Search

Brain, Mind, and Developmental Psychopathology in Childhood, part of the International Association of Child and Adolescent Psychiatry and Allied Professions'book series'Working with Children & Adolescents'edited by Elena Garralda and Jean-Philippe Raynaud, aims to help advance knowledge on the connections between brain, mind, and development psychopathology in children and young people, an area of high relevance across different contexts around the world. It outlines brain mechanisms underlying children's ability to regulate behavior, emotions, interactions with others, responses to stress, and child psychiatric disorders. The book contains expert views supported by empirical evidence, and there is an emphasis on drawing out the clinical implications. It brings together knowledge from a variety of disciplines on bodily and brain processes that underlie developmental and psychiatric disorders in children and young people. Chapters include conceptual and empirical discussion of the biological and psychological influences on developmental psychopathology in childhood, clinical updates focusing on the biological underpinnings of individual child neuropsychiatric disorders as well as integrating biological and psychological therapies in child mental health. The book also discusses broader psychological/social problems, with chapters on the effects of child maltreatment in the developing brain, an update on understanding and management of self-harm, and advocacy papers on learning disorders and child and adolescent mental health.

Object Relations Theory and Clinical Psychoanalysis is a collection of Kernberg's papers published or presented during the period from 1966 to 1975, with some new material included as well.

Segal establishes herself as one of the most productive and sensitive clinical psychoanalysts in the field today. Using techniques based on the work of both Freud and Klein, she shows a consistent interest in working with patients presenting the most severe type of psychopathology, as is evident in this volume of her clinical and theoretical papers.

Play Therapy and Families: A Collaborative Approach to Healing provides a thorough description of play from prominent academics, researchers, and relevant writers who review it historically. It contains a unique approach for helping families, outlining an in-depth review of play and its relevancy to healing for children and families, putting forth a brand new Collaborative Play Therapy Model. The application to healing and psychotherapy follows, outlining the directive and non-directive orientations to healing, models that are current in the literature, and selected family-based play therapy models.An extensive overview of family therapy and associated models is presented as a foundation for the reader in order to relate play and family therapy from an academic point of view. This provides the theoretical background for the chapters on play therapy approaches that follow. Family play therapy addresses the inclusion of the family with techniques that contribute to healing. Narrative play therapy is presented with an in depth historical account and the phases of the narrative approach. Filial and theraplay models of play therapy are presented with an account of their development and focus on the phases of intervention for children and families. The book concludes with a sandtray approach to working with adoptive families, rounding out this collection's presentation of current and researched models of play therapy.

In Philosophy's Role in Counseling and Psychotherapy, Peter Raabe argues that philosophy is an effective method in treating mental illness. Calling for a paradigm shift away from the standard belief that the brain and mind are identical Raabe argues that so-called “mental illnesses” such as depression and schizophrenia are not the actual causes of psychological misery. Instead, they are just labels for symptoms. For example, the word “depression” is merely a label attached to a collection of symptoms such as sadness, hopelessness, and low self-esteem. Raabe posits that distressing or painful life events can cause symptoms that are often clinically labeled as the mental illness of depression. The suffering brought on by painful life events can often be alleviated with helpful discussions, and without resorting to medications. Because philosophy is the foremost form of discussion, it means that the suffering that is labeled mental illness can be treated and even cured with philosophy. Raabe ultimately concludes that philosophy is beneficial in three ways: it can prevent the onset of a so-called mental illness in the person who studies it, it can be used to help individuals suffering from the distress that is labeled “mental illness,” and it will enhance the competence of the counselor or therapist who practices it.

In Life Witness: Evolution of the Psychotherapist, T. Byram Karasu demonstrates how a young therapist can become an expert clinician by transcending his own school of therapy. Every young therapist attempts to perfect his skills by anchoring onto a single paradigm and becoming an expert technician of that particular school. Within the first five to ten years of practice—the so-called experiential evolution phase—the therapist finds that no single paradigm is suitable for treating all psychopathology. The therapist thus begins to appropriate techniques from other schools of psychotherapy, and by shifting paradigms, synchronizes himself with the patient's mind. It is from this synchronization that all his techniques begin to evolve and an expert clinician can evolve into a master psychotherapist. The therapist who has transcended his school of psychotherapy now must transcend the field of psychotherapy itself. If he wants to address the patient's existential issues as well, the therapist first has to come to terms with those issues himself. After all, the therapist can take the patient only so far as he himself has come.Life Witness demonstrates that this formative evolution phase of a therapist encompasses a broad education in literature, philosophy, and spirituality. Karasu ultimately concludes that therapists must find the meaning and purpose of life before they can cultivate an authentic self and become someone whose presence is itself therapeutic. Once this occurs, all'therapeutic messages'will naturally emanate from within.

Good Stuff is divided into two main parts; Part I addresses Positive Attributes and Part II, Positive Actions. The former contains chapters on Courage, Resilience, and Gratitude. The latter contains chapters on Generosity, Forgiveness, and Sacrifice. Together, the six chapters constitute a harmonious gestalt of the relational scenarios that assure enrichment of human experience. This book offers socioclinical meditations to temper Freud's view that human beings are essentially ‘bad'and whatever goodness they can muster is largely defensive. By elucidating the origins, dynamics, social pleasures, and clinical benefits of courage, resilience, gratitude, generosity, forgiveness, and sacrifice, this book sheds light on a corner of human experience that has remained inadequately understood by psychoanalysts and other mental health professionals.

Success for Modern Day Relationships: Working with Dating, Engaged, and Married Couples by Barbara R. Cohl, PhD, is a compilation of practical, effective, empirically tested techniques and interventions that allow a therapist to evaluate and treat an array of marital issues. By using colorful and instructive vignettes derived from her private practice, Dr. Cohl provides lessons she has learned from happy and successful couples, and teaches her couples as well as her readers how to avoid the pitfalls that unhappy couples share. Success for Modern Day Relationships covers all of the different stages of romantic relationships, from the first date to engagement, marriage, and sometimes to separation and divorce. Through her book, Cohl helps readers to essentially take the guesswork out of creating a successful relationship.

