This paper describes a discourse analysis of the process of interpersonal psychotherapy (IPT) in the recovery from depression. It demonstrates how IPT is an effective treatment strategy for mental health nurses to utilise in the treatment of depression. The discourse analysis highlights how the development of more meaningful subject positions enables one woman to recover from her depression. The process of recovery is underpinned by an understanding of women's depression as promoted by contemporary social and cultural expectations for (...) detachment and reflexivity. This paper shows how IPT provides an opportunity for recovery from depression for one woman by facilitating a reconstruction of her subject positions in relation to others. The discourse analysis revealed that the therapist facilitated this through the use of a range of techniques: seeking information, exploring beliefs/values/assumptions, exploring communication patterns, exploring affective responses and exploring alternative subject positions. (shrink)

Harry Stack Sullivan has been described as 'the most original figure in American psychiatry'. Challenging Freud's psychosexual theory, Sullivan founded the interpersonal theory of psychiatry, which emphasized the role of interpersonal relations, society and culture as the primary determinants of personality development and psychopathology. This concise and coherent account of Sullivan's work and life invites the modern audience to rediscover the provocative, groundbreaking ideas embodied in Sullivan's interpersonal theory and psychotherapy.

Explicates the mutually fundamental commonalities between the methods and practices of Western psychotherapies, especially those whose bases are social, interpersonal, and communicational, and the disciplines of Buddhism, Vedanta, Yoga, and Taoism.

In 1975, Colwyn Trevarthen first presented his groundbreaking explorations into the early origins of human intersubjectivity. His influential model dictates that, during intimate and playful spontaneous face-to-face protoconversations, the emotions of both the 2–3-month-old infant and mother are nonverbally communicated, perceived, mutually regulated, and intersubjectively shared. This primordial basic interpersonal interaction is expressed in synchronized rhythmic-turn-taking transactions that promote the intercoordination and awareness of positive brain states in both. In this work, I offer an interpersonal neurobiological model of (...) Trevarthen’s intersubjective protoconversations as rapid, reciprocal, bidirectional visual-facial, auditory-prosodic, and tactile-gestural right brain-to-right brain implicit nonverbal communications between the psychobiologically attuned mother and the developing infant. These co-constructed positive emotional interactions facilitate the experience-dependent maturation of the infant’s right brain, which is in an early critical period of growth. I then address the central role of interpersonal synchrony in intersubjectivity, expressed in a mutual alignment or coupling between the minds and bodies of the mother and infant in face-to-face protoconversations, as well as how these right brain-to-right brain emotional transmissions generate bioenergetic positively charged interbrain synchrony within the dyad. Following this, I offer recent brain laterality research on the essential functions of the right temporoparietal junction, a central node of the social brain, in face-to-face nonverbal communications. In the next section, I describe the ongoing development of the protoconversation over the 1st year and beyond, and the co-creation of a fundamental energy-dependent, growth-promoting social emotional matrix that facilitates the emergence of the highly adaptive human functions of mutual play and mutual love. In the final section, I discuss the clinical applications of this interpersonal neurobiological model of intersubjectivity, which has a long history in the psychotherapy literature. Toward that end, I offer very recent paradigm-shifting hyperscanning research that simultaneously measures both the patient and therapist during a psychotherapeutic interaction. Using the Trevarthen’s two-person intersubjective model, this research demonstrates changes in both brains of the therapeutic dyad and the critical role of nonverbal communications in an emotionally-focused psychotherapy session. These studies specifically document interbrain synchronization between the right temporoparietal junction of the patient and the right temporoparietal junction of the clinician, a right brain-to-right brain nonverbal communication system in the co-constructed therapeutic alliance. Lastly, I discuss the relationship between the affect communicating functions of the intersubjective motivational system and the affect regulating functions of the attachment motivational system. (shrink)

Psychotherapy is a well-established, efficacious, and fully accepted treatment for mental disorders and psychological problems. Psychotherapy is an interpersonal practice engaging patient values, interests, and personal meanings at every step. Thereby, psychotherapy abounds with moral issues. In psychotherapy ethics, numerous moral issues converge, including self-determination or autonomy, decision-making capacity and freedom of choice, coercion and constraint, medical paternalism, boundaries between health and illness, insight into illness and the need for therapy, dignity, under- and overtreatment, and (...) much more. The Oxford Handbook of Psychotherapy Ethics covers the whole range of ethical issues in the heterogenous field of psychotherapy, closing a commonly perceived gap between ethical sensitivity, technical language, and knowledge among psychotherapists. The primary audience is psychotherapists in clinical practice. Furthermore, the Oxford Handbook of Psychotherapy Ethics addresses the whole range of professionals providing mental health services beyond psychology and medicine including counselors, social workers, nurses, or ministers. The Oxford Handbook of Psychotherapy Ethics is not only intended for a clinical audience but also for a philosophical/ethical audience. The goal of the is to explicitly link the two disciplines by fostering a productive dialogue between them, enriching both the psychotherapeutic encounter and the ethical analysis and sensitivity within and outside the clinic. (shrink)

The aim of this paper is to advance the understanding of psychotherapy as ethical care, a mode of healing practiced in societies rich in the phenomenaconcerning the operations of collective life. By contemplating and establishing the four concepts: situated negativity, therapeutic locale, bodily experience(insituated negativity), and speech as action, the author is able to delineate the modes of therapeutic interactions right at the locale between the therapist andthe patient in order to disclose the structure of interpersonal thwartedness and (...) connectedness within psychotherapy. Viewed in this perspective, psychologicalsuffering is always the suffering of situated negativity. Healing, however, is not to cancel this negativity but to let it become a source of new ways of existence.This reverse of attitude toward negativity involves ways of “talking” into bodily experience in psychotherapy. The meaning of ethical care thus can be describedas: what the therapist aims to approach through speech is not positive normative ethics, the socially recognized “should-be,” but the situated negativity whichdenotes an expelled position from normative interpersonal ordering and which is to be experienced as nameless and full of forces. Situated negativity is not thatwhich to be eliminated but the source to be appreciated by both the therapist and the patient. (shrink)

