Opening the closed heart: affect-focused clinical work with the victims of early trauma

This paper begins with the understanding that early trauma leads to powerful dissociative defenses which injure the capacity to feel. It further explores ways to restore this capacity through body-centred attention to affect-in-the-moment in the psychoanalytic situation. Using the author’s personal experience while in analysis as well as a case of severe early trauma, he demonstrates the consciousness-killing effect of primitive defenses and shows how body-sensitive techniques hold the promise of restoring the patient’s sense of aliveness and hence, opening the unconscious to those affect-images that are the building blocks of the human imagination. A final section focuses on the neglect of feeling in Jungian psychology and suggests that the “creation of consciousness” which Jung described as his personal myth, is quintessentially a process of emotional transformation – of bringing unconscious suffering into consciousness – as feelings.     

The Influence of Trauma Symptoms on the Therapeutic Alliance Across Treatment

The authors examined the influence of early phase dissociation, interpersonal problems, and retraumatization on the therapeutic alliance at early, middle, and later treatment phases. Participants were 84 female survivors of child abuse (ages 18 to 60 years, 53.6% Caucasian) who were receiving counseling at a university training clinic. Master’s- and doctoral-level students provided counseling using integrated relationship and trauma-based cognitive behavior therapy. Treatment followed a 3-phase model. The authors used structural equation models to test the hypothesis. In the early and later phases, fewer interpersonal problems significantly predicted a stronger alliance. In the middle phase, fewer interpersonal problems, less dissociation, and more revictimization significantly predicted a stronger alliance. Tasks, goals, and bond contributed significantly to the alliance in each of the 3 phases. Interpersonal problems were consistently the strongest predictor across the 3 phases, whereas tasks consistently made the greatest contribution to the therapeutic alliance across all 3 phases.     

The past,present, and future of the biopsychosocial model: A review of The Biopsychosocial Model of Health and Disease: New philosophical and scientific developments by Derek Bolton and Grant Gillett

Health psychology is a growing field generating exciting advances in theory, research, and applications that significantly improve the lives of individuals, shape the medical profession, and inform global public policy. For over 40 years, the field has been guided by the biopsychosocial model (Engel, 1977), an interdisciplinary and multifaceted model that posits the interrelations among the biological, psychological, and socio-environmental influences on health and disease. The theoretical implications and empirical research that it has generated have been vast. In The Biopsychosocial Model of Health and Disease: New philosophical and scientific developments, Derek Bolton and Grant Gillett (2019) present a summary of four decades of scholarship. They conclude that the model has fallen short clinically, scientifically, and philosophically. Although their book is timely, well-written, thought-provoking, and designed to highlight weaknesses that could drive science and practice forward, their criticisms are not fully convincing and are open to debate. The contributions this book could make may be to challenge a new generation of scholars and scientists to demonstrate that the biopsychosocial model is more relevant than ever, especially as areas such as social genomics, psychoneuroimmunology, health disparities, and global health become more important. Despite interesting philosophical challenges presented by Bolton and Gillett, theory, research, and practice focused on health, disability, illness, and wellness should remain grounded in the biopsychosocial model.     

意义疗法的理论、方法与技术:基于存在积极心理学的视角

意义疗法是以存在积极心理学为理论基础,以构建个体生命意义为目的,实现生活正负两极性的动态平衡,从而解决其心理困扰获得心理治愈与成长的一种整合性心理咨询与治疗方法。起源于Frankl意义学说的意义疗法是通往人类美好生活的路径,它源于对苦难生活所隐含意义的本质认识。在理论上,意义疗法以意义定向看世界为中心,以意义管理理论和双系统模型为支架; 在方法上,为保障意义获得,应遵循8个基本问题和12条原则,充分发挥意义源的作用,实现意义获得的双路径统一; 在技术上,灵活采用趋向性(PURE)策略、回避性(ABCDE)策略、以及双视角双通道策略或其它策略的整合。意义疗法因包含了精神成分而超越了心理动力学和个体心理学等传统心理治疗方式。未来研究还需明确意义疗法整合了哪些流派的具体方法和技术,细化意义疗法主要的技术与策略的操作步骤,考察成熟幸福感量表在中国文化下的适用性,以及充分整合质性与量化研究方法检验意义疗法在中国的适用性     

儒家文化与中国人健康心理的交互建构

中国传统文化的主体是儒家文化,文化与健康心理之间存在着相互作用、相互建构的关系。儒家文化与中国人的健康心理的交互建构作用主要表现在三个方面:一是心理问题躯体化,即文化心理与躯体症状的交互建构; 二是心理问题道德化,即文化心理与德行标准的交互建构; 三是心理问题生活化,即健康心理与伦理规范的交互建构。它们既是中国人健康心理与行为的典型表现特征,也是儒家文化与中国人的健康心理和行为交互建构的结果。心理健康、道德健康、伦理健康三者之间是一个相互作用、相互建构、协调发展的完整体系。中国心理健康服务要充分发挥心理健康理论的建构特性和行动特征,促进心理健康服务理论与实践协调发展。     

