Loss Through Betrayal: An Analysis of Social Provision Changes and Psychological Reactions

Results of two retrospective studies suggested that romantic betrayal led to the loss of key aspects of social support from partners, most notably attachment, guidance, and reliable alliance with the partner. Furthermore, specific social provision losses were found to reliably predict recalled and current negative psychological states associated with romantic betrayal. Perceived attachment losses predicted postbetrayal anger and disgust, as well as trauma reactions following betrayal. In addition, a decline in reassurance of one’s worth following betrayal predicted embarrassment about the event, and the degree to which reliable alliance with the partner was lost predicted anxiety and shame.     

The Tooth Fairy: Psychological Issues Related to Baby Tooth Loss and Mythological Working Through

In this article, we focus on the Tooth Fairy legend that emerged in the United States and Britain in the nineteenth century and on the bedtime rituals associated with it. Drawing on various children’s books, we present this legend and these rituals as among the many legends and rituals found around the world for dealing with the loss of baby teeth in early childhood. Our particular concern is with some of the psychological issues that are associated with the development of teeth in the second stage of infancy. We also draw on the clinical observations of Erik H. Erikson, as we focus especially on the role that teeth play in the loss of the original unity between the infant and its mother. We take note of Erikson’s suggestion that this is, ontogenetically speaking, the experience that is portrayed in the biblical story of the Fall and expulsion from the Garden in Genesis 3. We view the rituals associated with the Tooth Fairy legend as a mythological means of enabling children to address and work through these psychological issues.     

Unraveling: Betrayal and the Loss of Goodness in the Analytic Relationship

Reacting to a general distrust of government and authority that many people are feeling these days, this paper follows some developments of trust and of its betrayal in both the normal and clinical situations. It suggests that many are profoundly anxious about betrayal and that adequate parenting helps us learn how to overcome inevitable betrayal traumas and continue without losing hope. It recalls Freud’s own feelings of betrayal when he learned that hysterics lie and later when Dora stopped treatment, and it suggests that these betrayals may have been one factor in his turn from the clinical to the theoretical. It discusses trust in the clinical situation through the lens of the Freud–Ferenczi controversy and with special emphasis on early trauma and the kind of setting that may be necessary for the reestablishment of basic trust.     

Betrayal: A psychological analysis

Betrayal is the sense of being harmed by the intentional actions or omissions of a trusted person. The most common forms of betrayal are harmful disclosures of confidential information, disloyalty, infidelity, dishonesty. They can be traumatic and cause considerable distress. The effects of betrayal include shock, loss and grief, morbid pre-occupation, damaged self-esteem, self-doubting, anger. Not infrequently they produce life-altering changes. The effects of a catastrophic betrayal are most relevant for anxiety disorders, and OC D and PTSD in particular.Betrayal can cause mental contamination, and the betrayer commonly becomes a source of contamination. In a series of experiments it was demonstrated that feelings of mental contamination can be aroused by imagining unacceptable non-consensual acts. The magnitude of the mental contamination was boosted by the introduction of betrayal themes. Feelings of mental contamination can also be aroused in some ‘perpetrators’ of non-consensual acts involving betrayal. The psychological significance of acts of betrayal is discussed.     

Cultural Competence When Working With American Indian Populations: A Couple and Family Therapist Perspective

This article focuses on treating the underrepresented American Indian and Alaska Native population in therapy. The lack of literature on this topic may impede the ability of couple and family therapists (CFTs) to work effectively with members of this group. Issues such as the underutilization of therapy, dropout rates, culturally syntonic joining and assessment, religion, and spirituality are discussed. In addition, potential boundary issues of gift giving and community integration are explored. Finally, cultural strengths are addressed so they may be clinically integrated with this unique population.     

Therapist Grief and Functional Analytic Psychotherapy: Strategic Self-Disclosure of Personal Loss

Functional Analytic Psychotherapy (FAP), a behavioral approach that focuses on the development of genuine and meaningful therapeutic relationships including the strategic use of disclosure, provides a framework for therapist self-disclosure during times of personal loss. This article briefly outlines FAP and provides an example of FAP in practice following the death of the first author’s mother. Qualitative data from a client questionnaire on the impact of this disclosure are presented, which suggest that the disclosure was a positive experience for most but not all clients. The article concludes with clinical guidelines that can enhance therapeutic effectiveness whether or not therapists choose to disclose loss to their clients and general precautions for treading in this emotionally intense territory.     

Managing Anxiety: A Therapist Common Factor

In this paper, we propose that therapist anxiety in the therapy room, especially anxiety stirred up by difficult or triggering clients, represents a challenge to effective therapy, and that effective management of this anxiety be considered as a necessary therapist skill for conducting quality couple and family therapy (CFT). We propose that effective therapists need to be able to manage their emotions, especially their anxiety, in order to truly help their clients. The failure to do this can lead to break downs in the alliance and the flow of therapy, and these deleterious effects can be prevented when therapists actively navigate their internal states through self-awareness and ongoing introspection. Bridging psychotherapy literature, we discuss specific strategies to this end, and make clinical recommendations for CFTs and CFT training programs.     

A Family Therapist for Life: Observations and Options

“Life” is used here in the chronological sense of years spent as a family therapist and in the existential sense of experiencing “life” in terms of satisfaction, meaning, and vitality in one’s living. In the 1950s, there were few guidelines for professionals recognizing the need for working therapeutically with families. Becoming and being a family therapist are discussed, along with lifetime learning about family and tolerance for ambiguity in understanding family and marital relationships and dynamics; flexibility in implementing therapeutic interventions; functioning in ways that fit with one’s personality, beliefs, and principles; working where one functions best; and what works at what stage for the family therapist and relating these to establishing and maintaining “life” in one’s living.     

