Personal issues facing the psychotherapist in the National Health Service

SUMMARY

This paper examines some of the stresses and challenges to be faced by a Consultant Psychotherapist with a psychoanalytical orientation who works in the National Health Service. It considers factors in the psychotherapist which may exacerbate the stress. Finally, it suggests some solutions.     

Psychoanalysis and Politics by R. E. Money-Kyrle

Abstract

Group psychotherapists in their everyday practice confront a series of ethical problems, some of which rise to the level of ethical dilemmas. This two-part special series will address how the group psychotherapist can address these problems and dilemmas in a way that leads to an ethical course of conduct. This article introduces the series by examining ethical principles and decision-making processes that are relevant to the wide range of issues that confront the group psychotherapist. The article also considers the person of the group psychotherapist him or herself and notes that certain personal qualities might create a foundation for ethical thinking and behavior.     

Food and violence: Childhood violence and emotional abuse as complicating factors in the inpatient treatment of eating disorders

SUMMARY

This paper considers the treatment, on an inpatient eating disorders ward, of patients who have suffered violence and emotional abuse during childhood. The complex web of relationships surrounding these patients is discussed, and it is suggested that there are multiple transferences — to the institution, to various members of staff, and to other patients — and that splitting of these transferences is inevitable. Staff experience powerful countertransference feelings, related to the patient's violent history. A central task for the staff team as a whole is to understand and contain the patient's disturbance — taking on, tolerating, and processing the projections. This demands the close working-together of the members of the multidisciplinary team, so that staff can together openly examine the patient's interaction with them and their own emotional responses to the patient and to other members of staff. If these responses are not understood by the ward staff, they can lead to conflict and inappropriate decisions. On the other hand, if the staff team together can build up a picture of the patient's relationships on the ward, and their meaning for the patient, this picture, like a particular projection of the world in an atlas, provides a ‘map’ of the patient's inner world. This ‘map’ can be used by the staff team in navigating their interactions with the patient. It can also assist the psychotherapist in her work to help the patient recognise and, eventually, own the split-off parts of herself.     

Changes

Summary

Working as a psychotherapist gradually changes the person of the therapist. The author describes the positive and negative ways she has been affected characterologically by the experience of doing therapy over many years.     

Harriet Lerner: A Feminist Voice From the Wheat Fields

ABSTRACT

Harriet Lerner, a Menninger-trained psychologist, has published widely in scholarly journals and for a general audience. Her twelve books include The New York Times bestseller, The Dance of Anger, and she blogs for Psychology Today. In this chapter, she shares her personal and professional evolution as a feminist theorist, psychotherapist, and writer.     

A view from the visitors' gallery

SUMMARY

In this paper, the author describes aspects of his work as a psychoanalytical psychotherapist in a hospital for diseases of the colon and rectum. After reviewing some of the earlier psychoanalytic literature (Freud and Abraham), and more recent theoretical contributions, two cases are described in some detail, which help give a flavour to some of the work. The paper concludes with caveats about the internal and external working environment, which will facilitate or hinder working in particular medical settings.     

Healing presence in the psychotherapist

Abstract

Throughout graduate school I felt compelled to become a fine psychotherapist. Implicit in that motivation was my curiosity about what makes a psychotherapist effective. My curiosity was inspired by my experience with one therapist who helped me activate profound transformation. After identifying intuitive inquiry (Anderson, 1998, 2000, 2004) as my research method, I explored that experience through meditation, reading, and conversation and eventually identified her healing presence as the core quality that differentiated her from other therapists I had known. Though technique and experience are important, I sensed that it was her healing presence that allowed her to use technique and experience skillfully. Throughout Cycle 1 of intuitive inquiry, the “text” that claimed me was my personal experience of her healing presence, her ability to be present, to connect with me, to see me, and even, to love me. Through intuitive inquiry, I was able to expand my understanding of the healing presence of a psychotherapist to incorporate the experiences of many others.     

