Chapter 5 Development,Psychopathology, and Brief Psychotherapy

Abstract

When using a developmental model to conceptualize curative factors in brief psychotherapy, the impact of the developmental process and the nature of the psychopathology presented by the patient must be taken into account. Both factors shape the therapeutic work. A case example of a young adult in the midst of developmental transition illustrates these issues.     

Self Psychology, Dreams and Group Psychotherapy: Working in the Playspace

This paper presents one leadership style within a self-psychological approach to working with dreams in group psychotherapy. It stresses an empathic attunement, the creation of safety, and an experience-near playful relationship. Playful is not used lightly here. It is used in the spirit of Winnicott's intermediate space where a mother suspends questions of what is real or not real and what is me and not me. Freud's analogy to a playspace forms a metaphor for the creation of a special atmosphere in a group, or for that matter in individual work as well, that encourages exploration, risk taking, and vulnerability. Working with dreams in this playspace deepens the curative process, not only for the dreamer, but for the entire group.     

文化心理学视域下的心理治疗

近年来,心理治疗的文化取向日益为心理学界所关注。在概要分析文化心理学理论取向和传统心理治疗特点的基础上,重点对文化心理学取向下的心理病因观、医患关系、心理治疗方法、心理治疗效果评价观做了相应分析,并对未来文化取向下的心理治疗理论进行了展望,希望对我国心理治疗理论和实践有所帮助。     

Therapist Self Disclosure in Group Psychotherapy from an Intersubjective and Self Psychological Standpoint

The history of therapist self disclosure is traced from the early struggles of Ferenczi and Burrow to its valued, yet still ambivalent, contemporary status. The symmetry of self disclosure by therapist and group members is differentiated from the parity of their different roles and responsibilities. Using a case example, the process is discussed through which a therapist's self disclosure fosters task-appropriate satisfaction of selfobject needs as it also helps group members articulate and loosen archaic selfobject binds. The therapy group is described as a transitional space within which a therapist's disclosure offers members an intersubjective bridge to the therapist as well as a model for members' own active participation in the group's work.     

Chapter 1 Pluralism,Pragmatism, and the Therapeutic Endeavor in Brief Dynamic Treatment

Abstract

This article places representative formulations of brief dynamic psychotherapy in the larger context of psychoanalytic thought, reviews relational perspectives that inform contemporary approaches to time-limited treatment, and identifies tasks in continued development of theory, research, and practice. In doing so, it emphasizes the need to consider a broader range of psychopathology, dysfunction, and need in formulations of brief intervention and to develop more flexible and realistic approaches in treatment of vulnerable and underserved populations. The growing emphasis on theoretical pluralism and pragmatism in therapeutic practice generally should facilitate efforts to broaden the base of brief dynamic treatment.     

Phases of Group Development: A View from Self Psychology

This paper delineates four phases of group development from the standpoint of self psychological theory. The author contends that a stable sense of groupself develops over time and that the groupself has a distinct number of phases, each of which has a therapeutic impact on members. The individual patient's selfobject experiences include a relationship to the group-as-a-whole, a transference state of which the leader is but one part. Thus, rather than dilute the transference, group analysis offers a unique opportunity to help the individual experience him or herself within a selfobject matrix that extends beyond the dyad. Group analysis leads to a strengthening of the self, especially as it enables the self to experience itself as part of a group identity, which provides alter-ego selfobject experiences, as well as a sense of acceptance within a larger community. This paper attempts to clarify how different selfobject experiences may be highlighted within the groupself at different stages of group development.     

Using Self Psychology in Psychotherapy,edited by Helene Jackson

No abstract available for this article.     

Chapter 3 Integrative Short-Term Treatment of the Borderline Patient

Abstract

The realities of current practice necessitate that clinicians engage in briefer forms of treatment with borderline patients despite the fact that long-term treatment has been considered the treatment of choice because of their entrenched and pervasive personality difficulties, severe developmental arrests, and history of trauma. Most short-term treatment models are ill-suited for work with the borderline population because they favor highly motivated and well-functioning patients who have circumscribed problems. Nevertheless, there is a considerable body of practice principles that can be adapted to brief treatment with borderlines. This paper reviews the clinical features of borderline disorders and current views on their origins and treatment and then describes the components of an integrative short-term treatment framework.     

Chapter 4 Interpretation in Short-Term Therapy

Abstract

There is much theoretical and clinical literature on the role of interpretation in psychoanalysis, psychoanalytic psychotherapy, and brief dynamic psychotherapy, but little supporting research data. Using 112 audiotaped sessions from 38 patients in supportive-expressive time-limited treatment, the present study hypothesized that therapists would modify the object and temporal content and frequency of their interpretations in relation to the level of patient functioning. The results did not support this hypothesis. Therapists were not less active with more interpretations for higher functioning patients, nor were they more active with fewer interpretations for lower functioning patients. Therapists were more active and made more genetic interpretations with married patients, regardless of level of patient functioning. The findings are discussed in terms of their implications for supportive-expressive psychodynamic therapy.     

