SEPI members discuss
influential books on the SEPI email-list
From: Jerry Gold
Subject: SEPI influences in
psychotherapy integration
Here's a question borrowed from Ed
Zuckerman, Ph.D. and which appeared originally on the
PSYUSA list:
What are the books
and articles that each of us feels as having been
centrally influential in defining the ways that we think
about and practice psychotherapy? In particular, are there
any writings that opened the possibility of integration as
a real one. For example, my vision was changed forever by
Paul Wachtel's Psychoanalysis and Behavior
Therapy, an experience that I'm sure is/was
shared by many? Anyone care to contribute a bibliography
of such influences? Brief annotations might be fun too.
Jerry
From: Sliepack
Brazier, D.
(1995). Zen therapy: Transcending
the sorrows of the human mind. New
York:Wiley.
Captures my
ideas about the process and practice of therapy better
than any other book I've read...by far! In my mind a must
read for all therapists.
From: "George Bouklas"
I am sure this
is something many of us can relate to, but books never
captured the essence of integration for me. I think this
says something about the written word's inability to
impart much about the therapy process. Ros and Lenny
Schwartz trained us here in NY and in a two year period
brought in people from the behavioral, psychoanalytic,
psychodynamic movements and more, for marathon sessions.
After we had Ellis, we sat with someone from Esalen, then
a Jungian, then a neo-Freudian. Ros and Lenny continually
asked the integrating questions, stitching together what
seemed at first disparate and contradictory. Then I had
the pleasure of observing Arnold Lazarus who brilliantly
pulled together a number of approaches. Underlying his
behavioral system was a psychoanalytic sensibility that
was impossible to miss, and this came through in a
particular form of compassion for those suffering with
emotional problems. He told a story about a patient who
was criticizing herself over a certain symptom and at one
point he had exhausted behavioral remedies. But when he
joined her dystonically, that did the trick. I loved
Lazarus for telling that story, because he showed us how
to merge behaviorism with psychoanalysis, right there.
Spotnitz accommodated to every kind of technique and
suggested an integrative underpinning to all our work. You
had to have the "right feelings" for the patient. The
technique was secondary. I think in this way the modern
psychoanalytic movement has attracted folks with all kinds
of training, because it hunts down those ineffables, or
therapist variables that account for about half the
"action" in therapy. Probably "the book" that has most
influenced my integrative interest is "The
Book," by Alan Watts. Again, it gets at
universal underpinnings that shed light on symptoms,
suffering and growth.
From: Gerald Davison
My votes are
for the following:
London, P. (1964).
Modes and morals of
psychotherapy
Dollard & Miller (1950). Personality and psychotherapy (Out
of Stock)
Lazarus (1971). Behavior therapy and beyond
and of course
Wachtel (1977). Psychoanalysis and behavior
therapy
(which I
have assigned in my graduate course on psychological
intervention every year since it appeared; this semester
I'm using his expanded 1997 edition.)
-- Jerry Davison
From: Pio Scilligo
Here are some
of the books that have had an important influence on
me:
Wachtel, P. (1997). Psychoanalysis, behavior, and the
relational world. Washington: APA.
Lazarus, A. (1997). Brief but
comprehensive psychotherapy: The multimodal
way. New York: Springer
(and Lazarus's 1989
book)
Horowitz, M. J.
(ed.) (1991). Person schemas and
maladaptive interpersonal patterns.
Chicago: The University of Chicago Press.
Benjamin, Lorna, S. (1996). Interpersonal diagnosis and treatment of
personality disorders. New York: Guilford Press
(especially her interpersonal model).
I am adopting
all these volumes at the Graduate School for Clinical
Psychologists of the Salesian University in Rome and
Horowitz at the Second Graduate School of Clinical
Psychology of the Unversity of Rome "La Sapienza". Of
course, books are just stimuli, they are no substitute to
the creativness of the psychotherapist!
