叙事心理治疗的特征及其与中国文化的契合

基于后现代文化理念的叙事心理治疗,其主要特征与中国文化的契合体现在:问题外化的治疗手段顺应中国人的面子心理和辩证的思维方式;关系取向的治疗立场更适合具有关系自我观的中国人;关注差异的治疗模式与中医的个体化治疗模式不谋而合;重视来访者的内在力量可充分发挥中国人善于自律和反思的特长。     

The psychotherapy of parenthood: towards a formulation and valuation of concurrent work with parents

This paper explores the process and value of concurrent work with parents when their child is being treated in individual psychotherapy. The position taken is that psychoanalytic understanding generally and the specific formulations presented in this paper have a broader applicability in other aspects and approaches in child and adolescent mental health practice. The central issues are the interweaving of knowledge of family processes, child development and psychopathology, and the uses that can be made of an understanding of transference and countertransference. A particular formulation is presented in relation to aspects of the work that constitute ‘child guidance’ and those that may be considered as ‘psychotherapeutic’ in relation to parental psychopathology. We have coined the term ‘the psychotherapy of parenthood’ to give this work the status it deserves and to define a boundary within which to explore the areas and levels of this complex work. Some practice and training implications are considered.     

Psychotherapy in the aesthetic attitude

Abstract: Drawing upon the writings of Jungian analyst Joseph Henderson on unconscious attitudes toward culture that patients and analysts may bring to therapy, the author defines the aesthetic attitude as one of the basic ways that cultural experience is instinctively accessed and processed so that it can become part of an individual's self experience. In analytic treatment, the aesthetic attitude emerges as part of what Jung called the transcendent function to create new symbolic possibilities for the growth of consciousness. It can provide creative opportunities for new adaptation where individuation has become stuck in unconscious complexes, both personal and cultural. In contrast to formulations that have compared depth psychotherapy to religious ritual, philosophic discourse, and renewal of socialization, this paper focuses upon the considerations of beauty that make psychotherapy also an art. In psychotherapeutic work, the aesthetic attitude confronts both analyst and patient with the problem of taste, affects how the treatment is shaped and ‘framed’, and can grant a dimension of grace to the analyst's mirroring of the struggles that attend the patient's effort to be a more smoothly functioning human being. The patient may learn to extend the same grace to the analyst's fumbling attempts to be helpful. The author suggests that the aesthetic attitude is thus a help in the resolution of both countertransference and transference en route to psychological healing.     

How do psychological treatments work? Investigating mediators of change

Little is known about how psychological treatments work. Research on treatment-induced mediators of change may be of help in identifying potential causal mechanisms through which they operate. Outcome-focused randomised controlled trials provide an excellent opportunity for such work. However, certain conceptual and practical difficulties arise when studying psychological treatments, most especially deciding how best to conceptualise the treatment concerned and how to accommodate the fact that most psychological treatments are implemented flexibly. In this paper, these difficulties are discussed, and strategies and procedures for overcoming them are described.     

Interpersonally traumatised patients’ view of significant and corrective experiences in the psychotherapeutic relationship

Background: Clinical experience points to the importance of significant experiences in the therapy relationship for patients who have been interpersonally traumatised but the empirical research is limited.

Aim: The aim was to gain increased knowledge about how significant and potentially corrective experiences within the therapeutic relationship were described by patients in trauma-focused therapy and how the participants thought such experiences might have affected the therapeutic work.

Method: Five patients who were, or recently had been, in trauma-focused therapy were interviewed about their experiences of the therapy relationship. Thematic analysis was used to analyse the interviews.

Results: Four themes were identified: ‘Human contact’, ‘Validation’, ‘To face the painful’ and ‘Development of trust’. Positive experiences in the therapeutic relationship were sometimes seen as crucial for the therapeutic work and for patients’ improvement.

Conclusions: Previous findings about the significance of corrective experiences in psychotherapy were confirmed, particularly experiences of the therapist’s accepting stance, personal and human contact and encouragement. The therapist’s ability to evoke trust in the patient and her capacity to help patients to face painful material may be particularly important for traumatised patients.     

