Emergence,Adaptation, and Relational Improvisation: Commentary on Terry Marks-Tarlow’s “From Emergency to Emergence: The Deep Structure of Play in Psychotherapy”

Dr. Marks-Tarlow’s paper provides a valuable examination of play processes in psychotherapy, using the novel synthesis of psychoevolutionary and nonlinear dynamical perspectives. The author’s sophisticated blend of psychobiological and intersubjective accounts is of great clinical value, illustrating the need for a rapprochement between affective neuroscience, intersubjectivity, and complexity paradigms. Comparisons are made to the Dynamical Systems Therapy 10 (DST) model (Shapiro, this issue), which similarly aims to integrate psychobiological and intersubjective accounts of psychopathology with internal representations.     

It’s All About the Relationship: The Role of Attachment in Child-Parent Psychotherapy

Research on Child and Adolescent Psychopathology -     

Daoism and the German Mission in Martin Heidegger’s “The Thing”

In this article, I examine Martin Heidegger’s 1950 lecture/essay “The Thing” (Das Ding) in two ways. First, as a piece influenced by chapter 11 of the Daodejing. And second, as a postwar writing which can be interpreted vis-à-vis the Black Notebooks and his other writings. There are instances in “The Thing” which are analogous to his statements found in the Black Notebooks and his other writings which describe and clarify his controversial political affiliation. In brief, I suggest here that Heidegger’s articulation of the concept of wu 無 of chapter 11 of the Daodejing as the void of the jug in “The Thing” may potentially describe his controversial engagement with German National Socialism as part of his response to the call for German mission. Notably, the fundamentality of the void of the jug is comparable to the exclusivity and exceptionality of the Germans in their mission; and the use of the void of the jug as outpouring is an interesting way to emphasize his disagreement with the regime by pointing out that his support to German National Socialism is not to the extent of brutally annihilating the Jews.     

Hitting the Bull’s Eye in Personality Disorders Psychotherapy

Psychotherapy of personality disorders (PD) is gaining momentum, though the progress has been mostly concerned borderline PD, with the other disorders largely neglected. In parallel, many empirically tested approaches focus on a limited understanding of psychopathology, for example poor mentalization or affect dysregulation, while PD are complex entities; they require clinicians paying attention to multiple therapy targets in order to be treated effectively and for a hope of actual recovery. I contend here that a more comprehensive account of psychopathology is needed; therefore the papers in this special issue focus on some of these aspects, such as difficulties in mental state understanding, dysfunctional representations of self with others, poor affect regulation and lack of access to adaptive and healthy self-aspects. The papers included in this special issue try and provide the readers with an intensive qualitative account of how therapists can act and yield improvements in these domains, with the hope of improving clinicians’ abilities to treat PD no matter what their preferred orientation is.     

Child’s Play: The Creativity of Older Adults

In this article, I discuss Paul W. Pruyser's view presented in his article "An Essay on Creativity" (Pruyser in Bull Menninger Clin 43:294-353, 1979) that creative persons manifest early childhood qualities of playfulness, curiosity, and pleasure seeking and that adaptation is itself a form of creativity. I then discuss his article "Creativity in Aging Persons" (Pruyser in Bull Menninger Clin 51:425-435, 1987) in which he presents his view that aging itself is a potentially creative process, that creativity among older adults is not limited to the talented few, and that older adulthood has several specific features that are conducive to creativity. Significant among these features are object loss (especially involving human relationships) and functional loss (due to the vicissitudes of aging). Noting his particular emphasis on object loss and its role in late-life creativity, I focus on functional loss, and I emphasize the importance of adaptation in sustaining the creativity of older adults who experience such loss. I illustrate this adaptation by considering well-known painters who in late life suffered visual problems common to older adults. I suggest that in adapting to their visual problems these artists drew on the early childhood qualities (playfulness, curiosity and pleasure seeking) that all creative persons possess and that they are therefore illustrative for other older adults who are experiencing functional losses. I conclude with Erik H. Erikson's (Toys and reasons: stages in the ritualization of experience, W. W. Norton, New York, 1977) and Paul W. Pruyser's (Pastor Psychol 35:120-131, 1986) reflections on the relationship between seeing and hoping.     

The future of the American Group Psychotherapy Association: whither we goest?

