乳腺癌的现代与传统治疗模式的比较分析与思考

乳腺癌是女性最常见的恶性肿瘤之一,现代治疗模式已经广泛应用于临床。近年来,随着循证医学和基因相关技术及生物信息技术的不断发展,乳腺癌治疗方法得到不断改进,但远没有达到系统化、个体化、最优化的治疗目的。因此,现有的治疗模式值得我们去深思,并从哲学意义上探索更为完善的治疗模式。     

Encounter with a traditional healer: Western and African therapeutic approaches in dialogue

The paper explores the extent to which cultural aspects contribute to the modalities of human relations and consequently to the qualities of the internal objects and the sense of identity. Therapeutic relationships and techniques, as well as the theories on which they are based, are seen as being equally embedded in their cultural context. An encounter with a traditional African healer offers the author, a western trained European analyst, an opportunity to think about similarities and differences in the therapeutic approach to mental distress, as well as in the training of therapists/healers in the two cultures. Special attention is given to the role of ancestor reverence in African culture. The notion of the ancestors is related to what psychoanalysis describes as internal objects. Cultural differences in the role and importance of verbal language in the therapeutic relationship are described, and the importance and meaning of non-verbal forms of communication are explored.     

心房颤动的药物治疗决策

对于心房颤动（房颤）必须针对患者的具体情况合理选择好房颤的治疗策略,包括节律控制、频率控制和抗凝治疗。不管哪种策略,药物治疗都是大多数房颤患者的一线方法,需要针对不同的策略选择好和使用好抗心律失常药物,以最大限度地提高疗效和减少副作用。     

Don't get stuck in the mother: regression in analysis

This paper was part of an afternoon workshop on regression. It re views the author's recollections of her own analysis and clinical work with the purpose of discovering the sources of her own ideas on regression. Two specific forms of regression are then delineated – negative therapeutic reaction as described by Rosenfeld and 'umbilical transference' as a possible future development.     

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.     

Islamophobia and the therapeutic dialogue: Some reflections

In the atmosphere of fear and controversy that surrounds Muslims at this moment in time it is hardly surprising that they feel unable to voice their fears and concerns openly. Added to this is the fact that Muslims already underutilize mental health services (Patel et al., 2000 Patel, N, Bennett, E, Dennis, M, Dosanjh, N, Matitani, A, Miller, A and Nadirshaw, Z. 2000. Clinical Psychology: ‘Race’ and ‘Culture’: A training manual, Leicester: The British Psychological Society.  [Google Scholar]). In the counselling arena four distinct aspects of the counselling relationship are affected. First, the therapeutic alliance, second, the socio-political context in which counselling occurs, third, the awareness of personal characteristics and competencies that facilitate multicultural counselling and, finally, the training requirements of multicultural counsellors. This paper seeks to consider each of these aspects of the therapeutic encounter with regard to Muslim clients.     

Defining and Measuring Mechanisms of Change in Psychological Therapies: The Path Not Taken

Metcalf and Dimidjian (this issue) have provided an important review of the current evidence base for mindfulness‐based cognitive therapy (MBCT) and presented a helpful summary of the proposed mechanisms of change. It is necessary to engage in a continuous dialogue regarding the evidence base for change mechanisms, and the article by Metcalf and Dimidjian highlights an important barrier of concern to the field of treatment outcome research. The present commentary aims to expand the discussion regarding the definition, measurement, and evaluation of “mechanisms of change.” Using MBCT as an example, this commentary addresses the ambiguity surrounding the definition and operationalisation of these mechanisms in research on psychological therapies and how the method of measurement may impact the results obtained in clinical trials. It is argued that a potentially fruitful avenue of future research would involve investigation of techniques, important client‐therapeutic processes, and mechanisms in a single study in order to comprehensively evaluate how change occurs.     

三阶层多靶点综合集成法指导难治性皮肤病治疗

本文借鉴以往综合治疗难治性疾病的成功经验,运用系统科学的综合集成方法,提炼出“皮肤病三阶层多靶点综合治疗策略”,即治疗层次分为病因阶层、病机阶层及症状阶层,多靶点综合集成是多个作用机理不同的药物进行有机综合。本文列举了各阶层多靶点综合集成治疗皮肤病的成功案例,论证了该策略的指导作用。同时提出应该根据某一种难治性皮肤病的病因、发病机制等的研究新进展,定期更新治疗方案,以便与时俱进,提高疗效。     

What Is and Can Be Attributed to the Therapeutic Relationship?

This paper reviews findings from two studies that support the contentions of the Generic Model of Psychotherapy that therapeutic outcome must be viewed as arising from a complex interaction of common and specific factors. Patient, therapy, and relationship factors are shown to selectively add to the variance predicted in psychotherapy outcome studies. Moreover, an inspection of procedures that are common to two different therapies, and those that are unique to these approaches reveal that both contribute to outcome and do so in ways that suggest the presence of both synergistic and inhibiting effects.