Mobilizing self through short-term dynamic interpersonal psychotherapy: a preliminary report

Background: The key features of short-term dynamic interpersonal psychotherapy (STDIP) are outlined along with the background of its development. Preliminary data demonstrating functional improvement in a small case series of patients is presented.

Methods: Nineteen patients were evaluated at commencement and end of therapy in a pilot study. Instruments used were the Childhood Trauma Questionnaire (CTQ); Beck Depression Inventory (BDI); Brief Symptom Inventory (BSI); COPE (Coping Style Questionnaire); Relationship Styles Questionnaire (RSQ) and Social Adjustment Scale-Self Report (SAS-SR).

Results: This cohort had significantly elevated scores on the CTQ. They demonstrated substantial improvement on measures including the BDI, and several subscales of BSI, COPE, RSQ and SAS-SR.

Conclusions: The small numbers and naturalistic design preclude firm conclusions however the results suggest that STDIP can be used to successfully treat patients, notwithstanding a history of childhood trauma.     

Healing in the Midst of Chaos: Nah We Yone's African Women's Wellness Group

This article discusses the creative use of the group treatment modality to provide psychosocial support to African women refugees and asylum seekers with a history of refugee trauma, war, and human rights abuses who have fled to the United States. In particular, this article describes the African Women's Wellness Group developed by Nah We Yone, Inc., a small grassroots organization in the New York City area. This women's group draws on the tenets of traditional Western group psychotherapy while using African cultural awareness to provide healing. The rationale for this type of treatment, group design, specific techniques used to provide healing, along with various group-related themes and challenges are described. This type of treatment provides an example of the usefulness of group therapy technique with traumatized displaced women struggling to survive in a new cultural setting.     

Children of Nazi Germany 60 years on

Abstract

Defence against shock, feelings of guilt, and shame about German atrocities during National Socialism (NS) have dominated the public discourse in Germany for decades. Mitscherlich and Mitscherlich have talked about the inability to mourn due to the involvement of most German families in Nazi terror. The research projects “Childhood in War” at the University of Munich and “War Children and their Flight” at the Hamburg DPG Institute are studying the long-term implications of a childhood during World War II and the Nazi period. In most cases, the personal development of the “war children” was affected – in the case of psychoanalysts, their psychoanalytic socialisation and current professional practice as well. The transgenerational transmission forms an NS introject in the personality. Due to their parents’ lack of empathy, war children are unconsciously looking for a containment of their unbearable feelings in their childhood. Psychoanalysis (including training analysis) becomes a stage where the analysee's childhood loneliness, the taboo-forming, the inhibition to ask and the protection of the parents, as well as feelings of guilt and embarrassment in the family, not talking about matters, and silence, occur once more in transference.     

Reflections on catastrophic change

Abstract

The present paper examines the way Freud's letters, in particular the ones to Oskar Pfister and Karl Abraham, were edited. The nature and extent of distortions and cuts are demonstrated, and conclusions are drawn regarding the picture of Freud that emerges. Questions of confidentiality, medical discretion, and archival restrictions are discussed.     

Psychoanalysis is a two‐way street

The paper discusses psychoanalysis as a mutual exchange between the analyst and analysand. A number of questions are raised: What was Ferenczi's and the early psychoanalysts' contribution to the interpersonal relational dynamics of psychoanalytic treatment? Why did countertransference become an indispensable tool in relationship‐based psychoanalysis? Why is the transference‐countertransference dynamic seen as a special dialogue between the analyst and analysand? What was Ferenczi's paradigm shift in the trauma theory? How did he combine the object relation approach with Freud's original trauma theory? The paper illustrates through some case study vignettes the intersubjective and intrapsychic dynamic in the process of traumatization. We can look at countertransference as an indicator of the patient's basic interpersonal experiences and traumas. Finally the paper discusses countertransference in the light of attachment theory, connecting the early initiatives of inter‐relational approaches in psychoanalysis with recent research.     

Interpretation: signals from the analytic field and emotional transformations

Through numerous clinical examples and from a point of view focused on field theory the author reflects upon what are the main characteristics of ‘transformative interpretations’ and upon the mental and affective conditions that support it. He especially centers his attention on difficult patients who have experienced cumulative affective traumas in their lives.     