The problem of how to understand and to treat masochism has plagued the vast majority of clinicians. The Clinical Problem of Masochism, edited by Deanna Holtzman, PhD, and Nancy Kulish, PhD, focuses on the common and difficult clinical problems posed by masochistic patients who are spread throughout all diagnostic categories. Foremost psychoanalytic clinicians in the field from various theoretical backgrounds demonstrate their approaches to working clinically with these problems. Each expert provides detailed clinical examples, making their approaches and suggestions come alive. This volume, unique in its varied clinicaland practical focus, offers therapists of all theoretical persuasions ideas on how to think about and help individuals suffering from masochistic difficulties.

This manual has been written for a wide range of dynamic practitioners involved in treating patients with narcissistically-infused issues. The treatment model and case material presented in Listening with Purpose cover the spectrum of narcissistic vulnerability and may be applied to the relatively intact patient as well as to the relatively impaired patient. Throughout, it refers to issues of narcissistic vulnerability, from a perspective that assumes narcissistic mechanisms are implicated in all levels of personality functioning and in all people. They exist both in therapists and clients differing only in the level of prominence and degree of disturbance in the personality. Cutting across several schools of thought, this treatment manual places shame and its derivatives at the very center of narcissistic vulnerabilities, vulnerabilities which create character splits and dissociative phenomena in their wake.One can wonder if therapists have avoided looking at shame because of its contagious qualities. Human experience has demonstrated that shame is a ubiquitous emotion, yet when individuals encounter shame it places them in a seemingly paradoxical position which looks much like a dissociated limbo state with no way out. We experience it and yet don't experience it, we see it and don't see it, we feel it and don't feel it.Therapists and mental health professionals cannot adequately treat unexamined shame from within its core unless he or she finds a compatible language for the theory that informs the interventions. In particular, the theory cannot replicate pre-existing splits embedded within a treatment paradigm and cannot be weighted with theoretical underpinnings that are distancing, objectifying, or removed.The authors have proposed instead an innovative paradigm-shifting model that is very explicit in recommending an experience-near, moment-to-moment immersion in the conflicted and often disoriented life of patients. Unlike existing volumes in the field, Listening with Purpose: Entry Points into Shame and Narcissistic Vulnerability is by design replete with copious down-to-earth examples to help guide one's systemic shift in treatment focus, treatment emphasis, and treatment posture. The shift involves healing on many levels and opens up for re-examination and re-assessment heretofore difficult-to-treat cases of trauma, dissociation, character disturbances, and addictive disorders.

The diagnosis of dissociative identity disorder, formerly known as multiple personality disorder, remains controversial, despite its inclusion as an established diagnosis in psychiatry's Diagnostic and Statistical Manual (DSM-IV). This book consists, first, of the detailed description of the treatment of a patient whose syndrome of DID emerged in the course of therapy, by a psychoanalyst who entered into the therapy as a complete skeptic. The therapist's willingness to explore the meaning and reality of the dramatic and at times bizarre presentation of this disorder in a prolonged and difficult treatment was accompanied by an eventual successful outcome. Using this case as a reference point, the author then provides a contemporary exploration of the literature about the authenticity of this diagnosis and approaches to its treatment.

Clinical Applications of Psychoanalytic Theory provides in-depth descriptions of past and present analytic concepts, with accompanying examples of how these theories affect clinical interventions. A wide range of psychopathology is described, including child abuse, ADHD, autism, and hostile acts performed by adults as well as by children. Accounts of the treatment process and progress are prefaced by a review of the literature. Each clinical example is accompanied by a psychoanalytic understanding of what transpired in the treatment while the final chapter reviews the currently popular theories of what creates positive change in treatment outcome.

Freud's Other Theory of Psychoanalysis: The Replacement for the Indelible Theory of Catharsis argues that Freud's familiar theory of psychoanalysis is an elaboration of his catharsis theory. Although it changed from repression of painful memories to the repression sexuality, to repression of infantile sexuality, to repressing of the Id, it still remained structurally a theory of the repression of objectionable urges. Even in Freud's desperate attempt to replace it with a psychology of the ego, the repression of the objectionable urges, or the Id, remained the source of psychopathology. This theory had an indelible effect on Freud, and remained ‘the prototype'of almost all theories of contemporary psychoanalysis. However, when Freud changed his method of dealing with his patients to listening to their associations he discovered the workings of the primary process, the representation in the mind of the endosomatic stimuli, and the manner in which the primary and the secondary processes entwine to form both the normal and abnormal ‘psychical'products. Another theory of psychoanalysis came out of those core observations and Freud was able to give psychoanalysis a central position in western culture as a whole, and a significant place in the study and treatment of mental disorders. Freud's unstated discoveries had all the elements of another full theory; it was the theory that gave psychoanalysis its outstanding status. However, he did not articulate it as a distinct theory that could replace the catharsis theory. This tacit theory is a theory that does not explain psychopathology in terms of repression of objectionable urges, but explicates the manners of the entwinement of the primary and secondary processes that create the healthy and the psychopathological conditions. It is a comprehensive theory of psychoanalysis that has applications in almost all psychical matters, one of which is clinical. The replacement theory is not another theory like the ones offered by the contemporary schools. It is implicit in the Freudian text; it is a Freudian replacement for a popular, but flawed, Freudian theory.

