Discussion Of Psychotherapy Research Articles

Resolving Difficult Clinical Syndromes

Dr. Theodore Millon and Dr. Seth Grossman are recognized experts in the field of personality disorders and psychopathology. Psychological test reports frequently cite the results of Dr. Millon's personality assessment inventories. Both gentlemen have coauthored numerous textbooks and research projects. Dr. Millon was on both the DSM-III and DSM-IV task forces. Thus, clinicians anticipate that any new publications by Drs. Millon and Grossman may clarify the difficult clinical arena of personality psychopathology. Resolving Difficult Clinical Syndromes: A Personalized Psychotherapy Approach is one of 3 books in a series. The other 2 books are Moderating Severe Personality Disorders: A Personalized Psychotherapy Approach and Overcoming Resistant Personality Disorders: A Personalized Psychotherapy Approach, both of which are also available from the publisher. Clinicians know that no two patients are exactly alike. A patient may remind us of someone we saw previously, but we know that the interplay of backgrounds, genetics, and experiences differ even for identical twins. Yet, most therapists have a “favored” form of therapy. Those trained in cognitive therapy approach most patients in a cognitive framework. Those trained psychodynamically look for psychodynamic factors. A psychopharmacologist will utilize medications. Even for those who claim an “eclectic” approach, background and training influence the clinician just as specific personal factors influence the patient. In the authors’ words, “Personalized psychotherapy is not a vague concept or a platitudinous buzzword in our treatment approach, but an explicit commitment to focus first and foremost on the unique composite of a patient's psychological makeup” (p. ix). Drs. Millon and Grossman authored this series to take all these factors into account. The first part of the book includes basic information about personalized psychotherapy and the Millon-Grossman Personality Domain Checklist (MG-PDC). The clinician completes the MG-PDC regarding the patient in the following areas: expressive behavior, interpersonal conduct, cognitive style/content, self-image, mood/affect, intrapsychic mechanisms, intrapsychic content, and intrapsychic structure. The inventory gives the therapist a tool for personalized psychotherapy. The second part of the book discusses therapy for specific syndromes. Chapter topics include mood disorders, anxiety symptoms, substance abuse disorders, and schizophrenia. Each topic area includes general clinical picture, prevailing treatment options, and personalized psychotherapy. The personalized psychotherapy section focuses on the specific disorder with different personality presentations. Case examples follow with domain analysis and therapeutic steps. The case presentations and discussion of psychotherapy elucidate the concepts presented in the book. Although the subject of personalized psychotherapy has a promising future, this book does not present the material in a manner and with terms familiar to most clinicians. Therapists and physicians familiar with DSM-IV terminology may find the text wording and concepts slightly esoteric. An appropriate audience for this book series would be clinicians familiar with other publications and psychometric assessment instruments by the authors. Mary Jo Fitz-Gerald, M.D. Health Sciences Center, Louisiana State University, Shreveport, Louisiana

Review of Understanding depression: Feminist social constructionist approaches.

JANET M. STOPPARD Understanding Depression: Feminist Social Constructionist Approaches New York: Routledge, 2000, 249 pages (ISBN 0-415-16563-6, US$20.99, Softcover) Dr. Stoppard has written an excellent overview that brings together mainstream psychological and feminist research and writing about women and depression. The author, a feminist psychologist, brings a balanced view to this area, which has typically seen feminists and mainstream psychologists either avoiding or dismissing each other's work. Thus this book presents a unique and important integration that both feminists and psychologists should find useful. The book begins with a detailed and intelligent review of the data that shows women are more likely than men to be depressed from adolescence onwards. She presents a compelling argument that even though each kind of study has methodological limitations, all find that women are more prone to depression. She explores three definitions of depression: diagnosis using the DSM criteria, depressive symptom checklists, and women's depressive experiences. In a sophisticated discussion that is typical of this book, Dr. Stoppard argues that each of the three definitions of depression that researchers have used is partial, with both advantages and disadvantages. Her evaluation of different definitions is very evenhanded. Her discussion of how the DSM was developed and used is the best that I have ever read. In the second section of the book, Dr. Stoppard discusses four major approaches to understanding or explaining depression; that is, why do some women/people become depressed? She provides a careful and thoughtful review of the diathesis-stress model; theories based in women's psychology, including self-in-relation work; social models of depression; and material-discursive models. For each approach except the material-discursive, a critique is presented using feminist and social constructionist approaches. The third section explores women's depression in the context of different life stages beginning with adolescence, moving on to marriage and motherhood, and finally examining women and aging. The fourth and last section of the book consists of a chapter on treatments for depression, and a concluding chapter that argues the usefulness of the material-discursive model for explaining depression in women. The chapter on treatment is wonderful and includes discussions of psychotherapy, medical treatments (anti-depressants and ECT), and how some women cope with and recover from depression on their own. The latter is a refreshing acknowledgment of the limits of professionals and the strengths of women. Again, the author is clear that each of these approaches works for some women but not for others and that each has limitations. The strengths of this book are many. It is clearly written and accessible to a wide audience. At the same time it is methodologically and theoretically sophisticated. It is to my knowledge the only thorough integration of mainstream psychology and feminist discussions of women and depression. Because the author presents a balanced view of a range of definitions and theories of depression, all of which are partial, she is able to be critical without being dismissive. This leads to one of the most important strengths of this book from a feminist perspective. Throughout the book, Dr. Stoppard validates women's experiences of depression. One good example of this is in her discussion of hormones and depression. She argues that because women and researchers share cultural discourses of femininity, both women and scientists have constructed biological explanations of women's depression that depend on women's hormonal cycles. Although Dr. Stoppard's review of the positivist scientific literature on hormones and depression quite correctly describes the evidence as very mixed, she is careful to acknowledge that for some women the experience of depression is linked to premenstrual or menopausal experiences. …

