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Adler 1997

Created By: Jessica Stewart

Toward a Multimodal Communication Theory of Psychotherapy: The Vicarious Coprocessing of Experience   Herbert M. Adler, M.D., Ph.D.

n "talking" therapy, the personal-experience narrative provides a vehicle through which the patient and therapist can vicariously coprocess experience. This is a common therapeutic process that is also found in music, movement, and art therapies. Evidence from anthropology, experimental psychology, clinical experience, and ordinary social behavior is presented to support this hypothesis.
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Little 2010

Created By: Jessica Stewart


There are many therapeutic techniques that fall under the umbrella of psychotherapy. While a therapist might find that one technique best suits the individual, generally the therapist will use a variety of techniques with the same patient depending on the problems being experienced by that person.

Behavior Therapy

[2]Behavior therapy focuses on changing the unwanted and self-defeating behavior patterns of the individual through conditioning. In essence, this technique involves the removal of undesirable habits and replacing that behavior with more satisfying and rewarding behavior. Behavior therapy can help an individual to modify the stress response or overcome a crippling phobia.

Cognitive Therapy

[3]Cognitive therapy looks at the underlying thought patterns and core beliefs behind unwanted feelings and emotions. The basic idea is that our thoughts about a situation are what create our emotions regarding that situation, and often our thoughts are based on irrational or troublesome core beliefs that we might not even be consciously aware of. An example would be a perfectionist who is suffering anxiety because of all the pressure that they put on themselves. Cognitive therapy can help this person see that they are too rigid in their thinking and that it is irrational to expect to be perfect at all times.

Cognitive-Behavioral Therapy

[4]Cognitive-Behavioral therapy (CBT) is a combination of the above techniques, and this is the most popular therapy for dealing with depression and anxiety. The idea here is to simultaneously modify thoughts and behaviors to help the individual not only get beyond the negative core beliefs that are holding them back but also change the behavior patterns they have developed in response to those thought patterns. It is often our troublesome behavior that first brings us to therapy, and then, once the therapist has somewhat modified the behavior, the patient is in the position to work on changing the negative thoughts that create the unwanted behavior in the first place.



[5]Gestalt therapy is based on the philosophy of existentialism and phenomenology; basically, it is essential to understand who we are in relation to all the things around us, and we must study and observe what is going on in the present moment in order to truly know ourselves. The saying, “Man is not an island unto himself,” would describe the Gestalt view of human understanding. Everything is interrelated, and one cannot understand themselves without simultaneously understanding the world around them at this time.

Interpersonal Therapy

[6]With interpersonal therapy, or IPT, the focus is on improving relationship skills such as communication and improving the supporting relationships in the depressed or anxious person’s life. By learning how to deal with loved ones in a more productive and less combative way, the individual can improve these relationships and reduce conflicts that might be contributing to their feelings of depression or anxiety.


[7]Psychoanalysts guide the patient on a journey through their unconscious in order to uncover and understand internal conflicts that may be motivating emotional disturbances. Together, the therapist and client look at childhood problems, unconscious motivations, unresolved conflicts, and destructive behavior patterns to gain self-awareness and resolution. Freud is the father of psychoanalysis, but there are different schools of thought on how this technique should be used including the philosophies of Jung, Adler, Klein, and Sullivan.

There are different settings in which therapy can be performed. Individual therapy is just that—therapy performed one-on-one between the therapist and the client. If a person dealing with depression or anxiety decides to seek therapy in a group setting, individual therapy may still be important as it gives that person the opportunity to speak in a safe environment. Family therapy and couples therapy involve working together as a family unit to help understand and deal with the problems within the family that are contributing to the problems of the depressed or anxious member. Often there are patterns at play within the family dynamic which deeply affect the recovery of one or more members, and this will be uncovered through therapy performed as a group. Group therapy brings together several people experiencing the same disorder so that they may share experiences and break the isolation so often associated with depression and anxiety.

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Pawlik-Kienlen 2007

Created By: Jessica Stewart


Sigmund Freud was a psychoanalyst who favored a stream of consciousness therapy to tackle psychological disorders. The patient lay on a couch – even the bizarre psychological cases such as the Rat Man, Wolf Man, or Anna O – and talked about anything that came to mind, no matter how bizarre, frightening or dark. Freud experienced successes and failures (like everyone does); here are his three most bizarre psychology cases.

Freud's Bizarre Psychological Case #1: The Rat Man

[1]The Rat Man was an army officer who heard a fellow officer describing an unorthodox form of punishment: strip a man naked and release the rats. Rats will gnaw and chew their way through the anus – and thus punish the offender. The Rat Man was deeply affected by this image and started to imagine this happening to his father and his girlfriend. He developed an obsession, a system, of preventing this from happening to his dad and girlfriend. The Rat Man wanted to protect them.

