Bridging the Divide

Abstract

Women who consider themselves traditional or conservative in the context of religious practice often experience tremendous conflicts regarding the integration of same-sex emotional and sexual feelings with their religion and spirituality. Current religious teachings about homosexuality make this combination difficult as only heterosexual sexuality within marriage is permitted in most orthodox faiths. Further, the way that spirituality and sexuality are conceptualized as opposing dichotomous categories (e.g., body vs. soul) presents women with a framework where integration does not seem possible. Observant women who come to psychotherapy often experience tremendous distress, guilt, depression, and even suicidality due to the conflict between their sexual feelings and religious doctrine. Relieving the distress, and resolving the conflicts while honoring the emotional complexity of sexual feelings, spirituality, and religious orthodoxy can present tremendous dilemmas for the practitioner as well as the client. Using the example of psychotherapy of an Orthodox Jewish woman who integrated same-sex desire into her life, this article describes psychotherapy process and alternative ways of viewing spirituality and sexuality that permit possible resolutions for clients.     

Counseling and Guided Self‐Help Outcomes for Clients With Bulimia Nervosa: A Meta‐Analysis of Clinical Trials From 1980 to 2010

This meta‐analysis included 111 clinical trials exploring the effectiveness of counseling/psychotherapy and guided self‐help approaches in the treatment of bulimia nervosa. In general, single‐group studies supported higher efficacy of counseling/psychotherapy, whereas wait‐list, treatment‐as‐usual, and placebo studies indicated both approaches were equally effective at termination (posttest) and follow‐up in altering binging, purging, laxative use, and self‐reported bulimia or body dissatisfaction perceptions in nearly all comparisons.     

The relationship of clients’ social class to early therapeutic impressions

Using case vignettes that differed in the presentation of the client's social class, the influence of social class on therapeutic impressions was studied in the context of just-world beliefs. Results suggested that (1) participants with higher levels of belief in a just world saw poor and working-class clients as more unpleasant to work with and more dysfunctional and (2) working-class vignettes were associated with the lowest predictions of session depth and smoothness. The findings suggest that counselors may respond differently to clients based on their social class, and in a way that negatively predisposes them toward work with poor and working-class clients.     

Inside and outside the window: some fundamental elements in the theory of psychoanalytic technique

The underlying concern of this paper is that psychoanalysis as practised today is in danger of losing its specificity and so losing its way. The author suggests this is possible for three reasons: the problem analysts face in responding to the strong emotional demands the great majority of patients necessarily place on them, the unintended consequences of the apparent success of 'here and now technique' and the absence of good clinical theory. The paper mainly discusses the author's ideas about some core elements of the clinical theory that all psychoanalysts must use when they are working and proposes (at the risk of being facile) some relatively simple heuristics related to them which are meant to be helpful. Recalling Kurt Lewin's maxim that 'there is nothing so practical as a good theory', he will suggest that continuous reflection on how one is using theory in daily practice is highly practical, if the theory is good enough. Theory in fact is a necessary 'third' in psychoanalytic practice which, if kept in sufficient working order close enough to clinical experience, provides an ongoing and very necessary check on our sense of reality. But, of course, as a third it can, like reality itself, be the focus of both love and hate with equally problematic consequences. The paper starts with a clinical example of a difficult but apparently successful analysis reaching its end, which will be used throughout the paper to illustrate and elaborate the theoretical ideas set out.     

A Jungian approach to dreams reported by soldiers in a modern combat zone

Treating combat deployed soldiers is becoming more prevalent and needed in psychiatry. Modern combat produces unique psychological challenges, including those without criteria for post-traumatic stress disorder (PTSD). This article will attempt to share the primary author's experience with psychotherapy in a combat zone, along with understanding the general themes of dreams the author encountered while being deployed. Toward that end, the primary author [RW] discusses his personal experiences in Iraq working with soldiers whom he saw and treated while in theatre, with a particular focus on the dreams they reported. The co-authors [EG and MI] afterward collaborated with the primary author to formulate and provide insight into the dreams from a Jungian perspective.     

Temperament and sleep–wake behaviour from infancy to toddlerhood

Sleep–wake behaviours and temperament were examined longitudinally for trait stability and relationship to behavioural state regulation from infancy to early childhood. Subjects were 120 low‐risk, full‐term infants from a middle class sample. At 6 weeks, parents completed three consecutive days of the Baby's Day Diary which measures sleep, wake, fuss, feed and cry states and the Infant Characteristics Questionnaire. At 16 months, parents assessed sleep behaviours with the Sleep Habits Inventory and temperament with the Toddler Symptom Checklist. At 24 months, parents repeated 3 days of the Baby's Day Diary. Structural Equation Modelling was used to examine the cross‐age hypotheses for sleep–wake and temperament associations. From early infancy to toddlerhood, sleep–wake behaviours and irritable temperament were notably stable but independent in this cohort. Copyright © 2011 John Wiley & Sons, Ltd.     

矛盾分析法在心血管疾病心理治疗中的应用

随着我国人口老龄化趋势的加快,心血管疾病患病率、病死率不断上升,并往往伴随异常的心理状态,在传统治疗基础上辅以心理干预,将会改善患者的生活质量和预后。矛盾分析法是运用对立统一规律,观察、分析社会现象,应贯穿于心血管疾病心理治疗的全部过程。     

一种认知分析心理治疗模式对抑郁症患者的干预

为了探索基于"自我"与感受、需要、能力和角色交互相整合的认知分析心理治疗模式及其在抑郁症患者治疗中的效果,对7例门诊和8例住院抑郁症患者进行心理治疗,采用HAMD和CGI-GI评估治疗的效果,并追踪治疗1年后患者的社会功能及健康状况。所有患者治疗前后HAMD分值差异显著,配对t=8.08(P0.01),门诊与住院治疗患者HAMD分值和CGI-GI分值均无明显差异(P0.05),但产生治疗有效的平均时间差异显著,住院者(11.6±3.6)天,门诊者(60.6±25.0)天(P0.01)。该心理治疗模型能够整合到抑郁症患者的药物治疗中,产生整体治疗效果。