Pio Scilligo, Ph. D.
Professor of Psychology
University of Rome "La Sapienza"
Faculty of Psychology
From: Graz Kowszun
I would like
briefly to introduce myself before responding. I am a
humanistic integrative psychotherapist practicing in the
unfashionable south-easterly corner of London. My caseload
is multi-cultural and of diverse sexualities, and I offer
both short-term contracts and longer term opportunities. I
have practiced as a counsellor and psyhotherapist for some
15 years and was delighted when convergence between
analytic and humanistic schools began to take off, and
integrative trainings appeared in England:
I agree that
live experiences more than books encouraged me to consider
integration. Nonetheless the goodies for me include:-
Kahn, M. (1991) Between Therapist and Client,
New York: W.H. Freeman
Erskine, R.
& Moursand, J. (1988) Integrative
Psychotherapy in Action: Sage
Also an article:-
Erskine, Richard, G. (April, 1994) Shame and Self-Righteousness:
Transactional Analysis Perspectives and Clinical
Interventions, in Transactional Analysis Journal, Vol
24, No. 2.
Kepner, J. (1995) Healing Tasks:
Psychotherapy with Adult Survivors of Childhood
Abuse, San Francisco: Gestalt Institute of
Cleveland
Kaufman, G. (1989) The Psychology of
Shame, London: Routledge.
Whitmore, D. (1991) Psychosynthesis
Counselling in Action, London: Sage
These are mainly practice based
examples of integrative models that include what is dear
to me. Recognising the impact of shame and how approaches
to therapy can humiliate rather than heal was a turning
point in my understanding and practice. Developing the
sense of self (and a self operating on interdependent
levels)as an integrative tool means a lot to me also.
A brilliant question / topic - could
you please send the biblio when it is collated?
Thanks and best wishes,
- -- Graz Kowszun
From: Stanley Messer
In addition to
Paul Wachtel's
book, which was a key influence in my own work,
two other volumes come to mind. One is by Stephen
Appelbaum, called Out in Inner
Space: A Psychoanalyst Explores the New
therapies. It is his account of what he
learned visiting centers where the new therapies of the
70's (such as rolfing, biofeedback, bioenergetics,
macrobiotic dieting, transcendental meditation) were being
practiced, and what he could incorporate into
psychoanalytic practice. The other was Perry London's
book about the modes and morals of
psychotherapy in which he looked at the insight oriented
and action-oriented therapies within a broad, socicultural
context.
Stanley Messer
From: "P. Abrego"
I'm beginning
to see some of my favorite books appearing on this list. I
would like to add two more of Wachtel's books, Therapeutic
Communication (Guilford, l993) and Family Dynamics in Individual
Psychotherapy (Wachtel & Wachtel, l986). Also, I
like Lorna
Benjamin's writings on interpersonal
psychotherapy, Interpersonal
diagnosis and treatment of personality disorders (New
York, l996) and writings by Daniel Wile, After the
Fight (l993, Guilford) and After the Honeymoon (Wiley,l988)
for couples therapy. By way of introduction, I am a
psychologist in private practice in Seattle and am
affiliated with the Univ. of WA.
I
like this dialogue! Phil
From: "david gilbert"
I am struck
that in this discussion very little influence has been
attributed to basic psychological science (e.g., learning,
memory, information processing, neuroscience, cognition,
socail, recent work on affect and cognitive-affective
interactions). Modern psychological science has offered me
a great deal and provides conceptual frameworks and
heuristic guides for therapy integration. I find it useful
to look for common mechanisms of psychological and
behavioral change across therapies and in life and
behavior in general. I believe that basic science has a
lot to offer clinicians if they bother to integrate their
theories within broader frameworks.
David Gilbert
From: Gerald Davison
Dear Dr.