Edward Said (1935 – 2003): His relevance to psychotherapy

Abstract

This paper is an appreciation of the work of the late Edward Said, the distinguished Palestinian-American academic. By looking at three key themes within his thinking, I argue for the relevance of his work to the psychotherapist and for how much it has to offer in conceptualizing social and personal identity.     

Attitude change in marital cotherapy

Abstract

Ethical and legal issues concerning the application of informed consent in psychotherapy are reviewed in relation to: 1) controversies in defining an informed consent; 2) ethical and legal responsibilities of a psychotherapist in obtaining an informed consent; 3) potential ethical and legal liabilities for not implementing the informed consent doctrine; and 4) principles of confidentiality and privileged communication as they apply to this doctrine. Suggestions are made on how to implement an informed consent legally and ethically in psychotherapy.     

Sources of influence on the professional development of psychologists and psychiatrists in Norway and Germany

Background: There are many professional psychotherapists, but no psychotherapy profession. The psychotherapists’ professions vary between countries, the most frequent being psychiatry and clinical psychology.

Aim: As these professions have different basic training and also may be impacted differently by other factors, we wanted to study potential differences as to perceived influences on their development as psychotherapists across career level, theoretical orientation, and gender.

Methods: More than 2500 Norwegian and German psychiatrists and psychologists reported data on their professional development in the DPCCQ/2000, a lengthy multi-part survey instrument developed within the ‘Collaborative Research Network’ of the Society for Psychotherapy Research. The four groups were compared for differences, and a series of multiple regression analyses were conducted to examine the impact of profession on a variety of aspects of therapist experiences.

Results: Although a few therapist experiences (e.g. teaching, treating patients, institutional conditions) had a significantly different impact between the two professions, as a main effect, they only accounted for less than 1% or the variance.

Conclusion: Profession seems to have little influence on perceived development as a psychotherapist, and it is reasonable to conclude that other therapist qualities, often personal qualities, are more important for therapeutic processes and outcomes.     

Doing it for the team: Soccer coaches' identity leadership predicts players' effort,turnover intentions,and performance

ObjectivesThe present research investigates how coaches' identity leadership predicts individual and team outcomes in soccer. Specifically, we tested hypotheses that coaches' identity leadership would be associated with players' perceptions of (a) higher team effort, (b) lower turnover intentions, (c) better individual performance, and (d) better team performance. In addition, we aimed to examine the relationship between coaches' identity leadership and increased team identification of players and the degree to which the associations of identity leadership with these various outcomes were mediated by players' strength of team identification.DesignWe conducted a cross-sectional study of male soccer players in Germany.MethodThe final sample consisted of 247 male soccer players nested in 24 teams that completed measures of their coaches' identity leadership, team identification, team effort, turnover intentions, and individual/team performance.ResultsAnalysis revealed a positive relationship between coaches' identity leadership and team effort, as well as individual and team performance. Moreover, coaches' identity leadership was associated with lower turnover intentions. There was also evidence that the relationships between identity leadership and the investigated outcomes were mediated by team identification.ConclusionsThese findings support claims that coaches' identity leadership is associated with better individual and team outcomes because it helps to build a sense of ‘we’ and ‘us’ in the team they lead.     

Team coaching: One more clue for fostering team effectiveness

Introduction and objectivesThe purpose of this study was to examine the effects of team coaching (provided by the leader and by peers) on team performance and on the members’ satisfaction with the team. The mediated role of peer coaching in the relationship between leader coaching and individual and team results was also analyzed.MethodAdopting a multilevel approach and a cross-sectional design, 506 employees from 75 teams were surveyed. In the test of the hypotheses, multiple regression and hierarchical linear modeling (HLM) were computed.ResultsThe results showed a direct positive effect of peer coaching on individual and team outcomes, and also a mediated effect of peer coaching in the relationship between leader coaching and both outcomes measured.ConclusionsOur findings put forward the importance of coaching in the achievement of team goals.     

