Therapeutic Ideology Research Articles

Identity development of Arab drama therapists: The role of ethnic boundary work

Previous studies have suggested that creative arts therapists who work in conservative societies must adapt their Western therapeutic ideologies to collectivist and traditional norms. Less is known about how these creative arts therapists construct and maintain their professional identity in diverse sociocultural contexts. Building on the literature that emphasizes the role of ethnic boundary work in professional identity processes, we examined how Arab drama therapists maintain, challenge, and negotiate ethnic boundaries in the process of professional identity construction.Participants were 38 Israeli-Arab drama therapists (36 female) working in Israeli-Arab schools. Data were collected through semi-structured interviews (27 participants) and playback theater groups (12 participants). Thematic analysis revealed three different forms of ethnic boundary work: "Distinguishing Arab identity from drama therapy", "Drama therapy as an act of challenging ethnic and gender boundaries", and "Negotiating ethnic boundaries within the context of drama therapy".The current study emphasizes the sociocultural context of boundary work by illustrating how Israeli-Arab drama therapists define their professional identity across ethnic, gender, and political tensions. We conclude with implications for research and practice.

Consuming to Be Good: Therapeutic Ideology and Transracial Adoptive Mothers

This study reveals the therapeutic origins of the “good mother” ideal in a rarely studied context, that of transracial adoptive mothering. Using a comparative discursive analysis supplemented by illustrative case analysis, we show that what it means to be a “good mother” in transracial adoptive mothering discourse differs significantly from the ideal established in mainstream mothering discourse. The key differences uncovered relate to publicly contested challenges to legitimacy, the experience of stigma for families adopting children of difference races, and a relative dearth of market‐based solutions to these challenges. We propose therapeutic ideology as a powerful macro‐level theoretical construct capable of explaining the self‐reinforcing cycle of mothers' anxiety, expert advice, and market‐mediated solutions.

Conversations With Paul

In a tribute to Paul Ornstein, this article describes how Paul was one of the rising generations of self psychologists that embraced radical ideas that were opposed to the philosophical, theoretical, and therapeutic ideologies of the day. After highlighting his unfettered courage and optimism, I describe how Paul built on Kohut’s innovations, helping to spearhead a seismic shift in our philosophical and theoretical understanding of the underpinnings of psychoanalysis. I was fortunate to have the opportunity to discuss these major transitions with Paul during two years of taped Wednesday afternoon conversations. The article shares with you excerpts on selected issues from our conversations, covering topics such as how Paul found self psychology, empathy, the unconscious, the therapeutic alliance, curative fantasy, supervision, transmuting internalization, selfobject transference, and interpretation. It is through these exchanges that the breadth and depth of Paul’s clinical wisdom is most apparent.

The semiotics and politics of “real selfhood” in the American therapeutic discourse of the World War II era

AbstractThis article describes the semiotics and politics of “real” and “false” selfhood in American therapeutic discourses of the World War II era, focusing on Karen Horney and Carl Rogers. Giving a semiotic analysis of their work requires developing an account of Erving Goffman's understanding of commitment that can then be used to illuminate the form of politics that underlie their ideologies of selfhood. The article culminates in an account of the ironies of the neoliberal politics infusing these therapeutic ideologies. At stake is a historical period characterized by a knotting of ideologies about commitment, their semiosis, and the neoliberal imagination.

‘We are the 99%'—The Occupy Protest and Therapeutic Ideology

SYNOPSISSYNOPSISAs a therapist, do you see yourself as part of the Occupy Movement or outside of it? In other words, are you in the 1 per cent of the wealthiest, or in the 99 per cent occupied by the rest of us? Does it matter if therapists have an opinion or otherwise towards the Occupy Movement? And why did an economist introduce the ‘Happiness Model’ of CBT? This article raises pertinent questions about wealth and privatization, the Occupy Movement and the place of therapy, and invites the reader to consider their options for action.

Human Agency Revisited: The Paradoxical Experiences of Victims of Crime

Victims of violent crime often complain of feeling powerless. In some respects this represents a psychological aftereffect of the crime — an experience in which something was done to them against their will that they were powerless either to prevent or to stop. However, focusing attention on the psychological aftereffects of such experiences often overshadows other important considerations. For example, there is the possibility that an accumulation of subsequent social and institutional interactions may serve to minimize their ability actively to cope with their experiences. This paper seeks to address these issues head on by reframing victimization in terms of the interplay between victims' social and institutional interactions, on the one hand, and their agency to cope on the other.1 Following a brief review of the critical literature on victims' problematic institutional positions and a discussion of agency, data will be presented from a qualitative study of individuals who have suffered the murder of a loved one.2 As will be seen, the differing experiences of these individuals in a variety of social contexts have much to teach us about institutional influences, therapeutic ideologies, and human agency.