Beauty is often an invisible yet potent presence in clinical work. The Psychology of Beauty: Creation of a Beautiful Self, by Ellen Sinkman, LCSW,addresses the vital importance of beauty, its sources, and manifestations in everyone's lives—including psychotherapy patients. The ability to be mesmerizingly beautiful and beautifully creative, strivings toward mastering beauty, and wishes to be transformed are universal desires. During psychotherapy, patients manifest or defend against these forces. So it is striking that patients as well as therapists often overlook or dismiss issues about creating beauty in themselves.The book introduces this seeming contradiction with the ancient myth of Pygmalion and his sculpture of a beautiful woman. These enduring mythic figures represent the wish to emerge as a beautiful being and the wish for the power to create beauty in another. Patients in psychotherapy often pursue these elusive goals outside clinical work, rather than within treatment. Manifold venues enticingly promise reinvention. These activities may involve plastic surgery, beauty salon make-overs, diet gurus, elocution coaches, tattooing, and athletic training. Seekers of beauty engage with people whom they see as agents offering them ravishing physical or charismatic attractiveness. Psychotherapists may or may not be among agents seen as having the power to transform.The quest for beauty is widespread and in many instances non-pathological. Sinkman looks at multiple avenues of understanding and appreciation of efforts toward beauty, including artistic creativity and political activities. However there is a spectrum of investment in creating beauty. Pursuing beauty can become pathological. Therapists need to watch out for its appearance outside the psychoanalytic arena. Such material can be missed when the analyst falls into counter-transference difficulties such as feeling invested in transforming the patient, identifying with the patient's narcissistic injuries and/or needs to compete, or enacting battles with the patient. Such difficulties interfere with attunement to patients'experiences. The Psychology of Beauty considers definitions of beauty, gender identity themes, and origins of beauty in the mother-infant relationship. It investigates ugliness, sadomasochistic beauty pursuits, evolutionary factors, and aspects of aging. The book highlights emerging clinical material which has yet to gain notice and suggests what analysts may be missing, and why.

Presence and the Present: Relationship and Time in Contemporary Psychodynamic Therapy offers salient points learned from the author's forty years of practice and teaching, and applies psychodynamic psychotherapy to the contemporary practice climate. Emphasizing the therapeutic relationship and the dimension of time, it grounds the discussion in clinical application. Including more than fifty vignettes and four extended case presentations, the author deconstructs successful interchanges as well as errors. Part I sets out central themes and components of this contemporary view of dynamic therapy while part II examines present-day applications. Part I begins with an overview of the core (the relationship) and the contours (characteristics) of therapy and some of the challenges therapists face today. The ten contours discussed are the frame, uniqueness, not knowing, different types of knowledge, mentalization, the therapist's use of self, goals beyond symptom relief, integration with nondynamic approaches, integration with neuroscience and therapy outcome research, and, finally, the use of time and space. Following a discussion of these ten contours, the book summarizes evidence-based relationship elements in therapy and the robust empirical research demonstrating dynamic therapy's effectiveness, while providing a theoretical overview for therapists not familiar with psychodynamic theory. The last two chapters of part I examine the complex relationships among time, life, and psychotherapy and continue the exploration of therapy duration, the present moment, transience, unending therapy, and termination. Part II of Presence and the Present begins with two chapters on the therapy of trauma. Chapters 8 and 9 discuss the phenomena of trauma and include practical recommendations and frequent therapist countertransferences. Chapter 10 focuses on the organization of self experience through bodily sensations and offers a nuanced model to understand physical elements of transferences and countertransferences. The final three chapters explore therapy with couples who are struggling with disturbed adult or adolescent children, integrate cognitive-behavioral interventions with the dynamic approach, and examine the frequent and key affect of shame in psychotherapy.

Paradox for Life Review explains how older adults'levels of self-esteem become the lens through which they review their reminiscences. It shows how three bases for self-esteem—the epigenetic self, the family scripted self, and the metaphysical self—affect the accuracy of this lens. It then describes how life review groups have used paradoxes drawn from poetry, drama, word play, intergenerational family dynamics, Eastern and Western mystical traditions, and personal life experiences to enable members to discover new lenses for accepting their history with compassion and wisdom. The book uses the reminiscences of forty-two older adults to illustrate the positive influence of these paradoxes in integrating their personal history with a sense of purpose for their future.

The Impact of Complex Trauma on Development describes what happens cognitively and emotionally, behaviorally and relationally, to people who are repeatedly traumatized in childhood. Part One brings together trauma theory with a number of theories of human development. It directly addresses and describes developmental pathology and its origins. Through powerful examples, it conveys to the reader the pain and destruction caused by ongoing trauma, abuse, and continuous stress. Part Two, written from the perspective of a clinician who has worked extensively with traumatized children and adults, is primarily directed to mental health professionals and graduate students. These chapters are devoted to describing how to recognize the pathological consequences of trauma and how to intervene and remediate these developmental deficits. The overarching theory is psychoanalytically-based and developmental, but other treatment approaches are integrated into the therapy when they are developmentally and therapeutically appropriate. The text raises important questions related to the development of the self, its relationship to therapy, and the diagnosis and treatment of complex trauma in children, adolescents, and adults.

Radical Claims in Freudian Psychoanalysis: Point/Counterpoint, edited by M. Andrew Holowchak, features pro and con essays on some of the most extreme Freudian claims, including the Freudian unconscious and the Oedipus complex. Holowchak collects the writings of critical scholars in the fields of psychology and philosophy who have distinguished themselves in the area through prior publications. This edited collection comprises six parts that address the topics—the Oedipus complex, dreams and wish-fulfillment, religion as an illusion, free association, the Freudian unconscious, and Freudian psychoanalysis as a Weltanschauung—in pro/con essay format. The format of this volume allows for a close examination of contentious issues from more than one viewpoint so as to enable readers to see that there are (often wide) differences of opinion on contentious issues, thereby allowing for a broader perspective for critical engagement. Moreover, by addressing some of the most radical claims of Freud's psychoanalysis, this collection is proof that even many radical Freudian claims are still taken very seriously by prominent scholars.

The Electrified Mind helps therapists understand and empathize with patients who rely heavily upon cell phones and the internet for the purposes of self-expression as well as for defensive avoidance of actual interpersonal contact. The chapters by distinguished mental health professionals delineate therapeutic strategies for dealing with the dilemmas that arise in working with children, adolescents, and adults excessively involved with cyberspace at the cost of meaningful human relationships.

