Anti‐sweat politics

No Sweat: Fashion, Free Trade, and the Rights of Garment Workers, edited by Andrew Ross, New York: Verso Press, 1997, 314 pages; abundant photos, pb $19, £14.     

Transference Focused Psychotherapy for Patients with Comorbid Narcissistic and Borderline Personality Disorder

Clinical experience involving the treatment of patients with comorbid borderline and narcissistic personality disorders suggests that this patient population is among the more difficult to treat within the personality disorder spectrum. In this article, we present refinements of Transference Focused Psychotherapy (TFP) based on our clinical experience with and research data on patients with comorbid narcissistic personality disorder/borderline personality disorder (NPD/BPD). We briefly review object relations formulations of severe narcissistic pathology, as well as recent research in attachment and the allied concept of mentalization, which have provided a new lens through which to view narcissistic disorders. The research findings from two randomized clinical trials demonstrating the efficacy and effectiveness of TFP are presented. The data from the two Randomized Clinical Trials (RCT) allowed for the study of the characteristics of the subgroup of borderline personality disorder patients who have comorbid NPD/BPD. Findings on comorbidity, attachment status, capacity for mentalization, and level of personality organization of borderline patients with comorbid NPD/BPD, compared with borderline patients without comorbid narcissistic pathology (BPD), are presented. Clinical implications of the observed group differences are discussed, with a focus on refinements in the technique of TFP. Clinical case material is presented to illustrate the specific challenges posed by narcissistic patients to carrying out TFP in each phase of treatment.     

Emotion Regulation Across the Life Span: An Integrative Perspective Emphasizing Self-Regulation,Positive Affect,and Dyadic Processes

In this commentary, we build upon the papers featured in this 2-part special issue to advance an integrative perspective on emotion regulation that emphasizes the developmentally specific goal-contexts of emotional phenomena. We highlight the importance of (1) multilevel longitudinal investigations of interactions among biological, affective, cognitive, and behavioral processes with respect to emotion regulation; (2) the integration of emotion-regulation processes with self-regulatory processes across the life course; (3) the dynamic relationship between positive and negative affect and their respective influence on regulatory processes; and (4) greater consideration of the dyadic context of emotion-regulation processes. From this perspective, the optimal developmental outcome with respect to emotion regulation is not affective homeostasis, but rather a dynamic flexibility in emotional experience, the ability to pursue and prioritize different goals, and the capacity to selectively and proactively mobilize emotions and cognitions in the service of context-specific and developmentally specific goals.     

Integrating Diverse Developmental Perspectives on Emotion Regulation

Emotion regulation has been studied in diverse ways within different subdisciplines of psychology—most notably social development, personality and individual differences, social psychophysiology, interpersonal relationships, and stress and coping. The goal of this Special Issue is to demonstrate the value of integrating these diverse approaches for building multilevel, lifespan models of emotion regulation. We review each of the contributions to this special issue, highlighting recurring themes and previewing our own perspective on directions for future theory and research.     

Recollections of Being in Child Expressive Arts Group Therapy: A Qualitative Study of Adult Former Clients’ Conceptions of Their Therapy as Children

The current study aims to explore, through the eyes of adult former clients, the experience of being in expressive arts group therapy (EAGT) as a child. By focusing on the memories of adults, the study allowed the exploration of former clients’ understanding of what the therapy was about and its effects on their lives. Semi-structured open-ended interviews were conducted with 20 adult former clients who, as children, had participated for at least one year in EAGT. Findings point toward the background of the empathic, attuned, safety, together with the fostering of the capacity to enter into spontaneous creative states, as central themes in participant’ recollections of the therapeutic process. Further findings relate to the implicit and long-term quality of the therapeutic effect.     

The therapeutic alliance in adolescent substance abuse treatment: a one-with-many analysis

Studies of the therapeutic alliance typically use a one-with-many (OWM) design in which each therapist (the one) treats multiple clients (the many). This study used Kenny, Kashy, and Cook's (2006) OWM method to examine the composition of the therapeutic alliance and to analyze the association between alliance and outcome in a sample of 398 adolescents treated for substance abuse by 14 therapists. Both the client and therapist alliance ratings yielded large relationship variances, with limited consensus among clients treated by the same therapist about the quality of the alliance. If a client reported an especially strong alliance with his or her therapist, the therapist was likely to also report an especially strong alliance with that client (dyadic reciprocity). The association between the components of the alliance and treatment outcome was complicated, with different levels of measurement and different components of the alliance (perceiver, partner, or relationship) derived from different informants (therapist or client) relating to different outcomes.