This article provides a historical overview of the Existential-Phenomenological tradition in psychiatry and psychotherapy, tracing its development from its origin in nineteenth and twentieth century philosophical thought, through its major European psychiatric proponents and schools, to its emergence as an influential approach in North America after World War II. The emphasis is on the implicit themes that provide continuity within this movement as well as on the distinctive contributions of individual thinkers. We conclude with a discussion of the present (...) status and future prospects of this tradition. (shrink)

Objective: The COVID-19 pandemic is negatively impacting the mental health of COVID-19 patients and family members. Given the restrictions limiting in person contact to reduce the spread of the virus, a digital approach is needed to tackle the psychological aftermath of the pandemic. We present the development of a brief remote psychotherapy program for COVID-19 patients and/or their relatives.Methods: We first reviewed the literature on psychotherapeutic interventions for COVID-19 related symptoms. Based on this evidence, we leveraged ongoing clinical (...) experiences with COVID-19 survivors and family members to design an intervention model that could be disseminated and integrated into the workflow of the mental health system.Results: This 8-session model –inspired by constructivist and hermeneutic-phenomenological therapies– serves COVID-19 patients during hospitalization, remission and recovery. This model can also be delivered to people dealing with the COVID-19 hospitalization/discharge of a family member, or the loss of a family member due to COVID-19.Conclusion: We described a remote psychotherapeutic approach to tackle the COVID-19 pandemic psychological aftermath. To date, the approach seems feasible and highly customizable to patients’ needs. Studies are underway to test its preliminary efficacy. Once proven efficacious, this treatment model could provide a blueprint for future tele-psychology wide-scale interventions. (shrink)

Smith, Glass, and Miller have reported a meta-analysis of over 500 studies comparing some form of psychological therapy with a control condition. They report that when averaged over all dependent measures of outcome, psychological therapy is. 85 standard deviations better than the control treatment. We examined the subset of studies included in the Smith et al. metaanalysis that contained a psychotherapy and a placebo treatment. The median of the mean effect sizes for these 32 studies was. 15. There was (...) a nonsignificant inverse relationship between mean outcome and the following: sample size, duration of therapy, use of measures of outcome other than undisguised self-report, measurement of outcome at follow-up, and use of real patients rather than subjects solicited for the purposes of participation in a research study. A qualitative analysis of the studies in terms of the type of patient involved indicates that those using psychiatric outpatients had essentially zero effect sizes and that none using psychiatric inpaticnts provide convincing evidence for psychotherapeutic effectiveness. The onty studies clearly demonstrating significant effects of psychotherapy were the ones that did not use real patients. For the most part, these studies involved small samples of subjects and brief treatments, occasionally described in quasibeliavioristic language. It was concluded that for real patients there is no evidence that the benefits of psychotherapy are greater than those of placebo treatment. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Psychodramatic Psychotherapy for Schizophrenic IndividualsJohn Nolte, MD, PhD (bio)As a long-time student, practitioner, trainer, author and advocate of J. L. Moreno, MD,’s works and specifically the psychodramatic method, I am always appreciative of efforts, like Chapy’s, to commend and advocate for psychodrama. This is especially so because for a time, Moreno and psychodrama were heavily criticized, even maligned in the mental health professions. At the same time, (...) considering how poorly Moreno and his methods have been understood as well as the difficulty of accessing his original material, I feel an obligation to set the record straight when confronted with incomplete, inadequate, or sometimes incompetent expositions of Moreno’s psychodrama.Chapy’s article recommends psychodrama as a treatment method for schizophrenic people by calling upon existentialist and phenomenological concepts. Psychodrama, he proposes, opens up existence by allowing “schizophrenic patients to incorporate the experience of an ‘absolutely other.’”There are major flaws in Chapy’s presentation. His “clinical illustration,” the presentation of a psychodrama with a schizophrenic patient, while it may be considered psychodrama under the broadest definition of the term, hardly fulfills the requirements of a psychotherapeutic psychodrama. We must question the competence of the psychodramatist in Chapy’s example. Chapy’s description of the drama itself falls short of being an adequate account of a psychodrama, failing to convey the emotional intensity and realness which a well directed and reported psychodrama achieves. We do not learn, for example, if Damien’s perception of his father is introduced through role reversal with the father, a standard psychodramatic technique which is done in order to give the auxiliary ego taking that role an understanding how Damien experiences his father. We do not know if role reversals are made throughout the drama so that Damien can experience how he is perceived by father, can feel the force of his confrontation in the role of father, and is required to reply as his father to his confrontation. We are given little information about the psychodramatic techniques employed by the director other than the scene setting of the studio in which the psychodramatic [End Page 227] encounter takes place, and the soliloquy in which Damien expresses his worry and hopes for the outcome of the confrontation. It should be clear in the description of the drama whether the father’s statements in the drama were produced by Damien in role reversal, or by the auxiliary ego playing the role. There is a difference and it is significant. Although we are told that Damien “evokes a systematic relationship between him and his father” during the psychodrama, we do not see how this happens. Every psychodrama is an existential experience and its description should fully communicate its meaning and emotion.A more serious problem, however, is that this drama does not deal with Damien’s psychosis. Although Damien may be diagnosed as schizophrenic, his disorder is obviously in remission or controlled by psychotropic drugs. The drama reveals none of the hallucinations, delusions, or disorder characteristic of schizophrenic disorders. It could be psychodrama of any young man with a complaint about his father.The notion that people with schizophrenia can be successfully treated by psychodrama is not new. Moreno began developing psychodramatic psychotherapy at his Beacon Hill Sanitarium, established in 1936. He and psychodrama gained some fame because of his success in treating schizophrenic patients at a time when schizophrenic individuals were considered incapable of benefitting from psychotherapy. Moreno’s approach to the treatment of schizophrenic patients was much more robust than the psychodrama described by Chapy. During a psychotic attack, the individual’s perception of the world and self are distorted in ways that made action and interaction in the world of conventional reality impossible. Additionally, the psychotic episode makes the psychotic person incapable of being comprehended by anyone else, including the psychiatrist. Moreno’s solution was to make the chaotic, bewildering, sometimes violent and always terrifying inner world visible and tangible in the surplus reality of the psychodramatic stage. In moments of lucidity following the psychotic episode, he asked his schizophrenic patients to reenact their psychotic experiences. The result was that, “In this imaginary reality on the psychodramatic stage, the... (shrink)

This user-friendly companion to the comprehensive Guidelines for the Systematic Treatment of the Depressed Patient outlines psycho-behavioral interventions to help practicing clinicians select the appropriate therapeutic procedure for various patients. This brief reference book for professional psychotherapists is intended to help practicing clinicians select the appropriate therapeutic procedure for various patients.

Background: although cognitive behavioural therapy is the gold standard treatments for bulimia nervosa (BN) and binge eating disorder (BED), evidence for its long-term efficacy is weak. Empirical research support the efficacy of brief strategic therapy (BST) in treating BN and BED symptoms, but its statistical significance still need to be investigated. Objective: to statistically test the long-term efficacy of the BST treatment protocols for BN and BED through one-year post-treatment. Methods: a two-group longitudinal study will be conducted. Participants will (...) be sequentially recruited for inclusion in a state-funded community psychotherapy clinic. Multilevel growth curve modeling will be used to estimate the average growth trajectories from baseline to one year after treatment termination for the severity of the BN and BED features as measured by the Eating Disorder Examination Questionnaire. Discussion: findings from this study will clarify the impact of BST in treating BN and BED symtoms. Conclusions: translating research into practice may inform how to ensure high-quality patient care. (shrink)

