Understanding and Responding to Victims of Interpersonal Sexual Violence and Sexual Assault within Committed Relationships

Abstract

The purpose of this article is to increase therapeutic discussion surrounding intimate partner sexual violence (IPSV) by increasing understanding in how victims of IPSV perceive and respond to the assault. Although IPSV has received little research attention, sexual violence within relationships occurs at an alarmingly high rate. Theories of sexual assault, such as sex-role socialization, are discussed to aid clinicians in better identifying assaultive behaviors and common physical and emotional responses of victims. Additionally, the authors provide a framework for the assessment of IPSV and suggestions on “best practices” for creating conversations that promote hope and healing.     

Evidence for perceptual learning with repeated stimulation after partial and total cortical blindness

Lesions of occipital cortex result in loss of sight in the corresponding regions of visual fields. The traditional view that, apart from some spontaneous recovery in the acute phase, field defects remain permanently and irreversibly blind, has been challenged. In patients with partial field loss, a range of residual visual abilities in the absence of conscious perception (blindsight) has been demonstrated (Weiskrantz, 1986). Recent findings (Sahraie et al., 2006, 2010) have also demonstrated increased visual sensitivity in the field defect following repeated stimulation. We aimed to extend these findings by systematically exploring whether repeated stimulation can also lead to increased visual sensitivity in two cases with total (bilateral) cortical blindness. In addition, for a case of partial blindness, we examined the extent of the recovery as a function of stimulated region of the visual field, over extended periods of visual training. Positive auditory feedback was provided during the training task for correct detection of a spatial grating pattern presented at specific retinotopic locations using a temporal two alternative forced-choice paradigm (Neuro-Eye Therapy). All three cases showed improved visual sensitivity with repeated stimulation. The findings indicate that perceptual learning can occur through systematic visual field stimulation even in cases of bilateral cortical blindness.     

Time and again: Intermittent Brief Dynamic Therapy

Abstract

The author notes that in many of the settings in which Brief Therapy takes place that a client may return after the ending for a further series of sessions. Time-limited therapy has placed an emphasis upon the termination phase of the therapy and linked this to the process of individuation and separation. Such an approach, as articulated by Mann (1973 Mann, J. 1973. Time-limited psychotherapy, Cambridge, MA: Harvard University Press.  [Google Scholar]), which draws conceptually from the work of Winnicott (1965 Winnicott, D. W. 1965. The maturational processes and the facilitating environment, London: Hogarth Press.  [Google Scholar]) and the notion that the infant achieves unit status from the original undifferentiated merger with the mother, is not easily compatible with Intermittent Brief Dynamic Therapy. The work of attachment theorists and Stern (1985 Stern, D. N. 1985. The interpersonal world of the infant, New York: Basic Books.  [Google Scholar]) provide an alternative basis upon which to conceive of the development of the infant. While emphasizing the importance of attending to affects at points of separation and ending, as is evidenced in the work of Della Selva (2004 Della, Selva P. C. 2004. Intensive short-term dynamic psychotherapy, London: Karnac.  [Google Scholar]), such a framework is more readily compatible with the development of Intermittent Therapy, and with the realities of the settings in which much brief work takes place. The author also comments upon the flexibility inherent in Winnicott's own practice of brief consultations, and the implications of this for the development of Intermittent Brief Dynamic Therapy. The paper includes a case study that illustrates this debate and which provides evidence for the therapeutic potency of a form of Brief Dynamic Intermittent Therapy where a dynamic focus maintains a structuring pattern to the narrative over a sequence of several periods of Brief Therapy, spread over a number of years.     

Cognitive-Behavioural Treatment of School-Refusing Children: Maintenance of improvement at 3- to 5-year follow-up

Although evidence is accumulating on the immediate or short-term efficacy of cognitive-behavioural strategies in the treatment of school refusal, no studies have been reported on the long-term efficacy of this treatment approach. An earlier randomized clinical trial conducted by the authors demonstrated the efficacy of a manual-based cognitive-behavioural treatment program for school refusal relative to waiting list controls. We now report findings of a 3- to 5-year follow-up investigation of the treatment group. In general, results support the long-term efficacy of the treatment program, with children showing maintenance of improvements in school attendance and school adjustment. Methodological limitations of the follow-up investigation are emphasized.     