Working with differences: Issues for research and counselling practice

This paper considers our experience within a group researching domestic violence in minoritised groups and the implications for counselling practice. Issues of race, gender and power were significant within the research team. These issues are intrinsic to minoritised women's experiences of service responses and are also a powerful, yet often unexplored, dynamic in counselling practice. We reflect on issues of ‘outsiders’ and ‘insiders’ in terms of the research process and findings, and the impact and influence of these power roles on counselling practice. We acknowledge that it is only by retrospectively engaging with each other and our differences that we have been able to explore our parallel processes and consider their implications for counselling practice.     

Cultural Dimensions of Early Pregnancy Loss: Spiritual and Religious Issues

Nearly one in five clinically confirmed pregnancies ends in a loss before 20 weeks (Bardos et al., 2015). Despite the prevalence of miscarriage, many women and partners experience a lack of acknowledgment and support while also encountering complicated concerns related to the intersection of perinatal loss, culture, religious and spiritual issues, medical treatment, their reproductive stories, and grief (Randolph et al., 2015). Counselors working with these clients must address complex cultural considerations. As such, we review key cultural and religious/spiritual issues related to early pregnancy loss and offer recommendations for practice based on the current literature in the context of the Association for Spiritual, Ethical, and Religious Values in Counseling (2009) counseling competencies.     

Maggie and Dorothea: Reparation and Working Through in George Eliot's Novels

The American Journal of Psychoanalysis -     

Loss and change in primary care: Working with organisational anxiety

This paper will consider the identity of an inner voice that is experienced by everyone, but in very different ways. However, when working in the transference with psychotic patients the boundaries of personal identity and the question of choice and volition are so compromised by the illness that the phenomena are so to speak ‘writ large’. This allows the issues to be brought out with great vividness and intensity and it is the struggle with this that has led me to reconsider the identity of the inner voice in a way which I have found useful for the rest of my clinical work.

Prior to 1985, my clinical work with patients with psychotic illnesses was undertaken in the in-patient psychotherapy ward at Shenley Hospital that I was responsible for. With the movement of psychotherapy resources out of Shenley to set up the Willesden Centre, our ability to continue with this work was very compromised because the Centre is entirely an out-patient resource. However, a number of us persevered and gradually worked out ways to be able to continue to offer treatment to patients who had psychotic illnesses. This involved the establishment of a case-manager system to enable the therapist to work in the transference. This evolution has occurred in a specialist workshop that I have been running at the Willesden Centre since 1986.     

Disruption and Working Through in the Supervisory Process: A Vignette From Supervision of a Psychoanalytic Candidate

This paper describes the author’s supervision of a psychoanalytic candidate, including the development and resolution of impasse in both the supervised analysis and the supervisory relationship. When the author became aware of the degree to which her own anxieties and defenses were implicated, she sought consultation, after which both supervision and analysis moved forward. As supervision continued, work on supervisee’s and supervisor’s interlocking anxieties and defenses, and understanding of their impact on the supervised analysis, deepened. The author concludes that exploring supervisory disruptions allows both members of the supervisory dyad to come to grips with conflicts that subtly distort their work and facilitates a deepening of the supervised analysis.     

Therapist Use-of-Self Orientations Questionnaire: A Reliability and Validity Study

This article describes the development of the Therapist Use-of-Self Orientation Questionnaire (TUSO-Q), an instrument designed to measure therapists’ use-of-self orientations while working with clients. A total of 373 therapists participated in this study. Exploratory factor analysis in the structural equation modeling context revealed three different therapist use-of-self orientations: Transpersonal, Contextual, and Instrumental. The final model provided an excellent fit to the data. TUSO-Q scores exhibited satisfactory evidence of internal consistency reliability and construct validity. Implications for the scale’s use in clinical research and training are discussed.     

Twin Loss: Implications for Counselors Working with Surviving Twins

Multiple births are becoming increasingly prevalent due to the use of fertility drugs and women choosing to wait until later life to conceive. With the growth in the twin population, little research has been done to investigate the effects on the grief process when 1 twin dies. Counselors must understand the unique experience of twins to formulate interventions to counsel the surviving twin and parents. This article provides strategies for counseling this unique population.     

Therapist Positioning and Power in Discursive Therapies: A Comparative Analysis

The “discursive turn” in therapy gave the therapeutic relationship its deserved significance, which was implied but never fully recognized in traditional therapy literature. The exception would be the writing of Rogers, Satir, and Whitaker. Therapists’ actions in relation to clients became the topic of critical analysis and reflection rather than a resource for addressing some underlying inter- or intra-psychic forces and processes. This paper focuses on the issue of the therapist’s relational engagement with families, particularly the notion of therapist power, as conceived within three discursive approaches to family therapy: narrative, solution-focused, and collaborative.

Moving Through Loss: The Spiritual Journey of Gay Men and Lesbian Women

This article describes losses of gay men and lesbian women relative to their relationship with traditional religion and the mental health profession. By helping their clients reframe these losses into opportunities for transformation, counselors can facilitate spiritual integration both within and beyond the context of Judeo-Christian spiritualities.     

Asking About Ambivalence: A Different Kind of Therapist Neutrality

Recent articulations of systems theory emphasize the self-organiza-tion and autonomy of systems. From this perspective it was previously seen that symptomatic behavior reflects the conservation of an ambivalent autonomy embodying the system's striving for an ideal way of living and the simultaneous failure of this quest. Treatment typically opposes the symptom and allies itself with the idealistic pole of the ambivalence, thereby discounting the system's ambivalent autonomy. This often strengthens symptomatic efforts to conserve the ambivalence. Careful questioning can be used to circumvent this dilemma and this paper illustrates this type of therapist neutrality by means of a case example.