Thoroughly revised and updated, the new edition of this highly popular introduction features two new chapters, one on brief, focal psychotherapy and another on child therapy. As in the first edition, the contributors each take a particular form of psychotherapy and describe its goals, techniques, and applications, using a down-to-earth approach that blends theory with practical aspects. From reviews of the first edition: "An excellent book....Could not be done better in a brief presentation."--American Journal of Psychiatry. (...) "A smoothly edited and technically well-produced synopsis of psychotherapeutic techniques....Useful for senior medical students and junior residents seeking a rapid overview."--Hospital Community Psychiatry. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.4 (2005) 301-305 [Access article in PDF] The Beauty of Psychotherapy R. D. Hinshelwood Keywords awe, psychotherapy, representation, self-esteem The Enlightenment was devoted to clear uncontaminated reason; its success has given us the terrific achievements of science and technology. However, it has bequeathed problems too. Untrammeled reason has led to the devaluing and exclusion of emotions. Emotions are irrational—self-deception, akrasia, and so (...) on. They were a problem for the eighteenth-century philosopher Kant and right through to the modern therapist Aaron Beck. Callender rightly looks around the edges of rationalist thought to see what can be said about the emotional and subjective side of mankind. He argues that there is more to the human mind than cognition. Something has been left out. What can be found to fill the gap?Callender has searched for the missing link that might complete our view of human nature. And he came back with aesthetics. Meaning The Enlightenment failing is writ large for therapists who are confronted with people who feel things. So we need to ask what place the emotions have in understanding the nature of man? It is not a hypothetical question, but a very practical one for a therapist. Emotions, Callender says, and most people would agree with him, are what gives meaning to life, a sense of purpose in living, even an ill-defined or delusional purpose.He presents Kant's description of aesthetics. Aesthetic judgements have a number of features, the most enigmatic and perhaps profound is a "purposiveness without purpose." A work of art, say a portrait, may have a purpose insofar as it represents a person for his aggrandizement or for his descendents through many generations, but the aesthetic quality does not come from that purpose. The aesthetic purpose involves a different set of judgements. They are about the painting as a piece of art in itself. If it is possible to compare this kind of aesthetic judgement with a judgement of a person's life, then I find myself reminded of Wollheim's definition of a person: The simplest way of putting the matter, which is not to be taken as a metaphysical claim, is this: There are persons, they exist; persons lead lives; and as a result, in consequence—in consequence that is, of the way they do it—there are lives, of which those who lead them may, for instance, be proud, or feel ashamed. So there is a thing, and there is a process, and there is a product. (Wollheim 1984, 2) Although many things do not lead lives, we do. And our lives have a process and a product. Like an aesthetic product, our lives have a sense of emotional meaning, without it having a clear purpose.Aesthetic judgements are therefore of a particular and somewhat peculiar kind. They judges talent for producing "that for which no determinate [End Page 301] rules can be given," as the paper quotes Kant. Other kinds of judgements do have determinate rules. First are empirical judgements for getting practical things done; and moral judgements for assessing ethical good from bad. Aesthetic beauty does not have clear rules, although many systems of rules have been proposed starting with the rules of perspective as they were laid out by renaissance painters, through to systems of color, such as that proposed by Paul Klee, once color was correlated with electromagnetic wavelengths. However, artists have always kept one jump ahead and evaded imprisonment in codified rules. So too it is with leading a life, perhaps. The really creative life is not lead according to rules. The art of life is to live meaningfully without simply running along tramlines. Although moral conduct and the practicalities of life remain significant, perhaps leading a life implies simply a "flare for living." Representation Of these three kinds of judgements that a mind makes, two do have sets of rules. Only one based on rationality, empirical evidence, and reason. Reason judges what can be done and achieved in the real physical world. It is about pragmatics and the usefulness of action. Moral judgements, about what... (shrink)

The chapter begins with a brief preliminary investigation of the nature and role of theory in psychotherapy in general. Then, it introduces Gestalt therapy in an institutional and historical context. The distinctive theoretical tenets of Gestalt psychotherapy are outlined next. The chapter looks at some of the philosophical underpinnings of this theory and notes how such underpinnings tend toward subjectivism and an anti‐theory stance. It also suggests some alternative underpinnings, which could lead to a more integrated outlook (...) on the relation of theory to practice and a resolution of the objectivity‐subjectivity tension. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.4 (2005) 307-310 [Access article in PDF] Aesthetics, Criticism, and Psychotherapy John Z. Sadler Keywords aesthetics, psychiatry, psychotherapy, Sibley In his wide-ranging survey of how Kantian aesthetic theory is implicated in psychothera-py, John Callender has raised at least a dozen potentially profound and rewarding possibilities in applying aesthetic theory to psychiatry and psychotherapy. Although the idea of marrying aesthetic theory to (...) psychiatry and psychotherapy is not new, Callender's direction of the merger is distinctively novel. The mid-twentieth century had a distinct literature in applying psychoanalytic and psychiatric theory to aesthetic experience, summarized by the sizable bibliography by Norman Kiell, Psychiatry and Psychology in the Visual Arts and Aesthetics: A Bibliography (1965). This line of interdisciplinary work influenced a later generation of art historians and literary theorists in applying (particularly) psychoanalytic theory to interpretation and appreciation of the arts, contributions that are still being developed today, along with the emergence of complementary viewpoints from cognitive neuroscience (Peretz and Zatorre 2003; Rose 2004; Zeki 1999). Callender's project, however, is quite the converse—he wishes to show how philosophical aesthetics can contribute to psychiatry and clinical psychology. Exploring the aesthetics of psychiatry is the innovation.Before focusing my own comments on a few of Callender's points, I wish to call attention to the substantive questions he has directly raised or implied by his discussions. These questions are worthy of further development in this and other journals, and I hope that Callender will succeed in engaging the minds of his readers and inspire them to work in this exciting area in the philosophy of psychiatry. In his elegant review of Kant's key theoretical points of aesthetics, his discussion provokes us to consider the kinds of evaluations that patients make of themselves (moral? aesthetic? others?), as well as the kinds of evaluations clinicians make in their judgments of psychopathology. Evolutionists may wonder about the adaptive significance of aesthetic capacities (e.g., derivatives of grooming? mating displays?). In presenting Kant's notion of "disinterestedness" or contemplative judgment, readers may wonder about overlap with notions of therapist neutrality and unconditional positive regard. Should therapist relationships with patients be dominated by a similar aesthetic sensibility? What does the aesthetic posture have to do with the therapist posture?Importantly, Callender notes the connections and ambiguities between moral values and aesthetic values. This is borne out in his later discussions of clinical case material (considered again below). He focuses primarily on the duplication of aesthetic and moral values in the same terms of praise (honesty, integrity, originality), but there is no question that aesthetic experiences are had by viewers of art exhibiting perverse or depraved [End Page 307] imagery (consider, for instance, Francis Bacon's "3 Screaming Popes" or, even more extremely, the grotesque staged photographs of Joel-Peter Witkin). The implication here is that (as an example) to understand the aesthetics of sadomasochistic art may help us to understand the psychology of sadomasochistic people.By the time he introduces his case material, Callender has raised the issue of intersubjectivity in aesthetic experience, an experience that may be devoid of discursive cognitive content but may be profound with emotional content, thus challenging tenets of cognitive psychology and psychotherapy. His discussion of cases reflecting elements of Kant's components of aesthetic judgment point toward new ways of understanding psychopathology as disturbances in aesthetic self-appraisal.I would like to return to the problem of moral and aesthetic judgments in psychotherapy and in psychopathology. Dr. Callender presents three cases—a woman who has been traumatized by multiple instances of sexual abuse, a young girl with postpartum depression with fears of losing her child because of bad mothering, and a third patient with anorexia nervosa who demonstrates the typically distorted body self-image. I suggest that the aesthetic nature of these patients' self-judgments is not so clear cut as Callender suggests. His sexual abuse case summary certainly suggests a woman consumed by shame. Because shame is a typical "moral emotion," the question is raised of moral badness being involved in her self-concept as well as, or perhaps... (shrink)

