So many lifetimes locked inside: reflecting on the use of music and songs to enhance learning through emotional and social connection in Trainee Clinical Psychologists

Music is universal; it can provide a common language that speaks from the heart enabling others to connect with the private felt experiences of others regardless of differences within or between people. This ability to empathise with, and understand, the position of others from differing backgrounds is an important competency within the therapeutic work of Clinical Psychologists. There are many facets to diversity just as there are many facets to music. Diversity in music genres can reflect diversity in people. Indeed, there is music to cater for all tastes, cultural/ethnic backgrounds, gender, age and generations with listening often being guided by individual preferences. In the United Kingdom training to become a Clinical Psychologist consists of a university-based 3-year full time professional research doctorate funded through the National Health Service. Trainees work on placements 3 days a week and attend university for academic and research teaching 2 days a week. As part of the academic programme, Trainees undertake experiential learning through workshops and methods such as Problem-Based Learning (PBL). One of the PBL exercises is based on a typical referral within an Adult Mental Health (AMH) service. For the AMH PBL exercise music is used to enhance trainees’ ability to connect emotionally with the personhood of referrals, consider associated complexities, and to reflect on personal and professional boundaries and reflective practice during training and beyond. This paper reflects on the utility of music and songs to enhance the learning experience.     

Toward Holistic,Compassionate, Professional Care: Using a Cultural Lens to Examine the Practice of Contemporary Psychotherapy in the West*

The author describes work undertaken in New Delhi with two young Indian women and their families from 1995 to 1999. Both presented with depression and suicidal ideation. One was severely cerebral palsied, the other was diagnosed with endogenous depression. As an integrative therapist, the author looks at her work from several perspectives. The debates highlighted here focus on the optimal usefulness of each of these perspectives in different situations, both the benefits and the limits and the very limits of contemporary psychotherapy itself. The author uses a cultural lens to explore the use of the self of the therapist and issues around boundaries, continuity, ethics, and compassion in psychotherapy.*Part of this work has been published in N. Hutnik (1999). An unusual intervention: Disability and abuse. Psychological Foundations - The Journa1, 1, 81–84, and is reproduced here with the permission of Psychological Foundations, New Delhi.**My heartfelt thanks are offered to Reenee Singh, friend of many years and very competent family therapist, who offered me her comments on an earlier draft of this paper.     

Shadowed reality or the 'Prometheus-complex': analytical psychotherapy after political imprisonment and persecution

Traumatic experiences of violence like those that were brought about by the communist regime of the former German Democratic Republic (GDR) are still present as if they happened yesterday, causing severe disadvantages in everyday life even after all those years. Consequently, in cases of extreme traumatization induced by political imprisonment, persecution and applied psychological methods of disintegration, regressive processes take place which corrode the ego. The breakdown of cathexis, i.e., the failure of empathic connection at the time of the trauma, is the strongest characteristic of severe traumatization. As a result of this destruction for the traumatized there is an inability to keep upright an inner empathic, emotional connection. As we try to grasp, from a Jungian point of view, the psychodynamics of severe traumatization, we can speak of a powerful pathogenous complex, which I call the 'Prometheus-complex'. Gustav Bovensiepen speaks of this complex as a sub-network, a limited fragment of the matrix of all internalized experiences, consisting of internal working models, feelings and patterns of anticipation which interact mutually. The human being, captured in such isolation and paralysis of the mind, can find himself 'in the therapist' on a mental level.     

Mission,Reconciliation, and the Politics of Place

Through the retelling of some familiar biblical stories – Jonah, Acts 1, Acts 10 – and gospel narratives of inclusion, this paper looks at the transformation of politics and identities made possible by the sending of the Holy Spirit and the mission of reconciliation to which Christians are called. Through an examination of the themes of power, prejudice, partnership, and identity, the paper aims to offer a concrete approach to rethinking the spaces and places where a reconciling mission can be enacted. Central to an understanding of reconciliation are the disruption and transgressing of boundaries in which Jesus engaged. In addition to this, Jesus creates these unique spaces for reconciliation around his very person, and the Spirit leads the church into these same contexts. Finally, selections of John 17 are examined through a biographical lens in order to offer a new understanding of the politics of identity and the surprising contexts where God’s Spirit reconciles all things in Christ.     

