A challenge to ‘self’ centred ‘psycho’: Therapy as an introduction to an ‘inter-relational therapy’

This paper focuses on ‘psychotherapy’, particularly exploring the emphasis on the ‘psyche’. The term ‘psyche’ is described as potentially having different interpretations depending on the underlying ontological assumptions that influence its understanding and these, it is suggested, will have considerable implications for the therapy that identifies with the label ‘psychotherapy’. Two very different ontological perspectives are highlighted in this paper in order to illustrate the different conception of the term ‘psyche’; firstly, Freud’s interpretation of what is meant by ‘psyche’, which is then contrasted with a phenomenological perspective, with reference to the philosophy of Husserl and Heidegger. Both the Freudian and phenomenological approaches are then criticised for focusing on, what is described here as, an egocentric perspective and it is suggested that the term ‘psycho-therapy’ will inevitably lead to a preoccupation with putting the ‘self’ first as a basis for relating to the external world. An alternative term, ‘Inter-relational therapy’, is presented based on the ideas of Levinas and MacMurray, both of who are critical of a cultural preoccupation with focusing on the ‘self’ and suggest a need to acknowledge relationships with the external world, including the other people that populate it, prior to a ‘self’ reflective process.     

Do Psychotherapists with Different Theoretical Orientations Stereotype or Prejudge Each Other?

This study investigates a possible threat to the progress of psychotherapy. It aims to detect and compare stereotyped or even prejudiced views among psychotherapists of different theoretical orientations, building on social psychological theory of in-groups and out-groups. Swedish psychotherapists (n = 416) of four different orientations (psychodynamic, cognitive, behavioural, or integrative/eclectic) used the valuable elements in psychotherapy questionnaire to rate the importance of various elements in psychotherapy. They also estimated how therapists of other orientations would rate these elements. These estimates were then compared with therapists’ actual self-ratings in order to detect patterns of stereotyping or prejudiced views. Psychotherapists exaggerate the differences between their own and other orientations in a stereotyped way, but correctly predict what members of their own orientation (in-group) find important. However, they overestimate how important ‘orientation-typical features’ are to those of other orientations (out-group), indicating a clear tendency to stereotype. Overall, integrative/eclectic therapists’ estimates were less stereotyped than the estimates of therapists of other orientations. A somewhat unexpected finding was that cognitive and behavioural therapists seem more inclined towards stereotyping. The stereotyped views of other theoretical orientations among psychotherapists can be argued to have negative connotations and may thus be seen as prejudices. These prejudices could create irrational and unnecessary obstacles to the development of both the science and the practice of psychotherapy and signal the need for psychotherapists of all orientations to develop a more balanced picture of each other.     

‘Critical psychotherapy,’ ‘postpsychotherapy,’ and the cult of technicism

This paper about the terms ‘critical psychotherapy’ and ‘postpsychotherapy’ argues that the terms ‘critical psychology,’ ‘critical psychiatry,’ and ‘postpsychiatry’ are already in use, and we can see the new terms – ‘critical psychotherapy’ and ‘postpsychotherapy’ – as additions to this already existing family of terms. However, this paper also argues that what is of most importance is not the case for using these new terms, but the tendencies and features these terms might be taken to refer to. The paper begins with an experience the author had while working as a counsellor some years ago. The terms listed above are explored, as are the roots of ‘critical psychotherapy’ in psychoanalysis, before providing an example of how a philosopher’s work might be relevant to psychotherapists.     

(Re)Searching for a client in two different worlds: Mind the research‐practice gap

A criticism voiced by counsellors and psychotherapists is that research does not truly reflect the complexities of therapy. Researchers, on the other hand, accuse practitioners of not attending to research findings and suggest that as a result they engage in an ill‐informed process. This polarised understanding can give rise to the situation where the client is missed, falling into the research‐practice gap. In reality the research‐practice gap gets smaller and smaller every time a practitioner employs — which is often the case — a complex and sophisticated construct system in search of a client's psychological distress. The metaphor of the ‘search’ seems to become a point of connection between the practitioner's search and the researcher's (re)search. As a way of exploring this issue, the paper briefly considers the research‐practice gap and the critique of current research. It argues that counsellors and psychotherapists are themselves engaging in research when they practise therapy since every counselling and psychotherapy session is basically a (re)search process.     

