Exploring a patient's shift from relative silence to verbal expressiveness: Observations on an element of the analyst's participation

By tracing a portion of close process of a patient's shifts from a relatively silent and inhibited stance to one in which he is beginning to verbalize more about his experience and fantasy, I will illustrate some tensions between the analyst's role as facilitating expressiveness and as occupying a place in the patient's internalized world. Since the analyst's functions as facilitator and as internal object (often an obstacle to the patient's expressiveness) are sometimes in conflict with one another, it is important for the analyst to be able to work internally with this conflict as he works with his patient. Splitting processes between these two functions may provide the analyst with cues related to the patient's and the analyst's resistance to understanding the patient's communication of unconscious conflict and the patient's recruitment of the analyst into the patient's internalized world.     

中学生写作中思维品质的发展特点

从洛阳市一所普通中学6个年级随机选取801名被试,使用自编问卷研究了中学生写作中思维品质的发展特点,结果发现:(1)中学生写作中思维品质总体上呈随年级增长显著上升的发展特点,初二到初三阶段更为突出;(2)深刻性和灵活性品质为上升趋势,但在高一年级存在1个回调点;(3)批判性和独创性从初一到高一呈现明显上升趋势,高一以后呈波浪式发展;(4)中学生写作中的思维品质在初一、初二、高一和高三年级存在性别差异.     

Enhancing the Benefits of Written Emotional Disclosure Through Response Training

Writing about a personal stressful event has been found to have psychological and physical health benefits, especially when physiological response increases during writing. Response training was developed to amplify appropriate physiological reactivity in imagery exposure. The present study examined whether response training enhances the benefits of written emotional disclosure. Participants were assigned to either a written emotional disclosure condition (n = 113) or a neutral writing condition (n = 133). Participants in each condition wrote for 20 minutes on 3 occasions and received response training (n = 79), stimulus training (n = 84) or no training (n = 83). Heart rate and skin conductance were recorded throughout a 10-minute baseline, 20-minute writing, and a 10-minute recovery period. Self-reported emotion was assessed in each session. One month after completing the sessions, participants completed follow-up assessments of psychological and physical health outcomes. Emotional disclosure elicited greater physiological reactivity and self-reported emotion than neutral writing. Response training amplified physiological reactivity to emotional disclosure. Greater heart rate during emotional disclosure was associated with the greatest reductions in event-related distress, depression, and physical illness symptoms at follow-up, especially among response trained participants. Results support an exposure explanation of emotional disclosure effects and are the first to demonstrate that response training facilitates emotional processing and may be a beneficial adjunct to written emotional disclosure.     

How Does Change Occur Within the Psychoanalytic Encounter?

On November 6, 2002, Dr. James Fosshage delivered the following talk at a Clinical Training Conference held at the Blanton-Peale Institute. The Clinical Training Conference at Blanton-Peale provides experiential and conceptual resources to support the therapist-in-training in the context of his/her professional identity. The training conference is attended by candidates of all phases of the Psychoanalytic Program, the Pastoral Psychotherapy Program, and the Marriage and Family Program, as well as faculty members, administrators, staff, and interns of the institute. The residents were asked to review three articles written by Dr. Fosshage in preparation for his presentation: Toward Reconceptualising Transference: Theoretical and Clinical Considerations, International Journal of Psycho-Analysis (1994) 75 (2): 265–280; Countertransference as the Analyst's Experience of the Analysand: Influence of Listening Perspectives, Psychoanalytic Psychology (1995) 12 (3): 375–391; and Listening/Experiencing Perspectives and the Quest for a Facilitating Responsiveness, Conversations in Self Psychology: Progress in Self Psychology, (1997) 13: 33–55.     

Incarnational Christian psychology and psychotherapy: What do we believe and what do we do?