Previous accounts of psychiatry within Communist Europe have emphasized the dominance of biological approaches to mental health treatment. Psychotherapy was thus framed as a taboo or marginal component of East European psychiatric care. In more recent years, this interpretation has been re-examined as historians are beginning to delve deeper into the diversity of mental healthcare within the Communist world, noting many instances in which psychotherapeutic techniques and theory entered into clinical practice. Despite their excellent work uncovering these hitherto neglected (...) histories, however, historians of the psy-disciplines in Eastern Europe have neglected to fully consider the ways that post-World War II psychotherapeutic developments were not simply continuations of pre-war psychoanalytic traditions, but rather products of emerging transnational networks and knowledge exchanges in the post-war period. This article highlights how psychotherapy became a leading form of treatment within Communist Yugoslavia. Inspired by theorists in France and the United Kingdom, among other places, Yugoslav practitioners became well versed in a number of psychotherapeutic techniques, especially ‘brief psychotherapy’ and group-based treatment. These developments were not accidents of ideology, whereby group psychotherapy might be accepted by authorities as a nod to some idea of ‘the collective’, but were rather products of economic limitations and strong links with international networks of practitioners, especially in the domains of social psychiatry and group analysis. The Yugoslav example underscores the need for more historical attention to transnational connections among psychotherapists and within the psy-disciplines more broadly. (shrink)

For three decades Jeremy Holmes has been a leading figure in psychodynamic psychiatry in the UK and across the world. He has played a central role in promoting the ideas of John Bowlby and in developing the clinical applications - psychiatric and psychotherapeutic - of Attachment Theory in working with adults. Drawing on both psychoanalytic and attachment ideas, Holmes has been able to encompass a truly biopsychosocialperspective. As a psychotherapist Holmes brings together psychodynamic, systemic and cognitive models, alert to vital (...) differences, but also keenly sensitive to overlaps and parallels. This volume of selected papers brings together the astonishing range of Holmes' interests and contributions. The various sections in the book cover: An extended interview - covering Holmes' career and philosophy as a psychodynamic psychiatrist 'Juvenilia' - sibling relationships, the psychology of nuclear weapons, and the psychodynamics of surgical intervention. Psychodynamic psychiatry: Integrative and Attachment-Informed A psychotherapy section inwhich he develops his model of psychotherapeutic change 'Heroes' - biographical pieces about the major influences including, John Bowlby, Michael Balint, David Malan, Jonathan Pedder and Charles Rycroft. 'Ephemera' - brief pieces covering such topics as frequency of psychodynamic sessions and fees. Attachments: Psychiatry, Psychotherapy, Psychoanalysis - The Selected Works of Jeremy Holmeswill be essential and illuminating reading for practitioners and students of psychiatry and psychotherapy in all its guises. (shrink)

Summary With regard to the dynamics of human experience and behavior, Gestalt theoretical psychotherapy (GTP) relies mainly on Kurt Lewin’s dynamic field theory of personality. GTP is carried out by including a re-interpretation of Lewin’s theory in some aspects of psychotherapeutic practice in relation to critical realism. Human experience and behavior are understood to be functions of the person and the environment (including the other individuals therein) in a psychic field (life space), which encompasses both of these mutually dependent (...) factors. The anthropological model of this approach is, therefore, not mono-personal but, a priori, structural and relational in nature. It does not one-sidedly focus on the “inner components” of a person, but on the interrelation of the individual and a given environment, which affects experience and behavior. After a brief introduction of these basic concepts, this lecture will focus especially on Lewin’s concept of tension-systems, which may be considered as the Gestalt theoretical counterpart of Freud’s drive theory. Further, we define the basic assumptions which underlie GTP and explain how the person moves through her/his life experience in terms of Gestalt psychology. (shrink)

Pt. I. Philosophy and cognitive-behavioral therapy (CBT) -- Ch. 1. The "philosophical origins" of CBT -- Ch. 2. The beginning of modern cognitive therapy -- Ch. 3. A brief history of philosophical therapy -- Ch. 4. Stoic philosophy and psychology -- Ch. 5. Rational emotion in stoicism and CBT -- Ch. 6 Stoicism and Ellis's rational therapy (REBT) -- Pt. II. The stoic armamentarium -- Ch. 7. Contemplation of the ideal stage -- Ch. 8. Stoic mindfulness of the "here (...) and now" -- Ch. 9. Self-analysis and disputation -- Ch. 10. Autosuggestion, premeditation, and retrospection -- Ch. 11. Preditatio malorum and mental rehearsal -- Ch. 12. Stoic fatalism, determination, and acceptance -- Ch. 13. The view from above and stoic metaphysics. (shrink)

The place of rationality in Stoicism and REBT -- Ellis and Epictetus: dialogue vs. method in psychotherapy -- The intellectual origins of Rational Psychotherapy: twentieth-century writers -- REBT and rationality: philosophical approaches -- Rationality and the shoulds -- When did a psychologist last discuss "chagrin"?: American psychology's continuing moral project -- The social psychology of "pseudoscience": a brief history -- Historical aspects of mindfulness and self-acceptance in psychotherapy -- Marginalisation is not unbearable, is it even undesirable?

In lieu of an abstract, here is a brief excerpt of the content:Books ReceivedAt the Eleventh Hour: The Biography of Swami Rama. By Pandit Rajmani Tigunait, Ph.D. Honesdale, Pennsylvania: Himalayan Institute Press, 2002. Pp. 427. Hardcover $18.95.Awakening and Insight: Zen Buddhism and Psychotherapy. Edited by Polly Young Eisendrath and Shoji Muramoto. Hove, England: Brunner-Routledge, 2002. Pp. xii + 275. Paper $24.95.Beyond Metaphysics Revisited: Krishnamurti and Western Philosophy. By J. Richard Wingerter. Lanham, Maryland: University Press of America, 2002. Pp. (...) vii + 391. Hardcover $71.00.Bhāmatī and Vivaraṇa Schools of Advaita Vedānta: A Critical Approach. By Pulasth Soobah Roodurmun, foreword by V. N. Jha, and edited by Kanshi Ram. New Delhi: Motilal Banarsidass Publishers, 2002. Pp. xv + 297. Price not given.A Bibliography of Ananda Kentish Coomaraswamy. By James S. Crouch. New Delhi: Indira Gandhi National Centre for the Arts and Manohar Publishers and Distributors, 2002. Pp. 430. Price not given.Crisis Theory and World Order: Heideggerian Reflections. By Norman K. Swazo. Albany: State University of New York Press, 2002. Pp. x + 289. Hardcover $78.50. Paper $26.95.Devotional Literature in South Asia: Current Research 1997-2000: Proceedings of the Eighth International Conference on Early Literature in New Indo-Aryan Languages, Leuven, 23-26 August 2000. Edited by Winand M. Callewaert and Dieter Taillieu. New Delhi: Manohar Publishers and Distributors, 2002. Pp. xxii + 324. Price not given.Dharma Bell and Dhāraṇī Pillar: Li Po's Buddhist Inscriptions. By Paul W. Kroll. Kyoto: Italian School of East Asian Studies, 2001. Pp. viii + 95. Price not given.Essays on the Moral Philosophy of Mengzi. Edited, with introduction, by Xiusheng Liu and Philip J. Ivanhoe. Indianapolis and Cambridge: Hackett Publishing Company, 2002. Pp. xiv + 249. Hardcover $39.95. Paper $16.95. Professional price $12.95.Ethical Questions: East and West. Edited by Bina Gupta. Lanham, Maryland: Rowman and Littlefield Publishers, 2002. Pp. vi + 279. Hardcover $70.00. Paper $26.95.Ethical Relativism and Universalism. By Saral Jhingran. New Delhi: Motilal Banarsidass Publishers, 2001. Pp. xiv + 385. Price not given.Genius-In Their Own Words: The Intellectual Journeys of Seven Great 20th Century [End Page 431] Thinkers. Edited and with introduction by David Ramsay Steele, foreword by Arthur C. Danto. Chicago and La Salle: Open Court, 2002. Pp. xxii + 366. Paper $24.95.The Hatha Yoga Pradipika. The original Sanskrit by Svatmarama, an English translation by Brian Dana Akers. Woodstock, New York: YogaVidya.com, 2002. Pp. xii + 115. Hardcover $19.95. Paper $11.95.Human Rights and Chinese Thought: A Cross-Cultural Inquiry. By Stephen C. Angle. New York: Cambridge University Press, 2002. Pp. xviii + 285. Hardcover $65.00. Paper $23.00.Indestructible Truth: The Living Spirituality of Tibetan Buddhism. By Reginald A. Ray. Boston and London: Shambhala Publications, 2002. Pp. x + 495. Paper $17.95.Introduction to Eastern Thought. By Marietta Stepaniants. Edited by James Behuniak and translated by Rommela Kohanovskaya. Lanham, Maryland: AltaMira Press, a division of Rowman and Littlefield Publishers, 2002. Pp. xiv + 293. Hardcover $69.00. Paper $24.95.Jainism and Ecology: Nonviolence in the Web of Life. Edited by Christopher Key Chapple. Cambridge: Harvard University Press for the Center for the Study of World Religions, 2002. Pp. xliv + 252. Hardcover $32.95. Paper $22.95.Mediating the Power of Buddhas: Ritual in the Mañjuśrīmūlakalpa. By Glenn Wallis. Albany: State University of New York Press, 2002. Pp. xiii + 263. Hardcover $86.50. Paper $29.95.Methodology in Religious Studies: The Interface with Women's Studies. Edited by Arvind Sharma. Albany: State University of New York Press, 2002. Pp. xi + 253. Hardcover $78.50. Paper $26.95.Persons and Valuable Worlds: A Global Philosophy. By Eliot Deutsch. Lanham, Maryland: Rowman and Littlefield Publishers, 2002. Pp. x + 309. Hardcover $80.00. Paper $34.95.Philosophy and Art in Gurdjieff's Beelzebub: A Modern Sufi Odyssey. By Anna T. Challenger. Amsterdam and New York: Editions Rodopi B.V., 2002. Pp. xi + 145. Paper EUR 27,00, U.S. $25.00.The Pratyabhijñā Philosophy. By G. V. Tagare. New Delhi: Motilal Banarsidass Publishers, 2002. Pp. xii + 165. Price not given.Reflections on Reality: The Three Natures and Non-Natures in the Mind-Only School: Dynamic Responses to ong-ka-a's The... (shrink)