While the psychodynamic understanding of play and play's therapeutic potential was long restricted to the realm of children, Winnicott's work demonstrated the profound significance of the capacity to play for healthy mental functioning during adult life. Scattered writings of Erikson, Glenn, and Shopper notwithstanding, the early spark of understanding remained largely ill developed. In Play and Playfulness, the reader is offered an exciting and highly informative set of essays about the psychic area that lies between reality and unreality and between veracity and imagination. It is the area of paradox and creativity. It sustains the self, allows for ego-replenishing regressions, and adds to the joy of the vital and lived experience. This book provides an easy and readable passage to the valley of the transitional experience in which creative synthesis of reality and unreality leads to a world of vigor, enthusiasm, and liveliness. The cultural variations and the clinical implications of such an experience are thoroughly elucidated. The result is a volume replete with technical virtuosity, clinical relevance, and the basic and nearly self evident humane music of the day-to-day experience of life.

This book will help therapists understand and treat patients suffering from mild to dangerous forms of eating disorders, other compulsions and addictions, such as alcoholism, and even erotic attachments. The chapters help therapists think creatively about these types of patients who are coming to therapy more frequently than ever, and to see the effects of treatment. The problems that arise in therapy are explored in essays about dissociation, self-regulation, self-destructive behavior, enactment, and other clinical issues. The first half of the book addresses specific problems associated with patients who have eating disorders. The editors explore the patient's conflicts, affect regulation, transference, behavior, as well as the countertransference issues that inevitably arise in therapy. The second half broadens the scope and addresses a spectrum of addictions and associated issues such as creativity, sexuality and the transference.

Hostile, destructive kids become hostile destructive adults and create serious problems for society. Handling Children's Aggression Constructively: Toward Taming Human Destructiveness shows how to prevent the development of disturbed aggressive behaviors in children, giving caregivers and educators the tools they need to handle problems in the making so they won't become more difficult and costly problems to deal with later on. Unlike the fine books previously published on how to handle children who already suffer from significant aggressive behavior disorders, this book takes a preventive approach. It focuses on how the ways in which young children are raised contribute toward aggressive behaviors and recommends techniques to manage children's aggression constructively that can be applied from birth through adolescence.

This book describes the real-life journeys of women psychotherapists: why each woman chose this profession and what she learned about others—and most importantly, about herself—in this choice. Most critically, these women now share how they have integrated this wisdom into their everyday lives. While psychotherapists may also be authors, few write books about their journeys in the profession. Women Psychotherapists: Journeys in Healing is one of those rare books. Each contributor invites her readers onto the road traveled by the woman who listens to others needing her help and guides them into living a more joyous, successful life, even as she moves towards greater fulfillment in her own life.

This collection of transcripts from sessions by certified Dyadic Developmental Psychotherapists gives therapists, educators, and child welfare and residential treatment professionals a detailed understanding of how Dyadic Developmental Psychotherapy is used to help children who have a history of neglect, abuse, orphanage care, or other experiences that may interfere with the normal development of attachment between parent and child. The book begins with a description of DDP, its essential components, and the ways in which those components are used differentially in different phases of treatment. The transcripts that follow illustrate those components and their uses. They cover a diverse range of clients and families so that the reader can appreciate the depth and breadth of DDP. Both the editor and the therapists themselves provide analysis and commentary on the therapists'goals, impressions, and techniques. This book complements the treatment manual Dyadic Developmental Psychotherapy: Essential Methods and Practices, and will be useful in graduate courses on treatment, child welfare, family therapy, and child psychology.

The first edition of this now classic work provided the basis for adding post traumatic stress disorders to diagnoses of mental conditions. Each subsequent edition added new understanding, summaries of empirical new research, and new guides for clinicians. The thoroughly revised fifth edition adheres to changes that will be made in DSM-5 and gives the reasons for symptom formation and how treatment can not only resolve symptoms but encourage post-traumatic growth that leads to a more coherent sense of identity and renewed capacities for connecting compassionately with others. Stress Response Syndromes takes the reader from surface to depth with many lucid case examples and how-to advice for both trainees and experienced clinicians.

Ethical Practice in Child and Adolescent Analysis and Psychotherapy: Protecting Safety in a Therapeutic Environment by Anita G. Schmukler, Paula G. Atkeson, Helene Keable, and E. Kirsten Dahl provides a detailed study of ethical dilemmas of the child therapist and the child analyst, whose work with children and their parents presents unique and perplexing problems. The book examines both the unconscious motives for ethical lapses and addresses ways in which such behavior may be prevented. It addresses working with parents, while maintaining privacy for the child, pitfalls for the child therapist and analyst, and ways in which the process of supervision, a cornerstone of clinical training, may lead to departure from ethical principles. Ethical Practice in Child and Adolescent Analysis and Psychotherapy addresses the benefits and risks of presenting and writing about clinical cases, examining the field of working as consultant in custody cases and the role of ethical practice from a historical perspective. Pivotal is the role of the unconscious processes of transference and countertransference, processes that are acknowledged but often not fully comprehended. Contributions on ethics and forensic work by Moisy Shopper, MD, and contributions on ethical writing about psychodynamic work by Denia G. Barrett, MSW.

This book takes a new look at dynamic psychotherapy, from its most basic theory to the furthest limits of its capabilities. It invites the reader to re-examine a few of the most basic concepts underlying the practice of psychotherapy. What is emotion? What is a defense mechanism? It begins with emotion theory, an area of academic study that has traditionally been neglected in psychotherapy training programs. Throughout the book, it is argued that the patient's experience of emotion is critical for a successful outcome in therapy, and that the therapist's understanding of emotion will provide a solid theoretical foundation for practice. Attachment theory is also used extensively throughout the book. Case examples offer interventions that are designed to translate the theory into practical applications. In the middle chapters of the book, these basic ideas (emotion theory and attachment theory) are applied in an extended case example, using ample segments of verbatim dialogue. Memory theory is used to explain some of the treatment failures in dynamic psychotherapy. Memory theory can lead to a revised approach that provides more durable outcomes. Dynamic psychotherapy has largely been a therapy of bad memories, therefore, a systematic approach to focusing on positive memories of early attachment experiences is outlined. We must not only help the patient to face negative memories of his past; we must also help revive and strengthen positive memories until they have'trace dominance'over negative ones. Finally, the possibility that dynamic psychotherapy can lead to spiritual growth is explored. Early parent-child experiences of oneness can serve as the developmental precursors of the spiritual experience. Some of the child development literature, including Mahler's notion of'symbiosis'is reviewed. Some preliminary work with patients is presented, in which they are invited to broaden their new emotional connection with a parent (and others) until it leads to a greater sense of spiritual connection and oneness. This approach has no particular ties to any one religious movement; rather, it is an invitation to move from'emotions of expansion'(affection, pride, etc) to an expanded consciousness.