The fact that his dad had been dead for a few years and his girlfriend was safe from the war at home didn't seem to matter to the Rat Man. After many psychotherapy treatment sessions, Freud did find success. He helped the Rat Man shake off his obsession…only to be killed in WW I a year later.

Read more at Suite101: Three Bizarre Psychological Cases: Sigmund Freud's Psychotherapy Treatment of the Rat Man & More http://www.suite101.com/content/three-bizarre-cases-a18888#ixzz16AOa7SJw
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Yalom 1980

Created By: Jessica Stewart


[1]One of the first recorded cases of modern psychotherapy is highly il-
lustrative of how therapists selectively inattend to these extras.
1 (Later
descriptions of therapy are less useful in this regard because psychiatry
became so doctrinaire about the proper conduct of therapy that "off the
record" maneuvers were omitted from case reports.)
In 1892, Sigmund
Freud successfully treated Fraulein Elisabeth von R., a young woman
who was suffering from psychogenic difficulties in walking. Freud ex-
plained his therapeutic success solely by his technique of abreaction, of
de-repressing certain noxious wishes and thoughts. However, in study-
ing Freud's notes, one is struck by the vast number of his other thera-
peutic activities. For example, he sent Elisabeth to visit her sister's
grave and to pay a call upon a young man whom she found attractive.
He demonstrated a "friendly interest in her present circumstances" 2 by
interacting with the family in the patient's behalf: he interviewed the
patient's mother and "begged" her to provide open channels of com-
munication with the patient and to permit the patient to unburden her
mind periodically. Having learned from the mother that Elisabeth had
no possibility of marrying her dead sister's husband, he conveyed that
information to his patient. He helped untangle the family financial
tangle. At other times Freud urged Elisabeth to face with calmness the
fact that the future, for everyone, is inevitably uncertain. He repeated-
ly consoled her by assuring her that she was not responsible for un-
wanted feelings, and pointed out that her degree of guilt and remorse
for these feelings was powerful evidence of her high moral character.
Finally, after the termination of therapy, Freud, hearing that Elisabeth
was going to a private dance, procured an invitation so he could watch
her "whirl past in a lively dance." One cannot help but wonder what
really helped Fraulein von R. Freud's extras, I have no doubt, constitut-
ed powerful interventions; to exclude them from theory is to court

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Phillips et. al. 1985

Created By: Jessica Stewart


Attrition: The Number One
Problem of Psychotherapy
Practice and Research

[1]Over the past several decades psychotherapy has evidenced enormous activ-
ity without demonstrating much change. The proliferation of theories of psy-
chotherapy has grown to staggering proportions ( Corsini, 1981; Garfield,
Herink, 1980; 1981 Patterson). Given this much activity, there should have
been a greater distillation of ideas; not a rigid prescription of what is, or how
to do, psychotherapy, but a settling in on basic concepts and some unifica-
tion delimiting of practice.

[2]The reason for this proliferation of theories is more understandable than
its consequences. On the one hand, the "talking cure" has stimulated a lot of
thinking, guesswork, and some theorizing of value -- thus accounting for
many therapists/theorists throwing their hats in the ring -- but has resulted in
a corresponding lack of appropriate research addressing salient issues. Most
research has been on very narrow problems of technique, important in some
problem areas and apparently without much value in other areas ( Bergin &
Lambert, 1978; Glass & Miller, 1980; Garfield, 1978; Landman & Dawes,
1982; Smith, Glass, & Miller, 1980) -- and much has been left dangling among
studies of therapy evaluation and outcome. The matter of outcome is still an
important issue in psychotherapy.
How are we to judge the value of some-
thing unless we can study its consequences? The opinion that the outcome
problem has been left hanging is a judgment supported throughout this
book; but for the now, suffice it to say that the reason the outcome problem
is so hazy, ill-studied, and lacking in generalizability leads us precisely to the
main issue of the book: attrition.
[3]Atrition has lamed or even killed off much outcome research that was
testing hypotheses about psychotherapy practice, technique, diagnosis, presenting problems, and the like. The weak offerings it has rendered have
pointed to issues inherent in generalizing results to other populations.
If one
were to transport our culture to a different land, and were obliged to select
from the vast psychotherapy literature practices and validations that would
put the new society in good stead for dealing with its problems there would be
a great clamor by present-day therapists/theorists to be represented, but few
substantial criteria on which to base a decision. (One possible outcome of
such a hypothetical challenge might be that there were no winners and every-
body's notions would be up for grabs in the new land.)