This _Handbook_ provides a comprehensive guide to the practice and principles of child and adolescent psychotherapy around the world. Contents include: * a brief introduction to the child psychotherapy profession, its history and development * a review of the theory underlying therapeutic practice * an overview of the varied settings in which child psychotherapists work * analysis of the growth of the profession internationally * an examination of areas of expertise around the world * a summary of (...) current research Contributors are experienced practitioners from within a diverse range of schools and approaches and so provide a well-rounded picture of child and adolescent psychotherapy today. _The Handbook of Child and Adolescent Psychotherapy_ will be an essential resource for professional psychotherapists, students of psychotherapy, social workers and all professionals working with disturbed children. (shrink)

I wish to thank both Dr. Eagle and Dr. Thompson for their thoughtful and thought-provoking commentaries on my paper. I address some of the concerns they brought up in this response. When I began to write this paper, my first thoughts were to the effect of “How does one write a relatively brief article about a topic on which I’ve already devoted a rather lengthy book?” What do I include? And what do I leave out? Although the latter of (...) these questions left me dealing with many feelings of ‘existential guilt’ about leaving out ideas I think are important, the former took guidance from the stated purpose of this special issue to address a broad and interdisciplinary audience on the question of what.. (shrink)

In three studies, factors influencing the incidence of fraudulent financial reporting were assessed. We examined (1) the effects of personal values and (2) codes of corporate conduct, on whether managers misrepresented financial reports. In these studies, executives and controllers were asked to respond to hypothetical situations involving fraudulent financial reporting procedures. The occurrence of fraudulent reporting was found to be high; however, neither personal values, codes of conduct, nor the interaction of the two factors played a significant role in fraudulent (...) financial reporting. (shrink)

Community based research is conducted by, for, and with the participation of community members, and aims to ensure that knowledge contributes to making a concrete and constructive difference in the world (The Loka Institute 2002). Yet decisions about research ethics are often controlled outside the research community itself. In this analysis we grapple with the imposition of a community confidentiality clause and the implications it had for consent, confidentiality, and capacity in a province-wide community based research project. Through untangling these (...) implications we provide recommendations for reframing how to think about research ethics and strategies for enabling research ethics’ processes to be more responsive to and respectful of community-based research. (shrink)

This paper investigates the effect of the countervailing forces within organizations of formal systems that direct employees toward ethical acts and informal systems that direct employees toward fraudulent behavior. We study the effect of these forces on deception, a key component of fraud. The results provide support for an interactive effect of these formal and informal systems. The effectiveness of formal systems is greater when there is a strong informal “push” to do wrong; conversely, in the absence of a strong (...) push to do wrong, the strength of formal systems has little impact on fraudulent behavior. These results help to explain why the implementation of formal systems within organizations has been met with mixed results and identifies when formal systems designed to promote ethical behavior will be most efficacious. (shrink)

IntroductionDignity therapy is brief psychotherapy targeting psychological and existential suffering among patients with a life-limiting illness. Studies have been conducted on the use of DT by healthcare professionals. In Italy, the current legislation defines that any form of psychotherapy may be performed exclusively by psychotherapists. Consequently, this intervention is unlikely to be used by other healthcare professionals. Herein, we will describe a training on DT not as a psychotherapy intervention but as a narrative intervention for non-psychotherapists (...) health care professionals. Finally, we will explore the potential enablers/barriers as experienced by palliative care physicians and nurses.MethodsThe study was conducted in the Psycho-Oncology Unit within the Cancer Research Hospital of Reggio Emilia. It consisted of an exploratory qualitative case study. Data were collected employing observations and interview data and thematically analyzed.ResultsThe training was attended by six physicians and ten nurses and took place during two-afternoon sessions for 10 h. Two participants put their training into practice and administered DT under the supervision of a psychotherapist. Data analysis highlighted five overarching themes relating to the training experience and direct use of DT, namely, time required, psychological skills, patient’s disease awareness, patient’s life history, and distinguishing DT from Advance Care Planning.ConclusionPalliative care professionals found DT to be a valuable non-pharmacological hospital-based intervention to address the person beyond the patient and his clinical conditions. In our experience, considering that in Italy, psychotherapy is an intervention that psychotherapists can only perform, it can help organize different training on DT for psychotherapists and other healthcare professionals. (shrink)

Volume 25 of _The Annual_ is dedicated to the memory of Michael Franz Basch, who achieved distinction as both a psychoanalytic theorist of the first rank and an authority on the nature and conduct of dynamic psychotherapy. A wide range of original contributions bear witness to his theoretical, clinical, and educational interests. A number of papers remind us of Basch's prominence as a self-psychological theorist: Elson's self-psychological reappraisal of self-pity, dependence, and manipulation as self-states; Ornstein's developmental perspective on power, (...) self-esteem, and destructive aggression; Tolpin's review of sexuality from the standpoint of normal self development; and Wolf's discussion of self psychology and the "aging self." Basch's life-long educational concerns gain expression in Goldberg's discussion of clinical teaching, particularly the challenge of leading of case conferences; and Ornstein's and Kay's thoughtful consideration of "enduring difficulties" in American medical education. Additional highlights of the volume include: Fawcett's consideration of the role of pharmacotherapy in psychodynamic treatment; Jaffe's consideration of the applicability of hierarchical models to assessment and intervention in brief psychotherapy; Galatzer-Levy's review of the "witch" metapsychology; Gedo's analysis of mythic themes in the operas _Don Giovanni_ and _Der Rosenkavalier_; Modell's reflections on metaphor and affects; and Kernberg's discussion of a "new psychoanalytic mainstream," which he compares and contrasts with a parallel convergence of Kohutian and interpersonal analytic approaches. Many of these contributions incorporate reflections on Basch as a teacher and colleague, and the entire volume is framed by Goldberg's moving tribute. Analysts and psychotherapists sharing Basch's commitment to academic and clinical excellence and his keen awareness of the pragmatic requirements of doing effective therapy will find in Volume 25 a cornucopia of riches. (shrink)