When therapists work in a heart-centered way, they feel freer to be both professionals and loving human beings. Working from the Heart advocates for a deeper understanding that the therapist's expressions of non-sexual, non-romantic love are a core ingredient in effective psychotherapy. Each chapter in Working from the Heart focuses from a heart-centered perspective on a particular aspect of therapeutic work that has been insufficiently addressed in traditional training and supervision. Chapter topics include: removing patients'psychological blocks to receiving love; enabling patients to access their Higher Selves to solve complex life dilemmas; how to slog through professional and personal conflicts about touch in order to discern in what situations and with which patients gentle touch is the right therapeutic action; why a heart-centered approach is so important for male patients; how therapists can engage their'Big Hearts,'aspects of their Higher Selves, during sessions; and how to create sanctuary for patients and therapists alike. Working from the Heart addresses these issues in an informal style in order to make the book more accessible to wider spectrum of readers. Ryan is sharing his ideas, gleaned from thirty-five years of experience, and inviting a conversation.

Moving from one country to another causes a radical alteration of one's cultural and geophysical surround. Separation from friends and family, loss of valued possessions, and encountering new ways of living result in mental pain and disorienting anxieties. In Immigration and Acculturation, Salman Akhtar examines the traumatic impact of immigration and the acculturation process and the psychological defenses that are mobilized in the immigrant, including nostalgia and fantasies of return. Akhtar explores each aspect of an immigrant's life, shedding light on the complexities of work, friendship, sex, marriage, aging, religion, and politics, as well as showing how unresolved conflicts are passed on to the next generation. Akhtar provides first-hand accounts from immigrants from a variety of backgrounds and countries of origin, and he provides clinical strategies for working with immigrant and ethnically diverse patients and their offspring. Deftly synthesizing observations from psychoanalysis, anthropology, literature, history, and related disciplines in the humanities, Salman Akhtar elegantly elucidates postmigration identity change.

Grounded in attachment theory and trauma, Dyadic Developmental Psychotherapy (DDP) is an evidence-based, effective, and empirically validated treatment for complex trauma and disorders of attachment. This manual for the practice of DDP will give therapists, educators, and child welfare and residential treatment professionals the tools necessary to help children who have a history of neglect, abuse, orphanage care, or other experiences that may interfere with the normal development of attachment between parent and child. Becker-Weidman looks at the importance of a comprehensive and thorough assessment as the basis for treatment planning and explains in detail the main elements of DDP, including intersubjectivity, emotionally based dialogues, narratives, and co-regulation of emotions and meaning, as well as illustrating these elements through detailed case examples and dialogue. Dr. Becker-Weidman then looks at how the various principles, methods, and techniques of DDP are differentially used in each stage of treatment. A section on parenting outlines how therapists can train caregivers in attachment-facilitating parenting approaches. This book will serve as a treatment manual for DDP and will provide directly useful material for practicing therapists. In addition, the text will be useful in graduate courses on treatment, child welfare, family therapy, and child psychology.

In The Power of Specificity in Psychotherapy: When Therapy Works_And When It Doesn't Howard Bacal presents specificity theory, a contemporary process theory of psychotherapy that holds that therapy happens at the fit between the patient's particular therapeutic needs and the therapist's capacity to respond to them, both of which will emerge and change within the unique process of each particular dyad. Specificity theory challenges the traditional method and epistemology of psychoanalysis, wherein the understanding of the patient and the therapeutic response are apprehended through rules and prescriptions that are generated through the application of structure theories. The therapeutic engagement must necessarily and continually be monitored and adjusted to fit the specific and changing needs, capacities, and limitations of both participants, regardless of the therapist's formal working theories. Grounded in the innovative thinking of Sandor Ferenczi and drawing as well from the creative work of Michael Balint, Wilfred Bion, Donald Winnicott, Marion Milner, and Heinz Kohut, the perspectives of specificity theory are corroborated by cutting-edge findings in contemporary neurobiology and infant research. The Power of Specificity in Psychotherapy challenges psychotherapists to reconsider how treatment is optimally practiced.

The Mother and Her Child: Clinical Aspects of Attachment, Separation, and Loss, edited by Salman Akhtar, focuses upon the formation of an individual's self in the crucible of the early mother-child relationship. Bringing together contributions from distinguished psychoanalysts and child observational researchers, it elucidates the nuances of mothering, the child's tie to the mother, the mysteries of secure attachment, and the hazards of insecure attachment. These experts also discuss issues of separation, loss, and alternate sources of love when the mother is absent or emotionally unavailable, while highlighting the relevance of such ideas to the treatment of children and adults.

Transforming the Internal World and Attachment reviews and discusses four theories about what makes psychotherapy effective across forms of treatment, treatment settings, and diagnostic categories: mindfulness, mentalization, psychological mindedness, and the attachment relationship. Geoff Goodman offers some provisional hypotheses about therapeutic effectiveness and suggests some ways of testing these hypotheses empirically, using sophisticated assessment instruments that measure psychotherapy process and outcome. Managed-care companies are withholding reimbursements for treatments not considered'empirically supported.'Instead of engaging in horse races with randomized controlled trials (RCTs), Geoff Goodman suggests that we need to establish an empirical basis for the therapeutic effectiveness of all forms of treatment, move beyond examining common factors such as the therapeutic alliance, and turn our collective attention to common factors that psychotherapy researchers often erroneously promote as specific factors. Perhaps these so-called specific factors produce therapeutic change regardless of the brand-name treatment packages through which they are typically delivered. These specific factors might also work better for particular groups of patients with specific problem areas such as affect dysregulation and impulsivity. In Volume II, Goodman demonstrates how these specific factors can be implemented in a variety of therapeutic settings with a variety of patients.