Gilbert,
Thank you for reminding
me that an aspect of SEPI is, or should be (in my view), a
concern for linking therapeutic interventions with basic
psychological science. One way to do this is to work from
principles of change to innovative applications. This is
the rhetoric of behavior therapy, where my own primary
identification lies. Another way is to try to validate the
efficacy and effectiveness of existing therapies in
controlled studies. This is reflected in the Empirically
Supported Treatments work of Division 12, recent
information on which was just posted on another network I
am on.
The
books mentioned as influential so far, including those I
suggested, are not particularly noted for their empirical
underpinnings. Instead, they reflect primarily the
clinical impressions of creative clinicians, and these too
are important to advancing psychotherapy and encouraging
discussion and collaboration across school lines. But what
has begun to concern me about SEPI is that this is where
the interests and energies of most SEPI members seem
exclusively to lie, or at least that is how it appears to
me.
As
Arnold Lazarus and I have argued in a couple of recent
publications, advances in clinical work depend on both
creative, heuristically fertile hypotheses -- and I use
the word "hypotheses" intentionally -- and on systematic
study that is informed by what we know in general about
human behavior in a more scientific sense than holds the
interest of many practicing clinicians.
All of which
brings to mind O. H.
Mowrer's two 1960 volumes on learning theory
and clinically relevant speculations. I read these in
graduate school over thirty years ago and commend them to
anyone who is interested in how a brilliant experimental
psychologist extrapolated from basic S-R, mostly
animal-based theory and research to proposals that can
enhance our understanding of complex human behavior,
cognition, and affect.
Cheers,
Jerry Davison
From: "Jerry Gold"
The discussion
about the relationship of psychological science to
practice reminded me that I've been heavily influenced by
works such as Ferster and Skinner's Schedules of Reinforcement,
Mahoney's Cognition and Behavior
Modification, and the writings of Tolman,
Hull and Spence. Yet, these ideas don't spring to mind
immediately as clinical influences, but remain (dare I say
it about such authors?) unconscious influences (Or is it
introjects?). Clinical writers tend to influence me
clinically, as does of course, clinical experience and
modeling of other experienced clinicians. This discussion
is reminiscent of some of Hans Strupp's views on the
indirect relationship between science and practice and
also of George Stricker's publications on the local
clinical scientist.
George has a
new book (with Steven Trierweiler) just out on this topic,
The Scientific
Practice of Professional Psychology.
I wonder if colleagues who came to
SEPI from a psychodynamic background, like myself, are
less likely to look to basic psychological science as a
foundation?
Some other seminal
writings:
Beier, The Silent Language of
Psychotherapy (An integration of Freud
& Skinner);
Feather &
Rhodes on Psychodynamic behavior
therapy;
Franz Alexander on the
Therapist as a reinforcer.
Jerry
Gold
From: Paolo Migone
I would like
to make briefly few comments about the "important books"
one has in mind on psychotherapy integration. I agree on
the importance of Wachtel's work (beside his books already
mentioned in the list, I refer, for example, to such
contributions as his attempt at linking Freud's concept of
transference with Piaget's concept of coreggible schemas).
But I
would like to add that, to me, psychotherapy integration
can be only at the theoretical level. "Clinical"
integration is meaningless, because it does not exist, so
to speak: when me try to describe clinical interventions
or approaches, we always do theory, otherwise we could not
even talk about what we do. We always use concepts.
It is for this
reason that, for example, one of the books that I found
important is Lawrence Friedman's book "Anatomy of
Psychotherapy" (1988): the author tries to
review and understand various approaches, to see them
historically, to compare them, to see how and why they
work, what are the premises, etc.
In my opinion it is at this level that
"psychotherapy integration" really makes sense.
Paolo Migone, M.D.
From: Hilde Rapp
I appreciate the contributions people
are making towards constucting a reading list of what's
hot and helpful in psychotherapy integration and I hope
that the final product will be published in the Journal
for the benefit of those members who are not on email.
To add my penny's worth to the
existing list which of course contains some of my
favorites already:
Roth, T. and
Fonagy P. (1996) What Works for
Whom, New York: Guildford Press.