Family myth,the symbolic realm and the ancestors

Abstract: This paper¹ takes the shape of a diptych. The first part explores the ancestors as embodied ghosts, internal objects or as mediated through ancestral heritage, as these aspects intertwine in a Möbius strip. The second part looks at ancestral heritage and the different ways in which ‘family myth’ appears in a Jungian context and in Systemic Psychotherapy (family therapy). Both share an interface through the current paradigm shifts towards mutual reflexivity in patient and therapist and a focus on the interpersonal space. The ancestors give substance to the eternal riddle: ‘from whence do we come, who are we and where do we go’, which connects past, present and future. Our ancestors are part of our minds, perhaps in the way Damasio (2010) postulates that ancestral experiences mediated through culture shape our brains. The leitmotiv of individuation through mimesis (sameness) and alterity (difference) runs through both parts.     

The Couple's Mutual Identity and Reflexivity: A Systemic-Constructivist Approach to the Integration of Persons and Systems

This paper presents a systemic-constructivist approach to working therapeutically with couples. Therapeutic change is optimal when both the intrapersonal processes of each individual and their unique interpersonal system are synthesized. This approach targets partners' ways of knowing and experiencing themselves in the context of their relationship. The therapist endeavors to engage the aspect of personal identity which each partner derives through his or her participation in the relationship. Emphasis is placed upon (1) The mutual identity that emerges as a result of the couple's intersubjective, dialectical interplay; (2) each partner's ability to engage as participant–observers within their own relationship; and (3) the ability for the couple to utilize their conjoint reflexive faculty in the service of their own change. Change which arises from this combination of personal motivation and collective agency exhibits a self-generated life of its own predicated upon the couple's own expertise rather than that of an external agent.     

反社会型人格障碍的心理治疗

该文从认知一行为治疗、个别治疗和团体治疗等方面,介绍了反社会型人格障碍心理治疗的研究进展情况,旨在促进国内有关反社会型人格障碍心理治疗的研究。     

Therapist perspectives on using silence in therapy: A qualitative study

Twelve experienced therapists were interviewed about their perceptions of why they used silence in therapy. Qualitative analyses revealed that these therapists typically perceived themselves as using silence to convey empathy, facilitate reflection, challenge the client to take responsibility, facilitate expression of feelings, or take time for themselves to think of what to say. Therapists generally indicated that a sound therapeutic alliance was a prerequisite for using silence, and they typically educated their clients about how they used silence in therapy. Therapists typically believed they did not use silence with clients who were psychotic, highly anxious, or angry. They typically thought they now used silence more flexibly, comfortably, and confidently than when they began doing therapy. Therapists typically believed they learned how to use silence from their own experience as a client and from supervision.     

Standardized Web-Based Cognitive Behavioural Therapy of Mild to Moderate Depression: A Randomized Controlled Trial with a Long-Term Follow-Up

Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its efficacy. The authors assess the efficacy of therapist-guided web-based cognitive behavioural treatment (web-CBT) of mild to moderate depression. Fifty-four individuals with chronic, moderate depression participated in a randomized wait-list controlled trial, with an 18-month follow-up (immediate treatment: n = 36, wait-list control: n = 18). Primary outcome measures were the Beck Depression Inventory (BDI-IA) and the Depression scale of the Symptom Checklist-90-Revised (SCL-90-R. DEP). Secondary outcome measures were the Depression Anxiety Stress Scales and the Well-Being Questionnaire. Five participants (9%) dropped out. Intention-to-treat analyses of covariance revealed that participants in the treatment condition improved significantly more than those in the wait-list control condition (.011 < p < .015). With regard to the primary measures, between-group effects (d) were 0.7 for the BDI-IA and 1.1 for the SCL-90-R DEP. Posttest SCL-90- R DEP scores indicated recovery of 49% of the participants in the treatment group compared with 6% in the control group (odds ratio = 14.5; p < .004). On average, the effects were stable up to 18 months (n = 39), although medication was a strong predictor of relapse. The results demonstrate the efficacy of web-CBT for mild to moderate depression and the importance of therapist guidance in psychological interventions.