Independent on Sunday October 2nd One of the country's lead­ing philosophical counsellers, and chairman of the Society for Philosophy in Practice (SPP), Tim LeBon, said it typically took around six 50 ­minute sessions for a client to move from confusion to resolution. Mr LeBon, who has 'published a book on the subject, Wise Therapy, said philoso­phy was perfectly suited to this type of therapy, dealing as it does with timeless human issues such as love, purpose, happiness and emo­tional challenges. `Wise (...) Therapy, is part of a series aimed at promoting an integrative attitude as its ethos. Among all the many perspectives of psychotherapists and counselors, philosophy needs to take its place and needs to find its voice. Tim LeBon has provided an effective means by which counselors can bring philosophy into their work with clients' - APPA journal `Tim Le Bon's Wise Therapy is a comprehensible and well argued book dealing with the practical therapeutic applications of philosophical research that may well be of interest to philosophers but -- as the author himself intends -- will be of most obvious benefit to therapists and counselors, both by informing their dialogue with clients in new ways and by helping them become more informed about ways to resolve the ethical dilemmas arising within the context of their own work' - Metapsychology `A fascinating workshop for therapists and clients, backed up a thorough degree if philosophical acuity' - Journal of the Society for Existential Analysis `I strongly recommend the book for philosophers as well as practitioners, teachers, students and supervisors in counselling and psychotherapy' - Self and Society `Provides some additional and valuable arrows for the therapist's quiver' - Irvin Yalom, author of Love's Executioner `Like Aristotle, Tim LeBon examines what is said and extracts what is best from it…. There are many fascinating exercises designed to bring out and enlighten the client's values, conception of the good life, well-being, happiness, pleasure, and the proper place of reason in life…. Wise Therapy is well written and engaging. The case histories are illuminating examples of therapeutic techniques at work, the thought experiments are well designed, and the philosophical position adapted from the internal debates of the philosophers is level headed…. I recommend it highly to philosophers with an interest in counselling, and psychological counsellors with an interest in philosophy' - Jeff Mason, The Philosophers' Magazine `Tim LeBon has… authored a text which should become a staple on the philosophical counsellor's bookshelf…. Wise Therapy is a concise, well-written book…. His ability to relate philosophical concepts to counselling concerns is admirable and attests to the skill and knowledge he possesses as a working counsellor. But, by far the most important part of Tim LeBon's book to PC is the last chapter, "The Counsellor's Philosophical Toolbox"' - Craig Munns in The Examined Life ` Tim LeBon has done a good job of offering practical approaches to some of the most important and vexing issues that arise in counselling…. Tim LeBon's book contains helpful suggestions, practical information, and useful examples, and would make a good addition to the library of any counsellors willing to allow philosophy to turn mere client sessions into wise therapy' - Peter Raabe, Practical Philosophy Wise Therapy is an original and practical guide to how philosophy can benefit counselling and psychotherapy. Tim LeBon argues that therapy, informed by philosophy, can help clients make better decision and achieve emotional wisdom. He uses philosophical approaches to explore issues of right and wrong, the emotions and reasons, well-being and the meaning of life, and develops a 'counsellor's toolbox' of techniques that can help practitioners apply the wisdom of philosophy to good therapeutic practice. For counsellors who may find philosophical approaches to therapy useful, this work addresses key philosophical topics - the emotions, free will, the meaning of life and ethics. It is jargon-free where possible and assumes no previous philosophical training. From The Independent, 16th November 2004 Plato is my agony aunt It was the end of a love affair that broke her heart. Could the wisdom of the great philosophers show her how to be happy again? Claire Smith tries a novel form of therapy "The unexamined life is not worth living," Socrates said. Nor is the life you're left with after your boyfriend has left you for another woman - at least, that's how it felt in October last year when mine broke rank and went off with an art student from Cleveland, Ohio. We were over there for the opening of his new art exhibition. He'd flown over four days before me and had met her at a party. Supposedly, they "connected". The five months that followed were a roller-coaster of confusion, vitriol and despair. I knew there'd been problems in our relationship. We saw the world very differently; he delighted in the charm of the ordinary, I wanted maximum divinity. He walked; I galloped. He drank tea; I loathed the stuff. But, along the banks of the Thames, we'd made a promise to always stick together. Our love was something unique: "transcendental", I called it. And besides, we recycled. Surely a commitment to save the world would save our relationship? Alas, no. So there I was, a woman scorned. Hell truly hath no greater fury. And what made it worse was that I still believed in our transcendental love. If I wanted to change the way I was feeling, I needed to alter the way I was thinking. But how? A few bottles of wine and a sharp blow to the head might have done the trick. Fortunately, there's an older, more trusted way of turning your head on its head that counsellors are starting to use: philosophy. The idea of employing Plato as an agony aunt was begun in 1981 by the German philosopher Gerd Achenbach. Although philosophy spends a lot of its time asking real-life questions that affect real-life people - What is happiness? And is it always wrong to lie? - most of the debate goes on in ivory towers. What Achenbach and subsequent philosophers including Tim LeBon, the chairman of the UK's Society for Philosophy in Practice, wanted to do was "give practical application" to this gigantic library of great thoughts. So how does it work? Like most types of therapy, you sign up for a set of sessions. "Two would give you a new perspective on one issue; six would help you to make a major life-decision, like a career change; with 12 you can start to rethink your entire life philosophy," explains LeBon. Each session lasts 50 minutes and costs £50 - and, no, you don't have to have any previous knowledge of philosophy. "If you think of Friends, it would suit Ross and Chandler more than Joey," LeBon says. "It's for anyone who wants to make their emotions more intelligent. Or for those who have tried other kinds of therapy, and want something more cerebral." The first session begins with the patient venting off about whatever's troubling them. The rant over, the counsellor then picks out some key concepts that are crucial to the problem - in the case of heartbreak, it is love and happiness that come hurtling to the fore - and then gets the patient to define what they mean. So, what is love? What is happiness? To kick-start the patient's thinking, LeBon describes what a great philosopher had to say about it. In my case, he tells me what Plato wrote about love in his Symposium: that to stop man fighting the gods, Zeus decided to cut each human in two, so they would lose their strength. "This, then, is the source of our desire to love each other," Plato said. "Each of us is a 'matching half' of a human whole, because each was sliced like a flatfish, two out of one, and each of us is always seeking the half that matches him." This method of probing what we might think are "obvious" ideas, such as love and happiness, was devised by Socrates in the squares of Athens. "The only I thing I know is that I know nothing at all," he boasted. What Socrates showed was that although many of the thinkers of his time thought they knew what justice, happiness and goodness meant, their understanding was tied in to their personal agenda and world view, and, what's more, when pushed, their ideas often contradicted themselves. A bit like me on love. Whereas part of my understanding of love was something that gave life meaning, made it worth living and bound us together, I also believed that true love was "transcendental": that it was out of this world, and it didn't matter if the two people who loved each other couldn't get along in the day-to-day. Love was bigger than the mundane. But when it came to the next stage of the therapy, critical thinking - "to check out whether your assumptions stand up to examination" - I walked head first into a contradiction. If I think love's purpose is to make life worth living, but then say it's irrelevant to daily life, surely my two ideas of love are not compatible? As the cogs in my brain start to creak into motion, I feel myself taking a step back from my predicament: thinking about how I've been thinking. This idea I had of transcendental love might have started off as a romantic dream. But when the relationship stopped working, and I found myself feeling trapped and frustrated, I used it to justify the mechanics of a relationship that just didn't work in the daily grind. I used it to lie to myself. In the final stage, LeBon gets me to start thinking about how to go forward. "You can't change what has happened," he says. "You can't change that he's left you, or how you behaved in the relationship. So, as the Stoics did, let's work on controlling the controllables: the things that you can change." To work out what can be changed, he gets me to try out a thought experiment, a method often used in philosophy to imagine other worlds where people can have different codes of behaviour. Thought experiments shatter your preconceived ideas of how the world should be and let your imagination run wild to how the world could be. "I find Viktor Frankl very useful here, the Austrian psychiatrist and concentration-camp survivor who actually believed that everything in life happens for a purpose," LeBon says. "Suppose this break-up did happen for a reason that will work to your benefit," he suggests. "What might that be? The answer might be that you can now focus on something important that was denied in the relationship. Or - the Hollywood version - so you'll meet someone who is really right for you." Temporarily freed of any sense of responsibility for the relationship that was, and its sorry demise, the list came fast. I could now travel more; he didn't like me travelling on my own, but too often he didn't want to go anywhere, preferring to stay in his studio and make art. I'd love to meet someone with a similar sense of adventure to mine. For the first time in two years, I was being honest with myself about what I really wanted - listening to those voices that we all have inside our heads, and too often try to muzzle. So did philosophy save me? Well, I'm now dating a travel writer I have to run to keep up with. I still haven't got over the fact that my replacement came from Cleveland, Ohio. But I guess I never will. Tim LeBon can be reached by e-mail at [email protected] A FEW WORDS FROM THE WISE Compiled by Ed Caesar · "At the touch of love, everyone becomes a poet" - Plato · "There is always some madness in love. But there is also always some reason in madness" - Friedrich Nietzsche · "That man shall live as his own master and in happiness who can say each day 'I have lived'" - Horace · "The good of man is the active exercise of his soul's faculties in conformity with excellence or virtue... Moreover this activity must occupy a complete lifetime; for one swallow does not make spring, nor does one fine day; and similarly one day or a brief period of happiness does not make a man supremely blessed and happy" - Aristotle · "There is nothing on this earth more to be prized than friendship" - Thomas Aquinas · "Whatever you do... love those who love you" - Voltaire · "Happiness is not an ideal of reason but of imagination" - Immanuel Kant · "Happiness is a state of which you are unconscious. The moment you are aware that you are happy, you cease to be happy" - Jiddu Krishnamurti · "Love is an ideal thing. Marriage is a real thing" - Johann Wolfgang von Goethe I shrink, therefore I am Therapy has many answers, but some questions require the help of a philosopher, says Clint Witchalls Sunday November 21, 2004 The Observer Danny had worked in the City of London for 10 years. As a research analyst, stockbroker and fund manager, he'd made a lot of valuable contacts, earnt a lot of cash, and learnt some important business skills. However, as he approached his mid-thirties, he no longer felt good about himself or what he did for a living, and he found his colleagues cold and unfriendly. A chronic illness made him realise his mortality, and he began to reassess his priorities. Danny had been struggling with his career conundrum for nearly five years when he met David Arnaud, a philosophical counsellor. After a few soul-searching sessions, Danny arrived at a decision. Today, he teaches economics to sixth-formers, and he loves it. 'It's a much better lifestyle,' he says. Many people are turning to philosophical counsellors to get answers to questions such as: 'How do I make sense of myself?' 'What is important to me?' 'Where am I going?' These are perhaps not the sort of questions that require psychiatric intervention, but Arnaud, who recently completed the first empirical study of philosophical counselling in the UK, has found that within just five sessions the majority of clients, with important decisions to make, tend to move from a state of concern and confusion to a resolution. Modern philosophical counselling can be traced back to 1981, when the philosopher Gerd Achenbach opened the first practice near Cologne. Achenbach referred to the new discipline as 'therapy for the sane.' Today, there are hundreds of philosophical counsellors around the world, with the movement particularly strong in the US, Britain and the Netherlands. 'The dilemmas people face aren't always primarily psychological,' says Alex Howard, a philosophical counsellor from Newcastle. 'If people face problems that are social or economic, it doesn't make sense to define their problems in purely psychological terms.' Tim LeBon, a founder member of the Society for Philosophy in Practice (SPP) and author of Wise Therapy, adds: 'We are faced with far more life choices than our grandparents, yet have far fewer resources to deal with them. Our grandparents may have gone to a priest or to other family members for advice; most people don't trust these solutions any more and so want to make their own well-informed, well thought-out choices. Philosophical counselling can help these people - people in mid-life crises who are wondering how to make the most of the rest of their life. People who want to take stock of their values.' Where stressed executives might once have been prescribed a course of tranquillisers or antidepressants, they can now get a dose of Bertrand Russell instead: 'Success is too dearly purchased if all the other ingredients have been sacrificed to obtain it.' While some philosophical counsellors do recommend books for their clients to read, most sessions are about helping the client identify faulty thoughts. For example, a briefing in Aristotelian logic might show a client why their beliefs are erroneous. The person might infer that they're a screw-up because they've screwed up. The counsellor could point out that they're making an error called 'fallacy of composition' - that is, what's true of the part isn't necessarily true of the whole. In philosophical counselling, problems aren't pathologised as they are by the psychiatric profession, and the dialogue between client and counsellor is more like a meeting of equals, compared to many therapies where the client is treated like a patient and seen as someone who is, in some way, inadequate. 'Anybody can benefit from philosophical counselling,' says Howard. 'But it does require someone who is willing to take stock.' Lou Marinoff, author of international bestseller Plato Not Prozac! has done much to promote philosophical counselling. 'Some people who have stabilised their neurochemistry and validated their emotions now wish to examine or re-examine the criteria of their beliefs, the principles of their conduct, or the meaning of their lives,' he says. 'With whom shall they do this? Psychologists and psychiatrists can shed light on such issues - as can rabbis, priests, imams and gurus. Philosophers are now rejoining the ranks of helpers.' LeBon believes certain therapies (such as cognitive behavioural therapy) don't go far enough in helping their clients. 'For instance, if you are anxious about your relationship, a cognitive therapist would try to dispute your catastrophising and jump to conclusions to make you feel less anxious,' says LeBon. 'A philosophical counsellor would do this, but would also look for existential meaning in your anxiety - perhaps you really don't want to be in the relationship and that is what your anxiety is telling you.' LeBon also gives short shrift to psychoanalysts. 'There's very little evidence for the Freudian unconscious, and it's time to move on to more intellectually satisfying and helpful therapies,' he says. However, Alain de Botton, the man who popularised philosophy as self-help, isn't ready to bury psychologists and their ilk just yet. 'The truth is that psychoanalysis grew out of philosophy - it's not some completely new idea, and in fact, done properly, psychoanalysis is philosophical anyway. It may even be dangerous to the mental health of some people to suggest a philosopher rather than a properly trained analyst. The knowledge of analysts when it comes to many emotional problems is now much greater than that of most philosophers.' Guardian Unlimited © Guardian Newspapers Limited 2004. (shrink)

