Time and again: Intermittent Brief Dynamic Therapy

Abstract

The author notes that in many of the settings in which Brief Therapy takes place that a client may return after the ending for a further series of sessions. Time-limited therapy has placed an emphasis upon the termination phase of the therapy and linked this to the process of individuation and separation. Such an approach, as articulated by Mann (1973 Mann, J. 1973. Time-limited psychotherapy, Cambridge, MA: Harvard University Press.  [Google Scholar]), which draws conceptually from the work of Winnicott (1965 Winnicott, D. W. 1965. The maturational processes and the facilitating environment, London: Hogarth Press.  [Google Scholar]) and the notion that the infant achieves unit status from the original undifferentiated merger with the mother, is not easily compatible with Intermittent Brief Dynamic Therapy. The work of attachment theorists and Stern (1985 Stern, D. N. 1985. The interpersonal world of the infant, New York: Basic Books.  [Google Scholar]) provide an alternative basis upon which to conceive of the development of the infant. While emphasizing the importance of attending to affects at points of separation and ending, as is evidenced in the work of Della Selva (2004 Della, Selva P. C. 2004. Intensive short-term dynamic psychotherapy, London: Karnac.  [Google Scholar]), such a framework is more readily compatible with the development of Intermittent Therapy, and with the realities of the settings in which much brief work takes place. The author also comments upon the flexibility inherent in Winnicott's own practice of brief consultations, and the implications of this for the development of Intermittent Brief Dynamic Therapy. The paper includes a case study that illustrates this debate and which provides evidence for the therapeutic potency of a form of Brief Dynamic Intermittent Therapy where a dynamic focus maintains a structuring pattern to the narrative over a sequence of several periods of Brief Therapy, spread over a number of years.     

Mathematics and Theology: A Stroll through the Garden of Mathaphors

Mathematics has long been considered the language of science and has even been acknowledged as the universal language of the future. Yet mathematics also plays a less-recognized religious role in that metaphors drawn from mathematics (mathaphors) can influence our spiritual perspectives by helping us to entertain new religious ideas and to challenge old ones. Mathaphors are therefore useful tools in matheology (the study of mathematics and theology). This essay explores ten ways in which contemporary mathaphors affect our spiritual lives. Specifically, mathaphors are: changing our metaphors for God; challenging our human role in the universe; helping us accept ambiguity; revamping our understanding of the one and the many; revising our thoughts about free will and determinism; moving us toward pluralistic, multi-world views; pushing the envelope on what consciousness is; altering our expectations for afterlife; offering the hope of a more compassionate future; encouraging faith perspectives that are always incomplete and in process.     

Unpredictable yet Guided: Arendt on Principled Action

Political action is unpredictable because it unfolds among a plurality of independent actors. This unpredictability generates a fundamental puzzle: If an actor cannot know where her initiative will lead, what motivates and guides her in her doings? The aim of this paper is to develop and defend the solution to the puzzle that we can find in the thought of Hannah Arendt, namely the idea that political action is – or should be – motivated and guided by principles, principles like justice, equality, or honour. Such principles must be distinguished from goals because they do not designate a specific state of affairs, but are general ideas that allow for diverse implementations. I show that this distinction is of great practical importance for the actors involved, since their outlook and their attitude towards others will differ depending on whether they see their activity as aimed at a goal or as guided by a principle.     

Studies of Abnormal Behavior in the Rat: XVII. Guidance Versus Trial and Error in the Alteration of Habits and Fixations

Formation of a God concept, in accordance with the developmental hypothesis of object relations theory, includes the utilization of representations acquired within the context of significant relationships. Previous researchers have attempted to determine the comparative extent to which parent representations give rise to an individual's God image. In this study, we measured the similarities between subjects' composite parental ratings and their image of God. As predicted, the parental composite was significantly closer to the God rating than were the singular parent representations.     

