SEPI members discuss
influential books on the SEPI email-list
The active links below will take
you to Amazon.com to order the book.
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.
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