READINGS

𝘾𝙄𝙏𝘼𝙏𝙄𝙊𝙉: McWilliams, N. (2005). Preserving our #humanity as therapists. 𝘗𝘴𝘺𝘤𝘩𝘰𝘵𝘩𝘦𝘳𝘢𝘱𝘺 𝘛𝘩𝘦𝘰𝘳𝘺, 𝘙𝘦𝘴𝘦𝘢𝘳𝘤𝘩, 𝘗𝘳𝘢𝘤𝘵𝘪𝘤𝘦, 𝘛𝘳𝘢𝘪𝘯𝘪𝘯𝘨, 42(2), 139–151.



𝘼𝘽𝙎𝙏𝙍𝘼𝘾𝙏: Psychotherapists have traditionally embraced core values & beliefs that differ significantly from many values & beliefs that pervade contemporary, commercially oriented Western cultures. With their clients, #therapists often question or challenge the culture's materialism, consumerism, appeals to vanity & greed, disdain of dependency & vulnerability, & abetment of narcissistic entitlement. 𝗖𝘂𝗿𝗿𝗲𝗻𝘁𝗹𝘆, 𝗵𝗼𝘄𝗲𝘃𝗲𝗿, #therapy 𝗶𝘀 𝗯𝗲𝗶𝗻𝗴 𝗿𝗲𝘀𝗵𝗮𝗽𝗲𝗱 𝗯𝘆 𝗱𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝘃𝗲 𝗽𝘀𝘆𝗰𝗵𝗶𝗮𝘁𝗿𝗶𝗰 𝗱𝗶𝗮𝗴𝗻𝗼𝘀𝗶𝘀, 𝗽𝗿𝗲𝘀𝘀𝘂𝗿𝗲𝘀 𝗳𝗿𝗼𝗺 𝗽𝗼𝘄𝗲𝗿𝗳𝘂𝗹 𝗰𝗼𝗿𝗽𝗼𝗿𝗮𝘁𝗲 𝗶𝗻𝘁𝗲𝗿𝗲𝘀𝘁𝘀, & 𝗮𝗻𝘁𝗮𝗴𝗼𝗻𝗶𝘀𝗺 𝗳𝗿𝗼𝗺 𝗶𝗻𝗳𝗹𝘂𝗲𝗻𝘁𝗶𝗮𝗹 𝗮𝗰𝗮𝗱𝗲𝗺𝗶𝗰 𝗽𝘀𝘆𝗰𝗵𝗼𝗹𝗼𝗴𝗶𝘀𝘁𝘀, 𝗮𝗻𝗱 𝗶𝘀 𝘁𝗵𝗿𝗲𝗮𝘁𝗲𝗻𝗲𝗱 𝘄𝗶𝘁𝗵 𝗯𝗲𝗰𝗼𝗺𝗶𝗻𝗴 𝘁𝗵𝗲 𝘀𝗲𝗿𝘃𝗮𝗻𝘁 𝗼𝗳 𝘁𝗵𝗲 𝘀𝘂𝗿𝗿𝗼𝘂𝗻𝗱𝗶𝗻𝗴 𝗰𝘂𝗹𝘁𝘂𝗿𝗲 𝗿𝗮𝘁𝗵𝗲𝗿 𝘁𝗵𝗮𝗻 𝗶𝘁𝘀 𝗽𝗮𝗿𝘁𝗶𝗰𝗶𝗽𝗮𝗻𝘁/𝗼𝗯𝘀𝗲𝗿𝘃𝗲𝗿 & 𝗰𝗿𝗶𝘁𝗶𝗰. 𝘛𝘩𝘦 𝘢𝘶𝘵𝘩𝘰𝘳 𝘯𝘰𝘵𝘦𝘴 𝘴𝘺𝘮𝘱𝘵𝘰𝘮𝘴 𝘰𝘧 𝘵𝘩𝘪𝘴 𝘵𝘳𝘦𝘯𝘥 & 𝘰𝘧𝘧𝘦𝘳𝘴 𝘪𝘥𝘦𝘢𝘴 𝘢𝘣𝘰𝘶𝘵 𝘳𝘦𝘷𝘦𝘳𝘴𝘪𝘯𝘨 𝘪𝘵. 💡💡💡

PRESERVING OUR HUMANITY AS THERAPISTS

CITATION: Chapman, A.L., Turner, B.J. & Dixon-Gordon, K.L. (2011). To integrate or not to integrate dialectical behavior #therapy with other therapy approaches?. Clinical Social Work Journal, 39, 170–179. https://doi.org/10.1007/s10615-010-0283-4.