What does it mean to ‘drop out’ of therapy? Many definitions of ‘dropout’ have been proposed, but the most widely accepted is the client ending treatment without agreement of their therapist. However, this is in some ways an external criterion that does not take into account the client’s experience of therapy, or reasons for ending it prematurely. This study aimed to identify whether there were more meaningful categories of dropout than the existing dropout definition, and to test whether this refined (...) categorisation of dropout was associated with clinical outcomes. This mixed-methods study used a subset of data from the IMPACT trial, which investigated psychological therapies for adolescent depression. Adolescents were randomly allocated to a treatment arm (Brief Psychosocial Intervention; Cognitive-Behavioural Therapy; Short-Term Psychoanalytic Psychotherapy). The sample for this study comprised 99 adolescents, aged 11-17 years. 32 were classified as having dropped out of treatment and participated in post-therapy qualitative interviews about their experiences of therapy. For 26 dropout cases, the therapist was also interviewed. 67 cases classified as having completed treatment were included to compare their outcomes to dropout cases. Interview data for dropout cases were analysed using ideal type analysis. Three types of dropout were constructed: ‘dissatisfied’ dropout, ‘got-what-they-needed’ dropout, and ‘troubled’ dropout. ‘Dissatisfied’ dropouts reported stopping therapy because they did not find it helpful. ‘Got-what-they-needed’ dropouts reported stopping therapy because they felt they had benefitted from therapy. ‘Troubled’ dropouts reported stopping therapy because of a lack of stability in their lives. The findings indicate the importance of including the perspective of clients in definitions of drop out, as otherwise there is a risk that the heterogeneity of 'dropout' cases may mask more meaningful distinctions. Clinicians should be aware of the range of issues experienced by adolescents in treatment that lead to disengagement. Our typology of dropout may provide a framework for clinical decision-making in managing different types of disengagement from treatment. (shrink)