The stigma of the self

Abstract

After recounting some personal life experiences that sensitized him to the kind of stigma that Erving Goffman systematically explored in his 1963 classic, Stigma, the author, who Is a psychoanalytic psychotherapist, introduces hit concept of the stigma of the self. Paradoxically, the stigma of the self may occur when a person is treated as merely normal, and as only a social self and when, a? a consequence, there does not seem to be any recognition of what D. W. Winnicott has termed the true self. Drawing on his studies of the self [in his recently published The Singles Scene: A Psychoanalytic Study of the Breakdown of Intimacy(Alper, 1995)] the author explores the dynamics of what he calls intimacy hunger, an unappreciated but powerful need that, especially after a sufficient period of deprivation has elapsed, cannot be satuifed by a purely social substitute.     

Self-representing dreams

SUMMARY

Certain dreams are particularly striking for the way they represent themselves and the manner in which they are told within a psychotherapeutic relationship. Within such a dream is contained a picture of the dream's function and significance as part of the transaction between patient and psychotherapist. This phenomenon illustrates the nature and function of unconscious phantasy, the relations that hold between phantasy and mechanisms of defence, and the manifestations of phantasy within the transference.

Three examples are given of self-representing dreams which have been reported and re-enacted by trainee psychiatrists in psychotherapy supervision.     

“I control my own emotions for the sake of the team”: Emotional self-regulation and interpersonal emotion regulation among female high-performance curlers

ObjectivesThe purpose of this study was to examine emotional self-regulation and interpersonal emotion regulation within a team of competitive athletes.DesignInstrumental case study approach (Stake, 1995).MethodData collection involved multiple semi-structured interviews with all four members of a female high-performance curling team, as well as observation of team meetings, practices, and games over the entire season.ResultsAnalyses produced the main themes of emotional self regulation (body language and self-censorship) and interpersonal emotional regulation (providing positive and/or technical feedback, humour, cueing teammates about their emotions, prosocial actions and indirect actions). We also identified factors influencing emotional regulation (length of time together, team dynamics/cohesion, context, social norms and team roles, and seeking support outside the team).ConclusionsAthletes were aware of and took into account social and contextual factors (e.g., social norms and role on team) when regulating emotions in a team context, and they also identified challenges associated with emotional regulation within the team. Findings highlight the complex interplay between athletes' emotions, emotional expression, and self-regulation to achieve multiple goals (e.g., positive performances, positive social relationships), as well as the importance of examining interpersonal processes related to emotion and emotion regulation within team sports.     

The utility of modern theories of intergroup bias for research on antecedents to team identification

ObjectivesMuch of the literature on team identification has focused on assessing outcomes to the construct rather than on motives for its development and maintenance. This article comments on research and theorising in social psychology that can contribute to an understanding of motives for team identification.DesignA review and comment on the application of theories of intergroup bias to the study of team identification.MethodFour modern theories of intergroup bias—social identity theory, optimal distinctiveness theory, uncertainty-identity theory, and terror management theory—are overviewed. Potential applications of these theories to future research on motives for team identification are also offered.ResultsIt is argued that the four theories share similar tenets with reference to motives for social identity. A programme of research that evaluates these motives in the context of sport team identification is offered.ConclusionsIt is hoped that this paper will stimulate research into precursors of team identification and that the findings from such research will help sport teams and governing bodies to promote or control certain types of spectator behaviour.     