Ego consciousness in the Japanese psyche: culture,myth and disaster

With globalization, modern Western consciousness has spread across the world. This influx has affected the Japanese culture but ego consciousness has emerged through a long history and different course from that of the West. At a personal level, I have been interested in the establishment of a subject in a culture that values homogeneity and to understand this, I reflect on my own history of living in both the East and the West and on my experience practising psychotherapy. To show Japanese collective functioning at its best, I describe the human inter‐connectedness and collaboration during the 2011 disaster. I explore the ‘Nothing’ at the centre of the Japanese psyche, through a reading of Japanese myth, especially the most originary and almost pre‐human stories that come before the anthropomorphized ‘First Parents’. A retelling of this founding story, reveals the multiple iterations over time that manifest in embodied being; this gradual emergence of consciousness is contrasted with Western myths of origin that are more clear and specific. This study attempts to bring awareness of the value and meaning of Eastern consciousness and its centre in the ‘Nothing’.     

Therapist attitudes and countertransference as predictors of professional quality of life and burnout among psychotherapists

This study aimed to examine the role of attitudes towards psychotherapy and countertransference dimensions as predictors of professional quality of life and burnout among psychotherapists in Iran. Participants were 259 psychotherapists who worked in mental health centres in Tehran (Iran), and they completed the Professional Quality of Life questionnaire, the Therapist Response Questionnaire and the Therapist Attitudes Scale. Professional quality of life was associated with countertransference dimensions and attitude towards psychotherapy. This study concludes that psychotherapists can benefit from working on their specific countertransference issues and re-evaluating their basic attitudes towards psychotherapy to achieve the highest levels of professional satisfaction. Culture may play a role in a specific therapist's attitude and difficulties in addressing certain aspects of countertransference.     

Making a case for case studies in psychotherapy training: A small step towards establishing an empirical basis for psychotherapy training

The evidence debate in psychotherapy pays little attention to developing an evidence base for training practices. Understanding effective training requires an examination of what makes training work. This article examines the role of case studies in psychotherapy training. This has not been articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory in action; access to whole courses of therapy; access to different approaches; access to significant moments; access to the therapeutic relationship; access to a wide range of client types; access to working in different contexts; and the opportunity of identifying with therapists and clients. Writing or presenting cases offer students the opportunity of: learning to integrate information into a relevant whole; being in the ‘hot seat’; learning to give appropriate feedback; assessing the validity of interpretations, inferences, and interventions; adapting methods to suit the client; and learning to collaborate with other professionals. The paper presents directions for future research into psychotherapy training, specifically proposing an international survey of training practices at psychotherapy training institutions.     

Acting,feeling and thinking: psychoanalytic psychotherapy with Tracey

This paper consists of a case study and commentary which formed a part of the inaugural lecture in a series entitled ‘Working with Psychosomatic Issues’*. The audience consisted of psychoanalytic, body psychotherapy and integrative practitioners. The presentation was divided into three parts, (1) an outline of philosophical themes that inform perspectives on health, illness and psychosomatic phenomena, (2) the case study reproduced below and (3) a summary of Winnicott's work (1960, 1966, 1988) on ‘the indwelling of the psyche in the soma’. The case study describes work with a young woman who harms herself through self-hitting and, in addition, expresses other physical manifestations of psychological distress. The core approach of the practitioner is psychoanalytic. The work is informed also by postmodern sensibilities and phenomenological themes.     

Parents’ and psychotherapists’ goals prior to psychodynamic child psychotherapy

In order to explore goals of parents and psychotherapists prior to child psychotherapy, the following questions were asked: (1) How are goals for psychotherapy formulated? (2) How can similarities and differences between parents’ and psychotherapists’ goals be understood? Questionnaires regarding psychodynamic child psychotherapies (n = 33) with parallel parental work were analysed using qualitative methodology. The child psychotherapists’ goals were often connected to the intrapsychic and relational development of the child. The parental therapists formulated goals focused on providing support to parents. The parents’ goals, on the other hand, concerned to a great extent giving the child help and to a lesser degree receiving help for themselves. They expressed their expectations concerning the child’s psychological development with a more everyday use of language, often with an emphasis on general psychological wellbeing. The study also indicated that parents had limited knowledge about the therapy’s implementation and framework. Some clinical conclusions could be made. Negotiating goals prior to parental and child psychotherapy can help create realistic expectations and promote a beneficial therapy situation.     