Psychotherapy is a well-established, efficacious, and fully accepted treatment for mental disorders and psychological problems. Psychotherapy is an interpersonal practice engaging patient values, interests, and personal meanings at every step. Thereby, psychotherapy abounds with moral issues. In psychotherapy ethics, numerous moral issues converge, including self-determination or autonomy, decision-making capacity and freedom of choice, coercion and constraint, medical paternalism, boundaries between health and illness, insight into illness and the need for therapy, dignity, under- and overtreatment, and (...) much more. The Oxford Handbook of Psychotherapy Ethics covers the whole range of ethical issues in the heterogenous field of psychotherapy, closing a commonly perceived gap between ethical sensitivity, technical language, and knowledge among psychotherapists. The primary audience is psychotherapists in clinical practice. Furthermore, the Oxford Handbook of Psychotherapy Ethics addresses the whole range of professionals providing mental health services beyond psychology and medicine including counselors, social workers, nurses, or ministers. The Oxford Handbook of Psychotherapy Ethics is not only intended for a clinical audience but also for a philosophical/ethical audience. The goal of the is to explicitly link the two disciplines by fostering a productive dialogue between them, enriching both the psychotherapeutic encounter and the ethical analysis and sensitivity within and outside the clinic. (shrink)

The "Essentials of Gestalt Theoretical Psychotherapy" offer for the first time in English an insight into the guiding ideas of this integrative psychotherapy method, which is consistently anchored in Gestalt psychology (and in this respect also differs substantially from most streams of Gestalt therapy, with which it should not be confused). The anthology includes ten contributions by authors from Austria, Italy, Germany and the USA. These deal with fundamental questions and concepts of any psychotherapy: The role and (...) meaning of consistency in practical life and in psychotherapy; the question of human epistemic possibilities and an epistemology appropriate for psychotherapy; the personality theory of Gestalt Theoretical Psychotherapy; the basic principles of therapeutic relationship and practice; the role of emotions in the example of phenomenal causality of feelings; the task of diagnostics in Gestalt Theoretical Psychotherapy; a clinical example related to anorexia; Gestalt psychological viewpoints for therapy progress; the role of relational determination in intrapsychic and interpersonal experience. (shrink)

The Alternative Model of Personality Disorders integrates several theoretical models of personality functioning, including interpersonal theory. The interpersonal circumplex dimensions of warmth and dominance can be conceptualized as traits similar to those in AMPD Criterion B, but interpersonal theory also offers dynamic hypotheses about how these variables that change from moment to moment, which help to operationalize some of the processes alluded to in AMPD Criterion A. In the psychotherapy literature, dynamic interpersonal behaviors are thought (...) to be critical for identifying therapeutic alliance ruptures, yet few studies have examined moment-to-moment interpersonal behaviors that are associated with alliance ruptures at an idiographic level. The current study examined the concurrent and cross-lagged relationships between interpersonal behaviors and alliance ruptures within each session in the famous Gloria films. Interpersonal behaviors as well as alliance ruptures were calculated at half minute intervals for each dyad. We identified distinct interpersonal patterns associated with alliance ruptures for each session: Gloria ’s warmth was positively related with withdrawal ruptures concurrently in the session with Carl Rogers; Gloria’s dominance and coldness were related with increased confrontation ruptures in the session with Fritz Perls concurrently, while her coldness was also predicted by confrontation ruptures at previous moments; lastly, both Gloria’s dominance and Albert Ellis’s submissiveness were positively related with withdrawal ruptures. These interpersonal patterns demonstrated the promise of using AMPD dimensions to conceptualize momentary interpersonal processes related to therapy ruptures, as well as the clinical importance of attuning to repetitive, dyad-specific interpersonal cues of ruptures within each session. (shrink)

Many therapists can attest to the fact that adolescents can be difficult and frustating clients-problems are seldom well defined, clearly delineated symptoms are more exception than the rule, and troubling situations often involve the entire family. Gestalt therapist Mark McConville draws on his more than twenty years of professional experience to offer clinicians an effective model for understanding and treating adolescents. He outlines the Developmental Tasks Model, which describes adolescents' struggles, "temporary insanity," and ultimately, triumph of development. He clearly demonstrates (...) that the Gestalt therapeutic model bridges the theoretical and clinical gap, and offers an indepth exploration of the various aspects of clinical work. _Adolescence_ offers valuable nuts-and-bolts advice on initiating therapy with adolescents who are not yet ready to do the self-reflective, exploratory work. In addition, the book examines the therapeutic method of engaging and cultivating the adolescent's emerging inner world. With perception and sensitivity, McConville explains how the clinician can guide the adolescent in the very personal and subjective process of birthing and existential self. The book details the process of the creative reorganization of the self during adolescence and explores the changes that take place in the adolescent's relationships with peers, parents, and others in the adult world. The author also tracks the interplay of intrapsychic and interpersonal boundary development and shows how this interplay manifests itself in relationships and evolves from early through late adolescence. The Gestalt model of therapy allows the clinician to make sense of the confusion of the adolescent world and map out the multiple possibilities of clinical interventions. (shrink)

Many therapists can attest to the fact that adolescents can be difficult and frustating clients-problems are seldom well defined, clearly delineated symptoms are more exception than the rule, and troubling situations often involve the entire family. Gestalt therapist Mark McConville draws on his more than twenty years of professional experience to offer clinicians an effective model for understanding and treating adolescents. He outlines the Developmental Tasks Model, which describes adolescents' struggles, "temporary insanity," and ultimately, triumph of development. He clearly demonstrates (...) that the Gestalt therapeutic model bridges the theoretical and clinical gap, and offers an indepth exploration of the various aspects of clinical work. _Adolescence_ offers valuable nuts-and-bolts advice on initiating therapy with adolescents who are not yet ready to do the self-reflective, exploratory work. In addition, the book examines the therapeutic method of engaging and cultivating the adolescent's emerging inner world. With perception and sensitivity, McConville explains how the clinician can guide the adolescent in the very personal and subjective process of birthing and existential self. The book details the process of the creative reorganization of the self during adolescence and explores the changes that take place in the adolescent's relationships with peers, parents, and others in the adult world. The author also tracks the interplay of intrapsychic and interpersonal boundary development and shows how this interplay manifests itself in relationships and evolves from early through late adolescence. The Gestalt model of therapy allows the clinician to make sense of the confusion of the adolescent world and map out the multiple possibilities of clinical interventions. (shrink)

Can philosophy help ordinary people confront their personal or interpersonal problems of living? Can it help a couple whose marriage is on the rocks, or someone going through a midlife crisis, or someone depressed over the death of a significant other, or who suffers from anxiety about making a life change? These and many other behavioral and emotional problems are ordinarily referred to psychologists, psychiatrists, clinical social workers, or other mental health specialists. Less mainstream is the possibility of consulting (...) a philosophical counselor or practitioner. Yet, there is presently a steadily increasing, world-wide movement among individuals with postgraduate credentials in philosophy to harness their philosophical training and skills in helping others to address their life problems. But is this channeling of philosophy outside the classroom into the arena of life a good idea? Are philosophers, as such, competent to handle all or any of the myriad emotional and behavioral problems that arise in the context of life; or should these matters best be left to those trained in psychological counseling or psychotherapy? Through a diverse and contrasting set of readings authored by prominent philosophers, philosophical counselors, and psychologists, this volume carefully explores the nature of philosophical counseling or practice and its relationship to psychological counseling and psychotherapy. Digging deeply into this relational question, this volume aims to spark more rational reflection, and greater sensitivity and openness to the potential contributions of philosophical practice. It is, accordingly, intended for students, teachers, scholars, and practitioners of philosophy, counseling, or psychotherapy; as well as those interested in knowing more about philosophical counseling or practice. (shrink)