The literature on psychotherapy research contains infrequent and
unsystematic references to the impact of attrition. Herein lies a serious prob-
lem, open to study.


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Rubovits-Seitz 1998

Created By: Jessica Stewart

Depth-Psychological Understanding: The Methodologic Grounding of Clinical Interpretations

By Philip F. D. Rubovits-Seitz, Hillsdale, NJ, The Analytic Press, 1998, 480 pages, ISBN 0-88163-279-1, $69.95

Gerald P. Perman, M.D.

Key Words: Books Reviewed

How do we know that what we interpret to our patients is valid? Is it simply because we think or feel it is? Is it because our theory tells us it should be? These are difficult and perplexing questions. In addressing them, Dr. Rubovits-Seitz brings together his decades of thinking about this knotty issue in an intellectual and philosophical tour de force, taking us on a journey to explore the methodologic underpinnings of clinical interpretation. When we have finished we are much more aware of the panoply of tools at our disposal to help us validate what we tell our patients, and we are also better able to acknowledge and assess the vast shortcomings in this endeavor.

The uncertainty involved in inferring latent meanings and determinants in clinical data has been called (by Glover) the Achilles heel of psychoanalysis. To address this uncertainty, Rubovits-Seitz examines the methodology of clinical interpretation, with a focus on the construal and justification phases of the interpretive process.

Beginning with "Trouble at the Source" (chapter 1), the author describes Freud's positivist approach in his effort to use observational data alone to arrive at absolutely certain knowledge. Freud ran into difficulty as soon as he needed to infer latent content to his patients' free associations, resulting in a host of methodologic problems that the author enumerates and proceeds to examine in detail.

[1]By the 1960s, this positivist model came under increasing attack as scientists and philosophers recognized that logical empiricism could not provide a secure foundation for such absolutely certain knowledge. The author tells us that a radical shift, or postpositivist turn, occurred in the philosophy and conduct of science, suggesting that indirect, inferential, [2]presumptive knowing is the best we can do. This shift resulted in a more pragmatic, eclectic, qualitative, problem-oriented (rather than method-oriented) approach to scientific inquiry, in which words (rather than numbers), empathy, context, and the polydimensionality and nonlinearity of experience assumed increased importance. And yet the "lingering ghost of positivism" still pervaded our thinking, resulting in efforts to combine positivist and postpositivist approaches, as in Harre's "New Paradigm" and Quine's "Naturalized Epistemology."

But we are told that a "methodologic lag" persists. Kohut's views, in particular on interpretation and technique, are criticized as being outdated and positivist, although the author does not spare the rod with a number of other well-known analysts as well. He also lists a number of analysts whose methods he considers postpositivist and pluralistic. Interestingly, he includes Freud in this latter group, after having previously identified him as the main contributor to the origin of many of the difficulties under consideration.

Rubovits-Seitz then begins a critical review of language-based models, relation-oriented and pattern-oriented methodologies, and language-based related disciplines as they apply to [3]clinical interpretation. He examines the relationship of the cognitive sciences to interpretive methodology, including symbolic functioning and schema theory. In part, he uses many of these models as straw men, disassembling and knocking them down but also retrieving and applying what is applicable in them to clinical interpretation. He offers a fascinating evaluation of "commonsense" (intentional) psychology as another model of interpretive inquiry.

One full chapter is devoted to Grunbaum's ten major arguments against the validity of psychoanalysis as a science. Rubovits-Seitz then asks: "Must interpretations be justified?", "Can interpretations be justified?", and "Can interpretations be justified intraclinically?", after which he presents 14 ways to justify interpretations, in order of potency. We are next offered a case presentation to demonstrate the post-therapeutic justification of interpretations, on the basis of recurrent dynamic cycles, employing the methods of justification previously enumerated. Finally the author summarizes what he sees as the scientific status of interpretation as a method of inquiry, comments on the difficulties and the fallibility of clinical interpretive inquiry, and notes common but avoidable errors in clinical interpretation along with remedial strategies.

I found little not to like in this book. The author is a skilled wordsmith who obviously has an encyclopedic grasp of his topic. The book is extremely well written, though I did need to compile a glossary of philosophic and other terms as an aid to navigation. Kohutians and Kleinians will bristle at the treatment he affords their heroes and heroines in his effort to be brutally honest and pull no punches. The results of that effort may prove to be in the eye of the beholder, and I await with anticipation the array of reactions to his book.

[4]With psychoanalysis and psychodynamic psychiatry presently under heavy attack by the insurance-industrial complex, Dr. Rubovits-Seitz has importantly placed the interpretive aspect of our science squarely on an equal footing with other branches of medicine and scientific endeavor.


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