How Fear and Anxiety in Response to Countertransference and Somatic Countertransference Impacted the Clinical Decision-Making Of
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The Role of Therapist Activity in Psychodynamic Psychotherapy
ROLE OF THERAPIST ACTIVITY KATZMAN AND COUGHLIN The Role of Therapist Activity in Psychodynamic Psychotherapy Jeff Katzman and Patricia Coughlin Abstract: The teaching of psychodynamic psychotherapy is a critical component of psychiatric residency training programs. The authors argue that encourag- ing our residents to become active while providing psychodynamic psycho- therapy is a skill that can be taught. By helping residents to understand how to actively help patients focus on their internal world, identify and work with the defenses, and develop and maintain a treatment alliance, psychodynamic educators can enable psychiatric residents to feel far more competent when working in this paradigm. Such a stance inevitably leads to greater excitement and enjoyment for trainees, as well as better outcomes for patients. A middle-aged man enters his therapy session with a deep sigh and palpable sense of resignation. He sits silently and looks imploringly at his therapist, who also remains silent. Finally, the patient begins to discuss his ongoing depression, seemingly intractable problems with his wife, and stress in the workplace. He asks his therapist what he can do to improve his life. Not wanting to provide advice, the therapist (who is also a PGY-3 resident) throws the question back to the patient. Throughout the session, the therapist maintains a passive stance, mir- roring the slumped posture and slow, hesitant speech demonstrated by her patient. Both sink into a kind of quiet despair. Although the therapist wants to help and is well versed in the theory behind psycho- dynamic psychotherapy, she has not been trained to intervene actively and effectively in a manner consistent with that theory. -
The Founder of Common Factors: a Conversation with Saul Rosenzweig
The Founder of Common Factors: A Conversation With Saul Rosenzweig Barry L. Duncan Nova Southeastern University In preparation for a commentary on Saul Rosenzweig’s classic 1936 paper, “Some Implicit Common Methods in Diverse Forms of Psychotherapy,” an amazing discovery was made: Saul Rosenzweig is not only alive but also still contributing to science and society at age 93. This article sets the stage for a conversation with the incredibly prolific Dr. Rosenzweig by tracing the im- pact of his seminal contribution on early common factors theorists. This review reveals Rosenzweig’s unrecognized but profound influence on lead- ing figures of not only common factors but also of psychotherapy itself. A conversation with Rosenzweig, the founder of common factors, is presented. This noted scholar and wise elder of psychology reflects on the evolution of his thinking from common factors to idiodynamics, and on topics ranging from his passion for literature to his 1965 Buick Skylark, from the history of psychotherapy to falling in love with ideas. There is no new thing under the sun.—Eccles. 1:9 A literature search in preparation for a commentary (Duncan, 2002) on Saul Rosenzweig’s 1936 classic article, “Some Implicit Common Factors in Diverse Methods of Psychotherapy,” uncovered puzzling findings. After the 1936 article, there seemed to be a great void—nothing from Rosenz- weig in follow-up to his incredibly prophetic article and not much of any- thing else about common factors until the middle 1950s. Trying to make sense of the nearly 20-year hiatus as well as the surprising lack of reference to Rosenzweig’s contribution by early common factor theorists, I pursued information about Rosenzweig’s career to find some explanation. -
The Importance of the Relationship with the Therapist