Natural Health Discourses and the Therapeutic Production of Consumer Resistance

Social critics of the natural health movement charge that it indoctrinates consumers in a therapeutic consumerist ideology. This “dominated consumer” thesis ignores that socially situated individuals must negotiate a plethora of institutionally specific power structures aiming to classify and govern their identities. Accordingly, resistance toward specific institutional constructions of identity can be produced through marketplace ideologies. I explore this understudied ideological effect by analyzing the narratives of women who are using natural health alternatives to resist their ascribed medico-administrative identities. Natural health's therapeutic ideology enables these women to contest the degenerative implications of their medical diagnoses and, conversely, to reconstruct their chronic illnesses as an opportunity for discovering their inner regenerative potential and expanding their spiritual horizons. This analysis has implications for prior studies suggesting that resistance toward the technocratic and bureaucratic aspects of conventional medicine exemplifies a Foucauldian “care of the self.” I argue that a postmodern adaptation of Foucauldian theory is needed to address the complex interrelationships among the care of the self, medical consumerism, and the therapeutic ideology of the natural health marketplace.

Natural Health Discourses and the Therapeutic Production of Consumer Resistance

Social critics of the natural health movement charge that it indoctrinates consumers in a therapeutic consumerist ideology. This “dominated consumer” thesis ignores that socially situated individuals must negotiate a plethora of institutionally specific power structures aiming to classify and govern their identities. Accordingly, resistance toward specific institutional constructions of identity can be produced through marketplace ideologies. I explore this understudied ideological effect by analyzing the narratives of women who are using natural health alternatives to resist their ascribed medico-administrative identities. Natural health's therapeutic ideology enables these women to contest the degenerative implications of their medical diagnoses and, conversely, to reconstruct their chronic illnesses as an opportunity for discovering their inner regenerative potential and expanding their spiritual horizons. This analysis has implications for prior studies suggesting that resistance toward the technocratic and bureaucratic aspects of conventional medicine exemplifies a Foucauldian “care of the self.” I argue that a postmodern adaptation of Foucauldian theory is needed to address the complex interrelationships among the care of the self, medical consumerism, and the therapeutic ideology of the natural health marketplace.

The influence of evil on forensic clinical practice.

As the medicalization of criminal behaviour expands through forensic psychiatric practice it is reliant upon a therapeutic ideology based on clinical assessment and effective application of treatment strategies. When such criminal offenses are particularly heinous the perpetrators are often referred to as evil by non-professional accounts. However, the extent to which the concept of evil affects the perceptions of mental health professionals working with such offenders is little understood. This paper reports on research conducted in a high-security psychiatric hospital in the North-west of England and examines the construction of care plans in relation to a number of mentally disordered offenders who are considered by a group of mental health professionals as evil. Thematic analysis of mental health professionals' discourse pertaining to the care plans revealed a complex motivational and rational structuring of evil that dictated the switch from medical ideological discourse to lay notions of badness. From this, an Airaksinen model was constructed to display the types of evil manifestations.