Recent neuro-psychoanalytic literature has emphasized the view that our subjective identity rests on ancient subcortical neuro-psychic processes expressing unthinking forms of experience, which are “affectively intense without being known” (Solms and Panksepp, 2012). Devoid of internal representations, the emotional states of our “core-Self” (Panksepp, 1998b) are entirely “projected” towards the external world and tend to be discharged through instinctual action-patterns. However, due to the close connections between the subcortical and the cortical midline brain, the emotional drives may also find a (...) way to be reflected within an intrinsic self-referential processing, evident when the organism is not actively engaged with the external world. Thanks to such endogenous functioning, the core-Self emotional dispositions are not overtly executed, but they are organized within coherent dynamic mental structures, called “feeling-toned complexes” by C.G. Jung and “unconscious phantasies” by Melanie Klein. The intrinsic self-referential dynamism of the ‘brainmind’ originated from REM sleep arousal and then evolved in the resting-state activity of a complex of cortico-limbic midline brain structures (CMS), also called Default Mode Network (DMN). From our neuro-ethological perspective, it is sustained by an “introverted” SEEKING activity leading to the subjective exploration of internally constructed virtual scenarios. This “mind wandering” function, implicated in dreaming, fantasy processing, remembering and thinking, is the essence of the imaginative function and constitutes the first form of reflection, where intentions and drives gain a primordial form of conscious (but not self-conscious) representation. During postnatal development, this original (“archetypal”) imaginative function is slowly attuned in a relational “transitional” space and may be expressed first in non-verbal and eventually in abstract-verbal social communicative patterns. Our view has noticeable implications for psychotherapy. Instead of trying to directly modify interpersonal, extrinsic relationships (a top-down approach), dysfunctional emotional-relational patterns may be modified by a process in which the patient is helped to let-go of the perceived feeling-objects in favor of an immersion, via the actual feeling, from the superficial level of perception towards a void feeling-state, empty of images. Only starting from this “anoetic” feeling-state, the deep imaginal creative and re-structuring self-referential activity may be reactivated by a process of spontaneous imagination. (shrink)

Background: The classical symptom specificity hypothesis (Blatt, 1974) links obsessional symptoms to autonomous interpersonal behavior. Inconsistent findings from cross-sectional group studies on symptom specificity have previously been associated with several conceptual and methodological limitations intrinsic to nomothetic research. Previous empirical case research reported ambivalences between autonomous and dependent interpersonal behavior in obsessional pathology. Aim and Method: The present ‘theory-building’ case study specifically aims at further refinement of the classical symptom specificity hypothesis by testing specific operationalizations within an empirical (...) single case design. Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of a psychodynamic therapy. Interpersonal functioning is assessed by means of the Core Conflictual Relationship Theme method. The classical symptom specificity hypothesis is contrasted to an alternative hypothesis of interpersonal ambivalences as determinants of obsessional symptoms. Results: Close associations between obsessions and interpersonal dynamics are observed. Findings predominantly affirm the ambivalence hypothesis rather than the classical symptom specificity hypothesis. Psychodynamic interventions focusing on interpersonal conflicts are related to symptomatic changes. Conceptual and methodological considerations, limitations and future research indications are discussed. (shrink)

This article examines the cultural practices through which a group of professionals infuse their work and community with charisma. Although previous research has theorized the “charisma of office” (Weber 1978), we know little about how the occupants of such offices sustain it. I focus on a group of psychoanalytically-inclined psychotherapists, whose field, despite its early charismatic beginnings, has been especially embattled in recent decades. Drawing on ethnographic and interview data, I reveal how they share stories emphasizing their “idealization” by others, (...) draw boundaries between their professional and private lives to manage their work identities, and perform interpersonal affective work that shores up their claims to extraordinary abilities. Together, these cultural practices constitute charisma within the professional group. This article thus makes a case that, as expertise becomes increasingly contested, we must look beyond social organization and the evidentiary bases of knowledge to understand professional authority. (shrink)

Psychotherapy is entrusted with the ingrate mission to fight an enigmatic and demanding scourge of humanity—mental illnesses—with all its emotional suffering and personal distress, let alone their behavioral, physiological, interpersonal and societal consequences–and if this would not be enough a challenge, psychotherapists are left alone to their own devices, which is nothing more than words and wisdom. Thus, the feat to achieve clinically relevant sustainable changes and reductions in face of these demands and possibilities can hardly be overrated.It (...) might be reasoned that this is made possible by the constant evolvement and refinement of psychological models and methods, which underlie, stimulate and steer... (shrink)

Aim: The aim of this paper is to present the development and evaluation of an art psychotherapy brief treatment method for complex depression for patients referred to mental health services.Background: Art Psychotherapy literature describes a range of processes of relational change through the use of arts focused and relationship focused interventions. Complex depression has a prevalence of 3% of the population in the West and it is recorded that in 2016 only 28% of that population were receiving psychological (...) treatment. This study was developed to test the hypothesis of whether an accessible and acceptable approach to the treatment of complex depression could be developed in relation to existing evidence-based practice within mental health services.Method: The United Kingdom Medical Research Council phased guidance for complex intervention development was used to develop the intervention. The process included producing a literature overview, systematic description of clinical practice, including a logic model and a clinical protocol. The art psychotherapy protocol described an arts-based dynamic interpersonal therapy approach, offered 1:1 over 24 sessions. Further to this the intervention was tested for referrer acceptability. The intervention is in the early stages of evaluation, using changes to the patient's depression and anxiety measured pre- and post-treatment with a follow-up measure at 3 months following completion of treatment.Results: Phase I of the study provided a good basis for developing a logic model and protocol. The authors found that there was good clinical consensus about the use of a structured clinical art psychotherapy method and the literature overview was used to support specific examples of good practice. The verification of clinical coherence was represented by a logic model and clinical protocol for delivering the intervention. The acceptability study demonstrated very high levels of acceptability for referrers reporting that ADIT was acceptable for patients with complex/major depression, that they were likely to refer to ADIT in the future that the use of arts was likely to improve accessibility the use of arts was likely to improve outcomes and that offering ADIT was an effective use of mental health resources.Discussion: Phase I of this intervention development study demonstrated theoretical and practice coherence resulting in a clinical protocol and logic model. Whilst Phase II of this study showed promising results, Phase II would need to be sufficiently scaled up to a full trial to further test the intervention and protocol. (shrink)