Institutional pedagogy is a radical educational practice that began in France in the first half of the twentieth century. It aims to transform the material context of learning in order to empower students to collectively take responsibility for their own lives. As an analysis of the effects of this practice on the work of Félix Guattari, the purpose of this article is twofold. First, it aims to describe the theoretical and practical cross-pollination that occurred between the two movements of institutional (...) pedagogy and institutional psychotherapy. Second, it argues for a new methodology for reading the published works of Félix Guattari in the context of institutional pedagogy. The article begins with a brief analysis of the work of Celéstin Freinet, followed by an account of the development of his techniques by Aïda Vasquez, Fernand Oury, Jean Oury and Guattari. After showing how these practices informed Guattari’s work as a political activist, in the final section I argue that we should treat the figure of Félix Guattari as a special kind of ‘writing machine’. (shrink)

After a brief review of different definitions and types of loneliness I offer an analysis of the concept of existential loneliness and its philosophical background. In contrast to the interpersonal aspects of other types of loneliness, existential loneliness has been characterized as an intrapersonal default state of incommunicability or profound aloneness, part of or based on a fundamental ontological or transcendental structure in human existence. There are both conceptual and practical issues with the notion of existential loneliness, with implications (...) for psychotherapy. I offer a critical approach, and argue that there is no good philosophical basis for this conception of existential loneliness, and that although loneliness can be existential in some respect, it typically manifests itself in interpersonal contexts, and should not be considered a fundamental ontological structure of human existence. (shrink)

Brief description of Freud's life and work, emphasising the role of fictive belief and experience (phantasy) in his account of mental disorder.

ObjectivePreviously Mindfulness-Based Swinging Technique 's immediate efficacy for overcoming psychological concerns has recently received empirical support, yet its longer-term efficacy needed to be evaluated among women with breast cancer. The objective of this study was to assess and report the efficacy of MBST intervention among breast cancer patients for hopelessness, anxiety, depression, self-efficacy, oxygen intensity, and heart rate-beats per minute at an 8-week period.MethodThe State-Trait Anxiety Inventory, The Emotion Thermometer, Hospital Anxiety and Depression Scale, Self-Efficacy for Managing Chronic Disease, and (...) Beck's Hopelessness Scale were used for assessing the intervention's outcome; 149 BC patients were randomly assigned into two groups. The participants in the control group received Cognitive Behavioural Therapy -Cognitive-Disputation for 20 min, and intervention group received MBST intervention. No additional psychological interventions were given between week-1 and week-8.ResultOutcomes of the 8-week post-treatment follow-up exhibited significantly higher improvements in all evaluated-measurements for CG, and some for IG with large effect size in the following: anxiety and depression levels. It increased self-efficacy for managing disease and hopefulness, and saturation levels measured by pulse-meter/oximeter.ConclusionsBoth CBT-CD and MBST have been found to be efficacious interventions to shorten the psychotherapy duration for reducing clinical anxiety and hopelessness as well as increase self-efficacy for BC women. This may have a distinct clinical importance for supporting BC patient's adherence-to-treatment since CBT-CD could be an alternative technique to MBST as a brief intervention. In future studies, the effectiveness of MBST through adapting to virtual reality and other online delivery methods should be examined. (shrink)

Psychedelic Harm Reduction and Integration is a transtheoretical and transdiagnostic clinical approach to working with patients who are using or considering using psychedelics in any context. The ongoing discussion of psychedelics in academic research and mainstream media, coupled with recent law enforcement deprioritization of psychedelics and compassionate use approvals for psychedelic-assisted therapy, make this model exceedingly timely. Given the prevalence of psychedelic use, the therapeutic potential of psychedelics, and the unique cultural and historical context in which psychedelics are placed, it (...) is important that mental health providers have an understanding of the unique motivations, experiences, and needs of people who use them. PHRI incorporates elements of harm reduction psychotherapy and psychedelic-assisted psychotherapy, and can be applied in both brief and ongoing psychotherapy interactions. PHRI represents a shift away from assessment limited to untoward outcomes of psychedelic use and abstinence-based addiction treatment paradigms and toward a stance of compassionate, destigmatizing acceptance of patients' choices. Considerations for assessment, preparation, and working with difficult experiences are presented. (shrink)

The study investigated the extent to which defensive functioning and defense mechanisms predict clinically meaningful symptomatic improvement within brief psychodynamic psychotherapy for recurrent and chronic depression in an inpatient setting. Treatment response was defined as a reduction in symptom severity of 46% or higher from the baseline score on the Montgomery–Asberg Depression Rating Scale. A subsample of 41 patients from an RCT was included. For each case, two sessions of brief inpatient psychodynamic psychotherapy were transcribed and (...) then coded using the Defense Mechanism Rating Scales and the Psychotic Defense Mechanism Rating Scales, an additional scale developed to study psychotic defenses. Results showed that defensive functioning and mature and immature defense changed during psychotherapy and predicted treatment response. Patient’s defenses observed throughout therapy also predicted treatment response at 12-month follow-up. The addition of psychotic defenses allows a better prediction of the treatment response. Overall, these results are in line with previous research and provide further validation of defensive functioning as a predictor of outcomes and a mechanism of change in psychotherapy. (shrink)