I find this a very sensitive and
sensible, tightly argued book which covers many of the
debates stimulated within Sepi about the need to meet
client need through innovative and hence integrative
practice while at the same time endeavouring to work in
ways which are open to intellectual, ethical, scientific
and pragmatic scrutiny. Pages 44 onwards cover Sepi ( and
SPR) territory well, for instance.
Also, I want to add Marv Goldfried's
series "In Session" which addresses our need as busy
clinicians to form a quick overview of what has been
reported to work for whom in a clear and accessible way.
From a UK perspective there is perhaps a wish to see more
European contributions, but maybe there need to be
different series for different service contexts.
M.R. Goldfried (Editor in Chief)In
Session. Psychotherapy in Practice.Published Quarterly by
John Wiley and Sons.
I also really like Susan Heitler's
description of psychotherapy integration as 'Fitting
together the Pieces of the Puzzle'. It's not a new book,
but its modest style is, to my mind, characteristic of the
best of SEPI, especially where she looks at the
relationship between 'treatment focus', 'treatment
philosophy' and some relevant 'treatment techniques' in a
simple client or patient centred way ( pp190 ff, Bill
Pinsoff,John Clarkin, and Arnold Lazarus of course do the
same thing within more tightly formulated, and more highly
articulated theoretical and methodological frameworks, but
I am supposing that most of us know that already...):
Heitler. S (1990) From Conflict to Resolution. Skill and
Strategies for Individual, Couple and Family Therapy.
Colin Feltham's
(1997) Which Psychotherapy?Leading
Exponents Explain Their Differences.
London: Sage, raises important issues in the ever
necessary debate about which approach, framework,
technique might not marry at all well with which other one
and why, because, at bottom, there are fundamental clashes
between values.
REFLECTIONS
In
a way, the books I like most ( and there could be lots of
others which there isn't room to mention) locate our need
to integrate different ways of thinking and working at the
interface between an individual therapist and an
individual client ( family, group, organisation) regarding
a particular issue at a particular time. As Saul Raw (
following Shakespeare's adage 'readiness is all'?)
maintains ( see latest issue of JIP), sensitive timing,
and pacing, and recognising the solution, which is at that
moment within the grasp and the resources of the
client/therapist pair engaged in a dialogic relationship,
is the best we can ever hope to manage in practice. It is
a real boon if we can talk with colleagues about what
happened in those momemts where things moved on in
intelligent and intelligible ways. Better still if we can
write about it so that it helps all of to us to develop a
shared language . This makes it easier to recognise where
we're headed, and to preview what we might need to prepare
for...
I am always looking for frameworks
which help me to formulate quite precise questions about
how one may flexibly combine differential therapeutics. I
suppose the focus, for instance by Jacquie Persons (
Cognitive Behavioural), Tony Ryle ( Cognitive Analytic),
Peter Fonagy ( Psychoanalytic and Psychodynamic) on
labouring away to arrive at a reasonable, sensitive,
clear, and comprehensive formulation of the clients
difficulties is the same activity at the level of
integrative practice as the one I am advocating here at
the level of conceptualising the field of psychotherapy
integration.
At this higher level, I expect the
construction of such frameworks to be underpinned by
cumulated observations and conceptual debates: Has the
author wrestled with such questions such as:> what do
we collectively already know about what values,
objectives, aims, go together with what other ones?>
what have we collectively found out about what helps or
hinders (!!)whom in which context? or, as Marv puts it: do
we know anything about which therapist behaviours are most
likely to facilitate the beneficial workings of common
therapeutic factors? On optimistic days I think we know
quite a lot, on bad days I wonder how much, what we do
know, actually helps me to stay with this client now...
