Learning symbolic-experiential therapy: One approach

This paper is intended to serve as a stimulus to the thinking of students regarding ways in which they might better organize their symbolic training experiences. It illustrates how one supervisee derived a conceptual framework from the literature that made it easier to track process events and organize her training experiences. The authors believe it is important to discover ways to facilitate the learning process without operationalizing the approach.director of training and research and professor of family therapy in the same department.     

Learning to be possessed as a form of pathogenic relating and a cause of certain delusions

A form of pathogenic relating observed frequently by the author in family interviews is described in which it is communicated that a member has acted as if possessed by evil forces. This form of pathogenic relating is termed learning to be possessed. A number of illustrations are provided of the way this learning takes place beginning in childhood; how the so-called victim can gain insight into the process so that he or she is spared the worst penalties for impulsive, aggressive, or irrational behavior; but how the insight may be a cause of delusions, particularly persecutory or paranoid delusions, that become fixed. A comparison is made with the psychoanalytic theory of paranoid delusion, because that appears to be the only extant theory with which a comparison can be made.     

Dysfunctional isolation in the elderly: Increasing marital and family closeness through improved communication

Unique developmental crises in old age may lead to social withdrawal that negatively affects the individual and his/her marital and family relationships. Without an awareness of these aging dynamics, the therapist can inadvertently perpetuate these distancing behaviors which can exacerbate marital and family conflict. This paper discusses certain developmental crises which can result in increased isolation for the older adult, and suggests therapeutic interventions to facilitate increased closeness among family members.     

Resilience,Coloniality, and Sovereign Acts: The Role of Community Activism

Puerto Rico has been a U.S. colony since 1898. For the past decades, it has been mired in public debt, social problems, and ineffective and corrupt governance. In 2017, the island was hit by hurricanes which devastated our country. After the event, the term “resilience” became ubiquitous. Labeling Puerto Ricans’ capacity to tolerate misfortune and suffering “resilient” gave people a false sense of hope and offered government a pretext to postpone or inequitably dispense aid. So-called “resilience” also allowed Puerto Ricans to avoid the impact of colonialism and coloniality on pre-existing conditions which hurricanes accentuated. In this context, community activism played a major role. Community organizations initially provided aid and generated chains of solidarity. They initiated “sovereign acts” which are mostly guided by principles and values espoused by community psychology. Thus, we have a duty to contribute to efforts which can promote liberating our island from colonialism and coloniality.     

The Impact of Parental Suicide on Child and Adolescent Offspring

Child and adolescent survivors of parental suicide experience two stressful events simultaneously: (1) the loss of a primary caregiver, and (2) suicidal death of a significant person. These youths are thought to be at increased risk for mental health problems, but a systematic review of studies on these survivors has not yet been conducted. A comprehensive search for published literature identified nine studies. The existent studies provided modest yet inconsistent evidence on the impact of parental suicide on offspring psychiatric and psychosocial outcomes. More methodologically rigorous research is needed to inform and guide postvention efforts for these survivors.     

Epidemiologic Characteristics and Trends of Fatal Suicides among the Elderly in Taiwan

Taiwan has one of the highest suicide rates in the world, especially among its elderly. The epidemiologic characteristics and trends of the surging elderly suicide rates from 1993 to 2003 are described, with a special emphasis on the risk groups, the methods used in suicide, and their geographical variations. Data on annual mortality for persons over 65 years of age with external cause‐of‐death codes E950–E959 were obtained from the Death Certification data file provided by the Department of Health and used in the analysis. The suicide rate for each 5‐year age group over 65 years old increased during the 11‐year period. Elderly males had the highest suicide rate and experienced an increased rate of 49% during the decade. The average suicide ratio between elderly males and females was about 2:1. Never‐married males had the highest age‐adjusted as well as sex‐ and marital status‐specific suicide rates, and showed an increased rate of 66% over the 11‐year period. Geographical variations in suicide rates were significant, with the lest urbanized eastern Taiwan having a higher rate than other regions. Hanging, strangulation, and suffocation were the most used methods for committing suicide by the elderly, but their use had decreased from 63% to 54% during the decade; but jumping off a building and drowning increased significantly. Variation in suicide rate among months was not significant. With the increase in the elderly suicide rate, more governmental and societal interventions are needed to alleviate this social and human problem.     

Recent Suicidal Ideation Among Patients in an Inner City Emergency Department

The rates and associated features of suicidal ideation among 5,641 patients seeking routine, nonsuicide related care in an inner‐city emergency department were examined. Approximately 8% of patients seeking routine care in the emergency department reported some form of suicidal ideation within the past 2 weeks. Suicidal ideation was common in individuals who were single with poorer mental health, had higher depression, and had received some drug or alcohol treatment in the past 3 months or had used cocaine or marijuana in the past 30 days. Improved screening procedures could help to identify routine care patients who are at risk for suicide.     

Chain of Care for Patients with Intentional Self‐Harm: An Effective Strategy to Reduce Suicide Rates?

Chain of care for patients with intentional self‐harm was important in the Norwegian national action plan to prevent suicide. In this study there were two aims: (1) to calculate the potential effects of chain of care on reducing suicide rates, and (2) to assess whether suicide rates decreased more in areas where chain of care had been implemented than in other areas. We observed no differences in changes in suicide rates between areas with and without the intervention. The calculated potential effects of chain of care on national suicide rates were very small, even under unrealistically favorable conditions.