Clinical Science Insights Volume 1 Volume Knowledge Families Count On The Importance of Before beginning psychotherapy, most patients wonder, “Will this counseling really help me with the Relationship my problems?” Research shows that many factors affect whether treatment is successful, including With the Therapist: the severity of the problem(s) being treated, the patient’s belief that the counseling will work and Research shows that the therapeutic the skill level of the therapist. relationship is one of the strongest However, research over the past fifty years has predictors of successful treatment demonstrated that one factor – more than any other – is associated with successful treatment: by Lynne Knobloch-Fedders, PhD the quality of the relationship between the therapist and the patient. In 1913, Sigmund Freud hypothesized that the relationship between the therapist and patient was a key component of successful treatment. Since that time, research has shown that the quality of this relationship (the “therapeutic alliance,” as it is called) is the strongest predictor of whether or not therapy is successful. Strikingly, the quality of the therapeutic relationship appears critical to treatment success no matter what type of treatment is studied. Large studies have been conducted of individual, couple and family therapy, using a variety of assessment T H E F a m i l y I N S T I T U T E methods to measure the quality of the relationship AT NORTHWESTERN UNIVERSITY (i.e. patient or therapist reports or observational Our mission is to strengthen and heal families ratings). These studies, which used diverse from all walks of life through clinical service, patient groups (children and adults, in-patients community outreach, education and research. -
The Therapeutic Relationship and Alliance-Building Behaviors: Treatment Implications for Childhood Social Phobia" (2014)
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Psychology Dissertations Student Dissertations, Theses and Papers 2014 The Therapeutic Relationship and Alliance- Building Behaviors: Treatment Implications for Childhood Social Phobia William La Valle Philadelphia College of Osteopathic Medicine, [email protected] Follow this and additional works at: http://digitalcommons.pcom.edu/psychology_dissertations Part of the Psychology Commons Recommended Citation La Valle, William, "The Therapeutic Relationship and Alliance-Building Behaviors: Treatment Implications for Childhood Social Phobia" (2014). PCOM Psychology Dissertations. Paper 287. This Dissertation is brought to you for free and open access by the Student Dissertations, Theses and Papers at DigitalCommons@PCOM. It has been accepted for inclusion in PCOM Psychology Dissertations by an authorized administrator of DigitalCommons@PCOM. For more information, please contact [email protected]. Philadelphia College of Osteopathic Medicine Department of Psychology THE THERAPEUTIC RELATIONSHIP AND ALLIANCE-BUILDING BEHAVIORS: TREATMENT IMPLICATIONS FOR CHILDHOOD SOCIAL PHOBIA William La Valle Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology April 2014 Committee Members' Signatures: Elizabeth A Gosch, PhD, ABPP, Chairperson Susan Panichelli Mindel, PhD Vanessa K Johnson, PhD Robert A DiTomasso, PhD, ABPP, Chair, Department of Psychology iii Acknowledgements I would like to thank my chair, Dr. Gosch, for her dedication and commitment to this research project. I would also like to thank the other members of my committee, Dr. Panichelli Mindel and Dr. Johnson, for their commitment, time, and feedback throughout the process. This project also would not have been possible without the support and patience of my wife, Amber, and my parents. Thank you for everything. -
About Psychoanalysis
ABOUT PSYCHOANALYSIS What is psychoanalysis? What is psychoanalytic treatment for? Freud’s major discoveries and innovations • The Unconscious • Early childhood experiences • Psychosexual development • The Oedipus complex • Repression • Dreams are wish-fulfilments • Transference • Free association • The Ego, the Id and the Super-Ego Major discoveries and additions to psychoanalytic theory since Freud: the different strands and schools within psychoanalysis today • Classical and contemporary Freudians • Sándor Ferenczi • Ego-Psychology • Classical and contemporary Kleinians • The Bionian branch of the Kleinian School • Winnicott’s branch of the Object-Relations Theory • French psychoanalysis • Self-Psychology • Relational Psychoanalysis The core psychoanalytic method and setting • Method • Setting Various Psychoanalytic Treatment Methods (adult, children, groups, etc) • Psychoanalysis • Psychoanalytic or psychodynamic psychotherapy • Children and adolescents • Psychoanalytic psychodrama • Psychoanalytic Couples- and Family-Psychotherapy • Psychoanalytic Groups Psychoanalytic training Applied psychoanalysis The IPA, its organisation and ethical guidelines Where to encounter psychoanalysis? What is psychoanalysis? Psychoanalysis is both a theory of the human mind and a therapeutic practice. It was founded by Sigmund Freud between 1885 and 1939 and continues to be developed by psychoanalysts all over the world. Psychoanalysis has four major areas of application: 1) as a theory of how the mind works 2) as a treatment method for psychic problems 3) as a method of research, and 4) as a way of viewing cultural and social phenomena like literature, art, movies, performances, politics and groups. What is psychoanalytic treatment for? Psychoanalysis and psychoanalytic psychotherapy are for those who feel caught in recurrent psychic problems that impede their potential to experience happiness with their partners, families, and friends as well as success and fulfilment in their work and the normal tasks of everyday life. -