Linguistics, Pragmatics and Psychotherapy: A Guide for Therapists

Back to table of contents Previous article Next article Book Forum: Cognitive NeuroscienceFull AccessLinguistics, Pragmatics and Psychotherapy: A Guide for TherapistsSCOTT WETZLER, PH.D., SCOTT WETZLERSearch for more papers by this author, PH.D., Bronx, N.Y.Published Online:1 May 2001https://doi.org/10.1176/appi.ajp.158.5.827-aAboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail What distinguishes psychotherapy, the “talking cure,” from other forms of treatment is that the entire transaction between patient and therapist takes place using speech and language. It is a conversation with clear-cut linguistic rules, which, if broken, render communication meaningless and indecipherable. On the basis of this premise, Elaine Chaika, Professor of Linguistics at Providence College, R.I., believes that the field of linguistics has something to offer the field of psychotherapy. Trained by speech therapists in England, where they are licensed to conduct psychotherapy, Chaika uses speech therapy as a model for psychotherapy. If therapists learn to listen better and patients learn to speak more clearly, then therapeutic change will be achieved.Chaika argues that therapy is a joint speech event in which both parties work together using culturally based rules, such as syntax and semantics, to communicate. She suggests that good therapists are more attuned to the patient’s use of language and are able to fall into a “rhapsodic” rhythm with the patient. Conversely, bad therapists harm patients by their failure to listen. I doubt anyone would disagree that listening and communication skills are crucial for effective psychotherapy. Although it is intriguing to hope that knowledge of linguistics might help us to become better therapists, Chaika offers no evidence in this book that linguistics actually has anything to contribute to knowledge about psychotherapy.Of the six chapters, two are dense introductions to linguistic principles and the other four demonstrate Chaika’s premise that therapy can be described in linguistic terms. Yes, patients and therapists use language to communicate. We use proverbs, metaphors, idioms, nonverbal gestures. We repeat what the other person says to indicate that we understand, and sometimes we even finish each other’s sentences. We have well-established rituals for greeting and leave-taking, and often we give answers when asked a question. In other words, patients and therapists play by the same linguistic rules. Although Chaika believes that linguistic analysis of these therapy conversations has much to offer and claims to have data to support her position, I found no data in my reading, and she is not knowledgeable enough about psychotherapy to offer even a clinically compelling argument. As therapists, we are already fluent communicators, and more explicit knowledge of linguistic rules will not improve our fluency. If my intuitive communication skills guide me in using a particular metaphor or in understanding the implications of the patient’s use of a particular metaphor, the recognition that we use metaphor as a linguistic device does not offer much clinical benefit.At times, Chaika’s clinical analysis is correct but obvious: patients who use sentences without agents are trying to avoid responsibility. At other times, her advice is subtle but not supported by any data: since proverbs are community-based, they are most effective with addictive disorders. In all cases, Chaika’s discussion of psychotherapy is not informed by a basic knowledge of the literature. For example, she devotes one chapter to the idea that patients construct personal narratives without any mention that this topic has dominated the psychotherapy literature over the last decade or more.I was very disappointed by this book in part because I had been aware of Chaika’s solid record of research analyzing the linguistic errors of schizophrenic patients. She has catalogued the kinds of speech disorders characteristic of schizophrenia. This research has implications for the associated thought disorder and underlying neuroanatomy. She hypothesizes that individuals with schizophrenia pay poor attention to their linguistic productions, do not self-monitor, and therefore are unable to correct their own linguistic errors. Unfortunately, in this book, Chaika goes well beyond her own research findings in schizophrenia to present ideas about psychotherapy, often with patients who do not have schizophrenia.One reassuring thought: lest anyone believe that the practice of psychotherapy is merely the application of commonsense, it is comforting to know that people in other fields don’t know the first thing about how to conduct therapy.By Elaine Chaika. London, Whurr, 1999, 200 pp., $44.95 (paper). FiguresReferencesCited byDetailsCited byNone Volume 158Issue 5 May 2001Pages 827-a-828 Metrics History Published online 1 May 2001 Published in print 1 May 2001

