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PubMedDate not supplied

Client narratives: a theoretical perspective.

The role of subjective client narratives in health care represents a clinical and therapeutic tool, useful in complementing objective, scientific data. Of particular interest to mental health practitioners is the role narratives play as a therapeutic tool to guide clinical practice. This paper lays a foundation for understanding the importance of narrative in the psychotherapeutic process. It provides a brief overview of narrative theory and methods of structural analysis in order to provide a theoretical approach that can be utilized by nurses to address clients' needs.

Assertiveness↗
PubMedDate not supplied

Psychedelic and entactogenic drugs in the treatment of depression.

CNS deficiency of 5-hydroxytryptamine (serotonin) has been implicated as a biochemical basis in some forms of depression. Existing drug modalities for treating depression include some with serotonergic effects. Studies suggest that psychedelic drugs are also serotonergic. This may indicate a role for psychedelics in the treatment of depression. Such treatment has already been attempted using psychedelic drugs in both the indoleamine and phenylalkylamine categories. Encouraging results seem to recommend further research, with special emphasis on drugs in the phenylisopropylamine subgroup of phenylalkylamines that are only peripherally psychedelic. Certain of these, called entactogens or empathogens, cause substantially less distortion of normative consciousness than classic psychedelics, such as LSD or mescaline. They could therefore be more easily assimilated into existing psychotherapy approaches, where their function would be to enhance the normal psychotherapeutic process rather than serving a maintenance role as chemotherapeutic agents. Their usefulness in such an application would be mainly at the start of psychotherapy in order to (1) reduce the client's "fear response" that often inhibits ability to deal with repressed traumatic material; (2) facilitate the client's interpersonal communications with the therapist, spouse or significant others; and (3) accelerate formation of a therapeutic alliance between client and therapist.

3,4-Methylenedioxyamphetamine↗
PubMed1983

Modern psychotherapy and Halakhic values: an approach toward consensus in values and practice.

In this paper, I have examined in some detail a number of examples of actual and potential consensus between Jewish ethics and the practice of modern psychotherapy, psychology, and psychiatry. Moreover, I have posited specific halakhic models which represent analogies to modern psychotherapeutic principles and practices, which through analogy lend specific halakhic guidelines to modern practice. The unitary halakhic approach presented here is thus both heuristic--in that it seeks to demonstrate the ways in which psychotherapeutic processes are essentially halakhic ones--as well as practical. Through this approach, psychological theory and practice have been brought into intimate contact with the ethical requirements of the halakhically committed mental health practitioner and his or her patient, filling an inexcusable void in halakhic application to modern technology, and setting a direction for future work in this area.

Ethics, Medical↗
PubMed1976

MDA-assisted psychotherapy with neurotic outpatients: a pilot study.

Ten neurotic patients (five males and five females) were treated over a period of 2 to 6 months (mean, 4.1) as outpatients. The study allowed for a maximum of 75 hours of psychotherapy (mean, 51.55 hours). During the course of treatment, two to four (mean, 3.5) administrations of MDA (3,4-methylenedioxyamphetamine) were employed as adjunctive aids in an effort to enhance the psychotherapeutic process. The mean duration of the drug sessions was 8 hours (range, 6 to 14 hours). The first administration of MDA took place when, in the therapist's judgment, sufficient rapport had been established with the patient. All patients received an initial dose of 75 mg of MDA; subsequent dosage was allowed to range up to 200 mg. On these occasions, the drug appeared to be well tolerated with no serious side effects or complications observed. Psychometric assessments were obtained pre- and post-treatment, employing the Minnesota Multiphasic Personality Inventory (MMPI), Wittenborn Psychiatric Rating Scales (WPRS), and Brief Psychiatric Rating Scale (BPRS). In addition, follow-up evaluations were obtained 6 months after the termination of therapy by the use of the MMPI, WPRS, BPRS, and a Social History Questionnaire (SHQ) which had also been administered before treatment was initiated. Clinically, the impression was obtained that psychotherapy and the adjunctive use of MDA appeared to facilitate improvement in these patients. This impression was substantiated by significant reductions in scores on the psychometric assessments measuring depression, anxiety, and obsessive-compulsive traits. The meaures evaluating the sense of well-being and self-actualization also were encouraging. Although some of the patients were not as responsive as others, there were no observations to suggest that the condition of any of these patients had become worse.

