., often have the same element of punishment of the spoiler.Roger Carl F. Bach, Ph.D. participated in the data collection and the write-up of the results.     

An exposure approach to alcohol abuse

The drinking behaviour of alcoholics was firstly analysed in terms of antecedents, behaviour and consequences. Thereafter, treatment consisted of exposure to the antecedents of drinking, whilst patients were prevented from drinking. Five out of the six patients attained abstinence from drinking by the end of therapy, this abstinence being maintained over follow-ups of up to 9 months, and also noted an absence of desire to drink at the end of therapy. The possible mechanisms in operation during treatment are discussed, including operant or classical conditioning, teaching of self control and cognitive invalidation.     

Emotions as ecosystemic adaptations

Despite Gregory Bateson's interest in emotion and culture, the potential for understanding emotion systemically and culturally was lost very early in the mainstream development of family therapy, partly as a reaction to the dominant psychiatric‐psychoanalytic paradigm of North America at the time. In those pioneering years, to take emotion seriously was to risk appearing stuck in a one‐person psychology. In an interesting paradox, it is relational psychoanalysts and parent–infant researchers such as Beatrice Beebe and Frank Lachmann who have recently turned to systems theory to give a fuller account of emotions and emotional regulation in self and relationships. The author draws on their ideas together with the work of Peter Fonagy, Patricia Crittenden, Jessica Benjamin, Britt Krause and others to sketch briefly an ecosystemic theory of emotional expression. This sketch is used to give contextual meaning to two contrasting clinical topics in relation to anger: self‐harm and conduct ‘disorder’.     

Behavioral Marital Therapy: An Outcome Evaluation of Conjoint,Group and One Spouse Treatment

Abstract

Behavioral Marital Therapy has focussed on the modification of marital behavior in conjoint and couples group settings. This study extends previously published outcome studies in that one treatment condition involved treating only one of the partners. Fifty-seven couples were consecutively assigned to one of the three treatment conditions. Outcome evaluations included an independent assessment, marital satisfaction, sexual adjustment and an assessment of target problems. The results revealed no significant differences between the three treatment conditions. However, couples in the conjoint treatment resolved their target problems more rapidly than the other two treatments. The implications of the result as well as issues of outcome prediction, cost-effectiveness and the viability of treating one spouse are discussed.     

Therapist sexual abuse: An interview with Jill Sinclair

This interview, conducted in January 1991 with Jill Sinclair (Co-ordinator of the Support Network for those Abused by Therapists), covers: (a) the semantics of therapist sexual abuse, (b) its effect on clients, (c) suggestions for therapists working with clients abused by a previous therapist, (d) the current and future work of the Support Network, and (e) the question of whether or not therapists who have sexually abused their clients should be rehabilitated.     

A family‐therapy approach to child abuse: countering resistance

Abusing and high-risk families have been seen over three years at a new treatment resource with a family therapy orientation. The families present with established resistance to any treatment intervention and many have defeated a succession of previous helping agencies. Initial typology and treatment strategies are described with the aim of more systematic selection of therapeutic techniques.     

Toward competence: An eclectic approach

Recent developments in children's rights have led to increased criticism of the presumption of total incompetency until adulthood, a concept inconsistently defined by state law. Citing proposals from several disciplines, this article calls for increasing actual competency in decision-making through systematic education in conjunction with developmental levels and experience. The elements of informed consent are suggested as one mechanism for learning to make educated decisions in a variety of settings. The treatment of hyperkinetic children is discussed as a case example.     

Multifaceted Approaches in Spouse Abuse Treatment

SUMMARY

The understanding of spouse abuse has changed considerably in the last 30 years, shifting from a perspective based on individual psychopathology to that of a pervasive social problem. Current treatment solutions for stopping violence are limited to those that address resocializing the batterer. Several states often restrict the use of state funds for batterers' groups and forbid couples treatment as a primary treatment option in spite of the fact that most couples choose to remain in their relationships in the presence of repeated violence. This article argues for broadening options to include a specific type of couples treatment as a part of a coordinated community response to remediate domestic violence. Solution-focused therapy is described as an example of treatment of relationships that makes safety a priority and is not victim-blaming. It is suitable treatment both for couples who wish to stay together and those seeking a safe way to separate.     

