Prenatal depression effects and interventions: A review

This review covers research on the negative effects of prenatal depression and cortisol on fetal growth, prematurity and low birthweight. Although prenatal depression and cortisol were typically measured at around 20 weeks gestation, other research suggests the stability of depression and cortisol levels across pregnancy. Women with Dysthymia as compared to Major Depression Disorder had higher cortisol levels, and their newborns had lower gestational age and birthweight. The cortisol effects in these studies were unfortunately confounded by low serotonin and low dopamine levels which in themselves could contribute to non-optimal pregnancy outcomes. The negative effects of depression and cortisol were also potentially confounded by comorbid anxiety, by demographic factors including younger age, less education and lower SES of the mothers and by the absence of a partner or a partner who was unhappy about the pregnancy or a partner who was depressed. Substance use (especially caffeine use) was still another risk factor. All of these problems including prenatal depression, elevated cortisol, prematurity and low birthweight and even postpartum depression have been reduced by prenatal massage therapy provided by the women's partners. Massage therapy combined with group interpersonal psychotherapy was also effective for reducing depression and cortisol levels. Several limitations of these studies were noted and suggestions for future research included exploring other predictor variables like progesterone/estriol ratios, immune factors and genetic determinants. Further research is needed both on the potential use of cortisol as a screening measure and the use of other therapies that might reduce prenatal depression and cortisol in the women and prematurity and low birthweight in their infants.     

Self‐supervision,surveillance and transgression

Transgression is not only an inevitable part of systemic supervision but is also necessary if we are to work towards innovative and inclusive supervisory and therapeutic practice. Defying culturally generated ‘rules’ of systemic practice can allow for more relevant and productive ways of talking. Systemic practitioners are increasingly finding themselves trying to practice systemic therapy in employing authorities and training courses which are dominated by inflexible professional narratives and manualised procedures. Our profession is committed to ethical inner and outer dialogue, to self‐ and relational reflexivity as distinct from the rule‐bound surveillance culture in which we live and work. Systemic supervisors and therapists may find themselves at odds with monological institutional discourse and attempts from within our own profession to manualise practice. I introduce examples from supervisory conversations to illustrate how supervisors can develop more culturally sensitive practices through supporting practitioners to hear and have heard their own marginalised and oppressed voices and those of their clients.     

"THEISTIC PSYCHOLOGY AND PSYCHOTHERAPY": A THEOLOGICAL AND SCIENTIFIC CRITIQUE

I take the APA publication A Spiritual Strategy for Counseling and Psychotherapy (Richards and Bergin 2005), along with a devoted issue of Journal of Psychology and Theology (Nelson and Slife 2006), as a paradigmatic example of a trend. Other instances include the uncritical use of "Eastern" philosophy in Humanistic and Transpersonal Psychology, almost normative appeal to the "Sacred" within the psychology of spirituality, talk of "God in the brain" within neurological research, the neologism entheogen referring to psychedelic drugs, and calls for new specializations such as neurotheology and theobiology. In response to the legitimate ethical requirements of respect and openness regarding clients' religious worldviews, the trend is to make God an essential component in psychological theory. The argument is that God is active in the universe and especially in human affairs to such an extent that any accurate account of strictly psychological matters, not just a comprehensive, interdisciplinary purview that could include a distinct theological dimension, must include God as an explanatory factor. Less nuanced than standard theological thought about divine intervention—including a range of opinions from supernaturalism, to occasionalism, to providential and deistic naturalism—this trend would blur the epistemological differences between religion and science by appeal to claimed knowledge sources such as inspiration and revelation and thus undermine the achievements of evidence-based science and establish particularistic religious beliefs as standard explanatory accounts. The concern to include a spiritual, in contrast to a religious or theist, dimension in psychological theory is welcome; but elaborated approaches, such as my own and those of Roberto Assagioli, Viktor Frankl, and Ken Wilber, open to varied theological applications, already exist.     