Expertise in soccer teams: A thematic inquiry into the role of Shared Mental Models within team chemistry

AimsThe purpose of the current study was to establish a conceptual framework of team chemistry components in sport with an emphasis on Shared Mental Models (SMM).MethodElite soccer coaches (n = 6) and players (n = 3) were interviewed using a semi-structured interview guide. An inductive thematic analysis was employed to analyze the data.ResultsFour themes related to team chemistry components were identified: (1) members' characteristics (i.e., demographic data, on-field characteristics, and member's ego), (2) coach–players interactions (i.e., professional interaction and emotional intelligence of coaches), (3) interactions among the players (i.e., professional understanding, efficacy beliefs, team cohesion, players' emotional intelligence, team roles, and goals), and (4) interactions with environmental factors (i.e., owners, management, fans, and media).ConclusionsThe cognitive components of the team chemistry model were clustered to establish a conceptual framework of SMM. Furthermore, the cognitive-affective-social-behavioral linkage of team chemistry and athletic performance is examined in light of the emerged model and conceptual framework. Implications and future directions are also discussed.     

Examining the home advantage in the National Hockey League: Comparisons among regulation,overtime, and the shootout

ObjectivesTo investigate the magnitude of the home advantage in the National Hockey League (NHL) as games proceeded from regulation, to overtime, to the shootout, while adjusting for team quality.DesignArchival.MethodBinary logistic regression analyses were conducted using data from the 2005–2006 through 2013–2014 NHL seasons (N = 10,534 games) to compare home teams’ odds of winning in regulation, overtime, and the shootout.ResultsCompared to games decided in regulation, higher quality home teams' odds of winning were slightly lower when games concluded in either overtime or the shootout. Further, regardless of team quality, home teams’ odds of winning were moderately lower when games concluded in the shootout rather than overtime.ConclusionsThe shootout may affect home team players' psychological and behavioural states, generally resulting in a decrease in home teams’ odds of winning in the shootout relative to overtime.     

Self-efficacy,mental models and team adaptation: A first approach on football and futsal refereeing

ObjectiveWithin the football and futsal refereeing context, even though referees work within teams, there is very little research considering the implications of team dynamics. In response, this study starts to address this gap in the literature by investigating the moderating effect of mental models on the relationship between self-efficacy beliefs and perceptions of team adaptation within the exciting context of professional and national football and futsal refereeing.DesignWe obtained online questionnaires from 339 active football and futsal referees within the National and Professional league at two distinct points (April and May) within the football season.ResultsSelf-efficacy beliefs were positively associated with perceptions of team adaptation (only for football referees). Mental models were positively associated with team adaptation. Likewise, the moderation between mental models and self-efficacy beliefs was positively associated with perceptions of team adaptation. However, such an effect was only significant at the futsal referees’ level.ConclusionThis study emphasises the importance of mental models for team adaptation and the importance of self-efficacy beliefs in predicting perceptions of team adaptation. We hope that this study represents the first step in a greater appreciation of the salience of team dynamics and their impact on football and futsal referees’ performance and that future research can build upon our work.     

Adaptive thinking: Can adaptive dispositional attributions protect against the harmful effects of maladaptive situational attributions?

ObjectivesThe study was designed to examine if dispositional team-referent attributions moderate relationships between situational team-referent attributions and collective efficacy.DesignIn this cross-sectional design investigation, team athletes completed measures of dispositional team-referent attributions, situational team-referent attributions, and collective efficacy. Team outcome (i.e., win-loss status) was recorded.MethodAthletes (N = 163) on sport teams (K = 17) completed a measure of dispositional team-referent attributions (i.e., attributional style). They also completed a measure of situational team-referent attributions in reference to their most recent team competition and a measure of collective efficacy in reference to their next upcoming team competition.ResultsFollowing team victory, simple slopes analysis revealed a moderating effect such that adaptive dispositional team-referent attributions appeared to protect against the effects of maladaptive situational team-referent attributions on collective efficacy. This trend was demonstrated across stability and globality attribution dimensions. Following team defeat, no significant interaction effects were observed.ConclusionsThe results suggest that developing adaptive dispositional attributions after success may protect athletes from experiencing deleterious effects of maladaptive situational attributions. Future research is needed to confirm these results and understand how these results can be applied to attributional retraining interventions in sport.