The COVID-19 pandemic outbreak has led to a general reorganization of health services and an increase in outpatient telemedicine in mental healthcare for physically ill people. Current literature highlights facilitators and obstacles concerning the use of new technologies in psychotherapy, an underrated topic of research in the context of supportive expressive psychotherapy. More insight is needed to explore the characteristics of video in therapeutic alliance for treatment of specific mental disorders experienced in psychosomatics, particularly with people suffering from (...) a disturbed body- and self-image. Using two clinical vignettes, it is the authors’ intention to enrich the critical debate on current knowledge in psychosomatic remote psychotherapy, with special focus on mentalization deficits and their impact on therapeutic alliance in the consultation-liaison psychiatry setting. In particular, we will question the interpersonal processes at stake related to mirroring and the disruption caused by the use of videoconference applications. We will also reflect upon the relationship between the therapeutic alliance and the medical team, and that between patient and psychotherapist. The aim is to improve psychotherapeutic alliance maintained during the pandemic for specific mental disorders and to inform about possible clinical factors that could be the subject of future empirical studies or professional guidelines. (shrink)

Recent models of psychopathology and psychotherapy highlight the importance of interpersonal factors. The current review offers a biological perspective on these interpersonal processes by examining inter-brain synchrony—the coupling of brain activity between people interacting with one another. High inter-brain synchrony is associated with better relationships in therapy and in daily life, while deficits in the ability to achieve inter-brain synchrony are associated with a variety of psychological and developmental disorders. The review suggests that therapy improves patients’ ability (...) to achieve such synchrony through inter-brain plasticity—a process by which recurring exposure to high inter-brain synchrony leads to lasting change in a person’s overall ability to synchronize. Therapeutic sessions provide repeated situations with high inter-brain synchrony. This can lead to a long-term increase in the ability to synchronize, first with the therapist, then generalized to other interpersonal relationships, ultimately leading to symptom reduction. The proposed inter-brain plasticity model offers a novel biological framework for understanding relational change in psychotherapy and its links to various forms of psychopathology and provides testable hypotheses for future research. Understanding this mechanism may help improve existing psychotherapy methods and develop new ones. (shrink)

This is an introductory text on psychological theories and psychotherapy that approaches the topic from a multidisciplinary perspective. Written for psychiatry residents, but of notable relevance to other students and practitioners in medical and mental health fields, this book lays out a specific sequence for learning psychotherapy that emphasizes the fundamental importance of acquiring an appropriate foundational knowledge base in addition to learning the specific techniques of psychotherapies.Beyond emphasizing the details of major treatment models as well as the (...) theory and research findings that inform the field of psychotherapy in general, a specific learning sequence is laid out that will guide the reader toward developing beginning competence as a psychotherapist. Psychoanalytic theory and behavior theory are each presented in historical context, with explanations and clear distinctions made among categories of each. These include classical psychoanalytic theory, ego psychology, object relations, the interpersonal school, intersubjective and relational approaches, learning theory, cognitive theory, and mindfulness-based approaches. (shrink)

From the Couch to the Circle: Group-Analytic Psychotherapy in Practice is a handbook of group therapy and a guide to the group-analytic model - the prevailing form of group therapy in Europe. The book draws on both John Schlapobersky’s engagement as a practitioner and the words and experience of people in groups as they face psychotherapy’s key challenges - understanding and change. This book provides a manual of practice for therapists’ use that includes detailed descriptions of groups at (...) work; accounts of therapists’ own experience and the issues they face in themselves and in their groups. The book is devoted to the Group-Analytic model but the other principally psychodynamic models of group therapy - the Tavistock, Interpersonal, Psychodynamic, Modern Analytic and Structural/Systemic models - are brought into a comparative discussion and drawn upon to create an integrated and coherent approach. The book is divided into three sections: Foundations – aimed at practitioners using groups of any kind and working at every level, including those providing supportive psychotherapy and providing groups for psychosis, trauma, the elderly, people at risk, the elderly and children; The Group-Analytic Model – defines the group-analytic model at a basic and advanced level; The Dynamics of Change – aimed at group analysts, psychotherapists and psychologists providing short-term psychotherapy and long-term group analysis The book is illustrated with clinical vignettes including incisive, instructive commentaries to explain the concepts in use. It is intended for those seeking psychotherapy, whether to resolve personal problems or to find new sources of meaning in their lives. It is also intended for policy-makers in mental health, students of different models of psychotherapy and the psychosocial field. The comparative discussion running through the text about methods and models of practice will likely be of interest to the wider mental health and psychotherapy fields. The author draws together the inherited wisdom of group analysis since Foulkes’ time and makes his own lasting contribution. From the Couch to the Circle will be an invaluable, accessible resource for psychotherapists, psychoanalysts, psychologists, family therapists, academics, psychologists, mental health practitioners, academics and teachers in psychotherapy. (shrink)

Thick description was originally proposed to overcome the limitations of quantitative research and ground anthropological observations in concrete people’s expectations, rather than in normative theories. The ultimate objective was to account for the emotional aspects of worldviews and value-orientations that would otherwise be left tacit or implicit by quantitative investigations. The present paper aimed at reviewing the _conceptual framework_ that has characterized this relational turn and has made possible a deeper understanding of the subjective experience. The primary objective is thus (...) to make explicit the assumptions upon which thick description relies and discuss how these renewed conditions allow meaning to emerge in interpersonal relationships. We argue that both these objectives would be theoretically attainable if primarily centered on the exploration of the _possibility space_ and on the patient’s experience as driven by the power of _counterfactual thinking_. Under these conditions, human subjects may be led to recognize the contextual and semiotic dimension of _boundaries_ and, in so doing, become aware of the beneficial effects of weaving past and new experiences in meaningful relationships. (shrink)

Though the divide between reason-based and causal-explanatory approaches in psychiatry and psychopathology is old and deeply rooted, current trends involving multi-factorial explanatory models and evidence-based approaches to interpersonal psychotherapy, show that it has already been implicitly bridged. These trends require a philosophical reconsideration of how reasons can be causes. This paper contributes to that trajectory by arguing that Donald Davidson’s classic paradigm of 1963 is still a valid option.