Transforming the Internal World and Attachment reviews and discusses four theories about what makes psychotherapy effective across forms of treatment, treatment settings, and diagnostic categories: mindfulness, mentalization, psychological mindedness, and the attachment relationship. Geoff Goodman offers some provisional hypotheses about therapeutic effectiveness and suggests some ways of testing these hypotheses empirically, using sophisticated assessment instruments that measure psychotherapy process and outcome. Managed-care companies are withholding reimbursements for treatments not considered'empirically supported.'Instead of engaging in horse races with randomized controlled trials (RCTs), Goodman suggests that we need to establish an empirical basis for the therapeutic effectiveness of all forms of treatment, move beyond examining common factors such as the therapeutic alliance, and turn our collective attention to common factors that psychotherapy researchers often erroneously promote as specific factors. Perhaps these so-called specific factors produce therapeutic change regardless of the brand-name treatment packages through which they are typically delivered. These specific factors might also work better for particular groups of patients with specific problem areas such as affect dysregulation and impulsivity. In Volume I, Goodman explores the empirical and clinical bases of these specific factors and outlines their various influences on psychotherapy process and outcome.

Treatment of abuse and neglect needs to be family-focused in order to reduce troubling symptoms, address family risk and relapse potential, treat cross-generational patterns, and remediate attachment deficits. Evidence-based practices are available for child and family abuse treatment, including Trauma Focused CBT, but new intervention strategies are needed that reduce family and client denial, lower defensiveness, and prevent re-traumatization during the treatment process. Family-Focused Trauma Intervention: Using Metaphor and Play with Victims of Abuse and Neglect translates issues central to abuse and neglect recovery into metaphorical stories and family-based interventions. Each chapter provides a summary of an issue or theme, one or more pertinent stories, and parallel family, group, and individual interventions. These stories and family-focused interventions help clients regulate affect in order to reduce frequency and intensity of troubling symptoms. This volume is the'missing link'in the current literature on therapy and metaphor, as it focuses specifically on parent-child interaction and trauma. The content of this book, which may be used within any theoretical framework, provides a wide variety of practitioners with a needed bridge between theory and practice.

The Modern Kleinian Approach to Psychoanalytic Technique: Clinical Illustrations describes how today's practitioner typically treats a number of types of very disturbed and hard-to-reach patients who, while prone to intense acting out and early termination, are in great need of in-depth psychological reorganization. Many cases barely get off the ground due to levels of pathological conflict and destructive phantasy that make self/object connection extremely fragile. However, the modern Kleinian approach makes it possible to establish analytic contact within even the most chaotic situations and create a therapeutic experience that can be significant and meaningful. In doing so, there can be a healing process and the birth of new object relational experiences and interpersonal exchanges. Robert Waska details a more flexible method of practicing psychoanalysis, Analytic Contact, an approach that brings the healing possibilities of psychoanalysis to the more disturbed patients who tend to fill private practice offices. In addition, Analytic Contact enables the clinician to reach populations that are not usually considered easily treatable by the psychoanalytic method, including psychotic patients, couples who are seeking help with marital issues, and chronic borderline and narcissistic individuals.

Therapeutic metaphor and stories have long been used within modalities such as hypnotherapy, play therapy, narrative therapies, and expressive therapies. Metaphorical interventions reduce client defensiveness. They provide an'aha'that leads to insight and change, as the client's identification with one or more characters in the stories springboards him or her into treatment activity. Metaphorical Stories for Child Therapy: Of Magic and Miracles is a book for practitioners, including psychologists, social workers, special education or school therapists, counselors, and expressive therapists. The book uses metaphorical stories and interventions to address issues central to child and adolescent treatment. Each story addresses a particular issue or theme, gives examples of how the story may be used, and includes a set of'take-it-home'questions that may be assigned between sessions. These stories become core metaphors to be referred to throughout treatment, and children find them enjoyable and memorable. There have been a number of books published in recent years on metaphor and therapeutic stories. This volume sets itself apart, in that the stories are richer character-wise and many are more universal in their themes. The book is divided into two sections: Part I focuses on general treatment themes, such as self-esteem, affect-regulation, lowering defenses, and so on. Part II addresses specific DSM-IV diagnoses such as panic disorder, ADHD, OCD, divorce adjustment, fear of the dark, and eating disorders. The depth and versatility of the stories ensure that the practitioner will find him or herself using them over and over again.

Reflecting on his experience in the clinical trenches, a pragmatic existential therapist offers a provocative study of power, erotic influence, and illusion in the clinical relationship. Written in a conversational style that makes a challenging subject accessible to specialists in the clinical professions, teachers and students of the psychological disciplines, and scholars in the humanities and social sciences, Enchantments of the Clinic introduces readers to interesting ways in which language, ideas, and speech as well as illusions of the clinical station enable therapists to cast an unintentional spell that captivates and charms unsuspecting patients. Exposing this suggestive underworld of clinical experience, where the high-stakes game of persuasive dialogical therapy is often won or lost, critical attention is focused on the erotization of the clinic, the erotization of the clinician, and the erotization of clinical confession. Using dramatic examples from clinical practice, Carl P. Ellerman challenges prevailing dogmas of the therapeutic to demonstrate his thesis that enchantments of the clinic facilitate psychological healing if managed well, but if mismanaged, these volatile erotic enchantments may undermine the struggle against emotional illness in the clinical trenches. This ambitious study of the clinical relationship also addresses the disturbing fact that we are dwelling in a postmodern era in which clinical nihilism is flourishing. Ellerman conceives the dialogical therapist as a potentially dangerous, ethically vulnerable therapeutic artiste, whose strategic encounters in the postmodern clinic may be likened to aesthetic experiences in which an education to reality and a love of truth are obsolete or irrelevant, notwithstanding a clinical masquerade that reinforces in spellbound patients a blind trust in the phantastic therapist's honesty, truthfulness, and intellectual integrity. Embracing the Socratic mystique, Ellerman offers a vigorous philosophic critique of clinical nihilism while warning readers of the communal risks involved in surrendering the perennial quest for truth.

