Dual realities – The search for meaning: Psychodynamic therapy with physically ill people

Abstract

We summarize Kohut's (1971) bi-polar self which enables counsellors to understand and treat narcissistic behaviours and narcissistic personality disorders in a psychoanalytic framework. After Patton and Meara (1992), we describe Kohut's formulations regarding self-development and disorders of self and how such formulations inform critical components of psychoanalytic counselling with particular emphasis on the explicit and implicit strategies and characteristics the counsellor brings to the process. Finally, we suggest that a promising arena for future theorizing and applications of Kohut's ideas is consultation with parents, teachers and other community leaders to help prevent or remedy psychological self-injuries with systemic interventions outside short-term counselling or long-term therapy.

We have suggested that Kohut's self psychology is a good vehicle for understanding what brings a client to counselling: namely, disorders of the self or self-injury. We review strategies and ‘ways of being’ a counsellor must bring to and offer in the counselling encounter if the work is to succeed. We also examine implicit qualities (beyond the achievement of a mature bipolar self) we believe a counsellor or any facilitator must have if counselling or other helping relationships are to be effective. We purpose further conversations and empirical analyses which specifically and conceptually link critical components of psychoanalytic counselling to self psychology and to essential counsellor traits or virtues that seem intrinsic to good counselling practice.     

Putting the ‘heart’ back into community psychology: some South African examples

In this paper we explore the impact of emotional dynamics in the field of community psychology and the value of psychodynamic concepts in making sense of this. Emotional processes have often not been very well acknowledged or conceptualized in writing in the area of community psychology practice. This neglect is understandable given the individualizing, pathologizing and medicalizing assumptions underlying many psychological theories of emotion. Psychodynamic ideas may, however, make a useful contribution to understanding central concerns in community psychology in so far as they are able to shed light on emotional processes in groups, the political determinants of emotional response and the emotional dynamics of power, which are all central to the thinking of community psychologists. Using examples drawn from a long-term programme of consultation to community-based services in South Africa, we explore the potential of psychoanalytic understandings of emotional processes in illuminating some of the complexities and challenges faced in developing effective community partnerships and working towards the empowerment of communities.     

Love,artificiality and mass identification

How are we to understand the phenomenon of mass identification, epitomised in recent exhibitions of national feeling such as that of South Africa’s 2010 Football World Cup celebrations? Rather than focusing on the concepts of discourse and nationalism, or advancing an analysis of empirical data, this paper outlines a conceptual response to the challenge at hand, drawing on the tools of psychoanalytic theory. Three explanatory perspectives come to the fore. Firstly, such exhibitions of mass emotion might be understood as demonstrations of love, as examples of the libidinal ties that constitute and consolidate mass identification. Secondly, the marked artificiality of such displays of emotion and the fact of the ‘externality’ they entail might be seen, paradoxically, to be essential rather than inauthentic or secondary features of the displays in question. Thirdly, we might advance, via Lacan, that many of our most powerful emotions require not only recourse to the field of the inter-subjective, but reference also to the anonymous, ‘fictional’ framework of available symbolic forms.     

From consulting room to institution to society

Abstract

An examination of the links between clinical work and the context in which it takes place. The article will explore how the dynamics of the staff group can spill over into the consulting room and how unresolved issues in the consulting room can spill over into the staff group. It will also explore how the dynamics of both can be affected by broader social and political attitudes.     

Will the “Real Boy” Please Behave: Dosing Dilemmas for Parents of Boys with ADHD

The use of Ritalin and other stimulant drug treatments for attention-deficit hyperactivity disorder (ADHD) raises distinctive moral dilemmas for parents; these moral dilemmas have not been adequately addressed in the bioethics literature. This paper draws upon data from a qualitative empirical study to investigate parents' use of the moral ideal of authenticity as part of their narrative justifications for dosing decisions and actions. I show that therapeutic decisions and actions are embedded in valued cultural ideals about masculinity, self-actualization and success, as well as in moral conceptions of authenticity and personal freedom. I argue that this investigation of parents' moral justifications and dosing dilemmas raises questions about the validity of authenticity as a transcendent moral principle. Moreover, this study demonstrates that in order to be relevant, bioethical analysis of neurocognitive enhancement must engage with ground-up studies of moral principles and decision-making in context.     

ADHD Assessment

Abstract

This study examined effects of negative versus positive symptom formats on the assessment and subsequent classification of ADHD in children in public schools. Symptoms associated with the disorder based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) were presented to parents and teachers of referred children according to both types of formats. Informants were then asked to indicate whether the symptoms described the child's behavior over the last six months. Overall, the negatively phrased symptoms appeared to generate response bias which resulted in an increased percentage of children meeting the DSM-IV criteria for ADHD. Additionally, the decision reliability or classification agreement between the two formats was low, suggesting the possibility of confirmation bias in the assessment process. Implications for practice and future research are discussed.     

The Invisible Griever

Many people are equipped, through crisis intervention strategies and plans, to handle the immediate ramifications of a death within a particular school or community system. However, after the crisis has passed the question generally surfaces as to how one can help the children who have been greatly impacted by the death and are in the midst of the grieving process. The grieving child has often been invisible to adult caregivers like counselors, teachers, and school psychologist. The means of helping a child who has experienced a death in his family can be greatly enhanced by the developmcnt of grief support groups. Through the use of support groups children can learn to share their feelings, discover that they are not alone, and move through the grieve process.     

An Historical Overview of Basic Approaches and Issues in Ethical and Moral Philosophy and Principles

Summary

This article provides a condensed history of ethics development for the purpose of exposing psychologists and other mental health professionals to ethical and moral bases upon which modern psychological ethics are founded. In addition, it focuses on contemporary theories, with an emphasis on professional ethics.     

Methodological practices in cognitive style research: Insights and recommendations from the field of business and psychology

This study provides insights and recommendations concerning methodological practices of cognitive style research applied to the field of business and psychology. Based on a carefully designed selection process, 139 style-related articles published between 1986 and 2010 were content-analysed. In terms of research design, we found the field to be dominated by quantitative, cross-sectional, and single-source designs that relied heavily on self-reports, sample surveys, and student samples. While this might indicate a potential vulnerability in terms of internal and external validity, a strong emphasis on construct validity was also found, exemplified by high attention to reliability, and exploratory and confirmatory factor analyses. With regard to construct measurement, although more than 30 different instruments were used, the field was dominated by three of these. Regarding data analysis, traditional approaches have been mainly used and more advanced and novel approaches have not yet permeated through the cognitive style field. Implications and suggestions for future research are offered. This is the first review of methodological practices in cognitive style research and represents an important step in the advancement of the field.     

A trans-disciplinary study of the therapist's self

Participation in personal therapy during training is required by British accreditation bodies for counselling psychology as well as by most psychotherapy trainings. By contrast, trainee clinical psychologists are not required to undertake personal therapy, although they may elect to. Prior research in Britain and the US suggests that practitioners have a wide range of motives for entering therapy as well as motives for not doing so (Norcross &; Connor, 2005). This study addresses the fact that no research to date has specifically explored what individuals beginning their counselling psychology, clinical psychology and counselling training think and feel about participation in personal therapy during training. Data from open-ended questionnaires was analysed using inductive thematic analysis. Two main themes were identified. These consisted of: ‘Personal therapy helps me to be a better practitioner’, and ‘Personal therapy costs me’. The study results are considered in light of the limited prior research and recommendations for training are made.