EXAMINING A MODEL OF EVOLUTIONARY EDUCATIONAL SYSTEMIC CHANGE WITHIN EXISTING SOCIETAL SYSTEMS

Within today's emerging global society, educational systemic change is a dynamic, complex process that must seek to engage active participation of all stakeholders. This article examines alternative models of this process, providing different perspectives of the recursive and comprehensive nature of change when viewed from the vantage points of those stakeholders within the process. An envisioned school or educational system that addresses preparation of a citizenry dedicated to democratic principles and issues of social justice must consciously examine the relationships, that form and reform interconnecting and unifying diverse subsystems within the school's constructed meaning and purpose.     

Establishing ethics in an organization by using principles

Laws, codes, and rules are essential for any community, public or private, to operate in an orderly and productive fashion. Without laws and codes, anarchy and chaos abound and the purpose and role of the organization is lost. However, danger is significant, and damage serious and far-reaching when individuals or organizations become so focused on rules, laws, and specifications that basic principles are ignored. This paper discusses the purpose of laws, rules, and codes, to help understand basic principles. With such an understanding an increase in the level of ethical and moral behavior can be obtained without imposing detailed rules. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Ability to take an out-group's perspective in explaining positive and negative behaviors

A total of 251 Latvian and Russian schoolteachers explained positive and negative behaviours from their own perspective and from the perspective of an ethnic out-group. The results were in line with the attributional pattern usually found in studies using Hewstone's direct perspective of judgement, when participants are asked to take the perspective of an ethnic out-group. That is, there was an outcome effect in causal attributions for in-group actors and a categorization effect for negative behaviour from the imagined (out-group's) perspective. The attributions from the direct perspective only partly replicated the commonly found pattern. The results support Montgomery's perspective theory.     

Response to commentary on the multimodal treatment study of ADHD (MTA): mining the meaning of the MTA

In the December 2000 issue of the Journal of Abnormal Child Psychology, we published a set of papers presenting secondary analyses of the Multimodal Treatment Study of ADHD (MTA), and R. A. Barkley (2000) provided a commentary. A critique of the design of the study (MTA Cooperative Group, 1999) was presented based on a theoretical perspective of a behavioral inhibition deficit that has been hypothesized as the core deficit of ADHD (R. A. Barkley, 1997). The commentary questioned the design and analysis of the MTA in terms of (1) the empirical criteria for selection of components of behavioral (Beh) intervention, (2) the effectiveness of the Beh intervention, (3) the methods for analyses at the group and individual level, (4) implications of the MTA findings for clinical practice, (5) the role of genetics in response to treatment, and (6) the lack of a nontreatment control group. In this response, we relate the content of the papers to the commentary, (1) by reviewing the selection criteria for the Beh treatment, as outlined by K. C. Wells, W. E. Pelham, et al. (2000), (2) by addressing the myth that the MTA Beh treatment was ineffective (Pelham, 1999), (3) by describing the use of analyses at the level of the individual participant, as presented by J. S. March et al. (2000) and W. E. Pelham et al. (2000) as well as elsewhere by J. M. Swanson et al. (2001) and C. K. Conners et al. (2001), (4) by relating some of the suggestions from the secondary analyses about clinically relevant factors such as comorbidity (as presented by J. S. March et al., 2000) and family and parental characteristics (as presented by B. Hoza et al., 2000, S. P. Hinshaw et al., 2000, and K. C. Wells, J. N. Epstein, et al., 2000), (5) by discussing the statistical concept of heritability and the lack of a significant difference in the presence of ADHD symptoms in parents of the MTA families compared to parents in the classmate-control families (as presented by J. N. Epstein, et al., 2000), and (6) by acknowledging that an ethically necessary weakness of the MTA design is that it did not include a no-treatment control group. We discuss the use of secondary analyses to suggest how, when, and for what subgroups effectiveness of the Beh treatment may have been manifested. Finally, we invite others to use the large and rich data set that will soon be available in the public domain, to perform secondary analyses to mine the meaning of the MTA and to evaluate theories of ADHD and response to treatments.