The Therapist’s Needs: Beyond Mutual Recognition

Abstract

As early as 1965, Harold Searles argued that therapists’ needs for healing and growth are part and parcel of their work with patients. Since then, the relational movement has corroborated this idea by articulating the healing function of treatment for both patient and clinician. In this article, the authors examine therapists’ needs that have been overlooked or those that have not been considered fully in the literature. Using various ideas related to the concept of what the authors call therapeutic freedom, this article argues that clinicians must strive to adopt a therapeutic vision that aims to loosen their own ties to safe, familiar modes of engaging with patients, particularly in moments of enactment or impasse. The authors elucidate these ideas with case material from their clinical work and show how embracing various forms of therapeutic freedom results in a type of mutual surrender on the part of both patient and therapist, creating opportunistic conditions that generate therapeutic action and new possibilities for the dyad.     

Parental Influences on Memories of Parents and Friends

The authors evaluated the role parent–child relationship quality has on two types of memories, those of parents and those of friends. Participants were 198 Italian university students who recalled memories during 4 separate timed memory-fluency tasks about their preschool, elementary school, middle school, high school and university years. Half were instructed to recall memories involving parents and the remainder memories involving friends. Moreover, parent–child relationships were assessed by the Network of Relationships Inventory (NRI; W. Furman & D. Buhrmester, 1985) and Adolescents’ Report of Parental Monitoring (D. M. Capaldi & G. R. Patterson, 1989). Results showed that men with positive parent–son relationships had more memories of parents and more affectively positive memories of friends, supporting a consistency model positing similarity between parent–child relationships and memories of friends. Women with positive parental relationship quality had more affectively positive memories of parents but for friends, positive relationship quality only predicted positive memories when young. At older ages, especially middle school-aged children, negative parent–daughter relationships predicted more positive memories of friends, supporting a compensatory model. The gender of parent also mattered, with fathers having a more influential role on affect for memories of friends.     

The place of once-weekly treatment in the work of an analytically trained child psychotherapist

In this paper, I explore how we might link ideas about clinical facts to current issues in child psychotherapy research. I consider what our understanding of clinical facts might contribute to our research methods and how our research methods might better represent the clinical facts. The paper introduces a selection of psychoanalytic writers' formulations of the concept and describes some of the debates about the shortcomings of the traditional style of case reporting. The importance of keeping emotional experience central in our research is discussed. I describe a research method that I believe has the potential to capture and describe some of the complicated processes of change in psychotherapy. This is the concept of the ‘turning point’ session. Introducing the paradigm of complexity theory, I briefly explore how we might think about and understand the relationship between processes revealed through detailed analysis of a single session and change over a longer period of therapy.     

Metalinguistic development in French learners enrolled in an immersion programme: A longitudinal study

Research on bilingualism has shown a bilingual advantage in phonological and syntactic awareness, and more recently on some morphological awareness tasks in children who had acquired two languages simultaneously. However, there is still limited knowledge about this advantage in students who acquire a second language in school after having developed a first language. The present longitudinal study addressed this issue by comparing, over the first two years of primary school, the development of metalinguistic abilities in 33 French learners enrolled in an immersion French–German programme to that of 43 French monolingual peers. Results support the bilingual advantage and add to the growing body of research reaching the same conclusion. In this study, this advantage appears as early as in first grade and the gap favouring second language learners widens with time. The results are discussed in light of differences between the characteristics of the two languages.     

Factorial structure and psychometric properties of the French adaptation of the Dissociative Experiences Scale (DES) in non-clinical participants

IntroductionThe Dissociative Experiences Scale (DES) is a widely used instrument for assessing dissociation. However, there is disagreement regarding the internal structure of the DES and scores tend to be highly skewed.ObjectiveThe present study was designed to test the psychometric properties of a French version of the DES in non-clinical participants, in addition to applying a response scale as recommended by Wright and Loftus (1999) in order to resolve the problem of skewed scores.ResultsExploratory and confirmatory factor analysis (computed in two independent samples) suggested a two-factor solution, which seem to represent two forms of dissociation (“automatic pilot” related dissociation episodes and “defensive” dissociation episodes). Results also revealed high internal consistency, and satisfactory results in terms of skewness and floor effects. Finally, significant associations with other measures (anxiety, depression, traumatic experiences) indicate good concurrent validity.ConclusionsThis study offers evidence that the present version of the French adaptation of the DES reveals good psychometric properties. Analyses of the internal structure of the DES suggest that two types of dissociative experiences are being measured: automatic pilot-related dissociation episodes (e.g., associated with different types of cognitive failures) and defensive dissociation episodes that may act as defensive mechanisms, especially in persons who have been traumatized (e.g., the avoidance of a memory related to a traumatic event).     

