The integrative attitude–a personal journey

The origins of clinical psychotherapy date from the beginning of last century and the development of broadly four foundational schools–psychoanalytic, cognitive-behavioural, humanistic and transpersonal psychologies. The imperative to integrate these schools, however, is relatively recent and in the last 25 years a professional integration movement has developed, exemplified by the formation of SEPI and the UKAPI, and ‘integrative psychotherapist’ is now the most popular nomenclature used in the profession. This article gives a brief history of the integration movement, reviews some issues raised by developments so far, and discusses the personal dilemma that integration evokes in the would-be integrative practitioner. Using my own journey I espouse an integrative attitude that is based on the nature of integration as an evolving personal process rather than an ideal, fixed, profession-wide position. I describe three interweaving modalities of integration I call constructive, complicit and contiguous integration, which form a developmental framework that aims to encourage the individual activity of questioning, inventing, researching and interrogating the discipline within its philosophical, professional and social context. In concluding, this article exhorts the profession to see integration as a personal journey, as a way of being that is constantly becoming and unfolding in relation with the therapist's training, experience and interaction with peers and clients. The result is indefinable and unnameable, and perhaps represents the soul of integrative psychotherapy.     

Uses and abuses of theory: a group analytic perspective

Group therapy occupies a curious and ambiguous status in the overall mental health field: groups are recognized and marginalized, sought after and avoided, respected and dismissed as second best to individual therapy. Groups are now practised widely in many services, probably because of the pressure of referrals and increased concern about funding, but even then have a secondary status. The under-recognition of both the value and complexity of groups seems to parallel the problems of theory which are part of the group psychotherapeutic culture. Rather than attempt a comprehensive theory of groups in this article, I intend to present some of the problems about theory and its link to practice, focusing particularly on the ambivalence about groups that I see as a continuing concern. I do so from a position which values theory, seeing in theory the container of understanding which guides psychotherapeutic practice. I do not identify with a critical position which rejects theory. This position recognizes fully the risks and dangers of over-theorizing, the potential to distort human contact through a rigid adherence to theory; however, I write in the spirit of appreciating theory thoughtfully applied as without theory, our work might be impoverished and even impeded.     

Community Engagement as Liberal Performance,as Critical Intellectualism and as Praxis

This article aims to illustrate that engagement is a dynamic and evolutionary process, moulded by contesting ideological, social actor and contextual forces. For purposes of illustration, I draw on a university-affiliated, participatory enactment of community engagement as a case example. The case illustrates that community engagement may assume a form of action, critical intellectualism and praxis. As action, community engagement is oriented towards performance of liberal democracy. Community engagement, as shaped by the critical intellectualism of the Black Consciousness philosophy, reflects community self-affirmation, autonomy and intellectual independence. Community engagement as praxis may be characterised by reflexivity, vision-making and the building of interpersonal relationships. Community engagement is marked by a dynamic interplay between race, power and counter-hegemonic ideology.     

From prematurity to parenting stress: The mediating role of perinatal post-traumatic stress disorder

Preterm delivery may lead to the emergence of symptoms of Post-Traumatic Stress disorder (PTSD), which may, in turn, affect the quality of the mother-child relationship. The aim of this study is to shed light on the development of parenting stress in mothers of preterm and full-term children. It is hypothesized that PTSD symptoms mediate the relationship between preterm/full-term birth and the levels of parenting stress. Perinatal PTSD, parenting stress and social support were assessed in 156 mothers of full-term children and 87 mothers of preterm children. Mothers of preterm children experienced more post-traumatic stress and parenting stress than mothers of full-term children. However, the relationship between preterm delivery and subsequent levels of parenting stress was mediated by PTSD symptoms. These findings suggest that the maternal perception of childbirth as a traumatic experience and the subsequent development of PTSD symptoms are pivotal in the emergence of parenting stress.     

SOME IMPLICATIONS OF BION'S THOUGHT

Following up Bion's idea that dreaming is a continuous process that takes place in waking life as well as in sleep, the author develops its theoretical and technical implications. He describes the narrative derivatives of waking dream thought as the means, or interface, whereby access may be had, albeit indirectly, to the constantly forming sequences of alpha-elements. Examples of the formation of these sequences out of childhood memories, present-day experiences and sexual feelings are given. Reference is also made to the notion of the analytic field. The author goes on to demonstrate the clinical value of these concepts both for studying the session's microtransformations and as a means of in-depth examination of the analyst's own mental functioning, including its lapses, in a session. Abundant clinical material is presented to help analysts who normally apply different models of the mind share these ideas. Finally, it is suggested that night dreams result from a further elaboration of the elements formed during waking life.     

Real Relationship: The “Something More” of Psychotherapy

Although it often operates silently, the personal relationship is a part of everything that transpires between therapist and client. Following the psychoanalyst Ralph Greenson's (1967) early lead, the term Real Relationship is used to capture this personal aspect of psychotherapy. It is divided into two elements, realism and genuineness; and both these elements are further divided into magnitude and valence aspects. Research on the real relationship is almost nonexistent, and to an important extent this is due to the lack of a reliable, valid, and convenient measure. The author is involved in a research project aimed at developing such measures from both the client and therapist perspective. Examples of items are provided.     

Analytic Group Psychotherapy: A Uniquely Effective Crisis Intervention

This paper describes the author's experience doing crisis intervention with survivors of the 9/11 attack on the World Trade Center in New York City. It focuses on enhancing the understanding of and potentially expanding the theory and technique of analytic group therapy as applied to this unique situation.Private practice in     

中学生同伴交往接受和拒绝的归因研究

本研究参考国外相关量表的设计,结合我国实际,编制了中学生人际归因风格问卷,考察了人际归因风格和人格特征两个维度对中学生在同辈群体中的社会测量地位的影响程度。结果表明,这两者共同影响中学生的社会测量地位,被拒绝学生对正性事件的归因与其他学生存在显著差异,对负性事件的归因不存在显著差异。这提示我们,可以通过改变被拒绝学生不适当的人际归因方式来改善其同伴关系。     

Parent-Adolescent Relationship and Adolescent Psychological Functioning among African-American Female Adolescents: Self-Esteem as a Mediator

African-American female adolescents living in urban areas are at increased risk for adverse adjustment outcomes. The present study accomplished two goals. First, the quality of the parent-adolescent relationship across age groups was examined for differences among younger (i.e., 12'14) versus mid-range (i.e., 15'16) versus older (i.e., 17'18) adolescents. Second, self-esteem was examined as a possible mediator of the relationship between the quality of the parent-adolescent relationship and adolescent psychological functioning in a sample of 608 African-American urban adolescent females. With regard to developmental shifts in the quality of the parent-adolescent relationship, midrange adolescents reported a significantly poorer relationship with their mother than older adolescents. Results also indicated that self-esteem partially mediated the relationship between parent-child relationship and adolescent psychological functioning. Mental health professionals can broaden their interventions that aim to improve adolescent psychological functioning by either focusing on the quality of the parent-adolescent relationship or adolescent self-esteem.     

系统式团体心理辅导改善儿童同伴关系的研究

本研究将系统家庭治疗的思想及技术移植到学校情景中,对实验班人际距离较远的5名嫌弃儿在原班级中开展团体心理辅导活动.实验结果表明:嫌弃儿的人际距离明显改善.辅导中系统思想的引入、积极取向的气氛对同伴关系辅导有特殊的效果.