What does it feel like to encounter ourselves and one another as implicated subjects, both in our everyday lives and in the context of our work as clinicians, and how does this matter? With contributions from a diverse group of relational psychoanalytic thinkers, this book reads Michael Rothberg's concept of the implicated subject - the notion that we are continuously implicated in injustices even when not perpetrators - as calling us to elaborate what it feels like to inhabit such subjectivities (...) in relation to others both similarly and differently situated. Implication and anti-Black racism are central to many chapters, with attention given to the unique vulnerability of racial minority immigrants, to Native American genocide, and to the implication of ordinary Israelis in the oppression of Palestinians. The book makes the case that the therapist's ongoing openness to learning of our own implication in enactments is central to a Relational sensibility and to a progressive psychoanalysis. As a contribution to the necessary and long-overdue conversation within the psychoanalytic field about racism, social injustice, and ways to move toward a just society, this book will be essential for all relational psychoanalysts and psychotherapists. (shrink)

Heart and Soul is a collection of essays which examine those concepts and questions which are at the heart of both psychotherapy and philosophy. Topics discussed include the nature of the self, motivation and subjectivity, the limits of certainty and subjectivity in interpersonal situations, and the scope of narrative, dialogue and therapy itself. Looking at the work of key figures such as Wittgenstein, Socrates, Kierkegaard, Foucault, Lacan and Klein, contributors draw on a wide range of philosophical approaches and (...) examine how they can deepen our understanding of the processes involved in different types of psychotherapy in a wide range of clinical settings. Each chapter includes a summary of the implications to clinical practice of the ideas discussed. Contributors: Joady Brennan, John M. Heaton, Jeremy Holmes, Joan Hurd, Paul Sepping, Geraldine Shipton, Paul Sturdee, Digby Tantam, Myra Thomas, Emmy van Deurzen, Werdie van Staaden, John Wheway, and Catherine Wieder. (shrink)

The main aim of this study is to explore the breadth of the inference field and the type of etiopathogenetic contents of symptom explanations provided by the client and therapist in the first two psychotherapy sessions conducted using a systemic approach. Does the therapist use triadic explanations of psychopathology as suggested by her approach? And do clients resort almost exclusively to monadic and dyadic explanations as did the university students in our previous study? What kind of explanations do they (...) propose? The coding system “1 to 3: from the monad to the triad” was applied to the transcripts of 25 individual systemic therapies conducted by the same therapist. This manual allows to code the inference field of symptom explanations according to three categories: monadic, dyadic and triadic. These three broad categories are also used to analyse the etiopathogenetic content of each explanation: traumatic, intrapersonal, and interpersonal. Our findings showed that clients and their therapist actually used different inference fields: clients resorted almost exclusively to monadic and dyadic explanations, whereas their therapist included the triadic explanatory level. Moreover, the therapist provided more interpersonal explanations than her clients. Hence, the dissonance between client and therapist about the inference fields¬–a crucial premise of one of the most accepted ideas of therapeutic change according to systemic therapies–is proved, at least among our participants. Thanks to this dissonance, clients and therapists can create a new story, potentially able to change clients’ feelings, without disconfirming their emotions. (shrink)

A deeply personal account of the scientific, shamanic, and metaphysical encounters that led to the development of Metzner's psychological methods Recounts the author's meetings and friendships with Albert Hofmann, Alexander Shulgin, the McKenna brothers, Wilson Van Dusen, Myron Stolaroff, and Leo Zeff Details his lucid dream encounters with G. I. Gurdjieff, profoundly healing sessions with Hawaiian healer Morrnah Simeona, experiences with plant teachers iboga and ayahuasca, and ecological and mystical lessons learned from animal teachers Shares his involvement in the beginnings (...) of the therapeutic use of MDMA and how it safely and effectively supports the healing of trauma, PTSD, and interpersonal relationships Just as the search for the philosopher's stone is the core symbol of the alchemical tradition, Ralph Metzner, Ph.D., psychotherapist and one of the respected elders of the psychedelic research community, sees it as the central metaphor of his life-long quest to find methods of healing and insight through heightened states of consciousness. Through captivating stories Metzner shares his encounters from the 1960s through the 1990s with genius scientists, shamanic healers, mystics, plant spirits, and animal guides that led to the development of his "alchemical divination" psychological methods, a structured intuitive process of accessing inner sources of healing and insight. He details lessons learned with psychedelic research legends Albert Hofmann, Alexander Shulgin, Terence McKenna, and Dennis McKenna. He reveals his deeply healing encounters with the Kahuna bodywork healer Morrnah Simeona, the first to introduce the Hawaiian Ho'oponopono healing method to the West, and his experiences with West African trance dancing and the psychoactive plant-drug iboga. Metzner recounts in vivid detail his unwelcome encounter with malignant sorcery during an ayahuasca experience in Ecuador and the lessons it taught him about connections with spirits, both harmful and beneficial. He tells of his involvement in the beginnings of the therapeutic use of MDMA and shows how it is an effective and safe substance to support psychotherapy for healing trauma, PTSD, and interpersonal relationships. In sharing his remarkable encounters, Metzner shows how the most meaningful lessons in the alchemy of life come not only from the geniuses we meet but also from the spirits we encounter along the way. (shrink)

Recent research on “psychotherapy” in Greek philosophy has not been fully integrated into thinking about philosophy as a way of life molded by personal relationships. This article focuses on how the enigma of Socratic eros sustains a network of thought experiments in the fourth century BCE about interpersonal dynamics and psychical transformation. It supplements existing work on Plato's Symposium and Phaedrus with comparative material from Aeschines of Sphettus, Xenophon, and the dubiously Platonic Alcibiades I and Theages. In order (...) to select and illuminate commonalities among all of these, it also draws critically upon Jacques Lacan's psychoanalytic technique and his numerous comparisons between Socrates and psychoanalysts. What emerges is a more complex and qualified but no less sincere appreciation for the ideal of reflective, cooperative aspiration toward Beauty portrayed in Plato's dialogues. (shrink)

Both new and seasoned psychotherapists wrestle with the relationship between psychological distress and inequality across race, class, gender, and sexuality. How does one address this organically in psychotherapy? What role does it play in therapeutic action? Who brings it up, the therapist or the patient? Daniel José Gaztambide addresses these questions by offering a rigorous decolonial approach that rethinks theory and technique from the ground up, providing an accessible, evidence-informed reintroduction to psychoanalytic practice. He re-examines foundational thinkers from three (...) traditions—Freudian, relational-interpersonal, and Lacanian—through the lens of revolutionary psychiatrist Frantz Fanon, and offers a detailed analysis of Fanon’s psychoanalytic practice. Drawing on rich yet grounded discussions of theory and research, Gaztambide presents a clinical model that facilitates exploration of the social in the clinical space in a manner intimately related to the patient’s presenting problem. In doing so, this book demonstrates that clinicians no longer have to choose between attending to the personal, interpersonal, or sociopolitical. It is a guide to therapeutic action “on the couch,” which envisions political action “off the couch” and in the streets. Decolonizing Psychoanalytic Technique provides a comprehensive, practice-oriented and compelling guide for students, practitioners, and scholars of critical, multicultural and decolonial approaches to psychotherapy. (shrink)