Toward the Meaning of “The Person of the Therapist”

SUMMARY Too often, in discussions of psychotherapy, the techniques are given undue emphasis. Research suggests that the same techniques are differentially effective when used by equally trained and supervised therapists. Not only are some therapists more effective, irrespective of the type of therapy they practice, but some, because of their personal qualities, may actually harm those with whom they work. This research reflects the vast importance of the ubiquitous element in therapy, that of the “person” of the therapist. The question, then, follows, how may personhood be developed? This question is explored as it relates to both breadth and depth of life experience.

Aids, health, and mental health: a primary sourcebook

I n AIDS Health and Mental Health: A Primary Sourcebook, the authors approach the management of human immunodeficiency virus (HIV) disease using a systems theory model. They state, Systems theory is an integrative method at its core, an inclusive way of viewing experience. They do a fair job at being inclusive, but remain limited in their capacities to advance a well-integrated discussion. The book is based on their extensive experience with the AIDS Training Program at the University of Rochester School of Medicine and Dentistry. The authors do not present research-generated outcome data to support their claims of the benefits of using a systems approach. Their discussion of psychotherapy with both HIV-infected persons and people affected by the broader impact of HIV disease are generally excellent, and the case histories presented are well developed and add to the depth of the text. Chapter Two introduces three detailed case histories and discusses the biopsychosocial impact of HIV on the affected systems, ranging from its effects on the cellular level to its role as an evolutionary process affecting the biosphere. The case of Helene, an HIV-infected Haitian woman, is a particularly excellent example of the need for therapists to use a range of treatment interventions flexible to the changing needs of the patient as they negotiate the complex course of HIV disease. Chapter Eight, a detailed discussion of psychotherapeutic interventions, is

The Future of Psychotherapy and the Expanding Universe or Michael J. Mahoney

Human Change Processes (Mahoney, 1991) is an attempt to set experiential psychotherapy on a scientific basis. The first tow-thirds of the book, based on an extensive survey of diverse scientific and scholarly literatures, argues fairly convincingly for a conception of human beings in which attachment, subjectivity, emergent and unconscious mental processes-especially regarding the self-and emotionality are central to human development and psychotherapeutic change. The book's last part, a discussion of experiential psychotherapy, based largely on clinical experience and intuition, is vague on important points of psychotherapeutic procedure ad process and is less convincing. The disjunction between the scientific discussion of psychology and the non-scientific discussion of psychotherapy is the book's major flaw. Nevertheless, the book is important as an attempt to synthesize a psychotherapy that is at once humanistic and scientifically informed.

Emotionalism in the Discussion of Psychotherapy

Back to table of contents Previous article Next article ArticlesNo AccessEmotionalism in the Discussion of PsychotherapyMartin Grotjahn, M.D.Martin GrotjahnLos Angeles, Calif.Search for more papers by this author, M.D.Published Online:30 Apr 2018https://doi.org/10.1176/appi.psychotherapy.1950.4.1.80AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - APT - American Journal of Psychotherapy $35.00 Add to cart PPV Articles - APT - American Journal of Psychotherapy Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byJournal of Clinical Psychology, Vol. 11, No. 3 Volume 4Issue 1 1950, pp. 1–222Pages 80-84 Metrics PDF download History Published online 30 April 2018 Published in print 1 January 1950

THE EFFECT ON THE SKIN OF EMOTIONAL AND NERVOUS STATES

In reviewing the literature on the neuropsychiatric-dermatologic borderline, one is impressed with the comparative rarity of serious studies of the sexual psychoses as factors in the development and prolongation of dermatologic symptoms. The haste to disavow any leanings toward strict or ultrafreudianism, which just now is almost social good form among medical writers, has perhaps had a repressive effect on study of the sexual psychoses as they concern other fields of medicine. In the recent American dermatologic literature, Hazen and Whitmore 1 have had the courage to say that they believe that a large proportion of cases of pruritus vulvae are attributable to marital unhappiness or ungratified sexual desire. Reports of the occurrence of itching as part of sexual complexes have come largely from psychiatric sources, but Sack, 2 incidentally to a discussion of psychotherapy in cutaneous disease, specifically mentioned a type of case which I believe would be more