A psychology of difference: the American lectures

Otto Rank, A Psychology of Difference: The American Lectures. Selected, Edited, and Introduced by Robert Kramer with a foreword by Rollo May. Princeton, NJ: Princeton University Press, 1996. ISBN 0-691-04470-8. Separation, Will, and Creativity: The Wisdom of Otto Rank by Esther Menaker. Edited by Claude Barbre. Northvale, NJ: Jason Aronson, 1996. ISBN 1-56-821-802-8. The writings of Otto Rank (1884-1939) are in the midst of a rebirth. Rank-artist, poet, psychotherapist, philosopher, mythologist, and educator-was a leading disciple and confidant of Freud and the first lay psychoanalyst. Banished as a dissident from the inner circle of psychoanalysis in the 1920's, Rank was excommunicated like Adler and Jung before him. Though largely unacknowledged, Rank is a forerunner of ego psychology, object-relations theory, interpersonal psychotherapy, existential psychology, and Rogers' client-centered approach. The break with Freud was Rank's great turning point. In 1924 Rank transcended Freudian ideology in two bodks-The Development of Psychoanalysis (Ferenczi & Rank, 1924/1956) and The Trauma of Birth (1924/1952). He left psychoanalysis in order to help clients, having become disillusioned by endless analyses and therapeutic ideology. Writing now as a philosopher and metaphysician, Rank emphasized each individual's struggle to become separate, whole, creative. Rank emigrated from Vienna to Paris in 1926, where stayed until 1934 and treated artists such as Anais Nin and Henry Miller. He moved permanently to the U.S. in 1935. Rank's tragic death came in 1939 from an unexpected reaction to medication, only one month after Freud's physician-assisted death from morphine. Rank's original writings, be forewarned, are notoriously difficult. Rollo May (1950/1977) cautioned that Rank's terminology and dualistic mode of thought are uncongenial (p. 132), while Ernest Becker (1973) characterized Rank's work as a confusion of insights, so rich and diffuse that he is inaccessible to the general (p. xii). Anais Nin (1967) insisted that these writings don't do justice to his ideas, and admitted that Rank himself had tried to persuade her to rewrite his books (p. 16). It is not surprising, then, that Irvin Yalom (1980) has decried the wretched translations that are now almost mercifully out of print (p. 293). So, given the considerable learning curve, why bother with these works? Because Rank's thought has deep implications for development of the social sciences (Becker, 1973, p. xii-xiv). Like travel guides in unfamiliar territory, capable interpreters like Menaker and Kramer help us on our way. Fortunately, Esther Menaker's (1996) Separation, will, and creativity: The wisdom of Otto Rank makes this work approachable. Menaker, ninety, has nearly seventy years of experience as a psychotherapist and analyst. Having studied under professor Jesse Taft (the Rankian analysand, biographer, and translator), Menaker later traveled to Vienna in order to train with Anna Freud. For decades, Menaker has written and lectured about Rank, providing much-needed interpretation and explanation. Separation, comprised of thirteeen chapters, is broad in scope, ranging from an impassioned pilgrimage to view Rank's teenage diary to thoughtful discussions of the philosophy of science. Also included are seven case histories from Menaker's own private practice, intended to illustrate Rankian principles. All this material, even the personal and anecdotal, assists the reader in embracing the ever-difficult Rank. Rank was far ahead of his time, argues Menaker, and his thinking reflects the scientific ethos of our own time. She explains that Rank was a dialectic thinker, one who offered dualistic descriptions of psychological processes. Discussions are dedicated, therefore, to the life fear/death fear, the wish to differentiate/wish to merge, and the causality principle/will principle. Menaker (1996) is at her best in sorting out thorny technical concepts. …

International comparison of baccalaureate nursing degrees: collaboration in qualitative analysis

This paper describes a study which investigated the perceived similarities and differences of a selection of baccalaureate nursing degrees from different continents. An international research team was formed, and by using a modified version of the Delphi process and nominal group techniques the group undertook a qualitative analysis of curriculum documents. The major areas analysis were: aims, content, methods and assessment. Under these headings the group produced a list of key issues supported by a number of indicative statements by collating the independent analyses undertaken by each of the team members. Examples of findings are that critical thinking and personal development are most obvious in aims but that the progression of curricula may not achieve this, there are differences in 'western' and 'asian' orientations to the concept of personal autonomy. Sciences are valued more than arts or humanities. The lecture method as well as practice placement dominate the teaching methods. Transcultural nursing is not significant except where there are two therapeutic ideologies in existence. Assessment methods are largely summative. The findings have application in the development of credit transfer and international exchange schemes. The conclusions highlight areas of special considerations when designing such schemes.

Wendepunkte in der amerikanischen Psychiatrie des 20. Jahrhunderts

Sabshin describes three turning points in twentieth century American psychiatry. Following "the time of the Thirteen", the time of the founders of modern American psychiatry, the first turning point was marked by the rise of Meyerian psychobiology and had its peak impact during the second quarter of the twentieth century. In the post World War II years diverging therapeutic ideologies became dominant, including the important impact of psychoanalysis. But competing ideologies (e.g. in social and biological psychiatry) were of importance also. The most recent turning point was marked by the current surge of neuro-science and psychopharmacology along with empiricism and logical positivsm. It is predicted to peak in the middle of the current decade. Following the preceding demedicalization a remedicalization of psychiatry was the result. For the turn of the 21st century, as Sabshin predicts, a re-emergence of analogues of Meyerian psychobiology will take center stage, particularly concentrating on questions of coping and adaptability, on how the human being keeps himself healthy and sane during subsequent developmental stages as well as in the face of stressful life events.

