Facilitating Individuation Processes in Supervision Groups Comprised of Co-Therapists Conducting Group Therapy with Bereaved Parents

Helping Israeli bereaved parents work through losses and anger poses great emotional challenges for group therapists. Separation-individuation becomes an issue for both mourners and conductors alike. Supervision groups composed of such co-therapists often go through unique stages in the course of their development. The conflict between a defensive belonging to a dyadic subgroup with their co-therapist on the one hand, and involvement with the supervision group and its leader on the other, are the main reasons for this uniqueness. In these stages, special difficulties in the co-therapist's separation/individuation may be observed and furthered. An important emotional function we call reverse parallel process can be activated in supervision groups, and can eventually influence the therapy. It is achieved in the supervision through the containment and working through of difficult emotions disowned by the therapy group. What seemed to be an obstacle to the group's development, if processed by the co-therapists, can enable patients to work through their difficulties and improve their functioning. If, on the other hand, the co-therapists' separation/individuation development is faulty, containment dysfunction may burden the receptiveness and working through of dreadful projections, and result in massive acting-out. The rich Israeli experience in this field could contribute to cope with similar group situations.     

What Are Some Promising Developments in Psychotherapy with “Psychosis”? Introduction and Preview

A review indicates that there are some promising new developments in the aims and goals, and in the actual working methods, of doing psychotherapy with clients or patients considered as psychotic. Some of these new developments are rooted in the significant developments of the 1950s and 1960s, and some are recent developments in their own right. Capsule previews are provided of the subsequent papers of the special series.     

The Violation of Inner and Outer Boundaries in Political Persecution

One of the consequences of persecution for the individual is the experienced confusion of inner and outer worlds. With the help of a broadened concept of the transitional space, derived from Winnicott, we could understand the various psychological consequences of structural physical violence. The violation of the transitional space during physical violence can result in a transformation to an inorganic state, an introjection or incorporation of the bad object into the self, intrusive re-experiencing and shattered assumptions often seen long after psychotrauma. In this article a broadened and elaborated concept of transitional space is described. Therefore, several theoretical concepts, such as inner and outer world are discussed and defined which makes it possible to put them into practice of psychotherapy and research. An example is given of a documented case of imprisonment under extreme conditions in which the prisoners were able to build up a common transitional space in order to survive. In this case, the transitional space is not an aid for the passage from one developmental phase to another, but instead a way of keeping open the connection between the psychic inner world, the world of the prison and the free world outside the prison walls. It is suggested to extend the concept of the transitional space to this meaning.     

Healing and Psychotherapy: The Pentecostal Tradition

This paper explores the practice of healing in the Pentecostal movement. The practice of healing has a long tradition in Pentecostal practice. The meaning of divine healing and what could be components of a theology of healing are examined. It is important for pastoral counselors, pastors, and chaplains to be aware of the importance of divine healing for Pentecostal clients.     

Therapist Self Disclosure in Group Psychotherapy from an Intersubjective and Self Psychological Standpoint

The history of therapist self disclosure is traced from the early struggles of Ferenczi and Burrow to its valued, yet still ambivalent, contemporary status. The symmetry of self disclosure by therapist and group members is differentiated from the parity of their different roles and responsibilities. Using a case example, the process is discussed through which a therapist's self disclosure fosters task-appropriate satisfaction of selfobject needs as it also helps group members articulate and loosen archaic selfobject binds. The therapy group is described as a transitional space within which a therapist's disclosure offers members an intersubjective bridge to the therapist as well as a model for members' own active participation in the group's work.     

Scharffs' Application of Hopper's Concept: “Incohesion: Aggregation/Massification”

We begin by stating our understanding of the concepts presented in Hopper's paper, then comment on the clinical illustration, and conclude by describing two group situations in which we have applied the concepts we have taken from Hopper's paper. Hopper's fourth basic assumption applies to our work as individual psychoanalysts, family therapists, and group leaders because it integrates psychoanalytic and social understanding. We demonstrate how and why we find Hopper's idea to be a useful advance.     

The Practice of Pre-Therapy

Pre-Therapy is a theory conceptualizing about psychological contact practiced with low-functioning persons. This category includes schizophrenic people, retarded people, and geriatric clients who are too isolated and withdrawn for regular psychotherapy. The techniques, known as Contact Reflections, are Situational, Facial, Word-for-Word, Bodily, and Reiterative Reflections. The therapist expresses a foundational belief in implicit selfhood as presented in episodes of lucidity. There is compassion for the effort at self-expression even at regressed levels. The therapist's reception of symptomatic expression conveys empathy. The case history illustrates the application of Contact Reflections with a catatonic client without the use of neuroleptics. This gives a clearer example of the psychological effects of Pre-Therapy.     

The Understanding and Treatment of Immigrant Trauma Survivors: Finding the Right Mix

This paper reviews attempts by three authors to describe psychoanalytic conceptualizations and treatment of torture victims. It argues that because the transference-countertransference configuration with immigrants who have not suffered torture is very similar to that of torture survivors, that no special diagnostic categories, theories, or treatment methods are needed to work with torture survivors. Second, the paper contends that newer psychoanalytic paradigms such as Hoffman's Social Constructivism may assist clinicians to capture the richness and complexity of clinical work with torture survivors better than do traditional analytic conceptions such as neutrality. Via an analysis of the three papers in this volume, I conclude with a consideration of the strengths and the weaknesses of the field of cross-cultural psychotherapy in general.     

药物、心理及联合治疗缓解抑郁症之比较

针对抑郁症治疗完全缓解率低,运用临床思维方法,依靠循证医学证据,首先分析了抗抑郁药物的选择、优化、更换和联合用药的治疗效益。然后辩证分析并比较了药物与心理治疗,以及药物与心理治疗的单独与联合应用对重性抑郁急性和长期治疗的疗效,以及严重重性抑郁、严重慢性抑郁的短期和长期疗效以及费用效益,为确定治则、选择治法提供帮助。     

费尔贝恩人格客体关系理论的心理治疗观

英国精神分析学家费尔贝恩在修正与发展弗洛伊德和克莱因思想的基础之上,提出了一种纯粹的人格客体关系理论,他发展了一套修正的心理病理学思想。他认为,精神分裂是所有心理病理现象的基础;心理治疗的目标是要让病人从无意识中释放坏的客体和减少自我的分裂、达到人格的整合,而分析师与病人的关系则是心理治疗的中心。