Regards
Hilde
From: Mary Coombs
I have enjoyed
reading what others are interested in and recommended
readings. To introduce myself, although my background has
been predominantly clinical, I am currently doing
post-doctoral work at U. of Ca. - Berkeley in mental
health research. One of the areas that I have been working
on is that of the role of emotion in psychotherapeutic
change, and am looking in depth at the various major
schools of psychotherapy, including research, theory, and
clinical practice and their distinctive views of emotion,
its etiology, purpose, and how it relates to
psychotherapeutic change. I am particularly interested in
the contrast between the psychodynamic, cognitive and
behavioral approaches and their handling of the element of
client emotion. In my review of the existing measures of
emotion in psychotherapy, I am struck by the fact that
existing measures of emotion in psychotherapy (i.e. the Experiencing Scale (M. Klein et
al.), Wilma Bucci's Referential
Analysis, Enrico Jones' Psychotherapy
Process Q-sort) are orthogonal in certain
research studies and find that this raises very
interesting questions about what actual aspect of emotion
in sessions is being measured, and how experienced
clinician/researchers can view the same case in opposite
ways in terms of what is considered to be positive
psychotherapeutic change with respect to client emotion.
Grist for the mill. In this regard, I would add to the
list of helpful integrative material, some of the works by
Leslie Greenberg (such as Greenberg and Paivio (1997) Working with
Emotions in Psychotherapy and Greenberg
(1993) " Emotion and Change
Processes in Psychotherapy" in Handbook of
Emotions edited by Michael Lewis and
Jeannette Haviland). These works make a major
contribution, in bringing the focus of emotion more
clearly into the examination of psychotherapeutic process.
Greenberg's points about the different kinds of emotional
experiencing (i.e. what he refers to as "primary and
"secondary" emotion) offers a potential basis upon which
to view psychodynamic and cognitive/behavioral approaches
to handling emotion in psychotherapy and their potentially
complementary contributions given that each has superior
methods for handling certain kinds of emotion. Lorna
Benjamin also has written a key piece about the
therapeutic and counter-therapeutic handling of client
anger in sessions. Benjamin, L.S. (1990) "Interpersonal analysis of the
cathartic model" in Plutchik Robert, and Henry
Kellerman (Eds.) Emotion: Theory,
Research, and Experience. These writings
offer a grounded and integrated look at multiple
theoretical perspectives on what occurs commonly before
the eyes of the clinician.
A question I would like to see tossed
around is that of "eclectic" and "integrative"
psychotherapeutic approaches. Are they one and the same,
or do these terms have different meanings? I have heard
some interesting arguments about the impossibility of
actually doing effective "eclectic" psychotherapy (i.e.
each major school is too complex, requiring great skill
etc. too much to mix and match--pick one and do it well
vs. eclectic (or integrative) is what really allows the
therapist to meet the patient where they are and to offer
an effective intervention as it is needed and as the
psychotherapeutic process unfolds...).
Mary Coombs, Ph.D.
NIMH Post-doctoral Research Fellow
School of Social Welfare
120 Haviland Hall
University of California
Berkeley, CA 94720-7400
phone: 510- 643-6532
e-mail: coombs@uclink4.berkeley.edu
From:
ABOHART@DHVX20.CSUDH.EDU
I was going to send my own comments on
the things that influenced me the most anyway, but they
dovetailed with the recent comment by Mary Coombs on
emotion, and that finally mobilized me to take keyboard in
hand. My biggest influences were not in psychology, but in
philosophy and literature: the writings of the existential
philosophers, and writers like James Joyce and Lawrence
Durrell, both of whom created "integrative models" in
literature, models which continue to influence me. Within
psychology, the single most influential thing I ever read
was Eugene Gendlin's article "The
experiential response" in a 1968 book edited by
Emmanual Hammer called Use of
Interpretation in Treatment. That article
quite literally turned me into a good therapist overnight
(the next day I had a session; my supervisor was watching
through a one-way mirror and told me afterwards: "You've
finally got it!"). Furthermore it a) made sense for me of
Carl Rogers' formulations, which up to that point had
seemed too nebulous to be helpful (what do you do while
you're being warm, empathic, and genuine?), and b)
provided the first integrative model in psychology for
doing therapy that I was aware of. Basically Gendlin
(there and in subsequent writings) argued that can use any
intervention or any idea from any therapy if it is tuned
to the "experiential track" of the client in the moment,
and he then and since has continued to argue that we
should try to accumulate good ideas from all approaches to
use.