Mentalizing - the ability to understand oneself and others by inferring the mental states that lie behind overt behavior - develops during childhood within the context of a secure attachment relationship. It is crucial to self-regulation and constructive, intimate relationships. Failure to retain mentalizing, particularly in the midst of emotional interactions, is a core problem in borderline personality disorder and results in severe emotional fluctuations, impulsivity, and vulnerability to interpersonal and social interactions. Mentalization-based treatment for borderline personality disorder is (...) a 'How to Do It' book outlining a clinically proven treatment for Borderline Personality Disorder. Containing illustrative clinical examples, it details precisely how to develop and implement treatment and is a companion to the highly successful book Psychotherapy for Borderline Personality Disorder - mentalization based treatment. This practical guide explains how to treat borderline patients by helping them develop a more robust mentalizing capacity within the context of an attachment relationship. It provides the practitioner with everything they need to know about how to practise mentalizing treatment in day patient and out-patient settings. Enough theory is provided to orientate the clinician and there is step-by-step practical advice on the assessment of mentalizing and interpersonal relationships, how to structure treatment, the use of basic mentalizing interventions and how to apply them, as well as information on what not to do. In addition, it includes a check list to be used in the assessment of mentalizing and a self-rating exercise for practitioners to evaluate their adherence to mentalizing. (shrink)

In this book, David Konstan argues that the modern concept of interpersonal forgiveness, in the full sense of the term, did not exist in ancient Greece and Rome. Even more startlingly, it is not fully present in the Hebrew Bible, nor in the New Testament or in the early Jewish and Christian commentaries on the Holy Scriptures. It would still be centuries - many centuries - before the idea of interpersonal forgiveness, with its accompanying ideas of apology, remorse, (...) and a change of heart on the part of the wrongdoer, would emerge. For all its vast importance today in religion, law, politics and psychotherapy, interpersonal forgiveness is a creation of the eighteenth and nineteenth centuries, when the Christian concept of divine forgiveness was fully secularized. Forgiveness was God's province and it took a revolution in thought to bring it to earth and make it a human trait. (shrink)

Recent research on “psychotherapy” in Greek philosophy has not been fully integrated into thinking about philosophy as a way of life molded by personal relationships. This article focuses on how the enigma of Socratic eros sustains a network of thought experiments in the fourth century BCE about interpersonal dynamics and psychical transformation. It supplements existing work on Plato's Symposium and Phaedrus with comparative material from Aeschines of Sphettus, Xenophon, and the dubiously Platonic Alcibiades I and Theages. In order (...) to select and illuminate commonalities among all of these, it also draws critically upon Jacques Lacan's psychoanalytic technique and his numerous comparisons between Socrates and psychoanalysts. What emerges is a more complex and qualified but no less sincere appreciation for the ideal of reflective, cooperative aspiration toward Beauty portrayed in Plato's dialogues. (shrink)

Background: Psychopathy and substance use disorders are highly co-morbid and their co-occurrence is associated with higher severity of addictive behavior and increased risk of violent offending. Both substance use disorders and psychopathy are related to prominent impairments in emotion processing, which are also central features of alexithymia. The nature of the relationship between psychopathy and alexithymia is not well understood and has been particularly understudied among substance dependent individuals. Aims: Our goal was to evaluate the levels of psychopathy and alexithymia (...) in a relatively homogeneous sample of heroin dependent individuals and healthy controls and to examine group differences in the pattern of associations between these constructs. Methods: We examined 62 participants (31 heroin dependent individuals and 31 healthy controls) with the Psychopathy Checklist: Screening version (PCL:SV, Hart et al., 1995) and the Toronto Alexithymia Scale-20 (TAS-20, Bagby et al., 1994). Results: Heroin dependent individuals were characterized by higher levels of both psychopathy and alexithymia as compared to the control group. In addition, heroin dependent individuals with higher levels of psychopathy reported more difficulties in identifying and verbalizing emotional states. In the heroin group, alexithymia was more strongly associated with the impulsive/antisocial characteristics (impulsivity, irresponsibility, antisocial behavior) than with the interpersonal/affective features of psychopathy (grandiosity, manipulativeness, lack of empathy and remorse). Conclusions: Our findings suggest that alexithymia may be one potential mechanism linking psychopathy with opioid use disorders. The development of interventions targeting alexithymia could have significant applications in relapse prevention programs and psychotherapy of substance use disorders with concurrent psychopathy. (shrink)

This book offers a broad survey of psychotherapy discourses, including: The psychoanalytic The interpersonal The experiential The cognitive-behavioural The transpersonal This book offers a comprehensive overview of the ways in which these ...

The present work aims to efficiently carry out life-death education for college students, improve their psychological problems, and reduce suicide accidents by combining LDE with Dance Movement Therapy. DMT is a psychosomatic cross therapy that treats mental or physical diseases through dance or improvisation. Firstly, this paper introduces LDE and DMT and designs the activities of DMT intervention. Secondly, the relationship between DMT and LDE is analyzed. Finally, a questionnaire survey is conducted on the research objects. The research objects are (...) divided into the experimental group receiving DMT intervention, the control group participating in sports dance courses, and the benchmark group. The research data show no significant difference in interpersonal skills and emotional psychology among the three groups. The DMT intervention group has substantial changes in other factors except for the conflict control ability before and after the intervention. In addition, the questionnaire survey results after the intervention demonstrate that the DMT intervention group gets a significantly higher score in the interpersonal relationship, interpersonal relationship building ability, moderate rejection ability, self-disclosure ability, and emotional support ability. Therefore, DMT intervention positively impacts college students’ interpersonal relationships. After the sports dance course, there are differences in the total score of interpersonal ties and scores of interpersonal relationships building ability, self-disclosure ability, and emotional support ability in the control group, but with no significant difference in moderate rejection ability and conflict control ability. Therefore, compared with traditional psychotherapy methods, the DMT method reported here is conducive to releasing pressure and alleviating physical and mental anxiety. The research content provides new ideas for psychological education in colleges and universities and contributes to improving college students’ suicidal tendencies and helping college students grow up healthily. (shrink)