Hypocrisy Unmasked explores the motives, meanings, and mechanisms of hypocrisy, challenging two principal psychoanalytic assumptions: First, that hypocrisy expresses deviant, uncontrollable impulses or follows exclusively from superego weakness; and second, that it can be understood solely in terms of intrapsychic factors without reference to the influences of the field. Ronald C. Naso argues that each of these assumptions devolve into criticisms rather than explanations and demonstrates that hypocrisy represents a compromise among intrapsychic, interpersonal, situational, and cultural/linguistic forces in an individual life. Hypocrisy Unmasked accords a healthy respect to the hypocrite's existentiality, including variables like opportunity and chance, and focuses on situations where the hypocrite's desires differ from those of others and on the moral principles that count in decision-making rather than how they are subsequently rationalized. Ultimately, hypocrisy exposes the ineradicable moral ambiguity of the human condition and the irreconcilability of desires and obligations.

In this volume, Elena Garralda and Jean-Philippe Raynaud aim to contribute to advancing awareness of child and adolescent mental health within an international framework that gives special consideration to problems arising in different contexts around the world and through expert views supported by empirical evidence and considering clinical implications. There is increasing recognition worldwide of the importance of child and adolescent mental health problems, of the distress and impairment they can cause to children and their families, and of the markedly adverse effects on education and on adult psychiatric adjustment when left untreated. Globally, however, services to attend to these problems in children are uneven and patchy. There is a need to advance awareness of child and adolescent mental health and of factors that influence them. Chapters address the effects on child mental health of issues ranging from secular changes in family composition in both western and eastern countries, rapid industrialization, poverty, deprivation, and adoption, to refugee status and aboriginal life. It considers emerging issues, such as cyber addiction, PTSD, ADHD across different cultures, and the autistic'epidemic.'They discuss new service developments (Eastern Europe, paediatric liaison services) in the context of traditional methods (traditional Chinese medicine).

Reverence is defined as a sense of awe or profound respect for the person. It has become increasing rare in modern culture, not only in health care, but in education and in corporations, where people are too often treated in a dehumanizing way. This groundbreaking book is the most comprehensive volume to-date that explores in depth the concept of reverence and strengths-based approaches in the psychotherapy healing process as manifested in a wide variety of treatment modalities such as child and play therapy, family therapy, therapeutic assessments, and in training programs. Applications in head start programs and group homes, with both juvenile offenders and traumatized children, are covered in individual chapters along with using a strengths-based, reverent approach with providers.

How do we come to relative peace when we have behaved badly, or how do we come to grips with the misbehaviors of those around us? Forgiving oneself or others may not always be fitting, and forgetting may represent more denial than accommodation. Moving beyond conflict to beneficial solutions is often hard to achieve and sometimes seems beyond hope. In Forgiving, Forgetting, and Moving On, Robert Hooberman explains to clinicians and those interested in their own internal psychological workings how and why we become overwhelmed by conflict, and he explores methods to work through these conflicts. Hooberman believes that conflict can best be understood through a thorough process of psychological formulation culminating in a picture of the individual's character structure. Understanding character opens up the patient's internal world, leading toward greater appreciation of the causative factors. Using numerous case examples, Hooberman explains therapeutic techniques that assist patients in finding new solutions for conflicts that were previously felt to have been intractable.

In this direct and scholarly book, Dr. Joseph Fernando provides the first in-depth exploration and up-to-date revision of the psychoanalytic theory of defenses since Anna Freud's 1936 classic, The Ego and the Mechanisms of Defense. The workings of three basic forms of defense_repression, denial, and post-traumatic defenses_are clearly described and illustrated with examples from Dr. Fernando's clinical practice. While comprehensive and authoritative in its coverage of defenses, the book is also highly original and clinically relevant, as Fernando introduces and illustrates new concepts including the zero process (a form of mental functioning related to trauma), contrast defenses (a type of denial defense that leads to repetition), and compound defenses (defenses formed by the tight melding of two or more basic defenses). This is a book not only of innovation but also of integration. Classical psychoanalytic concepts are integrated with new ideas related to current concerns with trauma, denial, and narcissism, and theoretical explications are integrated with practical advice about the handling of different defenses and clinical situations. This book will appeal to both beginners and seasoned clinicians and theoreticians, as well as to anyone interested in psychoanalytic thought.

Applications of Family and Group Theraplay is rich in content and practical ideas guided by current research in attachment and neurobiological research. Most chapters are illustrated with a case study, including agendas from beginning, middle, and end sessions with an extensive appendix describing each activity, to help translate theory into practice. Theraplay, a research based therapeutic model that has gained increasing attention worldwide, is described in this book from its theory (based on attachment theory), research, to its underlying dimensions (structure, challenge, engagement, nurture) applied to a wide diversity of populations and formats. The book describes activities that have underlying goals of increasing parental attunement, creating a caring, accepting environment and co-regulating the child. It replicates normal parent/child interactions that are playful, physical, and fun. Applying Theraplay to a wide variety of populations (dysregulated, resistant, aggressive, impulsive, adopted, autistic, traumatized) and cultures (Aboriginals, American, Asian, German, Finnish) is included, as well as integrating Theraplay with other treatment methods. It also describes group Theraplay with father/son dyads and with troubled adolescents and offenders. This book will not only lead to a greater understanding of Theraplay, but will also stretch the reader's skills in the application of this very effective play therapy model.