Intrapsychic Perspectives on Personality
PSYCHODYNAMIC PERSPECTIVES ON PERSONALITY This educational CAPPE module is part i in section III: Theories of Human Functioning and Spirituality Written by Peter L. VanKatwyk, Ph.D. Introduction Psychodynamic theory goes back more than 100 years and has been a principal influence in the early history of clinical pastoral education (CPE). It is a way of thinking about personality dynamics in interpreting and understanding both the spiritual care-provider and care-receiver. This module will briefly summarize the basic theory and punctuate psychodynamic concepts that have been significant in the study of psychology of religion and theological reflection in the practice of spiritual care and counselling. Psychodynamic theories presently practiced include in historical sequence the following three schools that will be covered in this module: 1. Ego Psychology, following and extending the classic psychoanalytic theory of Freud, with major representatives in Anna Freud, Heinz Hartmann and Erik Erikson. 2. Object Relations Theory, derived from the work of Melanie Klein and members of the “British School,” including those who are prominent in religious studies and the practice of spiritual care: Ronald Fairbairn, Harry Guntrip, and D.W. Winnicott. 3. Self Psychology, modifying psychoanalytic theory with an interpersonal relations focus, originating in Heinz Kohut, systematized and applied for social work and counselling practice by Miriam Elson. In conjunction these psychodynamic theories offer three main perspectives on personality: 1. the human mind harbors conflict – with powerful unconscious forces that are continually thwarted in expressing themselves by a broad range of counteracting psychological processes and defense mechanisms. 2. each person carries an unconscious internalized world of personal relationships – with mental representations that reflect earlier experiences of self and others which often surface as patterns in current relationships and interpersonal problems. -
Classical Psychoanalysis Psikologi Kepribadian
Classical Psychoanalysis Psikologi Kepribadian Rizqy Amelia Zein 2017-09-14 1 / 67 [1] Image credit: Giphy 2 / 67 Classical Psychoanalysis [...also known as Ego Psychology, Psychodynamics] 3 / 67 First things rst: Instinct! 4 / 67 Instincts (1) Freud denes it as the motivating forces that drive behaviour and determine its direction. Instinct (or Trieb in German), is a form of energy, that is transformed into physical energy and serve its function to connect the physical and psychological needs. Freud argues that human always experience instinctual tension and unable to escape from it. So most of our activities are directed to reduce this tension. People could have different ways to reduce the tension (e.g. sexual drives can manifest in various sexual behaviours). It's also possible to substitute the objects (displacement) and this process is primarily important to determine one's behaviour. Freud coined the terms "life" and "death" instincts, which posit different process of primal motivations. 11 / 67 Instincts (2) The Life Instinct 1. Serve the purpose of survival of the individual and the species by seeking to satisfy the needs for food, water, air, and sex. 2. The life instincts are oriented toward growth and development. The psychic energy manifested by the life instincts is the libido. 3. The libido can be attached to or invested in objects, a concept Freud called cathexis. 4. So if you like Ryan Gosling so much, for example, then your libido is cathected to him. 12 / 67 Instincts (2) The Death Instinct 1. In opposition to the life instincts, Freud postulated the destructive or death instincts. -
Psychodynamic Approaches to Treating Antagonism