Relationships,not boundaries

The authors find it more useful to payattention to relationships than to boundaries.By focusing attention on bounded, individualpsychological issues, the metaphor ofboundaries can distract helping professionalsfrom thinking about inequities of power. Itoversimplifies a complex issue, inviting us toignore discourses around gender, race, class,culture, and the like that support injustice,abuse, and exploitation. Making boundaries acentral metaphor for ethical practice can keepus from critically examining the effects ofdistance, withdrawal, and non-participation.The authors describe how it is possible toexamine the practical, moral, and ethicaleffects of our participation in relationshipsby focusing on just relationships rather thanon boundaries. They give illustrations andclinical examples of relationally-focusedethical practices that derive from a narrativeapproach to therapy.     

Traversing boundaries: clinical ethics,moral experience,and the withdrawal of life supports

While many have suggested that to withdraw medical interventions is ethically equivalent to withholding them, the moral complexity of actually withdrawing life supportive interventions from a patient cannot be ignored. Utilizing interplay between expository and narrative styles, and drawing upon our experiences with patients, families, nurses, and physicians when life supports have been withdrawn, we explore the changeable character of boundaries in end-of-life situations. We consider ways in which boundaries imply differences – for example, between cognition and performance – and how the encounter with boundaries can generate altered meanings important for understanding decisions and actions in these contexts. We conclude that the reliance on mere roles to support the moral weight of withdrawing medical interventions is inadequate. Roles that lead us to such moments are exceeded by the responsibility encountered in such moments. And here, we suggest, is the momentous character of withdrawal: it presents the grave astonishment, the trembling awe, in the not-being-there of the other in death.     

Boundaries in the doctor-patient relationship

Boundaries in the doctor–patient relationshipis an important concept to help healthprofessionals navigate the complex andsometimes difficult experience between patientand doctor where intimacy and power must bebalanced in the direction of benefitingpatients. This paper reviews the concept ofboundary violations and boundary crossings inthe doctor–patient relationship, cautions aboutcertain kinds of boundary dilemmas involvingdual relationships, gift giving practices,physical contact with patients, andself-disclosure. The paper closes with somerecommendations for preventing boundaryviolations.     

心理体验及其对象类型--试论迈农的意向性理论

意向性作为现代哲学的核心概念之一,在迈农这里有着与在胡塞尔那里同样重要的决定意义。迈农在布伦塔诺意向性理论的基础上,通过对心理体验及其各自所对应的对象类型的这一深入探讨,不仅将对象概念发展到了极致,而且为价值的存在争取了一个独立的领域,从而也使得价值的意向性构建成为可能。因此,迈农的意向性理论不仅是对象理论意义上的深化,更是价值维度上的深化。     

Codependence and Interdependence: Cross-Cultural Reappraisal of Boundaries and Relationality

This article explores the cross-cultural implications of the Western notion of boundaries and the Asian matrix of relationality for pastoral care ministry. Theorists of codependence (relationship addiction) show that American awareness of boundaries produces phobic attitudes toward the interwoven interplay of human relationships. Noting the underlying American cultural ideal (i.e., individual autonomy), evidences that boundaries are culturally defined are reviewed. Drawing upon the social-psychological concept of interdependence (Asian construal of self), the author proposes that there is a need for a different understanding of boundaries, since some Asian people have strikingly different construals of the self, of others, and of the interdependence of the two. Boundaries and relationality need to be in dialogue with each other so as to create relational boundaries that empower mutual relations within which we may come to experience the power of the relational, triune God.     

The Use of Communication Technology in Private Practice: Ethical Implications and Boundary Dilemmas in Therapy

This study investigates the use of communication technology (CT) by therapists in private practice. CT has exploded in the last decade and therapists have begun to implement this technology in their work. It is important to understand better the types of technology therapists are using and how they decide which devices are most useful for clinical practice. Additionally, the availability of the therapist has long been debated and CT provides media to make therapists readily available. Results show that therapists have boundary concerns and ethical dilemmas regarding CT and often feel unprepared to handle inappropriate out-of-session contacts when they occur.