Love in therapy: A qualitative study of how clients perceive their therapists’ emotions

Relevant literature on attachment theory has explored the importance of emotional experience inside the therapeutic setting, highlighting that the active engagement of the therapist with the client is necessary in the process of change. However, less is known about the clients’ perception of the therapists’ emotional expression during a session. In this qualitative study, we used narrative thematic analysis to examine 10 semi-structured interviews with clients in an enriched systemic therapy approach. Focusing on the similarities of clients’ experiences, what emerged from the interviews were specific ‘perceived emotions’ and the related facial expressions of the therapists that were given attention by the clients. Based on our findings, six emotional themes were identified and are considered prominent: (i) ‘excitement’, (ii) ‘calmness’, (iii) ‘affection’, (iv) ‘empathy’, (v) ‘anger’ and (vi) ‘sadness’. Also, the analysis revealed two distinct functions of the expression of the therapist’s emotions: (i) they are an essential part of the therapeutic relationship and, (ii) they provide clients with alternative ways of experiencing emotions and motivate them to change. Therapists are invited to recognize the importance of their own emotional and facial expression in therapy considering it a form of self-disclosure. Suggestions for further research are also provided.     

Towards a systematic Qura’nic theory of personality

Based on hermeneutic interpretation of the Holy Qura’n and the theoretical suggestions of the eminent Muslim thinker Al-Ghazali, a Qura’nic theory of personality is articulated. Eight main interrelated concepts have been identified in the present analysis and serve as the building blocks of a Qura’nic theory of personality: nafs (psyche), nafs ammarah besoa’ (evil-commanding psyche), al-nafs al-lawammah (the reproachful psyche), roh (spirit), a’ql (intellect), qalb (heart), al-nafs al-mutmainnah (the serene psyche) and al-nafs al-marid’a (the sick psyche). The Qura’nic theory of personality is psychospiritual, structural, dynamic, topographic, holistic, and holds a largely negative view of human nature. The implications of this theory for research and practice are discussed.     

Les déterminants de la charge de travail perçue dans deux services d’urgence hospitaliers en France

This article gives an account of research carried out the workload of healthcare providers in hospital emergency wards, by focusing on several factors that are both related to the patients and to their activity. Based on 121 observations conducted in two hospitals, coupled with the NASA-TLX scale and an ad hoc questionnaire, this research indicates that the elements which contribute the most to perceived workload are the agitated behavior of patients and communication difficulties linked to handicap. However, variations in the number of tasks do not seem to have an influence on the workload perceived by health care providers which tends to highlight that the relations to patients contribute more to the perception of workload than the number of tasks. In the situation observed, the regulation of workload is made possible by the management of relational factors (physical demand, frustration and effort) which determine, in part, workload perception. In order to reduce or adapt this load, this article suggests basing interventions on the way to deal with difficult patients and not on the regulation of the number of tasks.     

‘Coloured’ Boys Talk: Constructing Heterosexual Masculinities in a Working Class High School Context

This article presents the results of a year-long ethnographic study of 13 ‘Coloured’, working class, high school boys aged 14–17 in KwaZulu-Natal, South Africa. Data derived using participant observation and semi-structured in-depth interviews. Social constructionist perspectives were used as a basis for discourse analysis. An interrogation of participant accounts illustrated the contradictory and ambiguous nature of their heterosexual identities. The findings suggest the simultaneous performance of crude, misogynistic masculinities, and more loving and respectful attitudes towards women and girls. The alternate discursive positions show potential for more equitable gender relationships to be encouraged in historically disadvantaged teenage boys.     

Discrete changes in the frequency and functions of autobiographical reminiscence in Huntington's disease

ABSTRACT

Autobiographical memory is widely posited to serve self, social and directive functions. Recent evidence suggests marked autobiographical memory impairments in Huntington's disease (HD), however, no study to date has determined how the perceived functions of autobiographical reminiscence may be altered in HD. The current study aimed to assess the self-reported frequency and function of autobiographical reminiscence in HD. We assessed autobiographical reminiscence in late premanifest (n?=?16) and early stage HD (n?=?14), relative to healthy controls (n?=?30). Participants completed the Thinking About Life Experiences Scale Revised (TALE-R), which measures three putative functions of autobiographical memory (self, social, directive). People with manifest HD reported talking less frequently about the past compared to controls. In contrast, no group differences were found in terms of thinking about the past. Manifest HD participants further reported using their autobiographical memories for social functions less frequently compared to controls. No other group differences were evident in terms of self or directive functions of autobiographical memory. These self-report findings complement recent reports of autobiographical memory disruption on performance-based tasks in HD. Future studies exploring how changes in autobiographical reminiscence impact a sense of self continuity in HD will be important in this regard.