Which brings me to Mary Coombs'
interest in emotion. She notes that measures of "emotion"
are orthogonal, and includes in that the Experiencing
Scale. But it is no surprise that the Experiencing Scale
may be orthogonal to other measures of emotion because it
is NOT a measure of emotion! The experiencing scale is
based on Gendlin's work, and Gendlin carefully
distinguishes between experiencing and emotion.
Experiencing has an affective component, but is more a
meaning-making process. The problem is that it is not a
meaning-making process in our typical western cognitivist
way of looking at things. Rather, it is not dealing with
"ideas" and "beliefs," but rather "bodily felt meaning",
closer to what cognitive scientists such as Lakoff and
Johnson describe as the basis of all knowing:
preconceptual bodily experience. In fact, the experiencing
scale, congruent with this, correlates more highly with
cognitive measures than with affective measures (at least
in some studies). As I tried to clarify in my 1993 Journal
of Psychotherapy Integration article, our theories tend to
dichotomize the world into Cognition and Emotion, and then
have a hard time classifying experiencing, which kind of
lies in between. In any case, I salute Mary's interest in
clarifying what it means to say that something is an
emotion.
Art Bohart
Department of Psychology
California State University Dominguez
Hills
Carson, CA 90747
From: Hilde
Rapp wrote:
Dear Sepi online
colleagues
I really appreciate
Gerald Davidson's reminding us of the importance of taking
account of research in general psychology. I would add
sociology and anthropology as well. In many ways,
therapeutic approaches which aim to repair earlier damage
or which aim to make up environmental deficits must base
their interventions on what practitioners would normally
help people to achieve certain developmental tasks
throughout the life span. Increasingly we can back up
these beliefs with findings from research into normal
social, cognitive and emotional developmental
processes.Both research outcomes and paradigms relevant to
infant- parent atunenement and attachment ( cf Wilma
Bucci) are informing psychoanalytic theories about the
therapeutic relationship between the therapist/analyst and
the adult client/patient. Similarly, Gerald Davison might
agree, cognitive behavioural approaches are more or less
constructed on the back of research into learning, memory
and skill aquisition.(Incidentally, this makes these
therapies particularly amenable to process and outcome
research, because there is not really any paradigm clash).
I also want to respond to Mary Coombs
contribution, which I think points us to the importance of
looking for integrative themes along particular axes of
enquiry: In Mary's case this axis co-ordinates the
different ways in which different approaches and
researchers like Lorna Benjamin, Enrico Jones, Leslie
Greenberg, etc, construct concepts of emotion, and hence
diferrences in how the importance of particilar emotions
in the genesis and treatment of psychological difficulties
is theorised, and how technical approaches follow from
that. What I find exciting is the increasing specificity
in our enquiries, looking quite precisely and minuteltely
at which differences and which similarities might matter
in relation to what issues. So, the orthogonality of
certain kinds of emotions is interesting in this regard.
(There is also some relevant work, for instance by Charles
Spielberger in Florida and by Stephen Palmer in the UK).
Wouldn't it make an exciting panel
plus co-ordinated workshop at a future sepi conference to
get these colleagues together to compare and contrast
their concepts and methodologies?!
Also, the perennial question raised by
you, Mary (Coombs) as well as by other contributors to
this 'poly'-logue, concerning the difference between
integration and eclecticism could perhaps be asked more
pointedly if we look to philosophy. Perhaps we could argue
that integrative approaches are constructed along lines of
enquiry where a particular 'pattern that connects' (to
quote Bateson), allied to certain fundamental values and
models of (wo)man inform the theoretical perspective as
well as a set of compatible practices?