Chapter 9 Clinical Risk and Brief Psychodynamic Therapy

Abstract

This article explores the risk environment confronting practitioners of brief psychodynamic treatment, and describes strategies that can help clinicians practice effective risk management. I argue that clinicians can reap only limited benefits from a focus on profiles of high-risk clients and litigation “hot spots.” The optimal approach is attention to the contextual dynamics shaping clinical practice. Among the most important are the relational processes driving the clinician-client dyad, the clinician-client-third party payer triangle, and the interface between the mental health and legal systems. I close with a discussion of the ambiguity and uncertainty that characterize clinical decision making and risk management.     

Trauma, Shame, and Group Psychotherapy: A Self Psychology Perspective

This paper attempts to define trauma from a self psychology/intersubjective perspective and explores shame as a basic aspect of trauma. Self psychologically oriented group therapy is examined as an effective treatment modality for dealing with issues of shame as well as the after effects of trauma.     

The Social Psychology of Groups and Group Psychotherapy: One View of the Next Century

Will fields that study groups in general, such as social psychology, and fields that use groups to achieve therapeutic goals, such as group psychotherapy, move toward unification in the future or will they drift apart? One possible future assumes that these two approaches to groups will become better integrated as (a) societal changes increase individuals' reliance on groups; (b) research and theory on group processes become more sophisticated; and (c) basic and applied researchers work together more closely in examining groups. Such unification requires, however, changes in the training, outlook, and procedures used by both practitioners and researchers.     

存在主义心理治疗的两个哲学教条

作为基本信念的两个哲学教条,即“存在先于本质”和“人是绝对自由”,导致存在主义心理治疗遭受各种诟病。前者造成人的存在与本质分裂,过分夸大个体选择意义和忽略人的现实性等问题;后者造成自由与必然关系的割裂,忽略自由的条件性和抽掉人的社会历史性等问题。基于对两个哲学教条的反思,存在主义心理治疗要求“抽象人”与“具体人”,“个体性”与“社会性”,“此在性”与“历史性”的辩证统一,从根本上实现对人的科学理解,进而提升实效性。

     

Psychotherapy training in a changing world: A Swedish perspective

The City and Hackney Primary Care Psychotherapy Consultation Service is an innovative, public sector service designed to support GPs in meeting the needs of patients with complex psychological/physical health issues throughout the London Boroughs of Hackney and the City. This paper provides an account of how this new model for the National Health Service (NHS) developed in the context of psychotherapy provision within the NHS, within the national and local context in the UK and gives an overview of some the service's key features and how it differs from other services operating in primary and secondary care. A linked paper, in this journal, explores the reality within which the service functions and describes clinical outcomes, health economic data, the modifications to the original model and prospects for the future.     

叙事心理治疗的特征及其与中国文化的契合

基于后现代文化理念的叙事心理治疗,其主要特征与中国文化的契合体现在:问题外化的治疗手段顺应中国人的面子心理和辩证的思维方式;关系取向的治疗立场更适合具有关系自我观的中国人;关注差异的治疗模式与中医的个体化治疗模式不谋而合;重视来访者的内在力量可充分发挥中国人善于自律和反思的特长。     

积极心理治疗思想概要

积极心理治疗虽然是以积极心理学作为自己的理论基础,但积极心理治疗的实践却早已有之。积极心理治疗作为心理治疗中的一个新生事物．它以反传统医学式心理治疗的面貌出现,运用故事作为治疗者与病人之间的媒介,充分发挥病人的直觉和想象,在与病人的观念不发生直接冲突的情况下提出改变病人观点的建议,这一较符合人性特点的心理疗法正越来越多地受到社会的广泛关注。     

Time Limited Treatment and C. G. Jung's Analytical Psychology

Abstract

The work of C. G. Jung has been largely neglected in recent discussions of time-limited psychotherapy. Notwithstanding this state of affairs, this paper argues that much is to be gained from familiarity with Jung's view on treatment. A brief overview of Jung's general system of psychology is presented, and contrasts are drawn to the work of Freud. Several distinctive characteristics of Jung's view of the clinical process are then identified, and a discussion of the course of treatment is provided with a brief reference to a case of Jung's and to the author's experience working with gay men.     

阿德勒心理治疗的回顾及展望

通过对阿德勒心理治疗理论及其发展历程的梳理,发现阿德勒心理治疗大致经历了初步发展、快速发展和当代发展三个阶段。阿德勒心理治疗已经形成一套行之有效的治疗体系和相对成熟的操作流程,发展成为专业的心理服务项目,发展出四步骤治疗程序,融合动力学、人本主义和认知-行为治疗等方法,形成家庭治疗、游戏治疗、团体治疗、短程治疗等模式,加强心理诊断和培训督导,注重治疗效果,关注多元文化背景,被广泛应用在家庭教育、学校教育、心理障碍、生涯发展咨询等诸多领域。

     

Alfred Adler's Treatment as a Form of Brief Therapy

Alfred Adler was largely overlooked during his era because he viewed people as creative beings in control of their own mental health and resisted the then-standard practice of treating human beings from a pedestal with a normative body of laws. His progressive style of treatment has become more popular in an age when efficient and collaborative treatment is valued for the sake of cost-effectiveness. This article positions Adlerian psychotherapy as a form of brief therapy, effective psychotherapy that takes place in 20 sessions or fewer. The article summarizes the fundamentals of Adlerian theory, outlines the general criteria of brief psychotherapy required by managed care companies, and specifically highlights how Adlerian psychotherapy qualifies as brief psychotherapy.