Otto Rank: Pioneering Ideas for Social Work Theory and Practice

This article examines Otto Rank's psychology and its profound implications for social work knowledge-building and practice. The paper begins with a brief biographical portrait, highlighting the significance of Rank's relationship and eventual break with Freud, and contextualizing the ideas that became the basis for the Functional Approach. We discuss Rank's conception of human functioning in the social environment, his influence on later theories, and a contemporary critique of Rank's ideas. The paper concludes with a discussion of Rank's contributions to the Functional Approach and to social work practice in general.     

Ferenczi's “Confusion of Tongues” Theory and the Analysis of the Incest Trauma

Abstract

The tender-mother transference of Ferenczi's humanistic analytic orientation was as important an advance in pioneering times as was Kohut's selfobject transference in contemporary psychoanalysis. Ferenczi's clinical theory and method began a focus on pre-oedipal experiences, which eventually became an alternate to the oedipal theory. Freud was critical of Ferenczi's formulation, leading a successful attempt to suppress his work and remove it from mainstream psychoanalysis because he believed it was “regressive.” In actuality, Ferenczi's “Confusion of Tongues” theory and “Relaxation Therapy” were prophetic and pioneering attempts to understand and treat the incest trauma (ironically the clinical data upon which Freud founded psychoanalysis 100 years ago). In the case of Miss T., Ferenczi's ideas are applied to the contemporary analysis of the incest trauma.     

Conversion Hysteria in a Pre-Adolescent Girl

Abstract

This paper is a case presentation of a 10-year-old girl with classic conversion hysteria symptomatology. Psychological test material as well as the ten session treatment is presented. The original Breuer/Freud conceptualization of hysteria and its linkage with trauma is considered. Current theories of trauma with the usual presenting symptoms of dissociation, abandonment fears, and repetition are also considered.     

Efficacy of Telehealth Treatments for Posttraumatic Stress-Related Symptoms: A Meta-Analysis

This meta-analysis summarizes the findings of outcome research on the degree to which telehealth treatments reduce posttraumatic stress disorder (PTSD)-related symptoms. In a search of the literature, 13 studies were identified for inclusion in the meta-analysis and were coded for relevant variables. A total of 725 participants were included. Results indicate that telehealth treatments are associated with significant pre- to postreduction in PTSD symptoms (d = 0.99, 95% confidence interval [CI]: 0.87–1.11, p < .001), and result in superior treatment effects relative to a wait-list comparison condition (d = 1.01, 95% CI: 0.76–1.26, p < .001). However, no significant findings were obtained for telehealth intervention relative to a supportive counseling telehealth comparison condition (d = 0.11, 95% CI: ? 0.38 to 0.60, p = .67), and telehealth intervention produced an inferior outcome relative to a face-to-face intervention (d = ? 0.68, 95% CI: ? 0.39 to ? 0.98, p < .001). Findings for depression symptom severity outcome were generally consistent with those for PTSD outcome. Telehealth interventions produced a significant within-group effect size (d = 0.98, 95% CI: 0.86 to 1.10, p < .001) and superior effect relative to wait-list comparison condition (d = 0.80, 95% CI: 0.56–1.05, p < .001). Relative to face-to-face interventions, telehealth treatments produced comparable depression outcome effects (d = 0.13, 95% CI: ? 0.55 to 0.28, p = .53). Taken together, these findings support the use of telehealth treatments for individuals with PTSD-related symptoms.     

BORGES IN MY OFFICE: THE ANALYSIS OF A MAN DWELLING OUTSIDE OF TIME

This article weaves together two threads: the intricacies of the analysis of a difficult‐to‐reach yet extraordinary patient and the literary works of Jorge Luis Borges, which played a significant role in the analysis as a source of inspiration, enriching the analyst's reverie and opening up new psychic spaces. The authors demonstrate the analyst's recourse to several of Borges's stories in order to enrich his own inner world and to better understand the analysand. Some of these stories are briefly presented through the analyst's dialogue with them, and there is a discussion of their function in facilitating the process of working through issues of time, memory, mortality, and identity, contributing to the enhancement of the patient's ability to come face to face with the unwanted, split‐off parts of his self and of reality.     

The child's experience of Munchhausen syndrome by proxy

This paper examines the emotional impact of Munchhausen syndrome by proxy on a child aged 6 who had been poisoned by her mother. It describes her treatment in child psychotherapy over twenty months at the Cassel Hospital where the family worked towards her successful rehabilitation home. The work with her showed her experience of dangerous relationships in her family that left her distrustful of any new relationship, and doubtful of her capacity to be close without being destructive. Like her parents, she was terrified of facing the murderous feelings in the family, retreating into denial when life was too painful. The paper describes three phases of treatment: fear of separation and preoccupation with the trauma of poisoning, ambivalence about facing the destructiveness in the family and the move into more appropriate latency behaviour as she prepared to go home with her parents. It concludes with an overview of the impact of Munchhausen syndrome by proxy on the developing child, as shown in this treatment: the delay in emotional and cognitive development, the interference with the capacity to relate, the retreat into illness under stress, and the fear of permanent damage caused by the emotional and physical abuse.     

Book Reviews

BRUNO BETTELHEIM : The Empty Fortress: Infantile Autism and the Birth of the Self. The Free Press, New York. 1967. $9.95. (£4 in England).

GERALD O'GORMAN: The Nature of Childhood Autism. (Illustrated, 8 plates)

C. M. HEINICKE and I. J. WESTHEIMER: Brief Separations.     

Light and movement: making contact with a traumatised and embattled latency girl

This paper shows a child psychotherapist learning and developing her technique as she attempts to make contact with a child who is extremely hard to reach. It is based on the first two years of three-times-weekly intensive psychotherapy of a latency girl who had little faith in a helpful therapeutic relationship. Her defences against such a relationship were entrenched and hard to shift. In this clinical work, the psychotherapist relies on close observation and her countertransference to develop a relationship with the child, in order to begin to make sense of her non-verbal emotional experience and communication.     

Homelessness Is Traumatic: Abuse,Victimization, and Trauma Histories of Homeless Men

Homelessness is traumatic, and trauma-informed care is an emerging best practice. Using structured interviews with day shelter clients (N = 152), this study examined trauma among homeless men. The PTSD Checklist (PCL–C) was used to assess for posttraumatic stress disorder (PTSD). Participants’ pattern of PCL–C responses suggested that 23% to 30% screened positive for PTSD. Those with positive PTSD screens had been homeless longer and were more likely to have met time criteria for chronic homelessness. They were significantly more likely to be veterans and to report violent attacks, abuse histories, and mental health problems. Importantly, only 69% of those with positive PTSD screens acknowledged current mental health problems. These individuals were much less likely to report mental health counseling in the prior year.