Perceived Ability to Cope With Trauma Among U.S. Combat Veterans

The Perceived Ability to Cope With Trauma (PACT) scale measures perceived forward-focused and trauma-focused coping. This measure may also have significant utility measuring positive adaption to life-threatening trauma, such as combat. Our objective was to examine perceived ability to cope with trauma, as measured by the PACT, and the relationships between this perceived ability and clinically pertinent information (anxiety, depression, posttraumatic stress disorder [PTSD]) among U.S. military veterans. Data were provided from 71 combat veterans, consisting of 47 veterans with PTSD and 24 veterans without PTSD who had subthreshold symptoms of the disorder. All veterans completed standardized clinical interviews as well as a battery of well-validated self-report symptom measures. We found that veterans with PTSD had significantly lower PACT scores than veterans without PTSD; those without PTSD self-reported more ability to engage in forward-focused and trauma-focused coping than those with PTSD. Importantly, we also showed relationships between the PACT scores and indices of psychological difficulties as both Forward Focus and Trauma Focus coping scores negatively correlated with PTSD, depression, anxiety, and alexithymia. Finally, the Forward Focus PACT scale improved prediction of PTSD severity over combat exposure alone. The PACT, especially the Forward Focus scale, appears to be a useful measure of perceived positive coping ability with trauma in combat-exposed veterans who report symptoms of traumatic stress, extending the utility of the measure from normative to clinical populations. The importance of adopting forward-focused coping is discussed.     

A Review of Research on Moral Injury in Combat Veterans

The moral injury construct has been proposed to describe the suffering some veterans experience when they engage in acts during combat that violate their beliefs about their own goodness or the goodness of the world. These experiences are labeled transgressive acts to identify them as potentially traumatic experiences distinct from the fear-based traumas associated with posttraumatic stress disorder. The goal of this article was to review empirical and clinical data relevant to transgressive acts and moral injury, to identify gaps in the literature, and to encourage future research and interventions. We reviewed literature on 3 broad arms of the moral injury model proposed by Litz and colleagues (2009) Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., &; Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29, 695–706. 10.1016/j.cpr.2009.07.003[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]: (a) the definition, prevalence, and potential correlates of transgressive acts (e.g., military training and leadership, combat exposure, and personality), (b) the relations between transgressive acts and the moral injury syndrome (e.g., self-handicapping, self-injury, demoralization), and (c) some of the proposed mechanisms of moral injury genesis (e.g., shame, guilt, social withdrawal, and self-condemnation). We conclude with recommendations for future research for veterans suffering with moral injury.     

The Risks,Benefits, and Ethics of Trauma-Focused Research Participation

With the rising interest in the field of trauma research, many Institutional Review Boards, policymakers, parents, and others grapple with the impact of trauma-research participation on research participants' well-being. Do individuals who participate in trauma-focused research risk experiencing lasting negative effects from participation? What are the potential benefits that may be gleaned from participation in this work? How can trauma research studies be designed ethically, minimizing the risk to participants? The following review seeks to answer these questions. This review indicates that most studies in this area have found that only a minority of participants experience distress when participating in trauma-focused research. Furthermore, these negative feelings tend to dissipate quickly over time, with the majority of participants self-appraising their participation as positive, rewarding, and beneficial to society. Design characteristics that may serve to minimize participants' risk of experiencing distress are discussed, as well as implications for public policy and future research.     

Telling a traumatic story through Art: Arshile Gorky’s ‘The Artist and his Mother’

For more than a decade, through re-working a composition based on a sepia photograph, Arshile Gorky (ca. 1904–1948) tried to give form and represent that which by definition defies forms and shatters one’s capacity for representation. Having witnessed the systematic ethnic cleansing of his people as a child, Gorky began a ‘journey’ in his attempt to comprehend his traumatic ordeal through Art. In 1926, with the safety of a constructed name and life, the artist started working on ‘The Artist and his Mother’ series. Focusing on the two versions of Gorky’s early painting and using relevant aspects of psychoanalytic theory, the paper explores his work through a psychoanalytic lens. Psychoanalytic theories on extreme traumatisation along with psychoanalytic notions of temporality will be utilised in an attempt to follow the artist’s struggle to re-create and rework aspects of his traumatic history.