Muslim Distress Mobilization Hypothesis: complex roles of Islamic Positive Religious Coping and Punishing Allah Reappraisal in Iranian students

Muslim religious coping may include distress mobilisation effects that explain why adaptive and maladaptive forms of religious coping correlate positively rather than nonsignificantly, as they usually do in the West. In this study, 147 Iranian university students responded to Islamic Positive Religious Coping (IPRC) and Punishing Allah Reappraisal (PAR) Scales along with Religious Orientation, Perceived Stress, and mental health measures. IPRC and PAR correlated positively, and procedures accounting for their covariance were essential in disambiguating their implications. IPRC predicted stronger Intrinsic and Extrinsic Personal Religious Orientations, but PAR displayed no relationship with religious motivations. PAR pointed toward broadly negative mental health influences with IPRC displaying limited ties with adjustment. PAR partially mediated some Perceived Stress relationships with poorer mental health. These data offered some support for a Muslim Distress Mobilization Hypothesis, but also uncovered issues that require further clarification.     

Clients’ experiences of dynamic interpersonal therapy (DIT): opportunities and challenges for brief,manualised psychodynamic therapy in the NHS

Dynamic interpersonal therapy (DIT) is a brief manualised psychodynamic intervention for depression. This is a first study exploring clients’ experiences of DIT specifically and brief, manualised psychodynamic psychotherapy (PP) in general. Interpretative phenomenological analysis was the methodology employed. Five participants completed a semi-structured interview, three weeks to ten months after completing DIT. The scores of pre- and post-therapy outcome measures of depression and anxiety were also available. Two emerging superordinate themes are presented here: (1) ‘The Distinct Features of DIT’, referring to how its therapeutic style and time limitations were experienced and (2) the ‘Impact of Therapy’, referring to perceived outcomes. While previous findings showed that therapist’s perceived limited activity in long-term PP was experienced as hindering/unhelpful, the perceived sense of direction in DIT appeared adequate to most participants. Secondly, the time limitations provoked complex responses. Reactions to the distinct elements of DIT are to be treated both as therapeutic opportunities and as challenges. Further, in line with psychoanalytic theory, most participants described relational changes that went beyond symptom relief and remained in progress after therapy ended. Intriguingly, there was no consistency between participants’ qualitative accounts of change and the scores of the outcome measures.     

Dynamic interpersonal therapy in an NHS tertiary level specialist psychotherapy service

We describe the introduction of dynamic interpersonal psychotherapy (DIT) into an National Health Service (NHS) tertiary psychoanalytic specialist psychotherapy service. Training in DIT began as our contribution to Improving Access to Psychological Therapies and primary care services, supporting the training and supervision of their DIT practitioners. We then discovered DIT could be a valuable treatment within our own tertiary NHS service for patients with complex presentations. Currently fighting for survival, like many NHS psychoanalytic psychotherapy services nationally, we have adopted a manual-guided, psychoanalytically based therapy to broaden our tertiary clinical psychoanalytic service and accommodate trends in mental health service provision, whilst protecting the quality and integrity of our psychotherapy. DIT helped us continue providing relevant and beneficial psychoanalytic and psychodynamic services to individual patients despite limitations of the financially challenged NHS, NICE guidelines and Payment by Results. We outline the progress and outcomes for patients with complex mental health presentations, include individual case discussion and our experience of using the DIT approach within a traditionally longer term psychoanalytic psychotherapy service.     

A fertile matrix: the birth of the Forensic Psychotherapy Society

This paper traces some aspects of the fertile matrix within which, over many years, the application of a psychoanalytic perspective to clinical work with the most severely mentally ill, difficult and at times frightening patients in secure and community settings has evolved and now led to the recent inauguration of the Forensic Psychotherapy Society (FPS), a new Member Institution of the British Psychoanalytic Council. The Society provides both a framework for a national, multidisciplinary professional training in psychodynamic forensic psychotherapy and the potential launching pad for an active post-qualification organisation supporting CPD and all other forms of professional development. The particular contributions to the birth of the FPS of the Forensic Psychotherapy Department at West London Mental Health NHS Trust, partly because we know it best but also because it is part of the largest forensic psychiatric service in the United Kingdom, are described.     

An Integrative Approach to Conceptualizing and Treating Complex Trauma

Complex trauma (CT) often presents with polymorphous symptoms (i.e., emotional dysregulation, dissociation, somatic distress) resulting from repeated and chronic exposure to traumatic stressors. While the public is increasingly aware of posttraumatic stress disorder (PTSD) and its accompanying symptoms, the phenomena of complex trauma is less recognized and understood. Since the trauma reactions with CT typically occur during childhood, and the symptoms go well beyond PTSD, the authors of this article assert that an integrative approach is needed that synthesizes the most effective elements of cognitive-behavioral therapy (CBT) while blending a self-psychological approach. A review of the literature addresses the definition of complex trauma, cognitive-behavioral conceptualizations and treatment approaches, self-psychological models, current theories of attachment, and advances in neuropsychoanalysis. An integrative model is then proposed, supported by clinicians in the trauma field, identifying three intertwined phases of treatment.     

Examining the indirect effects of religious orientations on well‐being through personal locus of control

Religiosity often positively correlates with well‐being. Some orientations towards religion may, however, adversely affect well‐being by decreasing perceptions of personal locus of control—a critical antecedent of mental health. We examined this possibility in a New Zealand‐based national sample of religiously identified adults (N = 1486). As predicted, fundamentalism had a negative indirect effect on life satisfaction, but a positive indirect effect on psychological distress. Conversely, people's intrinsic religious orientation had a positive indirect effect on life satisfaction, but a negative indirect effect on psychological distress. Notably, all four indirect effects were transmitted through personal, but not God, locus of control. These results highlight the diversity of religious orientations and show that religious orientations that deemphasize people's personal locus of control have negative consequences for well‐being.     

Clinical Exchange: The Architectural Failure

The Clinical Exchange invites eminent clinicians of diverse persuasions to share, in ordinary language, their clinical formulations and treatment plans of the same psychotherapy patient—one not selected or nominated by those therapists—and then to discuss points of convergence and contention in their recommendations. This Exchange concerns a Mr. L, a 47-year-old, married man presenting for outpatient individual psychotherapy with chief complaints of depression, anxiety, and a lengthy history of vocational underachievement. Drs. Herbert Fensterheim, Leslie Greenberg, and Leigh McCullough, who anchor their practices in the cognitive-behavioral, experiential, and psychodynamic orientations, respectively, are the featured commentators. Finally, Dr. Jerold Gold, the case contributor and Mr. L's psychotherapist, provides a few closing comments.     

Microcosm–Macrocosm

Much has been learned in the 20th century about the impact of covert group dynamics on the individual, the family and small group on the micro level and about institutions, communities, national and international process on a macro level. However, as we enter the new millennium this knowledge seems dwarfed by the burgeoning of knowledge about the brain and biological approaches to disturbed human behavior, casting a worrisome shadow on the future of dynamic group therapies. This article explores the impact of socio-economic-political forces on mental health delivery systems from the vantage point of group process and therapy, and raises questions about possible interventions to restore a balance between social dynamics and biology.