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Results for “Reality Therapy”

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At least 307 records · Page 17Linked to original sources
PubMed1994

Formulation of interpretation. From truth to experience.

The task of formulating an interpretation is discussed in terms of seeing it as the analyst's search to make the interpretation relevant to that specific point in the analytic process, in order to make it into something that can be felt by the patient as true and meaningful. Illustrations from the literature from Freud onwards are used to show how this search has been part of the history of psychoanalytic technique, which is still ongoing in order to make our newer understandings into something meaningful and therapeutic for the patient. One area that is particularly emphasised in this paper is the need to include consideration of the patient's relationship with his body as part of the analytic understanding in order for the patient to be able to experience an interpretation as having affective meaning and to create a link to external reality.

Adult↗
PubMed2006

Cognitive behavior therapy for fear of flying: sustainability of treatment gains after September 11.

This study examines the long-term efficacy of cognitive-behavioral therapy (CBT) for fear of flying (FOF) after a catastrophic fear-relevant event, the September 11, 2001, terrorist attacks. Participants (N = 115) were randomly assigned to and completed treatment for FOF using 8 sessions of either virtual reality exposure therapy (VRE) or standard exposure therapy (SE) prior to September 11, 2001. Individuals were reassessed in June, 2002, an average of 2.3 years after treatment, with a response rate of 48% (n = 55). Analyses were run on the original data and, using multiple imputation procedures, on imputed data for the full sample. Individuals maintained or improved upon gains made in treatment as measured by standardized FOF questionnaires and by number of flights taken. There were no differences between VRE and SE. Thus, results suggest that individuals previously treated for FOF with cognitive-behavioral therapy can maintain treatment gains in the face of a catastrophic fear-relevant event, even years after treatment is completed.

Adult↗
PubMedDate not supplied

Androgen replacement therapy in women: myths and realities.

In recent years, much attention has been directed at the potential of androgen replacement in the menopausal woman. Testosterone (T) replacement, in various forms, is widely used. However, evidence is lacking for a profound T deficiency state with natural menopause. Data confirming efficacy are also scant, and side effects have been demonstrated with prolonged therapy. The adrenal androgens, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S), also in contradistinction to T, decline substantially with age. Preliminary studies involving replacement of physiologic levels of DHEA have demonstrated some potential benefits: enhancement of the immune system and enhancement of the growth hormone axis. However, long-term trials have not been performed to date, so this modality of androgen replacement remains in the realm of clinical investigation. Ovarian and adrenal androgen replacement in menopausal women, while theoretically appealing, remains imperfect to date and should be used judiciously, if at all.

Adrenal Glands↗
PubMed1994

The evangelical uses of leprosy.

The history of leprosy treatment among the Karo of Sumatra illustrates how leprosy afforded missionaries an evangelistic opportunity, and how that opportunity eroded in the twentieth century with changing therapies for the illness. Because it symbolized Christian charity, leprosy care drew donations and support for the missionary movement of the nineteenth century. In Karoland, as elsewhere, leprosy patients were attracted to the missionaries' religion because therapy entailed separation from kin and community and then incorporation into a new kind of community, an asylum, where the authority structure, the dispensation of resources, and the constructed spaces of everyday life made the idea of a supreme deity an experienced reality. When therapies of leprosy shifted to an out-patient system, one of the older missionaries to the Karo struggled to maintain control of the leprosarium that had been one of the few pockets of conversion in this mission field.

Attitude to Health↗
PubMed2000

Reflections on psychic reality.

The author explores the nature and development of psychic reality and draws the following conclusions: (1) psychic reality is equivalent to subjective (conscious) awareness. (2) Psychic reality is open to unconscious influences, both as to content and motivation. Psychic reality thus is not equivalent to unconscious fantasy or transference, but can include effects of both. (3) Psychic reality can also include objective experience. (4) The capacities for internal psychic experience and knowledge of objective reality externally are modes of experiencing that develop early and achieve gradual integration through integrative play. (5) Psychic experience, and therefore psychic reality, cannot be regarded as exclusively subjective or objective, but as inherently both. The ways in which subjectivity does not preclude or exclude objectivity are discussed and related to transitional experience. (6) The inherent subjectivity of psychic experience precludes any form of direct intersubjective communication, that is, unmediated communication from subject to subject. The tensions of subjectivity and objectivity are discussed in relation to the analytic situation, in which perspectives of patient and analyst differ and reflect their respective psychic realities, each with its own validity and uncertainty and openness to unconscious needs, fantasies and motives.

Awareness↗
PubMed1997

Misunderstanding and psychic truths.

The author begins by pointing out that the psychoanalytical method and the concept of the unconscious are necessary conditions if the concept of psychic reality is to maintain its psychoanalytical relevance. She emphasises the importance of the concept of Nachträglichkeit, or retroactive assignment of new meaning, as a link between the concepts of psychic reality and historical truths on the one hand and decentred listening and misunderstanding on the other. Recalling the Freudian development of the concept of psychic reality, she stresses that 'the other' is present from the outset in the constitution of the psyche; she discusses the relations between intrasubjectivity and intersubjectivity in the transference and concludes that, through the function of 'listening to listening', misunderstanding becomes the royal path to the discovery of the patient's psychic reality. Some clinical examples are discussed in detail to illustrate the function of decentred listening. The author's viewpoint is not based on criteria concerning a correspondence, or lack of correspondence, between psychic reality and material reality. Her aim is to link psychic reality and historical truths as a way of overcoming solipsism.