Verbal probabilities: An alternative approach

Previous studies of verbal probabilities have tried to place expressions like a chance, possible, and certain on 0–1 numerical probability scales. We ask instead, out of a range of outcomes, which outcome a verbal probability suggests. When, for instance, a sample of laptop batteries lasts from 1.5 to 3.5 hours, what is a certain and what is a possible duration? Experiment 1 showed that speakers associate certain with low values and possible with (unlikely) high or maximal values. In Experiment 2, this methodology was applied to several positive and negative verbal probability phrases, showing a preference for high rather than low or middle values in a distribution. Experiment 3 showed that such maxima are not universally described by large numbers. For instance, maximum speed is often described in terms of a small number of time units. What can (possibly) happen is accordingly sometimes described with very low and sometimes with very high values, depending upon focus of interest. Finally, participants in Experiment 4 were given the role of hearers rather than speakers and were asked to infer outcome ranges from verbal probabilities. Hearers appeared to be partly aware of speakers' tendencies to describe outcomes at the top of the range.     

Child abuse in the early postnatal period: An atypical presentation

In cases of severe physical abuse of babies, the usual dynamics uncovered are a parental history of abuse and deprivation, lack of family support, extreme family stressors, bonding failure to the baby, and/or parental mental illness, including depression or psychosis. This paper presents four cases, from a sample of several hundred abusive families, that do not encompass the usual “abusive” dynamics outlined above. In all four cases, the abuse was perpetrated in the first few months postpartum, against a background of good physical care of the baby, an apparently adequate bond to the baby, and negative psychiatric findings in the abusing parent. The similarities within these four cases were striking, particularly the use of denial to deal with conflicts and long-standing difficulty in expressing any ambivalence in attachment relationships. An explanation of the complex dynamics involved in such cases is offered, and the difficulties in detection and intervention are addressed.     

Spouse versus other family caregivers: Psychological impact on impaired aged

This correlational study examined negative affect among impaired aged who live with and receive care from either a spouse or a younger relative. Covariance analyses, controlling for group differences in age, health, and functional disability, soundly disconfirmed hypotheses that spouses' care would prove less stressful than would that of children. In fact, the reverse obtained for measures of number of expressed worries, negative affect toward caregivers, and perceptions of both negative affect and negative behavior of caregivers toward elderly respondents. The two care groups did not, however, differ in self-rated depression or in feelings of dependency upon care providers. Examination of social support indices revealed that Spouse and Other care groups differed only in number of other household residents who assist with health care activities; this variable was, however, unrelated to affect measures. Results are discussed in terms of differential stressors upon aged couples in contrast with recipients of second-generation relatives' assistance, and of kinship factors which may influence elders' perceptions and affect.     

The Unseen Spouse: Pitfalls and Possibilities for the Individual Therapist

Individual therapists often hear a great deal about our patients' spouses or partners, and naturally develop ideas and beliefs about that unseen other and about the causes of any relationship difficulties the patient reports. Not uncommonly, therapists can lose touch with the fact that their impressions of an unseen spouse are constructions that have emerged from the transference/countertransference field, based on only partial or limited information—not veridical truths. They can then talk with the patient about his or her partner or relationship issues in ways that can ultimately do both patient and spouse a significant disservice and perhaps distract from the patient's own issues and analytic goals. This paper discusses several factors that seem to contribute to the development of this problematic dynamic, including various qualities of the transference/countertransference field, and offers suggestions for avoiding or reducing it. Clinical material is used to illustrate key points.     

Also Victims: Understanding and Treating Men Arrested for Spouse Abuse

The author describes characteristics of men arrested for spouse abuse and a small-group educational format for court-referred treatment of abuse.     

Focused group therapy: An integrative approach

Focused Group Therapy (FGT) was developed within a research project on treatment for burned out patients on long-term sick leave. The core of FGT is to find and formulate an individual focus expressed in behavioural terms. This focus is then worked with in the here-and-now of the group therapy. It is argued that the use of common factors in group therapy, rather than a special technique, improves the clinical work. Thesupport factor in group therapy is understood in terms of cohesion, therapeutic alliance and goal-corrected empathic attunement. Thelearning factors that are stressed are the experience of being a part of a developing group, building on similarities instead of differences, affective communication and the implicit knowledge developed in new ways of dealing with interpersonal relations. Theaction factor is considered to consist of challenging interpersonal situations corresponding to the individual focus, which are mastered in the here-and-now of the group.