> Integration vs Eclecticism
At the same time, there probably are
'problems' for which such a sustained alignment is not
necessary and an ad hoc 'eclectic' combination of ways of
achieving a particular objective are the optimal fast and
flexible response? But, perhaps even within an integrated
approach we may need to preserve the freedom to be
innovative by making ad hoc choices with particular
clients at particular times...? I believe, incidentally
that contemporary work in philosophy , especially
philosophy of mind,language, science, ethics and
aesthetics is grappling with questions which are highly
relevant to our work. Perhaps we could learn from, and we
should contribute, more fully to these discourses?
Thank you Jerry and Carrol, for making
this free flowing sharing of thoughts, questions and
exchanges of experience possible.
Hilde Rapp
(
Chair, British Institute of Integrative Psychotherapy,
Network co-ordinator, SEPI, UK )
21
Priory Terrace
London NW6 4DG
Tel 44 (0)171 625 4287
Fax 44 (0)171 813 4718
email: rapp.biip@cableinet.co.uk
From: "J.
Russell Ramsay"
Greetings to all,
First, to introduce myself, I am a
psychologist with the Center for Cognitive Therapy of the
University of Pennsylvania. I completed a two-year
postdoctoral fellowship before being named clinical
director of the Center's first satellite office, which is
located in Bucks County, PA. I am active in clinical
service, supervision of postdocs, and writing/research.
Second, I'd like to offer a short list
of books I found to be influential. First is Mahoney's
(1991) "Human Change
Processes" for his coherent integration of
a vast amount of scientific literature regarding behavior,
personal meaning-making, and change processes. This book,
along with a special issue of the Journal of Clinical and
Consulting Psychology (1993) devoted to cognitive and
constructivist therapises solidified my then growing
interest in the congruence of these two models. Wegner and
Pennebaker's (Eds., 1993) "Handbook of Mental
Control" is an interesting collection of
contributions regarding various aspect of human
experience, cognitive/emotional processing and how we
"make sense" of things. Finally, the "Evolution of
Psychotherapy" series (Zeig, Ed., 1987,
1992, 1997) provides a forum to listen in as master
clinicians share with one another their theories,
practices, and meta-frameworks. In striving to provide
empirically-supported treatment, I find it vital to
integrate transtheoretical phenomena such as learned
helplessness, social learning, social psychology,
emotional intelligence, cognitive heuristics, etc.
Sincerely,
Russ
Ramsay
from kathleen adams
I feel a bit
like a fish out of water reading everyone's comments. I
owe my entire writing career to Wachtel for his article
From the Surface to the Depths. I got so ramped up after
reading about his concerns about 'depth' that I took off
three weeks and just began writing about what I knew best:
depth. Articles ensued and a book is in progress, the main
theme of which is "FALLING FOREVER." I trained as a child
psychologist originally,working several years in long term
child and adolescent inpatient settings, which I think
opened my mind to the impact of early childhood trauma. My
favorite book on working with children is Boston and
Szur's Psychotherapy with Severely Deprived Children. The
population I specialize in appears superficially to be
highly functional (and indeed are, except for their level
of terror and dread and vulnerabiity to fragmentation) but
come from backgrounds of profound abuse and/or neglect.
They all have disorganized attachment as an underlay to
one of the varieties of insecure attachment. I work in
long term combined group and individual modalities. For
many years I worked with dissociative disorders, and these
patients have similar dynamics without the DID. These are
some of the influences which shaped me:
(1) Depth. In my consultation groups
with other therapists I steadfastly focus upon
facilitating depth of emotional experience in the
therapeutic hour, defusing therapists’ discomfort with
primitive states, and cultivate therapists’ capacity to
meet patients fearlessly at the edge of the unknown. We
read Ogden's The Primitive Edge; all of Winnicott and
Christopher Bollas and Lawrence Hedges and Michael Eigen;
Grotstein's Do I Dare Disturb the Universe, Corrigan &
Gordon's The Mind Object. Favorite Journals: Contemporary
Psychoanalysis, Psych Dialogues, Psychoanalytic Review.