The author describes his perspective about what the future holds for the American Group Psychotherapy Association (AGPA). Utilizing Nitsun's (1996) construct of the "anti-group" as an organizing metaphor, he delineates the destructive forces both within and outside the organization that are currently affecting it, and then describes how they can be transformed into instruments for positive development. He suggests that the AGPA can and must continue to provide a "holding environment" (Winnicott, 1960) for professionals interested in working with people in groups. In addition, he asserts that the organization will build upon its remarkable response to the September 11, 2001 debacle in the United States to expand its services to those who have been traumatized. Beyond this, he underscores the importance of the AGPA consolidating and expanding its various educational offerings into a coherent package that will meet the needs of any and all who are interested in learning about how to work effectively with groups. In these and other ways, he contends that the AGPA will thereby confirm Nitsun's assertion that anti-group forces can be transformed, and that organizations that confront these forces constructively can not only survive but thrive.     

Play Profile Constructions: An Empirical Assessment of Children’s Play in Psychodynamic Play Therapy

Play assessment can be used therapeutically to determine whether and how play would be an appropriate intervention mode for children with clinical diagnoses, and to track their therapeutic progress. However, detailed and standardized play protocols that can catalogue children’s play behaviors in psychodynamic therapy are not widely available. The aim of this study was to empirically construct profiles of play using items selected from the Children’s Play Therapy Instrument (CPTI), reflecting the complex play patterns of children with mental health difficulties. These constructed play profiles integrate quantitative items associated with cognitive, affective, social qualities of play, as well as children’s coping strategies. The initial session of 62 children in psychodynamic play therapy was recorded, transcribed and coded using the CPTI, and children’s play profiles were computed. The reliability of the play profiles, and their preliminary associations with children’s symptomatic and behavioral functioning were tested. Results showed that the play profiles showed good inter-rater reliability, internal consistency and their associations were in expected directions with the majority of the criterion measures. Given the limitations of the current empirical play measures in clinical settings, the preliminary validation provided in this study of the play profiles add a significant contribution to existing literature.     

Let’s Play: Using Systemic and Experiential Techniques in the Play Therapy Instruction of MFT Masters’ Students

Marriage and family therapists are uniquely poised to work with entire families, including children. It is surprising then, that so few MFTs affiliate with play therapy. Many COAMFTE accredited masters’ programs offer some form of play therapy training, but therapists often report feeling uncomfortable with play therapy (Gil, 2015). In this paper, we offer a condensed refresher course on play therapy for MFTs, including suggested readings, materials, and instructions to expand training from a 2-day seminar to a 14-week course. We discuss the strengths and weaknesses of offering play therapy instruction as a semester long required course for masters’ students.     

The Man of the House: Commentary on Thomas Burkhalter’s “Foregrounding Masculinities in Psychoanalytic Psychotherapy”

Thomas Burkhalter is complemented on so vividly bringing the reader into his personal struggles to find a true masculinity in the unforgiving context of contemporary South Africa where White masculinity is associated with apartheid. The struggle to be free of old identifications with the patriarchal order and gender binaries saturate the paper, and attention is drawn to the lingering presence of older conceptions of masculinity as a monolithic concept that leaves women as victims and nurturers and the male as dominant. Burkhalter’s clinical vignette is examined and found to illustrate well his struggle and to capture the vulnerability to genderized enactments and the enduring presence of the old order manifested by a reliance on defense analysis that constrains his construal of Mr. Jones’s statement that he is “after all the man in the house.” Potential alternative meanings of this phrase that foreground grief, hope, and a plea for companioning in pain are offered and a deeper engagement with Mr. and Mrs. Jones’s conscious and unconscious worlds is encouraged.     

Finding One’s Voice: Psychotherapy for Dissociative Motor Disorders in the Indian Context

Dissociation is a prevalent disorder in India, however there is a lack of evidence-based psychological interventions worldwide. The present paper includes two case studies of dissociative motor disorder with onset in the perinatal period, seeking treatment in the Indian tertiary mental health set-up. Both cases presented with disabling symptoms of paraparesis, and mutism in one. The case series discusses similarities in presentation, socio-cultural contexts, and the psychotherapeutic approach. The psychotherapy process is discussed in detail, with a focus on challenges encountered, therapist reflections and supervision. Insights from treatment are presented, including the melding of approaches, and sensitivity of interventions to the larger socio-cultural framework.