This comprehensive and tightly argued book deals with the process through which a coherent self evolves, the various ways such development fails to occur, and the therapeutic measures to put things back together. Beginning with the child's early relationships and their internalization as the substrate of the self, the text moves on to psychodynamically sophisticated and developmentally anchored descriptions of certain psychopathological syndromes that are widespread and yet inoptimally discussed. Going from the most severe to the least severe conditions in this realm, the book deals with the psychotic core, the schizoid wish to die and be reborn, the fantasies related to unresolved separation-individuation, the sociopathic tendency to lie, and the impact of excessive narcissism on love relations. The book also provides a unique perspective on the treatment of these conditions in so far as it not only elucidates the ways that a therapist listens and talks to his patients but also the subtle but deep impact of his ongoing attitude toward psychotherapeutic work. Even the role the therapist's office silently plays in the conduct of his work is discussed in detail. The book is theoretically sound and contemporary. More importantly, it is clinically generous and provides a number of vignettes to illustrate the ideas proposed. The writing style is a refreshing admixture of scientific scrupulosity, literary elegance, and humane relatedness.

The Mind-Body Interface in Somatization: When Symptom Becomes Disease represents a unique contribution to the clinician's tool chest for diagnosing and treating psychosomatic illness. This book breaks new ground by asking and answering many of the key questions that trouble every practicing clinician: Why do patients use somatization? Can we predict who will be a somatizer? Is there an underlying process involved? Why are these patients so difficult to treat? Beginning with a discussion of contemporary disease classification, The Mind-Body Interface in Somatization clarifies matters greatly by talking in terms of chronic and situational somatization, showing that chronic patients use illness as a way of life, while situational patients somatically respond to existential crises, and revealing how both are rooted in the mind-body interface. Drawing on elements of personality theory, the authors discuss the core conflicts and character structure inherent in both types of somatization and suggest treatment options appropriately geared toward the needs of each. The Mind-Body Interface in Somatization describes how chronic somatization can be addressed by cognitive-behavioral therapy and Dialectical Behavioral Therapy, while situational somatization can be managed with short-term existential psychotherapy. Concluding with a discussion of medications that may be helpful to the somatizing patient, this volume represents an original approach to explaining what goes on in the mind of the somatizer.

Volume one of this comprehensive approach to one of Freud's most important conceptual achievements, the theory of thinking, examines the emergence and changes in his conceptions of primary and secondary process thought in their theoretical and clinical contexts. Unlike most treatments, which emphasize their embeddedness in metapsychology, the text demonstrates the empirical grounding of these concepts in observation and describes how it led to a method of quantitative measurement. A summary of major, theoretically relevant findings with that method, plus a critical review of post-Freudian reexaminations of primary process, leads to a reformulation of the psychoanalytic theory of thinking that is, in Rubinstein's term, protoneurophysiological: as consistent as possible with contemporary knowledge in the brain sciences. In so doing, the author attempts to convert a psychoanalytic theory into a set of testable propositions using objectively quantifiable, scientific concepts. Moreover, he shows how data obtained with his method can be used to confront the theoretical propositions, verifying some, rejecting some, and significantly modifying others. Volume two is an enclosed compact disc. The first ten chapters constitute a detailed scoring manual, designed to be self-teaching, for applying the concepts of primary process, its controls and defenses, to data from the Rorschach and Thematic Apperception Tests, dreams, and free verbal data. The remaining chapters treat its reliability and validity, including a critical summary of over one hundred researches from around the world, demonstrating how it can be used not only to test psychoanalytic propositions but to illuminate issues in clinical psychiatry, clinical and developmental psychology, and personality. A concluding chapter points to many promising directions for further research.

What constitutes a lie? What are the different types of lies? Why do people lie? Is dishonesty ubiquitous in human experience? And what should be done with individuals who seek pschotherapeutic help and yet can not reveal important aspects of their lives and even fabricate histories, associations, and dreams? Such questions form the backbone of this exceptional book. Starting with the emergence of the capacity to lie in childhood and the formative influence of the family in children's moral development, the discourse goes on to include the variety of adulthood lies, including social lies, existential lies, pathological lies, narcissistic lies, and sociopathic lies. Contributions from distinguished psychoanalysts like Salman Akhtar, Harold Blum, Ruth Fischer, Lucy LaFarge, Henri Parens, and Michael Stone, along with others, explore the impact of dishonesty on the internal and external realities of an individual. Malignant forms of lies involving serious character pathology and criminality, as well as their detection, are also discussed. The book's aim is to help therapists enhance their empathy with patients who are compelled to lie and to provide them with better therapeutic strategies to deal with the clinical dilemmas that arise in working with such children and adults.

Loving Psychoanalysis is written by an analyst who loves doing psychoanalysis, and who believes that psychoanalysis is a fundamentally loving endeavor. Levine argues that the proper working attitude of the analyst is not one of neutrality, in the sense of the blank screen, but one of loving. This love should be expressed through the deepest empathy of which the analyst is capable, through the disciplined use of the arts and crafts of attention and interpretation, through thoughtful abstinence, through considered anonymity, and through the inevitable self-revelations and necessary self-disclosures that each particular patient requires. The chapters explore overlapping interdisciplinary themes, each chapter addressing elements of both theory and technique. How do the analyst's and patient's wishes to create and to be (re)created affect the treatment? What is the role of courage in the clinical endeavor for both analyst and patient? Why do analysts love doing psychoanalysis and why can psychoanalysis be thought of as aesthetic? What is the'self'of the analyst in self-revelation and self-disclosure, and how can we think about this technical issue in a fresh way? Levine addresses these and many other relevant questions in Loving Psychoanalysis.

The success of psychotherapy depends on the development of both the patient and the psychotherapist. This is the central thesis of Jaenicke's book, which addresses the clinical application of intersubjectivity theory in terms of the risk—what Jaenicke terms the'risk of relatedness'—the theory poses to both therapist and patient when executed as practice. In contrast to Freudian theory, intersubjectivity theory considers therapy a process that is co-constructed by patient and therapist, where the therapist eschews the role of neutral authority who provides patients with new insights and whose subjective reaction to the therapeutic process is sealed off from the therapist-patient interaction. Jaenicke'translates'and reformulates the theory's complexities into the terms of practical psychotherapeutic work. Using eight fundamental psychoanalytic concepts—empathy, defense, splitting, the unconscious, trauma, the myth of the isolated mind, transference/countertransference, and affect—he gives a vivid account of how intersubjectivity theory can be put into practice while describing common difficulties. Numerous case studies provide concrete examples.