This book charts Carl Gustav Jung’s 33-year correspondence with James Kirsch, adding depth and complexity to the previously published record of the early Jungian movement. Kirsch was a German-Jewish psychiatrist, a first-generation follower of Jung, who founded Jungian communities in Berlin, Tel Aviv, London, and Los Angeles. Their letters tell of heroic survival, brilliant creativity, and the building of generative institutions, but these themes are darkened by personal and collective shadows. The Nazi era looms over the first half of the (...) book, shaping the story in ways that were fateful not only for Kirsch and his career but also for Jung and his. Kirsch trained with Jung and acted as a tutor in Jewish psychology and culture to him. In 1934, fearing that anti-Semitism had seized his teacher, Kirsch challenged Jung to explain some of his publications for the Nazi-dominated Medical Society for Psychotherapy. Jung’s answer convinced Kirsch of his sincerity, and from then on Kirsch defended him fiercely against any allegation of anti-Semitism. We also witness Kirsch’s lifelong struggle with states of archetypal possession: his identification with the interior God-image on the one hand, and with unconscious feminine aspects of his psyche on the other. These complexes were expressed, for Kirsch, in physical symptoms and emotional dilemmas, and they led him into clinical boundary violations which were costly to his analysands, his family and himself. The text of these historical documents is translated with great attention to style and accuracy, and generous editorial scaffolding gives glimpses into the writers’ world. Four appendices are included: two essays by Kirsch, a series of letters between Hilde Kirsch and Jung, and a brief, incisive essay on the Medical Society for Psychotherapy. This revised edition includes primary material that was unavailable when the book was first published, as well as updated footnotes and minor corrections to the translated letters. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.1 (2001) 33-37 [Access article in PDF] "Impossible Things before Breakfast":A Commentary on Burman and Richmond Gwen Adshead "Why sometimes, I've believed as many as six impossible things before breakfast." --Lewis Carroll, Through the Looking GlassBoth Burman and Richmond discuss how a feminist critique or take on a body of theory helps to illuminate or confuse further theoretical development. Burman applies such a critique (...) to False Memory Syndrome (FMS); Richmond to psychoanalytic accounts of eating disorders. In this commentary, I want to discuss the application of a feminist critique to two vital concepts for psychiatry: the recording and measurement of data, and truthful accounts of experience. These concepts are of course related, and I want to explore their connections, not only with each other, but with specific areas of mental health practice, namely, mental health research, psychodynamic psychotherapy, and expert psychiatric testimony. The Recording Angel: Subjectivity and Objectivity, Measurement and Truth Most feminist critiques of measurement begin with an attack on the traditional theoretical distinction between objective and subjective worlds (for example, Fox Keller 1985). Classical accounts of Western scientific practice have assumed that it is possible to divide external physical experience in this way, and this assumption generates two further beliefs: first, that it is possible for an observer to, as it were, stand apart or outside the events observed, and second, that objective accounts of events are somehow real-er or true-er than subjective accounts. This account contains some very old ideas about natural experience: first, that a fixed reality exists that is external to those who have experienced an event, and second, that this reality is observable by others, that is, there is a space between the observer and the observed. This notion of objectivity has been thought to be crucial to valid measurement.In contrast, a feminist critique counterargues that every observer is influenced and influences what he is studying; that he is himself "positioned" in the subject of his interest, in Rom Harré's term. Further, feminist theory argues that because the objective-subjective split is artificial, subjective accounts of experience may be just as "true" as objective accounts. Overarching is the notion that all social behavior is socially constructed and affected by social context, including "science" in all its forms.Such doubts about the exact nature of science have been fueled by two sets of theory within [End Page 33] "science"--the claims of quantum theory in the 1920s and Thomas Kuhn's account of shifting scientific paradigms in the 1960s--and both of these theories have been important for feminism and feminist critique of scientific practice. Despite many odd features, quantum theory has produced research with considerable explanatory power (Hawking 1988, Barrow 1991, Smollin 1997), and some of its claims provide indirect support for the feminist position described above. For example, one claim of quantum theory is that, at the micro-level of events, what is being observed is influenced by the position of the observer. If true, then the notion of an easy divide between internal and external space, in which observer and observed are separately located, is undermined; rather, every position taken by the observer influences the observed in a dynamic relationship. There is no objectivity but rather a developing matrix of positions that are not externally fixed, but changing and uncertain. Similarly, in relation to social construction of theory, Kuhn's description of the changing nature of scientific paradigms also emphasizes the importance of social and community influences on scientific theories and how "true" accounts of events can change. Internal and External Worlds: Implications for Mental Health Research and Psychotherapy Practice Arguably, feminist claims about the social positioning of science are now unremarkable; no one involved in research (especially mental health research) could dispute that what is studied, what is funded, and what is published is hugely influenced by many social and political processes. Even if only to a limited extent, quantum theory and Kuhn do support the doubt thrown on classic notions of objectivity by feminist theory; if only by suggesting that reality... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Underplayed Ethics and the Dilemmas of Psychiatric CareChong Siow Ann and Tamra LysaghtThe practice of psychiatry is fraught with uncertainty. The exact causes and the biological substrates underlying mental disorders remain to be elucidated; even the diagnosis of these disorders is descriptive and not based on an etiological understanding and no biological diagnostic markers have been validated. The manifestation of almost all mental disorders results from a complex (...) interaction of biological and environmental factors which encompasses the patient’s unique life history, experiences and relationship with others and the community. In the face of such uncertainties — at times extending to the types of treatment (psychiatry is generally acknowledged not be an exact science) — it has been argued that adopting a pragmatic approach is necessary.1 Accordingly, this approach necessitates high ethical standards among mental health practitioners.Some mental illnesses are associated with varying degrees and types of cognitive impairments. Others have certain symptoms like auditory hallucinations and delusions that might severely compromise the patients’ autonomy, distort their sense of reality, increase the risk of harm to themselves or others and render them incapable of making informed decisions in their treatment and participation in research.Consequently, there are issues that are particular to the provision of mental healthcare. These include the need for enforced involuntary treatment with the corollary of depriving a patient of his personal liberty even [End Page 173] though it is often justified on the grounds that it is in the patient’s best interests. However, at times, it is the legal and societal obligation of mental health practitioners to protect those who might be harmed from the patient’s action that might seem to be more pressing. In this situation of double agency, lies the tension of providing confidential care for patients and acting as “an agent of the state” where that patient’s confidentiality might be breached and his liberty infringed upon. This situation is further aggravated by the stigma that clings ever so tenaciously to those who suffer from mental disorders and where it is the norm to stereotype them as dangerous and unpredictable.Consideration of a patient’s autonomy is also challenged by characteristics that are unique to the practice of psychiatry. The prescription of certain psychotropic medications can alter how people think and feel, while psychotherapy works towards changing the patient’s views and values. The philosopher, Jennifer Radden, describes this process as “re-forming the patient’s whole self or character … akin to the responsibilities of raising children”.2 The psychotherapeutic relationship is thus particularly personal and intimate because patients are asked to provide information that often reveals their innermost feelings, fears and fantasies. This information is provided on the basis of trust and assurance of confidentiality, and with expectation of being helped.Jeremy Holmes and Gwen Adshead have elaborated on the vulnerability of patients seeking psychotherapy: they might be particularly susceptible to exploitation because their past experiences of being exploited have led to their distress and help seeking — their dependency and the extreme privacy of the therapeutic relationship make any transgression difficult to be uncovered.3 There is a calamitous combination of the “unconscious wish in the patient to be used” with the complicity of an unethical therapist seeking to fulfil his own interests.4As in any other doctor-patient relationship, the relationship between the mental healthcare practitioner and the patient is one of unequal power where the former is ascendant. While that power should be exercised to heal and to relieve suffering, it also gives the practitioner tremendous power “to harm, reject, misunderstand, or exploit patients who struggle with the experience of mental illness, which itself may generate helplessness, despair, distress, and exceptional dependence on the clinician”.5 Given the potential of doing good and harm coupled with the likelihood of being so significant in the life of the patient,6 providing care for those with mental disorders and distress is necessarily ethically exacting — arguably more so than in other medical practice settings. [End Page 174]This precariousness has led to the suggestion that ethics in psychiatry should have a special status and that the more general principles of biomedical ethics are too limited in scope to... (shrink)

Summary The present work focuses on the transformations of the psychotherapeutic field through the relationship dynamics which occur within it. The first part of this article starts with a brief outline of the Gestalt psychological understanding of the field concept, also in its application to the psychotherapeutic situation, followed by a brief review of the introduction of the field concept into the psychoanalytic theory formation. After this, the first author first presents the theoretical concept underlying a new approach (...) he has developed for observing the relationship dynamics in psychotherapy. Mirroring a formation of both psychoanalytic and Gestalt theory of the main author, this new approach is based on the combination of psychoanalytic and Gestalt psychological concepts. According to the clinical experience and insights of the author, the phenomenological and relational approach of Gestalt theory fits well with the psychoanalytic approach; on this basis, a criterion for recording the progress of therapy can be developed. This criterion is the phenomenology of the development of the qualities of the relationships of the client, as they become visible in his dream narrations and the subsequent associations in the analysis room and continue to develop during the session and the further course of therapy. The relationship dynamics in the dream narration is thus compared with those which develop in the course of the subsequent associations. This is demonstrated and further elaborated in the second part of this article on the basis of a clinical case. The clinical example shows how the relationship dynamics develop in this sense in the individual therapy sessions and over a longer course of therapy. The associated transformations of the therapeutic field give a good indication of the progress of therapy. The main author gained such insights into the transformations of the therapeutic field and the progression of therapy, which are visible in the course of therapy, from the careful application of the criterion “MDAC of relational dynamics”. In the specific case, there was also a high degree of correspondence between the results of the application of this phenomenological criterion and the empirical evidence of the symptom questionnaire, a self-report measure requested by the patient himself during the course of the therapy. (shrink)