ABSTRACT: With mounting evidence for its efficacy in the treatment of borderline personality disorder (#BPD) and related problems and increasing dissemination nationally and internationally, front line clinicians in practice settings are increasingly aware of dialectical behavior therapy (#DBT). Indeed, it is likely that this treatment is reaching individuals who practice from a variety of theoretical frameworks, such as psychodynamic, humanistic, cognitive, or some combination thereof. Therefore, this paper considers the ways in which DBT is an #integrative approach, as well as the issues that may arise in the integration of DBT with other theoretical frameworks or with practices spawned by these alternative frameworks. We recommend that therapists practicing DBT adhere to the behavioral and dialectical theoretical foundations of the approach, in order to provide #therapy that is effective, coherent, and consistent.

TO INTEGRATE OR NOT TO INTEGRATE DBT

THE EFFICACY OF PSYCHODYNAMIC PSYCHOTHERAPY

THEORY AS STORY

READ BY: Ava Pasewicz.

CITATION: Modlin, N., Stubley, J., Maggio, C., & Rucker, J. (2023). On Redescribing the Indescribable: Trauma, Psychoanalysis & Psychedelic Therapy. British Journal of Psychotherapy, 39: 551-572.

ABSTRACT: The psychedelic state can be thought about as an interdependent intrapsychic, somatic, interpersonal & spiritual happening which encourages, perhaps both to the relief & dismay of those participating in the experience, the shocking & impressive emergence of one’s unconscious desires & traumata's; a state which may be experienced as cathartic or healing, and as anxiety-provoking & confusing. Often, in clinical trials investigating psychedelics in mental health conditions, these go hand-in-hand. Amid a renewed, at times hyperbolic, interest in psychedelics as a potential treatment for mental illness, significant gaps of knowledge remain. Additional studies exploring the impact of the extra-pharmacological factors & adjunct therapeutic models on treatment outcomes are needed. Drawing from psychoanalytic perspectives, this paper explores points of intersectionality between psychedelic therapy under investigation & psychoanalysis in the context of traumatic stress. To that end, the psychedelic state will be considered an attempt to make the unconscious conscious by immersing self in a bewildering waking-dream to better tolerate reality; immersing self in a willful state of vulnerability, to develop trust in one’s agency & capacity to trust others; immersing self in an indescribable experience to learn how to redescribe, to self & to others the traumatic past.

REDESCRIBING THE INDESCRIBABLE

CITATION: Shedler, J. (2021). The personality syndromes. In R. Feinstein (Ed.), A Primer on Personality Disorders: Multi-Theoretical Viewpoints. Oxford: Oxford University Press.
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KEY POINTS:

Personality refers to an individual’s characteristic patterns of thought, feeling, behavior, motivation, defense, interpersonal functioning, and ways of experiencing self and others. Clinical knowledge accrued over generations has given rise to a taxonomy of familiar personality syndromes. Personality syndromes exist on a continuum of functioning from healthy to severely disturbed. There is no discontinuity between normal and pathological personality.

Understanding personality syndromes requires an understanding of underlying personality processes such as inner conflicts, defenses, and motives. A diagnostic prototype is provided for each personality syndrome, which describes the syndrome in its “ideal” or pure form. A practical diagnostic method based on pattern recognition is provided, whereby clinicians consider the overall resemblance between patients and diagnostic prototypes.

The personality constructs provide the broad strokes of clinical case formulations. They can explain and contextualize presenting symptoms and disorders. Each personality syndrome is a distinct pathway to depression and requires a different treatment focus.
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Read by: Isabel P.

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THE PERSONALITY SYNDROMES

Download this article at https://www.researchgate.net/publication/232439924_Ten_traps_for_therapists_in_the_treatment_of_trauma_survivors.

𝗖𝗜𝗧𝗔𝗧𝗜𝗢𝗡: Chu, J. (1988). Ten traps for therapists in the treatment of trauma survivors. 𝘋𝘪𝘴𝘴𝘰𝘤𝘪𝘢𝘵𝘪𝘰𝘯, 1(4), 24-32.