Siblings as Selfobjects in Childhood: An Interview Study of Factors and Consequences

This study explores the factors psychotherapists working with adult clients identify as contributing to their clients' use in childhood of relationships with siblings to meet selfobject needs or the use of clients by their siblings for selfobject purposes in childhood, and the consequences of this to the children's intrapsychic development as evidenced in their adult psychotherapy. Using interviews with six psychotherapists practicing within the framework of self psychology, this research determines that the emotional and physical unavailability of parents was a common factor causing children to use their siblings for selfobject purposes. The research also explores the lasting impact of these selfobject ties on the psychological development of both the child using a sibling for selfobject purposes and the child who serves this function for another, as well as the role of psychotherapy in understanding these relationships. These findings give psychotherapists from a variety of disciplines, including social work, an enhanced conceptual framework from which to consider the role of siblings in psychological development.     

What is analysis?

This paper attempts to discern a ground for doing depth psychological work in times of disappearance, loss and the absence of the gods. Through the poetry of Friedrich Hölderlin, and to a lesser extent, Rainer Maria Rilke, it seeks to discover the significance of fragmentation and conflagration in the manifestations of both psyche and the post-industrial landscape we inhabit. What does the ‘death of god’ mean for our notions of symbol and self and for the practice of psychotherapy and psychoanalysis? How do we understand our daily clinical work in the context of ruin, holocaust and despair?     

Subjektive Einschätzung der eigenen Gesundheit und gesundheitsrelevantes Verhalten bei niedergelassenen Psychologischen Psychotherapeuten

From June until August 2004 we asked 488 established psychological psychotherapists in selected German federal states for a subjective evaluation of their own health, their utilization of the health care system and their health-related behavior. It turned out that the psychotherapists mainly reported a good state of health although their reported state of health was more negative than in the general population with equal age and level of education. This finding is surely connected with specific mental, physical and existential burdens of their profession as well as with specifics of the “psychotherapist personality”. The psychotherapists’ evaluations highly depend on age, but not significantly on sociodemographical criteria like gender and place of establishment (East/West Germany). Also the affiliation to a therapy school (psychoanalysis, depth psychological funded psychotherapy, behavior therapy) is irrelevant for the subjective evaluation of one’s own health. Concerning the annual number of consultations and disability days the psychotherapists are clearly below average. They report a lot of attentiveness about their health and practice a health-benefical behavior. In this case they make higher demands on themselves than the general population.     

In Search of a Paradigm for Psychological and Spiritual Growth: Implications for Psychotherapy and Spiritual Direction

This article presents categories, drawn from the work of Abraham Maslow and Paul Tillich, which can be used to explore the similarities and differences in psychological and spiritual growth. While both dimensions of growth are interrelated, they are neither synonymous as terms nor fused as processes. Models for psychological growth cannot be superimposed onto spiritual growth because of some significant differences in the way in which self-awareness, spirit, and self-transcendence are defined and used by psychology and theology. It follows that psychotherapy and spiritual direction make unique contributions to human growth and need not be perceived as synonymous or competitive. There is a point at which psyche and spirit, psychotherapy and spiritual direction, meet: the place of healing.     

‘Black holes’: escaping the void

The ‘black hole’ is a metaphor for a reality in the psyche of many individuals who have experienced complex trauma in infancy and early childhood. The ‘black hole’ has been created by an absence of the object, the (m)other, so there is no internalized object, no (m)other in the psyche. Rather, there is a ‘black hole’ where the object should be, but the infant is drawn to it, trapped by it because of an intrinsic, instinctive need for a ‘real object’, an internalized (m)other. Without this, the infant cannot develop. It is only the presence of a real object that can generate the essential gravity necessary to draw the core of the self that is still in an undeveloped state from deep within the abyss. It is the moving towards a real object, a (m)other, that relativizes the absolute power of the black hole and begins a reformation of its essence within the psyche.     