The following paper proposes a viewpoint regarding the working assumptions, theology and practice for an “incarnational” psychology or “Christian psychology,” particularly with regard to psychotherapy. This essay is primarily meant to be an affirmation and guide for those Christian psychologists and others working in the allied professions. However, both veteran theorists and newcomers to such inquiry will benefit from this essay. Discussion begins with the dynamic of surrendering and receiving a personal relationship with Jesus Christ. The understanding of the unique person as soul: in mind, body, life and spirit is discussed. In addition, the working of the incarnate Holy Spirit is elaborated for both therapist and patient in the regenerative and therapeutic process. Psychopathology is reframed in reference to the Judeo-Christian revelation of sin and evil. In addition, truth, falsity and psychopathology are considered in light of the essentially regenerated man/woman or “new creation” in Christ. Some practical examples for psychotherapeutic intervention are offered, including the unique role of the Christian psychologist and his or her relationship with both patient and Christ. Seven major assumptions of “incarnational” or Christian psychology, which diverge from purely secular (psychological) theory and practice, are presented. Lastly, Christian psychology is distinguished from both “integrated” psychology and theology; and Biblical counseling.

Psychological mindedness and therapist attributes

Background to study: Psychological Mindedness (PM) involves an interest in and ability to extract and make sense of psychological information (thoughts, feelings and behaviours) from a situation. The nature of the psychotherapeutic role and training demands therapists think about motives, distortions and inner experiences of others. Aims: This study empirically examined the association between PM and adaptive therapist attributes, clinician empathy, self understanding and the therapeutic relationship in practitioners. Method: Forty eight therapists responded to a postal questionnaire. Results: Statistically significant correlations were found between adaptive therapist attributes; empathy, the therapeutic relationship and level of self-understanding and PM.     

Therapeutic processes in group therapy: Intersections between general change mechanisms and motivational stages of change from patient perspective

Intersections between Grawe’s General Psychotherapy and Prochaska’s Transtheoretical Model were investigated in group therapy in a longitudinal design. It was assumed that general change mechanisms have an impact on patients’ stages of change. Specifically, the main hypotheses were that experiential change mechanisms (ECM; clarification of meaning, problem actuation, emotional bond and group cohesion) should be especially relevant for early stages of change (precontemplation and contemplation), whereas behavioral change mechanisms (BCM; resource activation, mastery/coping and task and goals) should be especially relevant for late stages of change (action and maintenance). Therefore, 140 outpatients attending different types of group therapy, with a typical duration of 8 sessions, were investigated. Patients completed the Form for the Evaluation of Therapeutic Processes in Group Therapy (FEPiG), the University of Rhode Island Change Assessment, short version (URICA-S) and several symptomatology measures (BDI-II, BSCL and IIP-32) at two measuring times. Intersections were analysed through correlational analyses, cross-lagged panels and a path-analytic model, supporting the hypotheses. Specifically, results suggested that experiencing ECM at t1 predicted higher levels of reported contemplation at t2. Patients experiencing higher levels of BCM at t1 reported higher levels of action at t2. Clinical implications of the results are discussed.     

Writing life narratives through art practice

This article shares some of my doctoral experiences in a practice-based PhD research in arts developed at the Chelsea College of Arts, University of the Arts London. It locates art practice within the academic research realm and contributes to researchers working on autobiographical studies and practice-based research methods. By offering an overview on my research topic focusing on the relationship between language and place in the life of Brazilian women living in London, I reflect on the relevance of “not-knowing” as a fruitful space for researching autobiographical and situated life narratives through art practice. The article concludes that qualitative methods are relevant for building passages from the individual to the collective sphere of an art practice developed within geographical displacement and in the context of academic research.     

Prospective writing: Randomized controlled trial of an intervention for facilitating growth after adversity

Little is known about how posttraumatic growth (PTG) can be fostered and controversy surrounds how it is best measured. We designed and tested an intervention, prospective writing, to facilitate PTG by encouraging people to explore new possibilities after adversity. Adults (N = 188) with recent adverse experiences were randomly assigned to do prospective writing, factual writing, or no writing weekly for one month. PTG was assessed with both retrospective and current-standing measures. Hierarchical linear modeling and response profile analysis were used to assess the intervention’s impact, and latent growth curve modeling was used to test mediation. Prospective writing participants showed the greatest gains in PTG as assessed by the current-standing measure, but did not reliably show greater retrospective PTG than controls. Although large effect sizes for the mediation paths suggested that engagement with new possibilities may be a plausible mechanism, this result fell short of statistical significance. Prospection-based interventions merit further investigation.     

儿童缺血性脑病的诊治策略

结合国内外文献资料,从儿童缺血性脑病的病因、临床表现、影像学特点、治疗方式及疗效等方面着手,进行分析和比较,加深医患对儿童缺血性脑病的了解,同时为该类疾病的临床诊断与治疗思路提供借鉴。