Psychodynamic Approaches to Treating Antagonism Christopher J. Hopwood, University of California, Davis Robert F. Bornstein, Adelphi University For D. Lynam and J. Miller (Eds.) Antagonism as a Personality Trait. Elsevier. Psychodynamic Treatment of Antagonism 2 Although trait and psychodynamic approaches to personality have taken adversarial positions at times (e.g, McWilliams, 2012), we see them as complementary (Wiggins, 2003). Trait psychology supplements complex psychodynamic theories with an evidence-based model of individual differences that can be used to generate reliable assessment methods useful for testing dynamic hypotheses about personality, psychopathology, and psychotherapy. Psychodynamic theories enrich descriptive trait approaches, enhance their clinical utility, provide a coherent framework for interpreting multimethod assessment data, and generate testable hypotheses about mechanisms underlying personality processes (see Hopwood & Bornstein, 2014; Hopwood, Zimmermann, Pincus, & Krueger, 2015). In this chapter we take a step toward integrating these complementary theoretical perspectives with respect to assessing and treating antagonism. We first describe similarities and differences between trait and psychodynamic conceptualizations of antagonism, with a focus on the specific features of the psychodynamic perspective that can augment a trait perspective. We then illustrate these features in describing principles of psychodynamic psychotherapy for antagonism. Trait and Psychodynamic Models of Personality The primary -
Transference and Countertransference and the Trauma Triangle: Ethics 3 Hours
TRANSFERENCE AND COUNTERTRANSFERENCE AND THE TRAUMA TRIANGLE: ETHICS 3 HOURS ROSALIE W. HYDE LCSW FACULTY CO-FOUNDER THE HOUSTON GALVESTON TRAUMA INSITUTE PRIVATE PRACTICE 3100 RICHMOND Ave #110 Houston Texas 77098 713-960-8450 [email protected] SUPERVISOR/TEXAS SOCIAL WORK LICENSURE CONSULTATION: INDIVIDUAL AND GROUP “EASIER SAID THAN DONE” Boundaries are the limits that allow for a safe connection based on the client’s needs. The law and our professional Codes of Ethics by themselves cannot address most of the situations encountered by therapists and their clients in the difficult work of psychotherapy with traumatized people. The law and code are both narrative and literal and the real territory of ethics is ruled by more implicit boundaries, which prohibit actions that betray the client and the therapist. This unchartered territory is the dangerous ground of the therapy relationship, and in which we must steady our course to make rational, relational decisions to protect the client, the relationship and ourselves. THE TRAUMA TRIANGLE VICTIM PERPETRATOR WITNESS/ RESCUER COLLUDING OR POWERLESS TRAUMATIC EXPERIENCES Psychological trauma can be anything that is too much for the person to manage emotionally. There are a variety of life events that are traumatic to a person, including some experiences that for one person may be overwhelming and not overwhelming to another. For Example: SEXUAL ABUSE PHYSICAL ABUSE/BATTERING RAPE FEMALE GENITAL MUTILATION NEGLECT EXPERIENCE OF BEING OVER-CONTROLLED OR MONITORED EXPERIENCE OF BEING CRITICIZED OR BLAMED WITNESS TO ABUSE OF ANY KIND TO ANOTHER TORTURE/IMPRISONMENT POVERTY/HUNGER WAR/COMBAT TRAUMA EARLY LOSS OF A PARENT LOSS OF A CHILD OR SIBLING DISABILITY/ CHRONIC ILLNESS IN A PARENT / SIBLING CHRONIC ILLNESS, REPEATED HOSPITALIZATIONS, TERMINAL ILLNESS ACCIDENTS: AUTO, FIRE, MANUFACTURING, ETC. -
What Is Mentalization? the Concept and Its Foundations in Developmental
What is Mentalization? The Concept and its Foundations in Developmental Research and Social-Cognitive Neuroscience Peter Fonagy Elizabeth Allison Address for correspondence: Peter Fonagy PhD FBA Research Department of Clinical, Educational and Health Psychology University College London Gower Street London WC1E 6BT E-mail: [email protected] Tel: 44 20 7679 1791 Fax: 44 20 7916 8502 Chapter submitted for Nick Midgley & Ioanna Vrouva (eds) Keeping Children in Mind: Mentalization-based Interventions with Children, Young People and their Families, January 2011. What is mentalization? When we mentalize we are engaged in a form of (mostly preconscious) imaginative mental activity that enables us to perceive and interpret human behavior in terms of intentional mental states (e.g., needs, desires, feelings, beliefs, goals, purposes, and reasons) (Allen, Fonagy, & Bateman, 2008). Mentalizing must be imaginative because we have to imagine what other people might be