_Treating Dissociative and Personality Disorders_ draws on major theorists and the very latest research to help formulate and introduce the Relational/Multi-Motivational Therapeutic Approach, a new model for treating such patients within a clinical psychoanalytic setting. Supported by her fellow contributors, Antonella Ivaldi provides an overview of existing theories and evidence for their effectiveness in practice, sets out her own theory in detail and provides rich clinical detail to demonstrate the advantages of the REMOTA model as applied in a clinical setting. (...) The narratives in this book show how it is possible to integrate different contributions within a multidimensional aetiopathogenic treatment model, which considers the mind as a manifestation of the relationship between body and world. From a conceptual perspective, according to which consciousness emerges and develops in the interpersonal dimension, this book shows how it becomes possible to understand, in the therapeutic space, what stands in the way of sound personal functioning, and how to create the conditions for improving this. Treating Dissociative and Personality Disorders will be highly useful in addressing the particular clusters of symptoms presented by patients, stimulating therapists of different backgrounds to explore the complexity of human nature. On reading this book, it will become clear that theories can truly become useful instruments, if approached with a critical mind and with humbleness, in order to venture into what we do not know and will never know completely: the relationship with the other, unique and irreplaceable. Treating Dissociative and Personality Disorders provides an integrative and comparative new approach that will be indispensable for combining relational clinical knowing and motivational theories. It_ _will appeal to psychoanalysts and psychotherapists, especially those in training, clinicians of different backgrounds interested in comparative psychotherapy, as well as social workers and graduate and postgraduate students. (shrink)

The article addresses a common difficulty of counselors in confronting clients with the problems in their thinking and behavior in a way that they could start benefiting from a constructive self-reflective state in the long run, a state that would replace the common tendency to hide oneself, to blame, to victimize or to repress aspects of their humanity connoted as negative in order to maintain a positive self image. The highlight is on the main characteristics of efficient confrontations with oneself (...) and others, so as to engender reasoning competence training without an unnecessary loss in the quality of the consultative relationship. Working in psychotherapy and having progressively integrated more philosophical work into this professional practice, the author puts together a few concepts and ideas that are likely to facilitate the processes in the psychotherapeutic and the philosophical approaches to intrapsychic and interpersonal dialogue. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Threat to Selfhood: Moral Distress and the Psychiatric Training CultureEsther NathansonWhile many medical specialties offer to heal, or even cure, psychiatry—uniquely—places the doctor–patient relationship at the center of the therapeutic effort. Psychiatrists must possess a complex and challenging combination of broad medical knowledge, finely honed interpersonal and analytic skills and confidence in their abilities, despite limited understanding of the workings of the brain. Inpatient psychiatry in particular (...) demands a degree of strength to withstand emotional, and sometimes physical, assault from patients who may be suicidal, desperate, paranoid, aggressive or delusional. Beyond these abilities, a good psychiatrist must have robust but ‘therapeutically porous’ emotional boundaries that allow genuine empathy for the patient but, at the same time, limit internalization of the patient’s anguish as the practitioner’s own: the exquisite balance of ‘self–versus–other’ in the therapeutic encounter.Unfortunately, during my psychiatry residency in the UK, development of these intangible but essential boundaries was entirely absent from the curriculum. Early in training I struggled with my tendency to become an emotional chameleon with feelings and energies buffeted around by the prevailing emotions of each patient that walked through the door. I felt that patients expected me to offer tidy explanations for their suffering and provide answers to profound questions of meaning; to make the world a safe and understandable place. Given the complexity of mental illness and its interplay with social circumstances this was naïve and, I now realize, often unnecessary, but the weight of responsibility was unbearable. I was also completely unprepared for the intensity of human suffering I saw, and wholly unready to provide the level of interpersonal engagement required for genuine healing. My own emotional integrity felt threatened by the depth of patients’ needs, and my response—both physical and emotional—was intense and frightening.Much of my distress resulted from the profound and inevitable tension between the empathy necessary to comprehend patients’ experiences, which were often extreme and bewildering, and the need for resilience and self–protection at a time when my grasp of psychological theories and treatment practices was still rudimentary. I felt guilty that patients bore the brunt of my inexperience, and duplicitous purporting to help while burdening them with intolerable drug side–effects and stigmatizing, albeit effective, treatments such as electroconvulsive therapy (ECT). Time constraints and guidance from senior faculty encouraged expediency over treatment efficacy or durability; psychopharmacology was prioritized over the psychotherapeutic techniques and psychosocial interventions I found more effective for many patients. During the phase of our training that took place in a rambling, now defunct, asylum in the U.K, visits to the locked ward, which was reserved for patients considered a danger to others, were usually prompted by nurses’ requests for chemical restraint, the ‘pharmaceutical strait–jacket’. I was deeply uncomfortable with the role of ‘restrainer’ but had insufficient experience or seniority to propose other methods. It was only when, years later, I investigated re–training in the U.S that the senior psychiatry resident at a well–known program told me gently, ‘Oh, we assume that students will have a breakdown in their first year, so we have systems in place to help’. I’ll never forget those words; they are, to this day, the only validation of the emotional toll of my early training years.Adding to my discomfort were various ethically dubious administrative practices, the most troubling being the clinic’s unwillingness to disclose to patients that we were trainees, with little clinical experience. Senior faculty were dismissive when I asked whether my first psychotherapy patient had been told I was a trainee, indeed that I had never conducted psychotherapy before. My question was greeted with amusement and an assurance that, although she had not been told, I (not the patient, interestingly) would do fine.Due to the large number of no–shows in psychiatric outpatient clinics it was also standard practice to triple–book appointment times on the [End Page 115] assumption that one or more patients would fail to attend. Not uncommonly, more than one patient would arrive for the same appointment, leaving others to suffer agonizing waits that were often intensified by the deep discomfort... (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)

Schizophrenia is a severe and disabling mental illness, associated with persistent difficulties in social functioning. While gaining and retaining a job or staying socially integrated can be very difficult for the patients, the treatment of poor functionality remains challenging with limited options in pharmacotherapy. To address the limitations of medical treatment, several interesting and innovative approaches have been introduced in the field of psychotherapy. Recent approaches incorporate modern technology as well, such as virtual reality. A potential therapeutic benefit of (...) virtual reality is particularly significant when an interpersonal dimension of the problem needs to be addressed. One example is a Virtual Reality based Theory of Mind Intervention, a novel method, which enables patients to practice complex social interactions without the burden of real-life consequences. Our paper presents a case report showing promising results of VR-ToMIS. Ms. Smith is a 50- year-old patient who has been suffering from schizophrenia for 20 years. Although in her case there was no problem with compliance throughout the years, she had severe problems regarding social functionality. With VR-ToMIS, she improved in ToM and communicative-pragmatic skills. The effects of the intervention went beyond the increased scores of the tests. Before the intervention there was a risk of the patient becoming unemployed as she was unable to follow the main principles of communicative exchange. Usually, her contribution was more informative than was required. After the intervention her communication became more balanced and she could retain her job. This case suggests that VR-ToMIS may be a promising tool for treating social disfunction in schizophrenia. (shrink)

