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Sexual contact between psychologists and their former therapy patients: psychoanalytic perspectives and professional implications.

Data was analyzed from the semi-structured interviews of 6 heterosexual male psychoanalytic psychotherapists who by self-report had not engaged in a post-termination sexual involvement. The focus of each interview was to elicit the participants' views about sexual contact between psychotherapists and their former therapy patients, as well as their related attitudes towards Standard 4.07 of the APA Ethics Code (1992). The results suggested great disparity of opinion regarding what might constitute acceptable, ethical behavior in this domain. Nonetheless, all the clinicians agreed that the potential for harm resulting from post-termination sexual involvements was great, They all shared the beliefs that transference did not resolve with termination, that professional responsibilities continued after treatment ended, and that power differentials between therapist and patient lingered, perhaps in perpetuity. However, it was determined to be premature to replace the current Standard 4.07 with an absolute prohibition against sexual involvements between therapists and their former patients.

Adult↗

Greed and the frightening rumble of psychic hunger.

Many patients are desperately struggling with feelings of envy and greed. For some, greed is experienced as a constant hunger, a feeling of being empty and alone. This type of patient can be aggressive or resentful in the way they feel and act. They are determined to take what they feel is rightly theirs. Other such patients are much more conflicted about their greedy phantasies and striving. This paper focuses on patients who are fearful and anxious about the greedy urges that shape their inner world. Case material is used for illustration.

Adult↗

Studies on the efficacy of child psychoanalysis.

This article summarizes 3 studies that evaluated the psychoanalytic psychotherapeutic treatment of diabetic children and adolescents with grossly abnormal blood glucose profiles necessitating repeated admissions to hospital. Study 1 used time series analysis to demonstrate that improvements in control were predicted by unconscious themes emerging in the analytic material. Study 2 compared the effect of psychotherapeutic treatment with that of minimal psychological intervention in two well-matched groups (n = 11). Patients in the treatment group were offered psychoanalytic psychotherapy 3-4 times per week on the hospital ward. The intervention was highly effective in improving the diabetic control of the children, and this improvement was maintained at 1-year follow-up. Study 3 used single-case experimental design to demonstrate the marked effect of psychotherapeutic help on growth in diabetic children with short stature.

Adaptation, Psychological↗

Measuring the therapist's impact on the patient's therapeutic progress.

This article describes methods and concepts developed by the Mount Zion Psychotherapy Research Group for empirically evaluating the pertinence of suitability of a therapist's interventions (behaviors) to a patient's particular problems, needs, and treatment goals. Intensive studies of 2 brief psychotherapy cases are presented. In these studies, patient-initiated critical incidents (tests) were identified, the case-specific accuracy of the therapist's responses to these incidents was rated, and the impact of these interventions on subsequent patient behavior was measured. The findings indicated that these patients tended to show improvement in the therapeutic process when the therapist's interventions were in accord with their particular problems and treatment goals. The application of this method to clinically relevant studies of psychotherapy is discussed.

Adult↗

Repetitive relationship themes in waking narratives and dreams.

The aims of the study were to see whether the core conflictual relationship theme (CCRT) measure can be reliably applied to dreams and to evaluate the degree to which the main components of the CCRT are present in both dreams and waking narratives in psychotherapy. For 13 psychoanalytic cases, the reliability of the CCRT was found to be good. Dreams and narratives were found to contain significant degrees of similarity in their CCRT components and similar and high level of negativity in both dreams and waking narratives. The results support the concept of a central relationship pattern that can be expressed in common in both waking narratives and dreams.

Adult↗

On the cover.

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Creativity↗

Glimpses of a Cassel Hospital outpatient group.

The following is a selective account of the experience of conducting a weekly out-patient analytic group at the Cassel Hospital, London. Certain features of this experience are highlighted: in particular, the significance and value of a male and female co-therapy pair as conductors. Attention is drawn to the fundamentally reparative potential for damaged individuals in group psychotherapy. Such an experience may be valuable, especially in terms of it facilitating a greater degree of personality integration. Certain suggestions are made as to the prerequisites for such a psychotherapeutic approach. The observations may be useful in the provision of psychotherapy services in the Australian health care system.

Adult↗

The group as a whole or acting out the missing leader?

To write about a group of individuals is to see them as a single entity for some analytic purpose, even if it is just to label them a group. At issue is the type of unity assumed, its density. The article is concerned with how the consultant or therapist's anxiety may lead him or her to overemphasize the dense wholeness of the group, and so miss a more complex drama, acting out the missing leader, in which members cooperate to create the pieces of a leader who might save them. Not a productive drama, it must be identified before its script can be rewritten.

Acting Out↗

The use of combined individual, group, and marital therapy to resolve the narcissistic transference.

This case study illustrates how combined therapy (individual, group, and marital) by the same therapist was used to resolve a woman's narcissistic transference. The author's position is that combined therapy creates a psychologically stimulating environment, which uniquely elicits a depth and range of transference feelings, thereby generating multiple therapeutic opportunities to experience and work through transference resistance in the here-and-now. Highlights of the treatment demonstrate how the synergy of three modalities is used to elicit, modulate, and resolve positive and negative aspects of the narcissistic transference. Four guidelines are suggested for treatment of patients in combined therapy.

Combined Modality Therapy↗