thinking or feeling. We can never know for sure what is in someone else’s mind (Fonagy, Steele, Steele, & Target, 1997). Moreover, perhaps counterintuitively, we suggest that a similar kind of imaginative leap is required to understand our own mental experience, particularly in relation to emotionally charged issues. We shall see that the ability to mentalize is vital for self-organization and affect regulation. The ability to infer and represent other people’s mental states may be uniquely human. It seems to have evolved to enable humans to predict and interpret others’ actions quickly and efficiently in a large variety of competitive and cooperative situations. However, the extent to which each of us is able to master this vital capacity is crucially influenced by our early experiences as well as our genetic inheritance. -
Chapter 1 the COHERENCE of the DREAM-WORK
Chapter 1 THE COHERENCE OF THE DREAM-WORK sychoanalytic theorizing begins with the fact that conscious thought is coherent or, at least, ordinarily capable of co- Pherence, whereas the manifest content of dreams is often partly or wholly incoherent. Sigmund Freud’s (1900) Interpretation of Dreams makes the methodological claim that incoherent images and ideas can be rendered coherent through their interpretation as symbols whose meanings are unconscious. As Fliess (1973) re- marked, “If a sequence of thought contains gaps that can be closed only by reading certain elements in it symbolically, then they are symbols” (p. 17). To explain why the psychoanalytic method of dream interpretation appears to work, Freud hypothesized that the un- conscious mind produces dreams by translating the contents of conscious and rational (“secondary process”) ideas into images, of which some are manifestly incoherent or irrational (“primary process”). In 1900, when Freud presented what came to be called the “topographic hypothesis” of the psyche, he allocated all rational thought to the system Perception-Consciousness (Pcpt.-Cs.) and only irrational symbol-formation to the system Unconscious (Ucs.). Carl G. Jung’s position was closely derivative. Although Jung (1938, p. 45) recognized that “the unconscious mind is capable at times of assuming an intelligence and purposiveness which are superior to 1 2 UNCONSCIOUS WISDOM actual conscious insight,” the observation, which was presumably clinical, was never formally expressed in theory. In Jung’s theory system, archetypes are unconscious instinctual forms that manifest conscious images whenever there is a quantitative imbalance in the distribution of psychic energy between consciousness and the unconscious. -
The Therapeutic Relationship As the Cornerstone of the Controlled Act of Psychotherapy
-2- The Therapeutic Relationship as the Cornerstone of the Controlled Act of Psychotherapy Volume 1 Submitted to the Minister of Health and Long-Term Care November 1, 2017 The Controlled Act of Psychotherapy: Recommendations of the Health Professions Regulatory Advisory Council Volume 1 TABS Tab 1………………………………………………………...……Report Tab 2………………….…………….Alternative Clarification Document The Therapeutic Relationship as the Cornerstone of the Controlled Act of Psychotherapy Volume 1 Thomas Corcoran Thomas Corcoran Chair President 56 Wellesley St W., 56, rue Wellesley Ouest, 12th Floor 12e étage Toronto ON M5S 2S3 Toronto ON M5S 2S3 Tel (416) 326-1550 Tél (416) 326-1550 Fax (416) 326-1549 Téléc (416) 326-1549 Web site www.hprac.org Site web www.hprac.org E-mail Courriel [email protected] [email protected] November 1, 2017 The Honourable Eric Hoskins Minister of Health and Long-Term Care 10th Floor, Hepburn Block 80 Grosvenor Street Toronto ON M7A 2C4 Dear Minister, The Health Professions Regulatory Advisory Council (HPRAC) is pleased to present our report on the controlled act of psychotherapy. Our approach included completing literature, jurisdictional, and jurisprudence reviews. To meet the timeline outlined in your August 4, 2017, correspondence, HPRAC undertook a targeted stakeholder consultation with key informants who would be affected by the recommendations on the controlled act of psychotherapy. HPRAC relied on this information to formulate the following advice: 1. In relation to clarifying the controlled act of psychotherapy: HPRAC believes that the client’s perspective should guide the clarification of the controlled act. As such, the key element of the controlled act is the therapeutic relationship between the client and the provider.