Systemic Constellation Work is a rapidly growing experiential healing process that is being embraced by a variety of helping professionals, both traditional and alternative, worldwide. This book explores the history, principles and methodology of this approach, and offers a detailed comparison with psychodrama - the original mind-body therapy - explaining how each method can enhance the other. Constellation work is based on the notion that people are connected by unseen energetic forces and suggests that the psychological, traumatic and survival experiences (...) of our ancestors are genetically passed forward to the next generation and may live within us. Using insightful case studies from a variety of client groups, this book shows how Systemic Constellation Work can expand the possibilities of psychodrama techniques, and can be successfully integrated with psychodramatic enactment, guided imagery, ritual, concretization and other methods of healing and personal growth. This book will be essential reading for students and practitioners of psychodrama and Constellation work, as well as counselors, mental health professionals, experiential therapists, creative and expressive arts therapists and alternative practitioners looking to widen their knowledge of mind-body therapies. (shrink)

Background The use of Artificial Intelligence (AI) has the potential to provide relief in the challenging and often stressful clinical setting for physicians. So far, however, the actual changes in work for physicians remain a prediction for the future, including new demands on the social level of medical practice. Thus, the question of how the requirements for physicians will change due to the implementation of AI is addressed. Methods The question is approached through conceptual considerations based on the potentials that (...) AI already offer and the focus on central normative concepts of trust, explainability, and responsibility which play an important role when implementing AI in everyday clinical practice. Conclusion Interpersonal communication will not disappear upon implementation of AI. Instead, it is much more likely that the exchange between various actors in medical practice will become increasingly important. This adds another level of complexity to practical concepts such as Shared-Decision-Making, which must be addressed in empirical research, including the involvement of AI systems as actors in communication. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.1 (2005) 77-78 [Access article in PDF] Language, Mind, and World Werdie (C. W.) Van Staden Keywords psychotherapy, linguistics, semantics, references, speech The paper by Mcconnell and Gillett touches, in a Lacanian way, on the connections between language, world, and the conscious and unconscious mind. Their paper brings together the influential ideas of Freud, philosophical phenomenology, existentialism, and structuralism in describing Lacan's approach to (...) these connections. Going further than Lacan's concerns in psychotherapy, their paper calls on us to consider the importance of these connections more generally in philosophy, psychiatry, and psychology.These connections matter substantially in the practice of psychiatry and psychology, for there we need to understand as much as possible of the ways in which language is intimately involved with the minds and brains of people and their biological and interpersonal worlds. Even at first glance, we can easily concede that people use language to express their troubled minds and their past, present, and anticipated relations with their biological and interpersonal worlds; that language use depends inescapably on brain functions (of the Broca and the Wernicke areas, for example); and that practitioners use language receptively and exploratively to access and examine the minds as well as the biological and interpersonal worlds of the people.Cognizant of the connections between language, mind, and world, language has received considerable attention in the psychotherapy literature and practice (e.g., Russell 1987), including from Lacan and his followers. In addition to these practices and theoretical expositions, empirical linguistic studies in psychotherapy have also been published recently (e.g., Van Staden in press; Van Staden and Fulford 2004; Spence 1995; Spence, Mayes, and Dahl 1994).There has been, furthermore, a growing interest in defining linguistic variables for empirical research in general psychiatry and psychology (Van Staden 2002; Thomas and Fraser 1994). The necessary and intimate role of language has also been reviewed recently in coming to a diagnostic understanding of people's difficulties (Van Staden 2003) and in conducting ethically sound assessments of mentally disordered people's capacity to give informed consent (Van Staden and Krüger 2003). Furthermore, the underlying connections between language, mind, and world, for example, have brought about the expectation that genetic factors in the etiology of schizophrenia would be related to the far-reaching capacity of human beings to use language (Crow 1997).A philosophical interest in the connections between language, mind, and world can be traced back to Plato. More recently, it has been taking a central place in analytic philosophy. The vast and sophisticated philosophical literature on this topic suggests that these connections are very [End Page 77] intricate and that we probably have an inchoate understanding of them. These connections are about theories of reference; theories of descriptions; semantic theories of truth; Kant's distinction between form and content; meaning; contextual content; linguistic pragmatism and speech act theories—all elaborate topics, of course, intertwined with various ontological commitments (cf. Luntley 1999).Lacan's contribution, driven by practical need albeit in the constrained area of psychotherapy, has not yet been taken up in analytic philosophy circles. The paper by McConnell and Gillett sets the scene for further philosophical examination that could determine whether Lacan's work does advance contemporary analytic philosophy on this topic. The most potential for such advance concerns probably, as indicated by McConnell and Gillet, insights about the unconscious mind.Notwithstanding a worthy philosophical examination of whether Lacan's work advances contemporary analytic philosophy on the connections between language, mind, and world, it may prove to be a challenging undertaking—probably even more challenging than the admirable groundwork done in the paper by McConnell and Gillett. The reason is, in my opinion, that the depth of Lacan's work is difficult to penetrate, in part because of the abundance of his esoteric terms, some of which are prima facie incommensurable with ordinary analytic language. The philosophical cogency of his work, moreover, is difficult to verify, because he often simply made conjectures, true as they might be, without explicating (sufficiently) the justification thereof.Lacan's work is commendable, however, even if... (shrink)

In this original and penetrating work, the origins of the Gestalt psychotherapy model are traced back to its roots in psychoanalysis and Gestalt cognitive and perceptual psychology. Drawing new implications for both Gestalt and psychotherapy in general from these origins - and with special emphasis on the neglected work of Lewis and Goldstein - Wheeler develops a revised model that is more fully "Gestalt" and at the same time more firmly grounded in the spectrum of tools and approaches (...) available to the contemporary psychotherapist. Along the way, a number of new insights are offered, not just in Gestalt, but in the working of the psychoanalytic and cognitive/behavioral models. The result is an integrated approach giving a fresh perspective on the universal processes of contact and resistance, both in psychotherapy and in social systems in general. The practitioner is given these tools for "addressing problems at the intra- and interpersonal level and wider systematic levels at the same time, and in the same language." Each chapter stands alone, and makes a fresh and significant contribution to its particular subject. Taken together, they constitute a remarkable excursion through the history of psychotherapy in this century, weaving powerfully through social psychology, behaviorism, and Gestalt itself, yielding a masterful new synthesis that will interest the practitioners of Gestalt and other schools alike. (shrink)