Adjustment Disorders↗
PubMed1981

A review of the alexithymia concept.

Alexithymia is a term meaning "no words for mood." It has been applied to patients who have marked difficulty in verbal expression of emotions and limited ability to use fantasy. These patients often have psychosomatic illnesses and tend to do poorly in traditional dynamic psychotherapy. The concept is discussed from an historical perspective and its current status in the understanding of psychosomatic illness is assessed. The alexithymia literature is critically reviewed with a focus on definition, measurement, etiological speculations, and the relevance of alexithymia to the psychotherapeutic process. The alexithymic concept has much to offer heuristically, but most of the literature to date has been anecdotal and theoretical, with few research investigations. Suggestions are made for future research that could serve to validate the concept and provide answers to questions regarding symptom formation and psychological problems.

Adult↗
PubMed1989

Hypochondriasis, acting out and counter-acting out.

The clinical picture of hypochondriasis is clear, the psychopathological structure less so. Hypochondriasis is characterized by a particular kind of acting out, basically medical, which in turn is likely to evoke medical counter-acting out on the part of the therapist. Acting out may be 'broad', as a character trait, and 'narrow', in close connection with the psychotherapeutic process. The medical acting out of the hypochondriac, 'broad' prior to therapy and occurring outside of the therapy situation, in the course of therapy becomes 'narrow' and contained within the boundaries of therapy.

Acting Out↗
PubMed1979

New therapeutic approaches to psychosomatic patients: verbal and preverbal.

Many of the patients passed on to us are not in a position to begin with a course of treatment aiming at introspection. Here we think that inpatient psychotherapy is a valuable preparation and initiation to the psychotherapeutic process. In a therapeutic community informal contacts with other patients can provide stimuli facilitating the transposition of physical complaints or concretistically experienced life situations. Concentrative movement therapy, group therapy and other methods are helpful to the psychosomatic patient, so as to bring about an awareness of the problematical nature of own views and attitudes.

Educational Status↗
PubMed1982

On freedom and induction.

Traumatizing events and traumatizing conflicts may lead to defense mechanisms which in the course of time become part of character formation. In psychosomatic medicine much attention has been paid in the past to the so-called psychosomatic character profiles. Though discussions about psychosomatic specificity have remained controversial, it still seems advisable to take into account the power of induction of specific defense strategies. In this paper special attention is paid to the fact that asthmatics, patients suffering from hypertension or coronary heart disease, as well as patients suffering from other psychosomatic syndromes, and even patients suffering from carcinoma may induce their own defense strategies in interviewers and therapists, who usually are not sufficiently aware of the fact of such transference phenomena. A distortion of the normal psychotherapeutic process is more often a result of induction processes than has been thought of.

Defense Mechanisms↗
PubMed1983

The biopsychosocial approach. Liaison medicine and its models.

Liaison psychiatry is an outgrowth of consultation psychiatry which it extends by emphasizing its teaching function with the physicians, nurses, and patients it has contact. Liaison teaches methods of identification, assessment, diagnosis, and therapy based primarily on an open-ended interview technique. This form serves in and of itself, as well as by extension, as a brief psychotherapeutic process. The liaison model utilizes a general systems approach in its study of the patient pursuing the latter's problem from the molecular through organ systems, intrapsychic processes and interactions with the social milieu. The biopsychosocial approach to the patient is one of addressing the patient and the significant others in the sequential stages of illness; acute, convalescent, and rehabilitative. These are largely influenced by the environments and the processes occurring therein. Liaison psychiatry might well be called ecumenical psychiatry inasmuch as it utilizes conceptual approaches derivative of the social sciences, psychoanalysis, behavioral medicine, neuroscience, and psychopharmacology. In addition, the function of the liaison consultant seems to be increasing as one in which he/she functions as an arbiter when there are conflicts between colleagues around decision-making processes. These frequently involve ethical problems affecting the behavior of staff and patients. The processes engaged in by the liaison psychiatrist will be elaborated.

Behavior Therapy↗
PubMed1986

Psychotherapy of the narcissistic personality disorder patient: two contrasting approaches.

The differences in the theoretical and clinical approaches that Kernberg and Kohut have defined are used to discuss the psychodynamics and psychotherapy of the narcissistic personality disorder patient. Their contrasting contributions help clarify the nature of these patients' difficulties, the possibility that there is a spectrum of narcissistic disorders, the effect of existing theory and the personalities of clinicians-theoreticians on the collection of clinical data, and the effects of theoretical formulations on the psychotherapeutic process.