重视终末期肾病患者的心理治疗

心理治疗在终末期肾病(ESRD)治疗中的作用非常重要,不但可缓解患者的心理压力,还可改善患者的生理障碍、减少并发症,因此重视对ESRD患者的心理治疗,可使患者保持良好的生理、心理状态,并能提高患者的生活质量,改善预后。     

当事人对领悟的看法：质化分析

为了从当事人的视角理解领悟, 采用协商一致的质化研究方法对15位当事人的访谈结果进行分析。结果发现7个与领悟有关的域：领悟的内容, 领悟的效果, 影响领悟产生的因素, 评估领悟质量的依据, 领悟出现时的反应, 领悟的来源和阻碍领悟发挥作用的因素。形成了领悟的概念界定：领悟是对自己和他人(主要是自己)的新认识, 对自己的认识内容包括, 自己的问题模式, 心理困扰或问题模式的原因、影响和解决办法, 以及自己内在的心理状态。     

Leadership and regressive group processes: A pilot study

Various perspectives on leadership within the psychoanalytic, organizational and socio‐biological literature are reviewed, with particular attention to research studies in these areas. Hypotheses are offered about what makes an effective leader: her ability to structure tasks well in order to avoid destructive regressions, to make constructive use of the omnipresent regressive energies in group life, and to redirect regressions when they occur. Systematic qualitative observations of three videotaped sessions each from N = 18 medical staff work groups at an urban medical center are discussed, as is the utility of a scale, the Leadership and Group Regressions Scale (LGRS), that attempts to operationalize the hypotheses. Analyzing the tapes qualitatively, it was noteworthy that at times (in N = 6 groups), the nominal leader of the group did not prove to be the actual, working leader. Quantitatively, a significant correlation was seen between leaders’ LGRS scores and the group’s satisfactory completion of their quantitative goals (p = 0.007) and ability to sustain the goals (p = 0.04), when the score of the person who met criteria for group leadership was used.     

Subjective education in analytic training: drawing on values from the art academy

Abstract: Kernberg and others have observed that psychoanalytic education has tended to promote the acquisition of theoretical knowledge and clinical technique within an atmosphere of indoctrination rather than of exploration. As a corrective, he proposed four models that correspond to values in psychoanalytic education: the art academy, the technical trade school, the religious seminary and the university. He commended models of the university and art academy to our collective attention because of their combined effectiveness in providing for the objective and subjective education of candidates: the university model for its capacity to provide a critical sense of a wide range of theories in an atmosphere tolerating debate and difference, and the art academy model for its capacity to facilitate the expression of individual creativity. In this paper, I will explore the art academy model for correspondences between artistic and analytic trainings that can enhance the development of the creative subjectivity of psychoanalytic candidates. I will draw additional correspondences between analytic and artistic learning that can enhance psychoanalytic education.     

Succeeding at succession: the myth of Orestes

Abstract: Although the myth of Oedipus seems an inevitable template for understanding succession in psychoanalysis, the myth of Orestes offers a more complex and promising view of the intergenerational transfer of leadership and authority, one that takes into account the entire community, not merely the individual leader. A closer look at the Aeschylus drama suggests three dimensions that need to be taken into account in managing succession: what are the mechanisms enabling the community to participate, what is the role of the unconscious irrational forces inevitably aroused in the process, and what are the wider social and economic issues that need to be addressed? This paper looks at the myth elaborated in the Greek drama, and then applies it to some of the current problems facing contemporary psychoanalytic institutions.     

Culture-sensitive functional analytic psychotherapy

Functional analytic psychotherapy (FAP) is defined as behavior-analytically conceptualized talk therapy. In contrast to the technique-oriented educational format of cognitive behavior therapy and the use of structural mediational models, FAP depends on the functional analysis of the moment-to-moment stream of interactions between client and therapist. This distinctive feature makes FAP particularly sensitive to the challenges posed by cultural differences between client and therapist. Core elements of FAP philosophy are invoked to argue that this vulnerability paradoxically implies an increased ability to capture and use relevant issues in the therapy process with culturally different clients. This argument focuses FAP's preference for concrete behavior over theoretical modeling, its emphasis on functional principles rather than topographically defined techniques, and its inclusion of the therapist's behavior in the assessment of clients' clinically relevant behavior. Suggestions are given concerning how academic and practical training and personal experience may be used to foster sound multicultural practice.