The insanity defense: Legal standards and clinical assessment

Although the insanity defense is used infrequently, it has received significant attention from legal and mental health professionals. In this article, we review the historical development of insanity defense standards and describe the standards currently employed in the United States. We present a model for evaluating a defendant's mental nonresponsibility, and we briefly discuss the legal standards and procedures for the assessment of insanity acquittees for release. Throughout the article, we discuss some scientific, ethical, and jurisprudential issues associated with the insanity defense and nonresponsibility evaluations.     

Analysis of physical abuse in American schools

This study examined variables included in press reports of excessive infiction of pain on school children over the past ten years. Cross-tabulations were used to examine the relationship between severe corporal punishment with sex of educator, sex of pupil, nature of infraction, severity of punishment, job position of staff member, and age of student. The results indicate that severe corporal punishment is most often administered by males to boys. The frequency steadily increased to 12 or 13 years of age and then decreased. There was no relation between type of misbehavior and severity of punishment. Tentative clinical and educational implications of the study are discussed.     

Socialization and cognition in children between the age of 18 and 24 months

A cross-cultural study of mother–child dyads was set up to test the hypothesis that sociocultural differences, mediated by variations of maternal intervention, influence the way in which the child manipulates objects and, thereby, his cognitive and social competences. Two series of observations were conducted with three groups of children aged 18–24 months (15 from the American middle class, 15 from French families and 15 from North African families—the last two groups both underprivileged): (a) ‘naturalistic’ observations of two systems of interaction (child–mother and child–children interaction) showed that each child is characterized by one type of object manipulation (protected, induced, activated or autonomous) and that maternal intervention varies with the sociocultural background; assessment of the child's behavioural sequences unravelled his strategies for solving and avoiding conflicts with his peers; (b) observations of the child with a standardized material permitted an evaluation of his cognitive competences for spontaneous problem-solving. Regarding the assumptions of our hypothesis, the results furnish the following conclusions: (1) social and cognitive competences are related to the object manipulation type. In all samples, children characterized by ‘activated’ and ‘autonomous’ manipulation obtain the better results; (2) maternal intervention differs among the samples depending on the sociocultural background; these differences (limitation and physical contact) do not correspond to differences in types of manipulation; (3) type of manipulation is an interactive construction; it characterizes the functioning of the mother–child dyad and its prevailing dynamics between permanence and change. ©1997 by John Wiley & Sons, Ltd.     

Historical shifts and underlying themes in ideas about rearing young children in the United States: Where have we been? Where are we going?

Common themes in ideas about rearing infants and young children in the United States can be traced from the nation's beginnings to the present day. These themes include a strong concern about child rearing; a belief that human beings are perfectible through better child rearing; an eagerness by parents to listen to the advice of ‘experts’; a belief that infants and young children should be educated in schools or day-care centers by experts, competing with the belief that infants belong at home with their mothers; a commitment to social reform, competing with the conviction that families should be autonomous. These themes provide a background for contemporary research, political controversy, and future discussion concerning how children should be reared. © 1998 John Wiley & Sons, Ltd.     

Incarnational Christian psychology and psychotherapy: What do we believe and what do we do?

The following paper proposes a viewpoint regarding the working assumptions, theology and practice for an “incarnational” psychology or “Christian psychology,” particularly with regard to psychotherapy. This essay is primarily meant to be an affirmation and guide for those Christian psychologists and others working in the allied professions. However, both veteran theorists and newcomers to such inquiry will benefit from this essay. Discussion begins with the dynamic of surrendering and receiving a personal relationship with Jesus Christ. The understanding of the unique person as soul: in mind, body, life and spirit is discussed. In addition, the working of the incarnate Holy Spirit is elaborated for both therapist and patient in the regenerative and therapeutic process. Psychopathology is reframed in reference to the Judeo-Christian revelation of sin and evil. In addition, truth, falsity and psychopathology are considered in light of the essentially regenerated man/woman or “new creation” in Christ. Some practical examples for psychotherapeutic intervention are offered, including the unique role of the Christian psychologist and his or her relationship with both patient and Christ. Seven major assumptions of “incarnational” or Christian psychology, which diverge from purely secular (psychological) theory and practice, are presented. Lastly, Christian psychology is distinguished from both “integrated” psychology and theology; and Biblical counseling.