Synthetiki Psychotherapy: An Integrative Psychotherapy for Individuals with Schizophrenic Symptoms

During the past 22 years, the author has developed an integrative psychotherapeutic model, called Synthetiki Psychotherapy (from the Greek word synthesis), for the treatment of individuals with schizophrenic symptoms. It has been influenced by certain philosophical and ethical principles, by ancient and modern Greek civilization and culture, and by the psychotherapy integration movement, and has been tested through research at the Laboratory of Clinical and Social Psychology of the University of Crete, Greece. The principles of Synthetiki Psychotherapy are presented and discussed.     

Poetry in Existential Psychotherapy with Couples and Families

The use of poetry during the process of existential psychotherapy with couples and families is described and illustrated. In this approach, poems can be utilized to help the couple and/or family notice meaning potentials in the future, actualize and make use of such meaning potentials in the here and now, and re-collect and honor meanings previously actualized and deposited in the past.     

Treating Hypochondriasis with Interpersonal Psychotherapy

The treatment of hypochondriacal patients can be conceptualized as taking one of three approaches. These typically address one of the following questions: 1) “Should the patient be preoccupied?” 2) “Why is the patient preoccupied?” 3) “What are the interpersonal consequences of being preoccupied?” Interpersonal Psychotherapy (IPT) is specifically designed to address the last of these questions. IPT focuses on understanding the patient’s real distress, exploring the patient’s maladaptive communications, and modifying those communications so that others are more able to meet the patient’s attachment needs. With a focus on communication in a time-limited frame, fostered by a strong collaborative relationship, IPT appears to be an effective method of reducing hypochondriacal behavior.     

Psychoanalytic Psychotherapy with People in Abusive Relationships

Summary

Psychoanalytic perspectives on violence between partners is describedand forms a foundation for an approach to group and individual psychotherapy of men and women in relationships in which there is physical violence between partners. The empirical results of a study of the outcome of psychoanalytically oriented psychotherapy are described. Nineteen men and 16 women completed research measures before beginning psychotherapy and after completing 16 sessions of group psychotherapy. Twelve people who completed group psychotherapy continued in individual psychotherapy and completed measures again after 16 sessions of individual psychotherapy, and nine people completed measures again after the 16 sessions of group and 32 sessions of individual psychotherapy. Statistical analyses addressed outcomes in terms of verbal and physical aggression and dysphoric affects and anger. Both research and clinical outcomes are discussed.     

Re-enactments in their developmental context

The power of the repetition compulsion is felt in an especially keen way during re-enactments within psychodynamic psychotherapy. In this paper, the authors recommend greater attention to the developmental aspects of re-enactments as providing valuable information about the affective character of the crisis being brought to life in the treatment. Specifically, the authors suggest that the current developmental stage of the patient influences the experience and expression of the core developmental conflict that lies at the heart of the re-enactment in the treatment dyad. Re-enactments in childhood, adolescence and young adulthood, as well as at midlife and in the later years, each have different signatures. Thus, increased knowledge and awareness of both developmental stage and developmental core conflict is important for the following reasons: It provides a firmer theoretical foundation for understanding what is, by definition, a formidable moment in treatment; it adds another dimension and thus enhanced flexibility to the clinician’s clinical stance during a time of greater countertransference potential; and it adds to the theoretical perspective that the compulsion to repeat functions, at least in part, as an attempt to master an intrapsychic, affectively charged, previous experience of defeat. Clarifying the developmental nature of re-enactments for both patient and therapist can serve an orienting function during what is often a confusing and destabilizing time in the treatment relationship, and it can help differentiate developmentally appropriate behaviour from re-enacted conflict.     

Marcel's Testimony in Existential Psychotherapy with Couples and Families

In recent years a number of family therapists and teachers of family therapy have questioned the direction of the family therapy movement into relationship-distant and procedurally based treatment orientations. The purpose of this article is to outline Gabriel Marcel's concept of testimony and to show how this concept can be utilized to facilitate an increased emphasis upon the treatment relationship during marital and family psychotherapy.     

Previews of a Paradigm Shift in Psychotherapy: An Interview with Alvin Mahrer

The main purpose of the interview was to explore Alvin Mahrer’s views on an uncommon issue, namely the possibility of a paradigm shift in the field of psychotherapy. The interview covers (a) a way to help bring about a revolutionary paradigm shift, and (b) preview possibilities for an across-the-board, comprehensive paradigm shift in the field of psychotherapy. Grateful appreciation is extended to the reviewers whose comments were helpful and constructive in enabling a substantial improvement in the earlier draft of the interview.     

Making Space for Every Body: Ending Sizeism in Psychotherapy and Training

Abstract

The importance of addressing weight bias as a social justice issue in psychotherapy and psychology education and training is introduced. The history of the development of fat studies is briefly reviewed. Current coverage of size and sizeism in psychology is critically examined and contrasted with the increasing adoption of the medical model of “obesity.” Fat shaming in the practice of mental health professionals is examined as a barrier to clients’ physical and mental health. Alternatives to medicalized weight management and fat shaming are introduced. Models that emphasize size acceptance and resist negative embodiment are encouraged. The potential for a future that makes space for every body is assessed.     

Re-Collection in Existential Psychotherapy with Couples and Families Dealing with Death

Re-collection is a treatment dynamic in existential family therapy in which the client family is helped to remember and honor meanings that family members have previously actualized and deposited in the past. This shrinks the family meaning vacuum and those symptoms and problems that grow and flourish in a family meaning vacuum. In this article, an existential orientation to re-collection with families who are dealing with the death of a loved one is presented, described, and illustrated with case material.     

