Psychotherapy Integration: Contributions from Lifestyle Theory

The lifestyle theory of intervention is evaluated with respect to its status as an integrated psychotherapy using theoretical integration, technical eclecticism, and the common factors approach as criteria. Because lifestyle theory integrates concepts from evolutionary biology, existential philosophy, cognitive psychology, social learning theory, and various therapeutic models it satisfies preliminary criteria for theoretical integration. To the extent that it provides an internally consistent model and makes use of techniques from disparate schools of psychotherapy, it adopts a technical eclectic approach to intervention. The lifestyle model also appears to qualify as an integrated psychotherapy by virtue of its attention to several common factors in psychotherapy.     

Sex differences in sexual fantasy patterns

A detailed sexual fantasy questionnaire was completed anonymously and returned by post by a sample of 90 Londoners stratified by sex and social class and representing a 30% return rate. Men and women were equally likely to accept and return the questionnaires. Information was also collected concerning sexual behaviour, libido and satisfaction. Factor analysis revealed four main types of fantasy: (1) Exploratory (e.g., group sex, promiscuity, homosexuality); (2) Intimate (e.g., kissing, oral sex, outdoor love); (3) Impersonal (e.g., watching others, fetishism, using objects for stimulation); and (4) Sadomasochistic (e.g., whipping or spanking, being forced). These four types of fantasy were positively correlated and were all more commonly reported by men, although women were almost as high on the Intimate factor. Women were also more likely to be passive or receptive in their fantasies, and men active. All fantasies were associated with high libido as indicated by self-rated sex drive and orgasm frequency, especially for women. In general, reports of many fantasies went with satisfaction in women but with dissatisfaction (frustration?) in men. This finding is explained in terms of the higher average level of libido in men than women, with the consequent difficulty experienced by men in acting out their desires.     

Self and external management compared with psychotherapy in the control of obesity

Seventy-four obese TOPS (Take Off Pounds Sensibly) members were assigned to one of five conditions: delayed treatment control, insight psychotherapy, self-management training plus external reinforcement, self-management training only, or external reinforcement only. The latter four groups met once per week for ten weeks and were seen at three and six months and followup. It was hypothesized that self-management plus external reinforcement would be superior to other conditions at both post-treatment and followup, and that this condition alone would produce continuing weight losses. Analysis of covariance on body weight, with pretreatment weight as covariate, indicated that self-management plus external reinforcement, self-management only, and external reinforcement only, did not differ in mean body weight at post-treatment. These three groups differed significantly from control and psychotherapy conditions, which did not differ from one another. Self-management plus external reinforcement produced better performance of techniques. At three and six month followup, differences between the four treatment conditions were no longer significant. Results are discussed in terms of evaluation of psychotherapy and behavior modification and durability of results.     

Psychic trauma and masochism

Three analyses are presented in which acute trauma (overwhelming internal or external stimulation so great as to preclude the patient's utilizing his usual defenses adequately) in childhood contributed to the development of masochism. The patients later attempted mastery through repetition, reversal, and erotization , and employed regression as a defense against feared oedipal wishes.     

Family therapy approach to incapacitating migraine

A nine-year-old boy who suffered from intractable migraine was referred for psychiatric consultation and treatment after failing to respond to congeries of medications and diets, notwithstanding thorough investigations by neurologists, pediatricians, and other specialists. The decision for a family systems treatment approach resulted in the following defined objectives: (1) to investigate triggers for the headaches and to see if these could be reduced and/or eliminated, (2) to see if therapy would help the boy stay in school, (3) to examine, and if possible, change family rules of interaction and transaction, (4) to allow for more fun within the family (5) to allow for ventilation without retribution, and (6) to clarify the mother's role as a significant contributor to the family's interactions, shifting the focus from the father as the sole generator of family tension. The principal therapeutic tools which proved efficacious involved the following: (1) scrutiny of the maternal and paternal histories, and (2) analysis of triangulations within the family system, leading to (3) the formulation of therapeutic strategies, and (4) specific task assignments. A major intervention by the therapist was the specific strategy to have the family examine the rules of transaction which were in the metapsychological sense unarticulated.     

A team-taught interdisciplinary approach to engineering ethics

This paper outlines the development and implementation of a new course in Engineering Ethics at the University of Tennessee. This is a three-semester-hour course and is jointly taught by an engineering professor and a philosophy professor. While traditional pedagogical techniques such as case studies, position papers, and classroom discussions are used, additional activities such as developing a code of ethics and student-developed scenarios are employed to encourage critical thinking. Among the topics addressed in the course are engineering as a profession and its role in society; ethical successes and failures; risk, safety, and the environment; professional responsibilities; credit and intellectual property; and international concerns. The most significant aspect of the course is that it brings both engineering and non-engineering points of view to the topics at hand. This is accomplished in two ways. First, as mentioned previously, it is team-taught by engineering faculty with an interest in ethical and societal issues, and by philosophy faculty with expertise in the field of professional ethics and an interest in science and technology. Second, the course is offered to both engineers and non-engineers. This mix of students requires that all students must be able to explain their technical and ethical decisions in a non-technical manner. Work teams are structured to maximize interdisciplinary interaction and to foster insights by each student into the professional commitments and attitudes of others. An earlier version of this paper was presented at the 2005 conference, Ethics and Social Responsibility in Engineering and Technology, Linking Workplace Ethics and Education, co-hosted by Gonzaga University and Loyola Marymount University, Los Angeles, CA, USA, 9–10 June 2005.