(2) Dissociation and
psychoanalysis. I observed my growing capacity to
recognize subtle dissociative defenses against
annihilation anxieties within my own high functioning
private practice patients. This shift in emphasis within
my own practice of psychotherapy represented a culmination
and synthesis of thirty years of work with primitive
states and profound pathology. Books: Bromberg's Standing
in the Spaces, Awakening the Dreamer,Nijenhuis and
Steele's The Haunted Mind. Favorite article: Chefetz and
Bromberg's Talking with Me and Not-Me,
(3) Layers of chronic shock in the
body: A convoluted personal journey involving chronic pain
and somatic dysfunction (fallout from a serious childhood
accident) and manypatientswith somatic complaints folowing
car wrecks or other traumata catalyzed a renewed interest
in the relationship between somatoform dissociation and
unbearable affects. Books: Levine's Waking the Tiger,
Ogden's Building Somatic Resources: Sensorimotor
Psychotherapy, Gendlin's Focusing, Nijenhuis' Somatoform
Dissociation, Rothschild's The Body Remembers.
(4) Unmentalized experience,
pathological organizations and attachment. Within the
context of teaching private practice therapists in study
groups, I became intrigued with the work of Judith
Mitrani's Ordinary People, Extraordinary Defenses and
other followers of Frances Tustin, with their emphasis on
unmentalized experience, the role of the second skin, the
autistic-contiguous position and autistic enclaves. At
this same time the concepts of attachment styles and
disorganized attachment were gaining attention in
psychoanalytic circles and illuminated my understanding of
traumatic attachment in my patients: Solomon $ George's
Attachment Disorganization, Goodwin &Attias'
Splintered Reflections, Susan Johnson's Emotionally
Focused Couples Therapy with Trauma Survivors, Fosha's The
Transforming Power of Affect.
(5)
The interweaving of neuroscience with trauma theory.
Neuroscience has been breaking new ground in the
understanding of self-states, early childhood experience
and emotional regulation. The school of interpersonal
neurobiology was founded by Siegel: The Developing Mind;
affective neuroscience's leader is Alan Schore's books
about Affect Regulation. Stern’s The Present Moment opened
up both group and individual therapy to lived experience
in the here and now. Cozzolino's The Neuroscience of
Psychotherapy and Badenoch's Being a Brain-WIse Therapist
integrate all the above.
(6)
Spirituality. Explorations of human suffering invariably
open a doorway to soul-searching about meaning and
meaninglessness. Contemplatives of fall traditions
emphasize the powerof love and compassion to transform
suffering into an acceptance of what is, to allow for life
in the present. Trauma has long been known as one of the
portals to trnsformation and spiritual awareness. Fear is
used all too often as an excuse not to risk, to act, to
embrace life, and to perpetuate the malignancy of a
contracted heart. When we are forced to confront
circumstances beyond our capacity, we always have a choice
about utilizing the crisis for stagnation or
transformation. John Rowan's posted question about how
come we integrationists don't talk about transpersonal
psychology was on point. Books: Eigen's The Psychoanalytic
Mystic, Moore's Dark Night of the Soul, Spezzano's Soul on
the Couch, Moody & Carrols's Five Stages of the Soul,
Muller's Spiritual Gifts of a Painful Childhood,
Chittister's Scarred by Struggle, Transformed by Hope;
favorite article K. Steel's Sitting with the Shattered
Soul.
So, although there isn't
much behavior therapy, CBT or DBT in my pedigree, I still
consider myself a loyal psychotherapy integrationist.
return to
top
|