     

It’s Child’s Play: Contemplative Anthropocosmic Creativity

The implicate or quantum connectivity of the coevolving phenomena of the cosmos, the ontohermeneutic complementarity relations between ourselves and the vast and minute systems we coconstitutingly participate, observe, prolong, and contextualize, and the eco-reciprocities among all forms of life afford us an understanding of ourselves as fractal or microcosmic embodiments and performances of what is irreducibly nondual anthropo-cosmogenesis. And if cosmogenesis is a self-referential process having nothing external to itself from which to obtain gain or satisfaction, we may analogously interpret our noninstrumentalizing contemplative experiences in complete attentiveness without regard to external payoffs as the fractal play of its creatively emergent self-delighting anthropocosmic self-awareness in the human dimensionality. Our attentive, noninstrumentalizing, and nonobjectifying contemplativity aconceptually presences connectivity and reciprocity in an aperspectivally transparent enactment of anthropocosmic ongoing-wholing whose meaning is the being of its own self-delighting. The sustainability of cocreative anthropocosmogenesis on Earth flourishes where our conduct and intrinsically rewarding contemplativity are consonant with and recreate the spontaneous coevolutionary play of intrinsically rewarding creatio continua unreduced, unobstructed, unfragmented, and uneclipsed by partial, excessively dualizing perspectives and related efforts for extrinsic gain.     

Child’s Play: The Role of Play in Mitigating the Fear of Death Among Pediatric Palliative Care Team Patients,Families, and Caregivers

Terror Management Theory (TMT), derived from Ernest Becker’s The Denial of Death (1974), maintains that humans are motivated by the desire to overcome our fear of death by constructing meaning and significance in our lives in various ways, including making light of our mortality. In this paper, we examine the role of play as seriously ill children involved with a hospital-based palliative care team live out what may be the remainder of their lives. We question the function that play has, if any, in mitigating the fear of death among dying children and their caregivers. We explore formal and informal manners of therapeutic play among children and adults occurring in moments of terrible stress, pain, and the looming threat of death. We draw on playful representations of death from popular culture and from extended field research conducted with a pediatric palliative care team in a large regional children’s hospital caring for seriously ill children and their families, as patients, families, and caretakers struggle to make sense of their suffering, fear and loss.     

The Haunting of Men: Commentary on Thomas Burkhalter’s “Foregrounding Masculinities in Psychoanalytic Psychotherapy”

Thomas Burkhalter’s paper opens an important conversation about the fate of White masculinity in post-Apartheid South Africa. The commentary celebrates the nuance and complexity of the analysis but also suggests that social and historical context would deepen its reach. This concerns taking account of the ways in which the therapeutic moment described owes its formation to a historically and socially specific form of White liberal masculinity. The implications of this for women gendered as female are explored.     

The Leader’s Illumination of Group Phenomena Hidden in Plain Sight: Why Is No One Talking About the Elephant in the Room?

This article discusses an important leadership function: calling attention to phenomena in group therapy that are NOT observed or observed but not commented on by group members. The article includes group scenarios that often generate member omission, ways to mitigate shame that can result from uncovering members’ blind spots, and misuses of this leadership function. Numerous clinical examples are provided. Concepts borrowed from attachment theory and interpersonal neurobiology help explain how the group’s internalization of this leader function may help the group become a more potent therapeutic environment. The limited contribution of neurological findings to clinical decision-making is discussed.     

The Intervention of Robot Caregivers and the Cultivation of Children’s Capability to Play

In this article, the authors examine whether and how robot caregivers can contribute to the welfare of children with various cognitive and physical impairments by expanding recreational opportunities for these children. The capabilities approach is used as a basis for informing the relevant discussion. Though important in its own right, having the opportunity to play is essential to the development of other capabilities central to human flourishing. Drawing from empirical studies, the authors show that the use of various types of robots has already helped some children with impairments. Recognizing the potential ethical pitfalls of robot caregiver intervention, however, the authors examine these concerns and conclude that an appropriately designed robot caregiver has the potential to contribute positively to the development of the capability to play while also enhancing the ability of human caregivers to understand and interact with care recipients.