𝗔𝗕𝗦𝗧𝗥𝗔𝗖𝗧: Trauma survivors, particularly those who have experienced early childhood #trauma, stand out in the clinical experience of many therapists as being among the most difficult patients to treat. These patients have particular patterns of relatedness, along with intense neediness & dependency which make them superb testers of the abilities of their #therapists. They often push therapists to examine the limits of their abilities & frequently force therapists to examine their own personal issues & ethics. 𝘼 𝙘𝙤𝙣𝙘𝙚𝙥𝙩𝙪𝙖𝙡 𝙛𝙧𝙖𝙢𝙚𝙬𝙤𝙧𝙠 𝙛𝙤𝙧 𝙪𝙣𝙙𝙚𝙧𝙨𝙩𝙖𝙣𝙙𝙞𝙣𝙜 #𝘵𝘳𝘦𝘢𝘵𝘮𝘦𝘯𝘵 𝙩𝙧𝙖𝙥𝙨 𝙞𝙨 𝙥𝙧𝙚𝙨𝙚𝙣𝙩𝙚𝙙, 𝙖𝙡𝙤𝙣𝙜 𝙬𝙞𝙩𝙝 𝙩𝙚𝙣 𝙩𝙧𝙖𝙥𝙨 𝙬𝙝𝙞𝙘𝙝 𝙩𝙝𝙚𝙨𝙚 𝙥𝙖𝙩𝙞𝙚𝙣𝙩𝙨 𝙥𝙧𝙚𝙨𝙚𝙣𝙩, 𝙘𝙤𝙣𝙨𝙘𝙞𝙤𝙪𝙨𝙡𝙮 𝙤𝙧 𝙪𝙣𝙘𝙤𝙣𝙨𝙘𝙞𝙤𝙪𝙨𝙡𝙮, 𝙞𝙣 𝙩𝙝𝙚 𝙘𝙤𝙪𝙧𝙨𝙚 𝙤𝙛 #𝘵𝘩𝘦𝘳𝘢𝘱𝘺. 🤔

TEN TRAPS FOR THERAPISTS IN THE TREATMENT OF TRAUMA SURVIVORS

In this article, Thomas Maeder explores how the "helping professions", notably psychotherapy & the ministry, appear to attract more than their share of the emotionally unstable. 
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CITATION: Maeder, T. (January 1989). Wounded healers. The Atlantic Monthly, 37-47.

"What asylum doctor has not had his own attack of madness by dint of continual association with madmen? ... But before that, what obscure inclination, what dreadful fascination had made him choose that subject?” -Marcel Proust

WOUNDED HEALERS

CITATION: Baum-Baicker C. & Sisti D. (2012). Clinical wisdom in psychoanalysis & psychodynamic psychotherapy: A philosophical & qualitative analysis. Journal of Clinical Ethics, 23(1): 13-27.

ABSTRACT: To precisely define wisdom has been an ongoing task of philosophers for millennia. Investigations into the psychological dimensions of wisdom have revealed several features that make exemplary persons “wise.” Contemporary bioethicists took up this concept as they retrieved and adapted Aristotle’s intellectual virtue of phronesis for applications in medical contexts. In this article, we build on scholarship in both psychology & medical ethics by providing an account of clinical wisdom qua phronesis in the context of the practice of psychoanalysis & psychodynamic psychotherapy. With the support of qualitative data, we argue that the concept of clinical wisdom in mental healthcare shares several of the key ethical dimensions offered by standard models of phronesis in medical ethics & serves as a useful, albeit overlooked, reference point for a broader development of virtue-based medical ethics. We propose that the features of clinical wisdom are pragmatic skills that include, but are not limited to, an awareness of balance, the acceptance of paradox, & a particular clinical manner that maintains a deep regard for the Other. We offer several suggestions for refining training programs & redoubling efforts to provide long-term mentorship opportunities for trainees in clinical mental healthcare in order to cultivate clinical wisdom.

CLINICAL WISDOM IN PSYCHOANALYSIS & PSYCHODYNAMIC PSYCHOTHERAPY

CITATION: Watson, J. (2011). Treatment failure in humanistic & experiential psychotherapy. Journal of Clinical Psychology, 67(11), 1117-28.

ABSTRACT: In this article, treatment failure in humanistic & experiential psychotherapy is defined & explored. Several markers that indicate when treatment is not going well are outlined. Factors that contribute to failure include client factors, for example, emotional processing capacities, shame, & impoverished narratives, as well as therapist factors including lack of empathic attunement & inflexibility. Treatment failure is illuminated with a case example drawn from humanistic / experiential psychotherapy, & clinical strategies for dealing with failures are recommended.

