It takes two to tango: Research and practice as an amazing dance

This paper offers an appreciative critique of Kim Etherington's recent book, Narrative Approaches to Working with Adult Male Survivors of Male Child Sexual Abuse. I discuss the issues raised in the book with reference to one of my current clients. Etherington does not produce new substantive theory: the power of this work is in the narrative. Her important contribution lies in the reflexivity with which she encounters her material. The use of critical reflexivity challenges the subject/object dichotomy inherent in much positivistic research, and presents a much‐needed approach to process that is congruent with the lived experience of counselling. I would suggest that research is more likely to succeed in informing practice if the material is open to personal interpretation by the reader/therapist. Further, I would claim that the activity of using research creatively is itself a heuristic process: useful learning is most likely to occur if the dialogic relationship with the client and therapist is mirrored in the relationship between the therapist and the research text.     

An Ounce of Prevention: A Model for Working with Couples At-Risk for Battering

Literature on preventing spousal battering before it starts is virtually non-existent. This article describes a prevention of abuse program that targets couples at-risk for battering. At-risk couples and the process of engaging them in couples counseling are described. The prevention model is based on a Bowenian approach that focuses on partner differentiation and reducing emotionality and promoting rational thinking. It is assumed that increasing differentiation decreases the risk of spousal battering. The various techniques used to facilitate differentiation are presented as well as a case example illustrating a successful prevention of abuse experience.     

Desire and the female analyst

The literature on erotic transference and countertransference between female analyst and male patient is reviewed and discussed. It is known that female analysts are less likely than their male colleagues to act out sexually with their patients. It has been claimed that a) male patients do not experience sustained erotic transferences, and b) female analysts do not experience erotic countertransferences with female or male patients. These views are challenged and it is argued that, if there is less sexual acting out by female analysts, it is not because of an absence of eros in the therapeutic relationship. The literature review covers material drawn from psychoanalysis, feminist psychotherapy, Jungian analysis, as well as some sociological and cultural sources. It is organized under the following headings: the gender of the analyst, sexual acting out, erotic transference, maternal and paternal transference, gender and power, counter-transference, incest taboo - mothers and sons and sexual themes in the transference.     

A comparison of the accuracy and reactivity of methods of monitoring male sexual behavior

Two self-report methods of monitoring male sexuality have been compared—an ongoing method in the form of a diary card and one eliciting retrospective reports in the form of a monthly sexuality interview. Male volunteers were assigned at random to three testing conditions: (a) diary card and monthly interview for 3 months (N=29); (b) three monthly interviews (N=18); and (c) pre- and postinterview only, separated by 2 months (N=21). The correspondence among frequency reports, quality ratings, and number of sexual problems as obtained in diary card and interview measures was examined for respondents in the first condition, revealing that coital frequency and quality ratings were generally quite similar in the two modes of assessment. Interview responses for all subjects were examined for the existence of differential reactive effects according to the frequency of the assessment regimen. No differences emerged among conditions, although a trend for all groups over time was identified. Implications of the results are considered for clinical trials monitoring the effects of new contraceptive methods on sexual functioning.This study was supported by the World Health Organization's Special Programme of Research Development and Research Training in Human Reproduction (Project Nos. 76297 and 79003) and was conducted at King's College Hospital, London.     

精子捐赠与伦理

引起男性不育的一个重要原因是无精症、死精症。精子捐赠的出现为这些患者带来了福音,使其享受天伦之乐成为可能,但同时也带来了一系列伦理学、社会学上的问题,包括子代的知情权问题、近亲结婚问题、家庭内部矛盾问题等等。因此要准确认识、运用和完善新的医学技术,并对其进行伦理和法律的规范,防止滥用。     

A Couple-Based Psychological Treatment for Chronic Pain and Relationship Distress

Chronic pain impacts individuals with pain as well as their loved ones. Yet, there has been little attention to the social context in individual psychological treatment approaches to chronic pain management. With this need in mind, we developed a couple-based treatment, “Mindful Living and Relating,” aimed at alleviating pain and suffering by promoting couples’ psychological and relational flexibility skills. Currently, there is no integrative treatment that fully harnesses the power of the couple, treating both the individual with chronic pain and the spouse as two individuals who are each in need of developing greater psychological and relational flexibility to improve their own and their partners’ health. Mindfulness, acceptance, and values-based action exercises were used to promote psychological flexibility. The intervention also targets relational flexibility, which we define as the ability to interact with one’s partner, fully attending to the present moment, and responding empathically in a way that serves one’s own and one’s partner’s values. To this end, the intervention also included exercises aimed at applying psychological flexibility skills to social interactions as well as emotional disclosure and empathic responding exercises to enhance relational flexibility. The case presented demonstrates that healthy coping with pain and stress may be most successful and sustainable when one is involved in a supportive relationship with someone who also practices psychological flexibility skills and when both partners use relational flexibility skills during their interactions.     

Couples' Disease: The Experience of Living with a Partner with Chronic Depression

This study is concerned with the impact of chronic depression on partners. Thirteen male and female participants who lived with a partner with chronic depression were interviewed. Data were analyzed using thematic analysis. Findings highlighted a need for caregivers to be more centrally involved in their partner's care, given that they face stigma, shifts in role identity, and uncertainty, which all potentially threaten the level of support they can give their partner. In this sense, depression might be described as a “couples disease,” suggesting that couples therapy and group support for partners should be more widely available to help reduce the burden on partners and potentially prevent relationship breakdown.     

Participant Perceptions of Relationship Education Programs Adapted for Same-Sex Couples

Mixed methods data were collected from 57 couples who participated in the Strengthening Same Sex Relationships (SSSR) Programs, relationship education programs adapted for same-sex couples. Quantitative and qualitative data yielded key themes, including high program satisfaction, appreciation that the program was designed specifically for same-sex couples, and requests for more detailed content addressing same-sex couples' unique needs. Participants expressed preferences for specialized programs for male or female same-sex couples. Women strongly preferred female sexual minority program leaders; men valued leader competency over match in gender or sexual orientation. Results can inform efforts to provide culturally sensitive relationship education to same-sex couples.     

Another dragon in the kitchen: Psychological experiences of hepatitis C treatment among HIV‐hepatitis C co‐infected gay men

Background: Increasing numbers of HIV‐infected gay men acquire hepatitis C virus (HCV) co‐infection, which causes serious medical consequences. Treatment for HCV is associated with many severe side effects, in some cases psychological, and many patients subsequently fail to adhere, even when psychological services are utilised, to improve treatment adherence. Objective: This qualitative study aimed to explore the experiences of HIV‐infected gay men undergoing treatment for HCV in order to inform psychological services to better meet specific treatment needs of this population. Methods: Thirteen HIV‐infected gay men who had undergone HCV treatment were interviewed and a qualitative analysis was conducted. Participants described HCV and its treatments in the context of their relationships and lifestyles. Findings: Four domains emerged: HCV diagnosis and treatment; HCV treatment education; change in sense of self; and sexual risk‐taking. Adhering to treatment was a significant challenge for all participants and emerged across all domains. Discussion: Psychological services for this population of co‐infected gay men should assist this clinical population not only with adherence to hepatitis C treatment but should also be available at an earlier stage in the process to help patients make informed choices about whether or not to begin a course of treatment. Assessing factors such as coping strategies, treatment readiness and knowledge, self‐awareness, and level of risk‐taking, can guide clinicians in tailoring treatment and adherence planning for HIV/HCV‐co‐infected gay men.