Aims in parent work: a brief qualitative survey

Child psychotherapists’ views of the treatment aims of parent work in a community Child and Adolescent Mental Health Service (CAMHS) were explored. Parent work undertaken by the child psychotherapy team in one calendar year was analysed. The parent worker was asked to describe the primary aim of the work for each case. The resulting thematic analysis found that the main aims of parent work were: increasing empathy with the child; decreasing enmeshment; and containing anxiety. Linking with Alvarez’s notion of a hierarchy of interpretative approaches, the study’s findings suggest that there are parallel ‘levels’ of intervention in parent work, where therapists work in ways appropriate to the parent’s psychological functioning.     

From horror to ethical responsibility: Carl Gustav Jung and Stephen King encounter the dark half within us,between us and in the world

This paper explores the experience of horror. The term is usually understood collectively to refer to experiences of terrorism, racism and other conflicts; however, the paper explores the equal horror for the individual of facing deep and painful psychic contents and traumatic experiences. The paper explores the way that both C.G. Jung, through analysis of the psyche, and the author Stephen King, through his horror novels, have accepted and explored the experience of encountering ‘the dark half’ or ‘It’ that is the other within themselves, forming images and symbols capable of linking their personal experience to that of the collective. This encounter is transformed, as far as Jung is concerned by analytical psychology and for King by fiction, through an attitude of active imagination. This led both men to developing an ethical responsibility towards the images of the unconscious, as well as the personal and collective contents of human life. The paper depicts how encountering the ‘dark half’, through Jung and King can provide a Jungian analyst with a special attitude with which to deeply explore and ethically process the experience of horror in different fields, including therapeutic practice, analytical training and in the traumatic and conflictual facing of the other, with which, today as always, the world presents us.     

Countertransference issues in psychotherapy with lesbian and gay clients

This article briefly reviews literature on responses towards same-sex (lesbian and gay) sexualities from psychoanalytic and ‘lesbian and gay affirmative’ psychotherapeutic perspectives. An analysis is presented of reports of countertransferential reactions to lesbian and gay clients, obtained from interviews with fourteen psychotherapists who work in a lesbian and gay affirmative manner and eighteen clients who had received affirmative psychotherapy. Data were subjected to grounded analysis. Participants consistently attended to the thoughts, feelings and values that therapists held in relation to lesbian and gay clients and how these affected the meanings and practices available to them. These were linked with the therapist's sexual identity among other factors. Negative countertransferential reactions were regarded as potentially occurring among heterosexual and lesbian and gay therapists and were seen as arising from therapists’ conscious and unconscious fears about same-sex sexualities. These findings indicate a need to continue debating these issues more widely in the professional arena.     

Plädoyer für eine Direktausbildung zum Psychotherapeuten

The undisputed necessity of a reform of the Psychotherapist Act could open up the chance to reconsider the training of psychological psychotherapists and to completely renew the structure from the ground up. This article proposes that psychotherapy training should be designed based on the profession itself. Starting from the question of what a good psychotherapist needs to have learnt, a study curriculum is drafted which is structured towards this professional target from the very beginning. This direct training imparts psychotherapeutic competence based on a broad psychological, medical and social scientific education, encourages targeted social competences and enables clinical experience in advance. The training terminates after six years with a state examination and qualification for the profession of psychotherapist. Subsequently, qualified psychotherapists undertake a four-year in-house advanced professional education to an adult or pediatric and adolescent psychotherapist. After completing half of the study period, i.e. after three years, students decide on one of the scientifically recognized courses and subsequently the study course is partly procedure-related and mostly interprocedural. The study incorporates a practical year which accompanies the last four semesters as a half day practical training. Universities which want to offer this study course must be qualified to award doctorates and have a psychotherapy research walk-in clinic. They must also cooperate with recognized training partners who participate in the course of the study and professionally structure the four-year in-house advanced professional education.