TREATMENT FAILURE IN HUMANISTIC & EXPERIENTIAL THERAPY

4TH WAVE BEHAVIORISM - ACT, DBT, & NONDUAL WISDOM

Download this article at https://www.apa.org/pubs/journals/features/pap-a0034041.pdf

CITATION: Tummala-Narra, P. (2015). Cultural competence as a core emphasis of psychoanalytic psychotherapy. Psychoanalytic Psychology, 32(2), 275–292. DOI: 10.1037/a0034041

ABSTRACT: Psychoanalytic theory has been criticized for decontextualizing individual development. While recognizing the historical neglect of sociocultural context in psychoanalytic theory, this article raises attention to psychoanalytic contributions to the exploration of sociocultural issues in psychotherapy & calls for a systematic inclusion of cultural competence as a core area of emphasis of psychoanalytic psychotherapy. The article includes a brief review of #culturalcompetence in professional #psychology, and both a critique of psychoanalysis regarding the neglect of sociocultural context in #therapy & a discussion of psychoanalytic contributions to a complex understanding of #sociocultural issues in psychotherapy. Specific approaches to cultural competence that extend existing psychoanalytic theory concerning sociocultural context are presented. These include the recognition of historical #trauma & neglect of sociocultural issues, indigenous cultural narratives, role of context in the use of language and expression of affect, influence of experiences of social oppression & stereotypes on therapeutic process & outcome, and the dynamic nature of cultural identifications.

CULTURAL COMPETENCE AS A CORE EMPHASIS OF PSYCHOANALYTIC PSYCHOTHERAPY

Download this article at https://www.researchgate.net/publication/226290810_The_Guijin_Therapist_and_the_Nature_of_Therapeutic_Truth_A_Relational_Perspective.

CITATION: Tosone, C. (2005). The guijin #therapist & the nature of therapeutic truth: A relational perspective. Clinical #SocialWork Journal, 33, 9-19.

ABSTRACT: The professional literature is replete with examples of the benefits of the client–clinician dyad being of the same ethnic group. Noted advantages include a perceived implicit understanding of the client’s subjective experience & a furthering of the therapist’s personal & professional #growth as a result of the therapeutic interaction. This paper suggests that there are also benefits to the clinician being considered a "Guijin" or “outsider” to the client’s #culture of origin. Utilizing a #relational perspective with an emphasis on multiple self-state theory, this paper will discuss the advantages of being perceived as an outsider when working with an Asian bicultural client.

THE GUIJIN THERAPIST & THE NATURE OF THERAPEUTIC TRUTH

CITATION: McMillan, R., Kaufman S., & Singer J. (2013) Ode to #positive constructive #daydreaming. Frontiers in #Psychology, 4, 626.

ABSTRACT: Nearly 60 years ago, Dr. Jerome Singer (Yale University) launched a groundbreaking research program into daydreaming that presaged & laid the foundation for virtually every major strand of mind-wandering research active today. We review Singer’s enormous contribution to the field, which includes insights, methodologies & tools still in use today, and trace his enduring legacy as revealed in the recent proliferation of #mind-wandering studies. We then discuss the central theme in Dr. Singer’s work — the adaptive nature of positive constructive daydreaming — a revolutionary idea in the 1950s that remains underreported today. Lastly, we propose a new approach to answering this enduring question: Why does mind-wandering persist & occupy so much of our time if it is as costly as most studies suggest? 🤔

ODE TO POSITIVE DAYDREAMING

CITATION: Bauwens, J., & Tosone, C. (2010). Professional post-traumatic #growth after a shared traumatic experience: Manhattan clinicians’ perspectives on post-9/11 practice. Journal of Loss & Trauma, 15(6), 498–517.

ABSTRACT: Clinicians who live & work in natural & man-made disaster-prone areas are often exposed to trauma primarily as citizens & secondarily as a result of their professional practice. In an attempt to better understand this increasingly common experience of collective #trauma, this study explored the long-term impact of September 11th on the professional lives of 201 Manhattan clinicians. Participants reported that 9/11 was the impetus for enhancing self-care, changing clinical modality, & forging new skills. Positive changes were also reported within the therapeutic #relationship, including increased #compassion & connectedness with clients. Negative effects included feeling ill-equipped to work in the gravity of 9/11, an increased sense of #vulnerability, & disappointment with professional organizations. ☮

PROFESSIONAL POST-TRAUMATIC GROWTH AFTER A SHARED TRAUMATIC EXPERIENCE

CITATION: Tosone, C. (2011). The legacy of September 11th: Shared trauma, therapeutic intimacy & professional post-traumatic growth. Traumatology, 17(3), 25-29.

