Seeing in the Dark: A View into Dissociation and Healing

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched’s (2013) recommendation for a “binocular stance” to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client’s unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.     

Dance becomes therapeutic in the mid to late 20th century

The convergence of dance art and therapeutic culture engendered the development of dance-movement therapy in the mid to late 20th century internationally. This article traces the sociopolitical, institutional, and aesthetic influences that coalesced in this process by contrasting histories of dance-movement therapy in Hungary and in the United States. The professionalization dance-movement therapy, through which it established its own theory, practice, and training institutions, occurred first in the United States in the late 1940s. Modern dancers in the United States began to conceptualize their activity as therapeutic, and the dancer as a (secular) healer, a therapist. The influx of therapeutic concepts into the field of dance is viewed as an example of therapeutic discourse permeating various areas of life in the 20th century. The Hungarian case provides a contrasting history of therapeutic culture, one that deviates from the predominant view of the phenomenon as a product of the global spread of Western modernization and the growth of free-market capitalism. Hungarian movement and dance therapy indeed developed independently from its American predecessor. Its history is intimately tied to the sociopolitical context of state-socialist period, particularly to the institutionalization of psychotherapy in public hospitals, and to the adaptation of Western group psychotherapies within the informal setting of the “second public sphere.” The legacy of Michael Balint and the British object-relations school provided its theoretical framework. Its methodology was rooted in postmodern dance. The methodological differences between American dance-movement therapy and the Hungarian method reflects the shift in dance aesthetics that occurred internationally between 1940 and 1980s.     

Clinician experiences of homework in couples and family therapy: A survey of perceived impact on the working alliance

The process of engaging clients in homework assignments has been studied extensively in research settings, but rarely have the challenges in the implementation of the science been considered in couples and family therapy. A survey was conducted of 226 clinicians regarding (1) their experience of homework adherence (quantity and quality) with couple and family clients, and (2) their experience of the impact of homework non-completion (IHN) on the working alliance. Clinicians working with families reported less overall homework quantity and quality. However, across both couples and family clients, more negative IHN was reported among clinicians experiencing less homework quantity, both in terms of IHN bond (couple ρ = 0.71, p < 0.001; family ρ = 0.78, p < 0.001) and IHN agreement (couples ρ = 0.25, p < 0.001; ρ = 0.19, p = 0.006), and among clinicians with fewer years of clinical experience (r = 0.19, n = 136, p < 0.05). The present findings suggest that, in the context of couples and family therapy, there is a risk of perceived negative IHN on the working alliance. There would be merit to future investigations examining the processes of facilitating homework engagement within the context of a strong working alliance.     

When left hands touch: shadow vows and Jung’s quaternity

Is there a connection between the exchange of vows and the fighting and suffering of couples that are unique to the institution of marriage? This essay introduces the concept of Shadow Vows, the unacknowledged assumptions, agreements, and obligations each partner brings to the relationship, which the authors believe are often responsible for longstanding marital discord and strife. The authors ground the existence of shadow vows in Jung’s quaternity, alchemy, typology, archetypal theory, and depth approaches to couple therapy. The essay concludes with a list of themes indicative of shadow vow enactments in clinical work with couples.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Examining awareness of privilege among midwestern college students: An analysis of race/ethnicity,gender, and religion

Dominant group members often are not aware of the privileges they benefit from due to their dominant group membership. Yet individuals are members of multiple groups and may simultaneously occupy multiple categories of dominance and marginality, raising the question of how different group memberships work in concert to facilitate or inhibit awareness of multiple forms of privilege. Examining awareness of privilege is important as awareness may be linked to action to dismantle systems of privilege that maintain oppression and inequality. Grounded in intersectional scholarship, in this study we examined how occupying intersecting categories of race/ethnicity, gender, and religion corresponded to an awareness of White, male, and Christian privilege. In a sample of 2321 Midwestern college students, we demonstrated that students from marginalized groups broadly reported greater awareness of all forms of privilege than students from dominant groups, and the difference between marginalized and dominant groups was most pronounced when the specific group category (e.g., gender) aligned with the type of privilege (e.g., male privilege). We also tested interactions among race/ethnicity, gender, and religion, only finding an interaction between race/ethnicity and religion for awareness of White and male privilege. These findings helped to clarify that multiple group memberships tended to contribute to awareness as multiple main effects rather than as multiplicative. Finally, we examined mean differences among the eight intersected groups to explore similarities and differences among groups in awareness of all types of privilege. Taken together, these findings quantitatively demonstrate the ways in which group memberships work together to contribute to awareness of multiple forms of privilege. We discuss study limitations and implications for community psychology research and practice.     

Intensive specialised multi-family therapy for multi-stressed families: Therapeutic alliance as predictor for effectiveness

The effectiveness of intense specialised multi-family therapy (ISMFT) for 111 multi-stressed families, and the therapeutic alliance as a possible predictor of outcome, were examined. A repeated measures design was used, where changes in all ISMFT phases (preparation, multi-family therapy and follow-up) were assessed and compared for both mothers and fathers. Evidence was found for improved family functioning after the therapy period, which was maintained at 3 months follow-up, although the multi-stressed families still functioned in the problematic range. The therapy did however not decrease parenting stress, or did so only temporarily. Observations of the therapeutic alliance with the System for Observing Family Therapy Alliances (SOFTA) scales indicated that high therapist engagement was related to positive therapy outcomes, both at the start of therapy and later. High family engagement also predicted therapy effectiveness, but only at the start of therapy. The present study shows that solution-focused multi-family therapy at least seems to provide the first step in alleviating problems in multi-stressed families.     

Conceptualising,designing and drafting a monthly multi-family therapy programme and manual for adolescents with anorexia nervosa

The written transmission of therapists' expertise in manuals is an important issue which is highlighted in the literature. Manuals are essential for research, training and therapeutic guidance. However, the conceptualisation, design and drafting of therapy manuals have received little attention. Our team conceptualised and designed a 10-monthly session multi-family therapy programme for adolescents suffering from anorexia nervosa. This paper presents the methodology used to evolve from training and theoretical models to designing a programme and drafting the accompanying manual. We then describe how our team reached a consensus regarding the role to be attributed to food-related symptoms in the programme. These arduous tasks were rewarded by fruitful discussions among team members, which led to a shared theory of treatment. The methodology presented here is drawn from both the experience of specialised teams and from that of families in providing care to adolescents with anorexia nervosa.     

The Intergenerational Transmission of Party Preferences in Multiparty Contexts: Examining Parental Socialization Processes in the Netherlands

Research shows that parents have a strong influence on the party preferences of their children. Yet little is known about how such preferences are transmitted in multiparty systems with weak party identification and high electoral volatility. We propose a model of intergenerational transmission that includes both direct effects of parents' party preferences on those of their children, as well as indirect effects through left–right and issue positions. We test this model with original survey data of Dutch adolescents (14–20 years old) and their parents (N = 751 adolescent-parent pairs). We find two paths through which parents exert influence on the party preferences of their adolescent children. On the first path, parental party preferences function as a direct predictor of adolescent party preferences. On the second path, adolescent left–right and issue positions function as a mediator between parental left–right and issue positions and adolescent party preferences, with the effect of left–right positions being stronger than that of issue positions. The frequency with which adolescents discuss political topics with their parents moderates these effects.