Analytic Group Psychotherapy: A Uniquely Effective Crisis Intervention

This paper describes the author's experience doing crisis intervention with survivors of the 9/11 attack on the World Trade Center in New York City. It focuses on enhancing the understanding of and potentially expanding the theory and technique of analytic group therapy as applied to this unique situation.Private practice in     

Practicing Rational Emotive Behavior Therapy and Religious Clients

REBT is a process of: (1) identifying dysfunctional emotions and behaviors which inhibit more effective pursuit of what clients experience as their deepest and most abiding desires; (2) relating these dysfunctions to irrational beliefs; (3) inducing clients to reduce the controlling role played by these beliefs in their lives and (4) adopting more self-helping beliefs and practices related to their goals thus reducing their dysfunctional emotions and behaviors and increasing their joyful living. This article discusses how this can be done from within an individual's supernatural belief system, whether that system is theistic or nontheistic.     

Can men talk about problems with weight? The therapeutic implications of a discourse analytic study

This paper discusses the implications for counsellors of a discourse analytic study examining men's talk about body weight. It is argued that research in the area of problems with body has neglected the growing pressures on men to manage body as a feature of self. This research perpetuates the dominant discursive construction of men's relationship to body as unproblematic — a construction that may present many barriers to men in seeking help for any distress encountered. An analysis of men's talk is discussed in terms of the expectation that body is not problematic and the observable downplaying of any concerns acknowledged. The accountability of body as a site of regulation also emerges within the extracts presented. It is argued that this property within the accounts resonates with work highlighting the growing pressures on men to exercise control over body. The contradictions between the two discourses identified are discussed in terms of their therapeutic implications. It is postulated that male distress emerging from the growing pressures to maintain body weight may be neglected within primary care and therapeutic domains if discourses formulating such difficulties as not relevant to men remain dominant.     

On the logic of psychoanalytic theory

Psychoanalytic theory shows some specific features and problems. It exists in a number of variations, according to different schools as well as cultural and subcultural conditions, with different understandings even of core concepts. Instead of producing definite knowledge, results remain uncertain. They vary in use and imply a permanent reworking of ideas and conceptions. This is the effect of the kind of theory psychoanalysis has to use. Since psychodynamics are a special kind of heterogeneous, changing, always different, emergent-in a word, autopoietic-reality, psychoanalysis cannot use the methods of a denotative theory (algorithmic reduction leading to strictly defined and formulated calculations) but has to use connotative theories. Connotative theories use open concepts which provide an active and flexible access to autopoietic reality. They are able to cope with the difference between singularities as well as with the distance between general logic and empirical reality. Problems tied to this possibility are structural fuzziness, a dependence on forms of use, multiple paradigms and difficulties in legitimation and balance of theories. This causes problems of institutionalisation. These problems are not a sign of immaturity but the normal way in which connotative theories appear and develop. They can therefore not be eliminated but only be treated in a better way.     

A Buddhist contribution to the psychoanalytic psychology of self

The author attempts to integrate the concepts of self used in psychoanalytic theory with the understanding of the nature of self as explained within the Buddhist meditative tradition. He divides different concepts of self in psychoanalytic theory into three major levels of consciousness and abstraction: self as experience, representational self and self as system. The representational level is defined as consisting of unconscious organizing structures of interaction: the system level is a hierarchically higher organization of representations, while the experiential level consists of the moment-to-moment flow of consciousness. He argues that for the sake of theoretical clarity these levels should be differentiated in discussions of self. He then describes the Buddhist psychology of self and tries to show how this perspective can enrich psychoanalytic understanding of the experiential self and of narcissism, which in Buddhist language would be described as clinging to (seeking or avoiding) images of self that arise in the mind. Last, he describes a model of therapeutic development using different levels of self and the interrelationship between them, showing how psychoanalytic psychotherapy and Buddhist insight meditation emphasize different levels of self using complementary rather than mutually exclusive methods.     

The capacity to be an analyst: A contribution from attachment research to the study of candidate selection

In this paper the author discusses how the study of candidate selection, once a topic of vibrant research, has unfortunately languished. Certain qualities were thought to characterize the successful candidate. However, they were never successfully operationalized nor empirically tested. Possibly because of this lack of empirical data, selectors today have difficulty articulating their criteria and are relying on intuition. In order to provide a more rational basis for contemporary selection, the author looks to the attachment literature. This makes sense because attachment theory shares some basic assumptions of contemporary psychoanalysis. The Adult Attachment Interview (AAI) is a research tool that predicts the ability of a parent to convey attachment security. It is scored by attending to how a person speaks about his early attachment experiences. The AAI appears to tap into similar qualities to those selection researchers have sought in their candidates. Further, the scoring method of the AAI appears to be similar to the last attempt by selection researchers to operationalize them. Given these similarities, the author recommends an empirical study using the AAI to operationalize these qualities in analytic candidates. The study would test their importance for success in the training program, thus offering selectors some empirical grounding for their choices.     

Personality Disorder Attributes as Supplemental Goals for Change in Interpersonal Psychotherapy

Interpersonal Psychotherapy (IPT) is a manualized, short-term (usually 12–16 sessions) based on the assumption that psychological disorders often emerge secondary to social and interpersonal problems that require active intervention to achieve symptom remission. The time-limited nature of IPT compels therapists to establish the goal of diminishing, on a weekly basis, a small number of focused interpersonal problems with a decided emphasis on proximal rather than historic conflicts and associated patterns of behavior. This strategy discourages the adoption of diffuse therapy goals and directions that have more opportunity to emerge in long-term, unstructured treatment modalities. The role of traditional personality testing in short-term therapy, when it occurs, is to identify and quantify symptom clusters that warrant attention as dependent measures in the treatment process. The role of personality factors in the genesis or maintenance of psychological disturbance is rarely addressed. The present article explores theoretical and pragmatic objections to the use of personality testing in IPT. A method is proposed for the limited but systematic incorporation of personality testing in the IPT treatment process using the Millon Clinical Multiaxial Inventory (MCMI-III). While unreasonable to expect personality transformation through short-term therapy, the partial attenuation of maladaptive behavioral, attitudinal, and emotional reactions to stressors could prove exceedingly helpful to short-term treatments such as IPT.     

Ethical Considerations for Therapists Working With Demographically Similar Clients

The increasing emphasis on multicultural competence within psychotherapy continues to highlight the need for being sensitive to key differences between therapist and client. However, this attunement to the psychotherapeutic impact of therapist–client differences may obscure the equally critical need to evaluate ethical problems associated with therapist–client similarities. It will be argued that therapists treating clients who are demographically similar to themselves encounter a unique set of ethical challenges that warrant careful consideration and caution precisely because of therapist–client matching. The extant research on matching therapists and clients based on demographic similarities is discussed, with a particular emphasis on psychotherapeutic outcomes and client preferences. Attention then turns to the nonrational heuristics and biases that can often cloud therapists’ ethical decision making regarding the appropriate uses versus contraindications for demographically matching therapists and clients. Within the discussion of nonrational heuristics and biases, suggestions are offered for managing related challenges for ethical decision making.