Special Issues in Psychotherapy with Minority Deaf Women

Abstract

Minority Deaf women have been traditionally underserved by mental health professionals, and specifically, therapists are unaware of issues unique to this population. It would be highly unlikely for a minority Deaf woman to have a therapist who matches her in racial background, hearing status, and communication mode. Therefore, the therapy process will be completely cross-cultural. Therapists who provide psychotherapy services to minority Deaf women need to be aware that their clients are members of a community where deafness is a culture and not a disability. Minority Deaf women are also likely to report feeling forced to choose between competing identities in order to get important needs met. In the following article, case examples are provided which illustrate some of the major issues that are likely to arise in therapy with minority Deaf women. These issues include: access to important information; communication, support and level of involvement with biological families; competing cultural demands; health concerns; and coping with chronic mental illness.     

重视终末期肾病患者的心理治疗

心理治疗在终末期肾病(ESRD)治疗中的作用非常重要,不但可缓解患者的心理压力,还可改善患者的生理障碍、减少并发症,因此重视对ESRD患者的心理治疗,可使患者保持良好的生理、心理状态,并能提高患者的生活质量,改善预后。     

Pete the diesel: Psychotherapy with a severely disturbed five-year-old boy

The psychic significance of the figure of the grandmother in psychodynamic psychotherapy has received scant attention. This paper develops the concept of the ‘grandmaternal transference’ in parent–infant psychotherapy and explores its identification, its possible functions and its therapeutic significance. The grandmaternal transference has special relevance to parent–infant psychotherapy since the grandmother often represents both the mother’s mother and the child’s grandmother and offers a unique third position between mother and child. Three clinical vignettes illustrate how the grandmaternal transference may operate in this third position. In the first vignette, the therapist becomes in the transference a containing grandmother thereby facilitating maternal containment. In the second case, the therapist may be experienced as a differentiating grandmother able to help mother and infant with separation and individuation. In the third one, the therapist is transferentially experienced as a paternal grandmother who acts as a pseudo-father able to embody the paternal function. In each of these positions, the transference and countertransference – whether positive or negative – require that the therapist responds to rather than enacts the grandmaternal role. The three configurations of the grandmaternal transference have different clinical manifestations and offer different therapeutic ports of entry.     

Treating Depression in Older Medical Patients with Psychotherapy

This purpose of this paper is to discuss the effectiveness of psychotherapy for treating depression in older, primary care patients. This paper highlights the feasibility of implementing psychotherapy in primary care settings, patient preference for psychotherapy, and the utility of primary care versions of therapy in treating depression in older adults. The discussion is supported with examples from three ongoing research projects, specifically the San Francisco General Hospital Depression in Late Life Study, the Hartford Foundation/California Healthcare Foundation IMPACT study, and the NIMH PROSPECT study. The findings presented here support the value of offering psychotherapy as a treatment alternative in primary care medicine.     

Cyclical Maladaptive Patterns: Interpersonal Case Formulation for Psychotherapy with Children

This paper proposes the use of Hans Strupp's case formulation method, Cyclical Maladaptive Patterns, with child clinical cases. While Strupp's case formulation method was developed for use with adults in Time-Limited Dynamic Psychotherapy, this interpersonally-based model is viewed as consistent with recent literature in child development and psychopathology which emphasizes the centrality of peer relationships, interpersonal schema, and social attribution biases in the development of maladaptive interpersonal behavior. Application of this method underscores the interpersonal nature and context of childhood problems as well as their cyclical and self-perpetuating quality. Use of this case formulation method with children is proposed as a basis for individually tailoring treatment plans with children who have problems with aggression, rejection, and other maladaptive interpersonal patterns.     

Confrontation Group Psychotherapy with Gifted, Dually Diagnosed, and Self-Destructive Adolescents in a Residential Setting

An adolescent mutation has proliferated since the late 1960s who has been immune to traditional therapeutic and educational approaches. It takes a new breed of group leader to work with this difficult-to-treat youth, who either self-medicates abusing psychoactive substances and/or takes prescribed and potent psychotropic medication. Innovative and humanistic treatment techniques are needed to convince an unconvinced youth to use, rather than abuse, superior intellectual and artistic abilities.     

Psychotherapy with an adolescent boy who refused medical treatment

In this paper we describe psychotherapeutic work carried out in a paediatric hospital to illustrate the important contribution of a psychoanalytically-oriented approach in a hospital context. The work concerns an adolescent boy who had undergone several surgical operations with the result that some of his natural orifices were obstructed and artificial ones had to be created. He was referred to us because he refused pharmacological and rehabilitative treatment necessary prior to further surgery and his eventual recovery. The boy's experience of loss of control of his life and the more primitive anxieties of not feeling safely contained in his physical and psychic skin emerged and were worked through in the psychotherapeutic relationship. The parallel work with medical staff reduced the risk of splitting and acting out by the patient and professionals. The approach adopted enabled this boy to resume his medical treatment and his developmental process.     

一种认知分析心理治疗模式对抑郁症患者的干预

为了探索基于"自我"与感受、需要、能力和角色交互相整合的认知分析心理治疗模式及其在抑郁症患者治疗中的效果,对7例门诊和8例住院抑郁症患者进行心理治疗,采用HAMD和CGI-GI评估治疗的效果,并追踪治疗1年后患者的社会功能及健康状况。所有患者治疗前后HAMD分值差异显著,配对t=8.08(P0.01),门诊与住院治疗患者HAMD分值和CGI-GI分值均无明显差异(P0.05),但产生治疗有效的平均时间差异显著,住院者(11.6±3.6)天,门诊者(60.6±25.0)天(P0.01)。该心理治疗模型能够整合到抑郁症患者的药物治疗中,产生整体治疗效果。