ABSTRACT: This article describes the personal & professional experiences of the author as a result of her direct exposure to the World Trade Center Disaster. The author proposes the use of the term "shared #trauma" to describe the experience of clinicians exposed to the same collective trauma as their clients. Shared trauma can result in the blurring of clinician–client roles, increased #clinician self-disclosure & emphasis on the shared nature of the experience. Posttraumatic #growth can also occur, including in the professional realm where clinicians develop a renewed appreciation for the value of the profession, learn to initiate greater safeguards in protecting personal time, & gain an intimate understanding of patients’ traumatic experiences. The results of her 9/11 research as well as plans for collaborative #research in environments characterized by chronic acts of terrorism or exposure to natural disasters are summarized. ☮

THE LEGACY OF 9/11: SHARED TRAUMA, THERAPEUTIC INTIMACY & PROFESSIONAL POST-TRAUMATIC GROWTH

CITATION: Tosone, C. (2006). Living everyday lies: The experience of self. Clinical Social Work Journal, 34(3), 335–348. https://doi.org/10.1007/s10615-005-0035-z

ABSTRACT: Lying is a ubiquitous feature of everyday social convention and also permeates the intimate bonds of romantic and family life. This article reviews the research literature on the gender-based motivations for lying and the contexts in which it occurs, along with relevant psychoanalytic perspectives, which help to explain how lying is related to one's experience of self. Emphasis will be placed on contemporary psychoanalytic formulations, which emphasize the subjective nature of truth and the multiplicity of self-experience. A case illustration is offered to demonstrate the applicability and complementarity of various viewpoints on the topic.

LIVING EVERYDAY LIES: THE EXPERIENCE OF SELF

CITATION: Goldstein, H. (1990). The knowledge base of social work practice: Theory, wisdom, analogue, or art? Families in Society, 71(1), 32–43.

ABSTRACT: Lured by the promise of the scientific method, social work (SW) has turned away from its own foundations of practice wisdom and has not entirely succeeded in developing its own value base, theories, and methods. A historical overview traces the tendency to accumulate theories that are, in many ways, alien to the SW's original mission of serving humanity. A range of theories have appeared in the literature as alternatives to the normative or positivistic orientation of the SW practice knowledge base. These include narrative theory, social constructionism, cognitive theory, moral theory, faith and spirituality, feminist theory, and the humanities.

THE KNOWLEDGE BASE OF SOCIAL WORK PRACTICE: THEORY, WISDOM, ANALOGUE, OR ART?

𝗖𝗜𝗧𝗔𝗧𝗜𝗢𝗡: Masland, S., Shah, T., & Choi-Kain, L. (2020). Boredom in borderline personality disorder: A lost criterion reconsidered. Psychopathology, 53, 239–253.

𝗔𝗕𝗦𝗧𝗥𝗔𝗖𝗧: Difficulty with boredom was eliminated from the formal diagnostic criteria for #borderline personality disorder (BPD) in 1994 based on significantly limited & unpublished data. However, it is apparent in clinical practice that boredom remains relevant to #BPD. This review synthesizes empirical #research, with consideration of theoretical accounts, to critically examine the relevance of boredom to BPD. We first briefly review issues in defining & measuring boredom, then offer an expanded conceptualization for BPD, which includes the notion of #boredom reactivity, before turning to boredom’s differentiation from & overlap with feelings of emptiness, with which it was paired prior to its removal from the DSM. We then discuss perspectives on boredom’s significance in BPD, briefly touching on its relevance in other personality disorders. We propose a "Boredom Cascade Model" that articulates how boredom & boredom reactivity interact with identity disturbance & chronic emptiness to create escalating patterns of behavioral dysregulation. Finally, we make recommendations for research & treatment. 🤔

BOREDOM IN BORDERLINE PERSONALITY DISORDER

CITATION: Hayes, S. (2004). ACT, RFT, and the 3rd wave of behavioral & cognitive therapies. Behavior #Therapy, 35, 639-665.

ABSTRACT: The 1st wave of behavior therapy countered the excesses & scientific weakness of existing nonempirical clinical traditions through empirically studied first-order change efforts linked to behavioral principles targeting directly relevant #clinical targets. The 2nd wave was characterized by similar direct change efforts guided by social learning & cognitive principles that included #cognitive in addition to #behavioral & emotive targets. Various factors seem to have set the stage for a 3rd wave, including anomalies in the current literature & philosophical changes. Acceptance & Commitment Therapy (ACT) is one of a number of new interventions from both behavioral & cognitive wings that seem to be moving the field in a different direction. ACT is explicitly contextualistic & is based on a basic experimental analysis of human language & cognition, Relational Frame Theory (RFT). RFT explains why cognitive fusion & experiential avoidance are both ubiquitous & harmful. #ACT targets these processes & is producing supportive data both at the process & outcome level. The 3rd wave treatments are characterized by openness to older clinical traditions, a focus on 2nd order & contextual change, an emphasis of function over form, and the construction of flexible & effective repertoires, among other features. They build on the 1st & 2nd wave treatments but seem to be carrying the #behavior therapy tradition forward into new territory. 🤔

READINGS

INTEGRATIVE DBT & PSYCHOTHERAPY