Animals↗
PubMed2006

Treatment of specific phobia in adults.

This is a comprehensive review of treatment studies in specific phobia. Acute and long-term efficacy studies of in vivo exposure, virtual reality, cognitive therapy and other treatments from 1960 to 2005 were retrieved from computer search engines. Although specific phobia is a chronic illness and animal extinction studies suggest that relapse is a common phenomenon, little is known about long-term outcome. Treatment gains are generally maintained for one year, but longer follow-up studies are needed to better understand and prevent relapse. Acutely, the treatments are not equally effective among the phobia subtypes. Most phobias respond robustly to in vivo exposure, but it is associated with high dropout rates and low treatment acceptance. Response to systematic desensitization is more moderate. A few studies suggest that virtual reality may be effective in flying and height phobia, but this needs to be substantiated by more controlled trials. Cognitive therapy is most helpful in claustrophobia, and blood-injury phobia is uniquely responsive to applied tension. The limited data on medication have not been promising with the exception of adjunctive D-clycoserine. Despite the acute benefits of in vivo exposure, greater attention should be paid to improve treatment acceptance and retention, and additional controlled studies of more acceptable treatments are needed.

Adult↗
PubMed2006

The assessment and treatment of specific phobias: a review.

Specific phobia is one of the most common and easily treated mental disorders. In this review, empirically supported assessment and treatment procedures for specific phobia are discussed. Exposure-based treatments in particular are highlighted given their demonstrated effectiveness for this condition. The format and characteristics of exposure-based treatment and predictors of treatment response are outlined to provide recommendations for maximizing outcome. In addition, several other treatments for specific phobia are reviewed and critiqued, including cognitive therapy, virtual reality, eye movement desensitization and reprocessing, applied tension, and pharmacologic treatments. The review concludes with a discussion of future directions for research.

Antidepressive Agents↗
PubMed1990

Managing strain in a classical analysis: re-establishing the therapeutic relationship or interpreting unconscious wishes.

The therapeutic relationship frequently comes under a strain during the course of an analysis. At these times, the analysand perceives and reacts to the analyst as if the analyst were a critical or seductive archaic object. When this occurs, the analyst has the choice of interpreting the unconscious source of the analysand's non-therapeutic reactions or of interacting with the analysand in a manner which re-establishes and potentially strengthens the therapeutic relationship. Interpretations during the early phases of an analysis are unlikely to mitigate the strain until the therapeutic relationship has become stronger and until considerable reality testing has promoted a context which allows the analysand to understand and to tolerate her or his unconscious wishes.

Humans↗
PubMed1992

The transference: distortion or plausible conjecture?

The paper begins with a description of two conceptions of the transference found in the literature: transference as distortion and transference as plausible conjecture based on the signals received by the analysand from the analyst. The plausibility of the transference phenomenon in the Freudian conception of the transference is then reviewed. The author continues by considering the analyst's function as bait and how it is related to the stripping down of reality practised by the analyst. A brief clinical vignette is given to illustrate these propositions. To conclude, there is a discussion of the paradox of the reality sense, the transference and interpretation, based on the ideas of Matte-Blanco, mental functioning being considered in terms of bi-logic.

Adolescent↗
PubMed1998

Disavowal of reality as an act of filial piety.

The author argues that often the hidden power of disavowal of reality gradually makes itself felt in a treatment. The psychoanalytic process then seems to have been brought to a halt by something that defies meaning and continually eludes any genuine subjectivisation by the patient. In the famous case of the Wolf Man (1918), Freud speaks of a rejection of reality, which he clearly distinguishes from repression, in that the rejected representation has not in any way been erased from consciousness; rather, its meaning remains as if in suspension, no longer open to judgement. Certain key moments in the treatment of a borderline case help to illustrate the necessity for the analyst to grasp the peculiar nature of his own involvement. He may have been induced to assume a parental attitude reproducing a 'community of disavowal' that belongs to the patient's unrecognised history. By adopting an interpretive formulation acknowledging his own participation in the disavowal--which the parents must have been unable to do--the analyst can then allow the patient to get out from under it. These considerations allow us to shed light on two possible theoretical difficulties regarding, firstly, the difference between negation and disavowal of reality and, secondly, the way that the disavowal tends to hamper the very process of symbolisation necessary for the deployment of fantasy.

Adult↗
PubMed1981

Transference, psychic reality, and countertransference.

A return to Freud's broader concepts of transference and psychic reality as general psychological principles would include applying both concepts to the analyst as well as to the patient and thus obviate the need for the concept of countertransference.

Countertransference↗
PubMed1997

Distortions of time in the transference: some clinical and theoretical implications.

The author considers that patients' distortions of time can frequently and readily be observed in clinical psychoanalysis, reflecting both their psychopathology and their reactions to the temporal aspects of the psychoanalytic setting. These phenomena are considered in order to examine the assumptions that can implicitly be made about the nature of space and time in object-relations theory. Two case histories are given to exemplify these clinical phenomena-the first being an example of a fixation and the second one of a psychic retreat. These cases are compared to demonstrate the unconscious processes underlying the particular time distortions being considered, their impact on the patient's lives and their manifestation in the clinical setting. On the basis of these studies, it is suggested that the asymmetry of the 'arrow of time' cannot be assumed in the structure of psychic reality. The clinical evidence suggests that psychic reality has to be seen as discontinuous and that the structure of the discontinuities is revealed by the impact that the temporal aspects of the psychoanalytic setting have on the patient.

Humans↗