Body language and metaphors revealed through applications of Movement Psychotherapy in a hospice: A clinical case of refractory pruritis

Movement psychotherapy (MP), and dance/movement therapy (DMT), are body-orientated psychotherapy approaches that use movement for the integration of emotional, cognitive, physical, social and spiritual aspects of self (European Association Dance Movement Therapy, 2010). It is distinctively a combination of moving and sensing the body with verbal self-reflection (Bloom, 2006). Several papers have presented DMT as a treatment in general medical care and cancer care, but there is still a paucity of evidence-based studies. The authors describe a clinical case illustrative of many of the situations in which facing death was particularly tormenting. The emotional pressure can produce a barrier of communication with the risk of rupturing the therapeutic relationship. The movement therapist’s function is to clarify the elements of body language and this has important implications for clinical practice because the end-of-life decisions are difficult, like palliative sedation therapy (PST). Even if procedural guidelines for PST help physicians and care teams through the decision-making process and make them more comfortable when responding to physical suffering, physicians more frequently report an emotional pressure when their patients experience psychological symptoms, with the risk that PST could become a potential “counterphobic defence to treat”.     

The emerging therapeutic landscape of psychotherapy in the twenty-first century and the contribution of anthroposophic psychotherapy

In recent years the counselling and psychotherapy profession has experienced significant changes. On the one hand there has been the advent of managed care and evidence based practice which in the UK takes the form of the Improved Access to Psychological Therapy scheme. On the other hand there has, during the same period since the 1980s, been a rich and varied process of innovation in the profession. This has included the so-called relational inter subjective turn in the United States. Second, an increased sensitivity to the interface between therapy and social and political phenomena. Third, the revolution in neuroscientific thinking. Finally, the development of therapy as an interdisciplinary intervention in complementary and alternative medicine teams as in the case of the spiritually-orientated anthroposophic psychotherapy in Europe. In this article I will argue that these innovatory developments, which I refer to as the ‘new integration’, are much needed in order to counterbalance the increasing dominance of managed care and evidence based practice.     

More transparency of world view assumptions: Commentary on “Psychiatry and religion: Consensus reached!” (Verhagen, 2017)

ABSTRACT

The commentary compares the WPA position statement with a similar paper published recently by the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN; Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde). These papers should be a starting point to foster R/S studies within the bio-psycho-social-spiritual framework, a thoughtful discernment of the psycho-spiritual mixture and more training opportunities for therapists to better integrate the spiritual dimension into treatment.     

‘Pre-crime’, Prevent,and practices of exceptionalism: Psychotherapy and the new norm in the NHS

Section ’26 of the Counter-Terrorism and Security Act 2015 places a duty on local authorities and public sector institutions to have ‘due regard to the need to Prevent people from being drawn into terrorism’. Accordingly, NHS staff are now required to attend a Workshop to Raise Awareness of Prevent (WRAP), ensuring they are trained to spot the ideological symptoms and psychosocial vulnerabilities thought to predict extremist activity. In this paper, I suggest that the insertion of counter-radicalisation duties into the work of psychotherapists and other mental health professionals is not simply to be understood as an attempt to forestall and avert extremist activity. Rather, drawing on the work of Georgio Agamben and Judith Butler, I argue it can be viewed as an innovative tactic of governmentality whose technologies of surveillance ensure a culture of conformity in the NHS through which a ‘state of exception’ can be established and normalised. I illuminate this by examining two interrelated aspects of the Prevent duty: one, the decision by the government to embed Prevent within the existing rhetoric and practice of ‘safeguarding vulnerable children and adults’; and two, its discursive representation of the consulting room as ‘pre-criminal space’. I conclude by suggesting that the government’s determination to allow ‘no ungoverned space in which extremism is allowed to flourish’ targets the limits of acceptable speech and so the very conditions for radical thought and critique on which psychotherapy depends.     

以有机哲学的视角看中国传统心理治疗思想

西方现代心理治疗的体系与方法逐渐暴露出一些问题,西方传统文化中的机械唯物论和二元对立的逻辑是其误区所在。怀特海的有机哲学思想在一定意义上为缓解或消除这些问题提供了哲学的指导,而蕴涵在中国传统文化中的心理诊疗思想为西方乃至世界心理治疗的发展能够提供有益的启示和补充。     

Are Some Psychotherapies Much More Effective Than Others?

In a previous paper we had reported on the examination of comparisons of 18 metaanalyses of active treatments with each other (Luborsky, Rosenthal, Diguer, et al., 2001). These metaanalyses gave a small and nonsignificant mean level of difference between types of treatments. The smallness of this correlation confirms Rosenzweig's (1936) expectation that because of the large overlap in effective ingredients of different psychotherapies, comparative studies of psychotherapies would show little difference. Such a comparison that includes psychoanalyses seems a long way off, but if outcomes of psychoanalyses are defined similarly to those in the other psychotherapies, the expected differences in outcomes may also be small.     

Panic disorder and depression: A psychodynamic exploration of comorbidity

Eight of twenty-one patients presenting for treatment in an open trial of brief psychodynamic psychotherapy for panic disorder also carried the diagnosis of major depression. For the patients who completed the study, depression remitted as well as panic disorder. The authors highlight psychodynamic factors that they hypothesize may contribute to the significant overlap between panic disorder and depression, and describe three videotaped cases to illustrate these points.     

The use of observation in the psychoanalytic treatment of a 12-year-old boy with Asperger's syndrome

The author describes some aspects of a once-weekly psychoanalytic psychotherapy of a 12-year-old boy diagnosed with Asperger's syndrome. The patient's emotional and cognitive development had been impaired since early life, possibly due to an internal deficit and to the likelihood of inadequate environmental holding. He was unaware of having difficulties but was underachieving academically, was socially isolated and often visibly unhappy in his life. The patient's denial, splitting, and projection of emotion and insight presented the therapist with the difficult task of how to reach him. In order to communicate with him emotionally, the therapist created a modified technique which reflected the patient's development from part-object to whole-object relationships. This development became apparent in the sessions and was interpreted in the transference relationship. An account of the patient's early years was pieced together from a detailed commentary of what was being observed and intuited by the therapist during the sessions, as well as by an understanding of the countertransference. By the end of two years' treatment, the patient's sensitivity and creativity, which had been buried beneath a self-sufficient, autistic-like encapsulation, finally began to emerge in his communications with his therapist.     

Attack on the Self: Charismatic Leadership and Authoritarian Group Supervision

Charismatic group leadership carries the potential for indoctrination and abuse when countertransference issues remain unexamined. This paper is a personal account of participation by the author in an authoritarian and confrontational supervisory experience with self-serving charismatic leadership. Group casualties are portrayed and discussed. This report applies self-psychological principles to understand the powerful merger of the compliant self and idealized object. Further, the dynamics of group identification with the aggressor are described through the Ferenczian lens of confusion of tongues.     

Spiritual Psychotherapy for Antisocial and Psychopathic Personalities: Some Theoretical Building Blocks

Until now a profound theoretical model for spiritual psychotherapy, which is constructed specifically for nonreligious antisocial and psychopathic patients who have spiritual and philosophical interests, is missing. In this paper some important theoretical issues with respect to spiritual psychotherapy for antisocial and psychopathic patients will be discussed such as the links between spirituality on one hand and authenticity, vanity; emotional, moral, and social capacity; reality testing; creativity; and faith in life on the other. Furthermore, the spiritual psychotherapist's attitude towards his or her patients will be explored.