Attitude of Health Personnel↗
PubMed1977

Biofeedback and psychotherapy.

Biofeedback, a procedure in which patients observe and interact with personal physiologic events, may serve as an experiential adjunct to the psychotherapeutic process, perhaps by assisting them to develop their abilities to recognize and affect the internal events under scrutiny.

Adult↗
PubMed1982

The concept of responsibility in psychotherapy.

Psychotherapists must be concerned with the manner in which they ascribe responsibility to patients. We tend to avoid conceptualizing this issue, however, and deal with it inconsistently. It is possible to develop a model for ascribing responsibility which can be used to facilitate the psychotherapeutic process.

Character↗
PubMed1987

Working through: a cornerstone of psychotherapy.

The concept of working through, initially addressed by Freud in 1914, and elaborated upon over the past seventy years, remains controversial. Theoretical elaborations of this concept are reviewed and the central role of working through in the psychotherapeutic process is emphasized. Methods for evaluating working through are also suggested.

Affect↗
PubMed1991

Psychotherapy of an Arab patient by a Jewish therapist in Israel during the Intifada.

Fragments of a psychotherapy of an Arab patient by a Jewish psychotherapist in Israel, during an exacerbation of a historical political conflict, are presented. In addition to the delineated characteristic difficulties embedded in a cross-cultural/ethnic/national psychotherapy, an Arab-Jewish dyad evokes a complicated interaction between external political reality and the therapeutic space, confusing and obscuring the discourse, the transference, and the countertransference. We believe that the complex and intricate relationship between external reality and inner psychic reality, as it appeared in the therapeutic space, endangered the psychotherapeutic process by blurring the boundaries and creating a fertile ground for projective identification. Both the use of political reality as a defense, or its denial may preclude the possibility for a real dialogue. Implications for emphasizing the differences between patient's and therapist's ethnic affiliations, guarding sensitively the authenticity of interaction, and strengthening both participants' identity in all the relevant levels are pointed out to facilitate the dialectic process of the psychotherapy.

Adult↗
PubMed1995

Hermeneutics and psychoanalytically oriented psychotherapy.

Psychic or psychosomatic disorders--symptoms as well as the structures on the basis of which symptoms usually develop--include substantial impairment of communication. Psychogenic symptoms often seem incomprehensible and strange. Psychotherapy then involves the figuring out of the meaning of a symptom and, at the same time, the effecting of change in the sense of an enhancement of communication. Here, philosophic hermeneutics can point the way for psychotherapeutic reflection. Hermeneutics, when applied to psychotherapy, is the art of understanding and of making understood when the means of understanding and agreement between persons is disturbed. The psychotherapeutic process itself is executed within a "hermeneutic circle." A short case presentation illustrates the hermeneutic technique.

Adult↗
PubMed1995

The image of the psychotherapist in literature.

The current study explores the image of the psychotherapist as he/she is portrayed in literature in an attempt to broaden the perspective of existing research on this topic. In the past, studies and surveys on the image of psychotherapists have mainly been conducted among the general public and fellow colleagues rather than among the patients of psychotherapists. It is suggested that psychotherapists shy away from being the subjects of study. Moreover, it is proposed that research on the image of the psychotherapist suffers from a one-way gaze, whose bias stems from the asymmetrical nature of therapist-patient relationships. The present study explores the image of the psychotherapist through an analysis of nineteen literary works featuring twenty-six figures of psychotherapists. The literary image was examined by means of a questionnaire and content analysis. The profile that emerges suggests that psychotherapists and the psychotherapeutic process are well understood by authors representing both individual patients and the general public.

Humans↗
PubMed1997

On the "true-false" memory syndrome: the problem of clinical evidence.

A patient in twice-a-week psychoanalytic psychotherapy began to recover childhood memories of chronic sexual abuse, including oral, anal and genital penetration. These memories sometimes included bizarre content that created skepticism regarding their authenticity. However, this dubious quality was in marked contrast to the internal consistency, continuity, and emotional authenticity of the psychotherapeutic process. Criteria for attempting to distinguish between fantasy and reality are noted. Despite their tenuous nature, these criteria are important because, most frequently, they will be the only data available within the clinical situation.

Adult↗