Expressed Emotion,Appraisal and Coping by Patients with Recent-onset Schizophrenia: A Pilot Investigation

This pilot study sought to follow up on indications that patients from households with high levels of expressed emotion (EE) differ from those from households with low levels of EE in ways not assessed in typical symptom rating profiles. We examined how patients appraised and coped with a prominent societal stressor. Soon after the start of the Gulf War, 22 patients with recent-onset schizophrenia living in Los Angeles appraised the stressor and completed a coping questionnaire. Results indicated that patients from high-EE homes were likely to use emotion-based confrontational methods to cope with the crisis, while patients from low-EE environments were likely to use avoidance and denial. Patients from high-EE homes thus coped with this non-familial, societal stressor in a way similar to the way in which they have been observed to cope with family conflict: they more readily expressed their anger and frustration than patients from low-EE homes. These pilot data suggest that increased attention should be directed toward those patient behaviours that may be associated with either an increase or decrease in negative affective behaviour from relatives. It may also be fruitful to consider more broadly the adaptive and maladaptive features of the preferred coping strategies of patients from high-EE and low-EE environments.     

Does scientific thinking lead to success and sanity? An integration of attribution and attributional models

A motivational model is introduced that integrates conceptions of attributional antecedents with those of attributional consequences, and suggests that it is functional to make realistic attributions. This model is applied to the analysis of achievement behaviour and depression. The use of a new experimental paradigm designed to test the model's assumptions demonstrates that realistic attributions maximise performance. The model was also used to investigate whether depressives are more realistic than non-depressives. This research revealed that depressives draw more "pessimistic" conclusions from covariation information than non-depressives. In addition, depressives expect their partners to make more negative attributions about the depressives' outcomes than their partners in fact do. However, these negative views could not be traced back to faulty inferences from covariation information. Finally, research is described showing that, in addition to depressogenic attributions, certain evaluative cognitions need to be present in order to trigger depressive mood reactions.     

Dialectical Behavior Therapy in the Treatment of Abusive Behavior

Summary

Research suggests that a subset of men who abuse their partners have characteristics associated with borderline personality disorder (BPD). Dialectical Behavior Therapy (DBT) has shown promise as a treatment for BPD, and thus may be useful for these men. This paper describes how DBT principles might be applied to address the problem of partner abuse, including discussion of why one might expect DBT to be a helpful treatment model for this population, and how implementation of the model might be designed.     

Subject benchmarking,Orders in Council and European Directives

This paper describes a range of professional self-regulation and of higher education (HE) developments which form a backdrop to decisions the profession/s of psychotherapy (and counselling) may wish to take on issues around professional self-regulation. The developments described are: - the codification of ‘subjects’ and their qualifications in HE by the Quality Assurance Agency, especially ‘Subject Benchmarking’ led by ‘Subject Associations’, and the opportunities this offers, - European Directives of various sorts relating to regulated professions and the impact the relevant Directive would have if the profession was regulated, - the legislative history of professional self-regulation up to the present day and ‘Orders in Council’ made under the Health Act, 1999, and - criteria and safeguards for professions to enjoy statutory self-regulation and their implications. The paper concludes with how these developments interact and options for how the profession could respond to them including a separate Order or joining the Health Professions Council     

Book reviews

Peter E. Hodgkinson and Michael Stewart (1998) A Handbook of Post-Disaster Psychosocial Aftercare, 2nd edn, London: Routledge, $15.99 (pb)

Caroline Garland (ed.) (1998) Understanding Trauma: A Psychoanalytic Approach, London: Duckworth, Tavistock Clinic Series, $14.95 (pb)

Claudio Neri (1998) Group, preface by Parthenope Bion Talamo, foreword by Malcolm Pines, London: Jessica Kingsley, $16.95

Robert L. Perkinson (1997) Chemical Dependency Counseling: A Practical Guide, London: Sage, $24

Mary Turner (1998) Talking with Children and Young People about Death and Dying: A Workbook, illustrated by Bob Thomas, London: Jessica Kingsley, $17.95

Jan Wiener and Mannie Sher (1998) Counselling and Psychotherapy in Primary Health Care: A Psychodynamic Approach, London: Macmillan, $11.99 (pb)

Melanie Hart and James Loader (eds) (1998) Generations: Poems between Fathers, Mothers, Daughters, Sons, London: Penguin, $14.99

David Kennard and Neil Small (eds) (1997) Living Together, London: Quartet, $9.00

Sally Skaife and Val Huet (1998) Art Psychotherapy Groups: Between Pictures and Words, London: Routledge, $47.50 (hb), $15.99 (pb)     

Relational Psychoanalysis Potential Usefulness with Black South African Clients

The aim of this article is to suggest that relational psychoanalysis may be a useful approach for working with clients from indigenous African cultures. In particular, the article considers the utility of relational psychoanalysis to understanding and enacting the therapeutic relationship with clients from an indigenous African cultural background. The notion of “we” self from the perspective of African cultures is a case in point for possible compatibility between relational psychoanalysis and black clients who come from background that place a high value on communal or “we” selves. An integrative therapy that combines African worldviews and relational psychoanalysis is possible.