Some questions concerning states of fragmentation: unintegration,under-integration,disintegration, and the nature of early integrations

The paper attempts some clarifications and differentiations concerning (1) Bick's classic distinction between states of helpless unintegration and states of defensive disintegration; (2) the difference between a state and a phase, and Bick's apparent challenge to some aspects of object relations thinking. The paper then lists some types of early pre-depressive and pre-Oedipal integrations and integrators: these include, as well as various kinds of containment, the role of the interested, interesting, and occasionally reclaiming object.     

On Phallicism; Developmental Aspects,Neutralization, Sublimation and Defensive Phallicism

Many children in need of psychotherapy are latency-age boys who have little or no contact with their fathers. Their problems typically include low self-esteem, identity problems, depression, difficulties in peer relationships, and aggression. Clinical material illustrates that the consequences for the child of fatherlessness depend on many factors, among them the mother's attitude to the father and other mature males. If the mother devalues all men, her son has little space to grow into a healthy adult. The male therapist may be experienced as a threat to the mother-son union, which may render his efforts to help the boy fruitless. If, in contrast, the mother's experiences of her own father and other men are more positive, her pride in her son's masculinity may strengthen his need to find support for his male development. These observations are discussed as affecting the capacity for triadic object representations in mothers and sons.     

Uncovering and managing unconscious ways of ‘looking’: A case study of researching educational care

Abstract

In this paper the author argues for the importance of those working as counsellors with children and adolescents to have specialist training. She outlines the need for many more properly trained counsellors to be available to children, and emphasizes the need for them to have detailed knowledge of children's emotional development. The argument is throughout illustrated with clinical examples. She draws attention to the differences between working with children and adolescents as opposed to adults, with an exploration of the special skills that need to be developed if working with younger clients. Reference is made to the differences in the contract and the thinking about the family. She explores the importance of including in a specialist training infant observation and the consideration of group and institutional dynamics.     

Psychodynamic counselling in a university setting: A space for thinking together over emotional problems

Abstract

The authors describe their experience as psychoanalytically oriented psychotherapists at the Counselling Service for University Students of the Office for Student Affairs, Naples. In this service they have provided, for the last fourteen years, to any student who applies to it, up to four individual sessions, with the possibility of follow-up sessions, should the client ask for them after a few months. Both the procedure and the aims of the interventions are similar to those described by psychotherapists working at the Tavistock Clinic (Copley 1976; Salzberger-Wittenberg 1977) and the Brent Consultation Centre (Hurry 1986; Novick 1987) of London. The technique is an adjustment of the psychoanalytic one and the therapist undertakes a careful listening to the student's verbal and non-verbal communications. The main objective of the intervention is to enter into an alliance with the adult parts of the client in order to examine together his/her personal difficulties. A case report is presented, in order to exemplify both an emotional conflict which can interfere with academic success and the technique of the intervention.     

‘The bereaved therapist speaks’. An interpretative phenomenological analysis of humanistic therapists' experiences of a significant personal bereavement and its impact upon their therapeutic practice: An exploratory study

Aim: The aim of the research was to explore the under‐researched area of therapists' personal bereavement and its impact upon their therapeutic practice. Method: Data were collected via semi‐structured interviews with four humanistic therapists and were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Four master and eight subordinate themes emerged from the rich data collected that exemplified both convergence with and divergence from the small body of extant literature on therapist bereavement and current thinking in thanatology. The findings suggest that bereavement is a unique experience that can affect the individual's personal and social identity and worldview. It can also be a transformative experience resulting in personal growth and a renewed sense of self and agency. In terms of professional practice, the findings suggest that the lived experience of the grieving process, mediated by supportive supervision, enabled participants to experience deeper levels of empathy and connectedness within their therapeutic relationships. Conclusion and implications: Bereavement is an experience that can profoundly impact upon therapists' personal identity and assumptive world. Such an experience can have an equally profound impact upon their therapeutic practice. There are therefore implications for students, trainers, therapists and supervisors particularly in terms of self‐care and the use of the ‘self’ in therapy. Further research needs to be undertaken in order to explore in greater depth the intersection between personal bereavement and therapists' evolving personal and professional identity development.     

Traumatic Attachments and Self-Harm Behaviors

Abstract

Work and the structure it affords is one of the most important vehicles for the expression of worth in our society. With so much invested in the external world of position and achievement, threats to job security pose fundamental challenges to individual identity. Recent upheavals in the workplacedownsizings, early retirements, and corporate reorganizationshave shaken the psychological equilibrium of many of our clients, giving rise to feelings of despair and hopelessness. When disruptive and unwanted changes occur later in life, they become additionally tinged with latent concerns about aging and finding meaning as a mature adult.     

Undercurrents

SUMMARY

In a story-telling mode, with a personal and intimate flavor, this article takes a look at one approach to the treatment of an extramarital affair. With roots in Bowen theory, and an attention to the underlying dynamics of the emotional system, the treatment is further enriched by an improvisational approach which acknowledges the self of therapist.     

The Protean Therapist

SUMMARY

The subject of the following article is the protean journey therapists make as they adapt to changing situations and challenges in their own lives and the ultimate impact it has on their clinical work with patients. I have used the example of my own life, in which certain critical events have transformed me from a person with a rather ordinary perspective to someone who has come to appreciate the fragile nature of life with its rich tapestry of complicated ties and patterns. I have tried to demonstrate that significant events in my life and my personal development over the past thirty years have furthered my appreciation and treatment of my patients. I have also come to recognize that my patients' particular journeys, on which I have accompanied them, have similarly contributed to and enriched my life in myriad ways.     

Tales of a Therapist

ABSTRACT

Historically, theorists and clinicians from various schools of family therapy have discussed therapist self-disclosure in terms of either helping or inhibiting therapeutic progress. Although postmodern language-based theorists and therapists accept and encourage its use, few clinical examples of therapist self-disclosure exist in the family therapy literature. In this paper, a postmodern family therapist working within the language-based tradition describes the use of self-disclosures with a couple. The therapist then reviews the effects of those self-disclosures through the eyes of husband, wife, and therapist.