Hypnosis for multiple personality disorder: a framework for beginning.
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OBJECTIVE: The aim was to design and run a three-session training module for psychiatric registrars on professional practice with particular emphasis on boundary setting. This included the concept of boundary transgression, an understanding of how it occurs and how it may be avoided. METHOD: Drawing on North American experience a curriculum was designed and trialed for trainees at all levels. A variety of media were employed to present a range of common clinical and professional issues. Evaluated were trainee satisfaction, trainee responses to target vignettes at the beginning and at the end of the course, and supervisor awareness and involvement in the process. RESULTS: High attendance and high satisfaction ratings in most areas confirmed that a course such as this is attractive and relevant for psychiatric trainees. Vignette responses suggested some change may have occurred by the end of the course, with a more limited tendency to avoid potentially challenging situations and a higher capacity to explore them. Supervisor involvement remains largely unaddressed despite interest and enthusiasm. CONCLUSION: The area of interpersonal relatedness in psychiatry, including the issue of sexual attraction and the possibility of sexual misconduct, can be introduced as a training package in a way which is acceptable to trainees and their supervisors in an Australian setting. The impact of the training module on actual registrar behaviour is uncertain.
The race of the therapist can play a significant role in the manifestation of transference and counter-transference phenomena in inter-racial psychotherapy. References to the race of therapist may be the first sign of a developing transference relationship. Failure to appreciate the impact of racial difference can impede therapeutic progress while sensitive confrontation may be a valuable tool in the recognition and communication of emotionally charged feelings in therapy. Dream material is influenced by the race of the therapist who may be less easy to disguise in dreams, and the therapist may avoid certain dream interpretations because of unacknowledged discomfort about race. These observations have implications for the supervisory process in training and for the general issue of the influence of the person of the therapist on the process of psychotherapy.
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This article elaborates ways that using hypnosis may create special vulnerability for the clinician, not only to experiencing sexual feelings toward patients but also to becoming confused about the meaning of these feelings and their relevance to treatment, as well as about the maintenance of appropriate patient-clinician boundaries. Special qualities of the hypnotic experience and relationship likely to generate erotic feelings and impulses in patients and clinicians alike are addressed. A clinical case example illustrates many possible meanings of therapist sexual feelings and the impulses to avoidance or acting out they may provoke. Clinically appropriate and inappropriate ways of managing boundaries in the presence of sexual arousal and of using sexual feelings to deepen clinical understanding and direct treatment interventions are discussed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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The development of combined individual and group psychotherapy is split between the "separationists" and the "integrationists" with regard to therapists' handling of the interface between the individual and group sessions. To bridge the impasse, a high-benefit--low-risk series of guidelines is offered for therapists that includes techniques for analyzing patients' "cross-references" to the other component modality. The four guidelines provide for a harmonious balance that preserves the confidentiality of the individual sessions vis-à-vis the group, while enhancing the group interaction rather than draining it. The therapist guidelines maximize patient initiative in integrating parts of the self expressed in the individual and group sessions, while employing the least intrusive methods necessary to best integrate the processes into a unified combined modality.