Messianic Personalism: A Role Analysis of the Unification Church

This paper reports the findings of a participant observation study of the role system of the Unification Church. After noting several strategic inconsistencies in the literature on roles and the organization of authority in the Church, the paper describes 1) the therapeutic ideology of heart elaborated by the Moonies; 2) the communal ideal they pursue, the personalized family; 3) the two fundamental role-sets of the Church: father and child, Abel and Cain; and 4) the organization of these roles in a therapeutic but hierarchical apparatus of charismatic relations. On the basis of its role system, the Church synthesizes the seemingly opposed social forms of personalism and authoritarianism in a distinctively therapeutic religion; it is an egalitarian gemeinschaft which organizationally integrates the impulsive focus of the contemporary narcissistic culture of emotions with its apparent opposite, the institutional focus of extreme religious fundamentalism.

Negotiating Trouble in a Battered Women's Shelter

The treatment of battered women is discussed by examining the micro- and macropolitical forces impinging on the operation of a battered women's shelter. Funding agencies, other social services, and interpretive frameworks of staff members formed the organizational context of the micropolitical context. The women's troubles were negotiated at three major stages—intake, processing, and return to the shelter—and the major micropolitical features of this negotiation were a therapeutic ideology, the need for social control, interpersonal conflicts, and personal feelings. Criteria for evaluating and controlling the troubles of women were established in light of self work, the primary objective of shelter residence. Professional expertise was the justification for imposing staff's definitions. Women who rejected the demands of staff were labeled failures and held responsible for the problems they encountered as battered women.

Defining and understanding the therapeutic community.

The term "therapeutic community" has been used to describe a vast array of milieu therapy techniques; thus the term has come to mean different things to different people. The author defines the therapeutic community through an examination of its historical roots in the British military hospitals of World War II and the development of the treatment concept as an ideology. He classifies therapeutic communities as left, right, or center in their therapeutic ideology. It is in the communities of the center, the least dogmatic and most flexible typology, that the author finds hope for the most effective type of therapy.

Retribution, Responsibility and Freedom: The Fallacy of Modern Criminal Law from a Biblical-Christian Perspective

are today subverting the basic principles of the American criminal justice system. Whereas a hundred years ago the expert in mental medicine claimed to be able to deal with violent or deluded patients, or with those who were unmanageably hysterical, depressed to the point of total incapacity or senile to the point of infantalism, now the psychiatrist and the social worker ask to apply their therapeutic model of the criminal and the deviant, as a legal right to treat, reform, and rehabilitate any perpetrator of crime.1 This therapeutic ideology of crime control and treatment rests upon the implicit assumption that crime is a medical issue rather than a matter of legality and morality. The law-breaker, it is claimed, is suffering from a disease of the mind; he or she is therefore to be cured rather than punished, and the treatment is to be determined according to the expertise of modern medical and psychiatric treat-

Changing Therapeutic Ideologies: First-Year Psychiatric Residents

The subjects were a group of first-year residents in psychiatry. The therapeutic ideologies of the residents were serially measured using the questionnaire developed by Strauss. Over the course of the first year of training these residents increased their belief in sociotherapy, decreased their belief in psychotherapy, and experienced no change in their level of belief in somatotherapy. The results are discussed as they relate to the specific training program and to the problems of program evaluation in postgraduate psychiatric training.

On limited-time group psychotherapy: I. Setting, admission, and therapeutic ideology.

On limited-time group psychotherapy: I. Setting, admission, and therapeutic ideology.

Faculty and resident commitment to varieties of psychiatric treatment.

A study was made to evaluate the congruence of faculty attitudes towards psychodynamic psychiatric treatment and the process of identification of resident psychiatrists with these attitudes. Identical questionnaires regarding types of psychiatric treatment and ideology were given to 26 faculty members and 29 residents in a three-year training program. The results showed a striking congruence of attitudes within the faculty with psychodynamic-psychoanalytic treatments rated highly. Resident responses differed for each year of training, but showed a definite development of major ideology similar to that of faculty members as training progressed. Adherence to major theoretical and therapeutic ideologies by residents plays a definite role in developing their identity as psychiatrists.

Implications of prior socialization for residency programs in psychiatry.

ANY.NY STUDY of how persons become socialized into a specialty of medicine should take into account what the trainees bring with them into the training situation. Numerous studies have focused upon the psychological characteristics of individuals who have elected to enter psychiatry.¹There have been studies of the therapeutic ideologies of psychiatrists.²There have also been attempts to link personality characteristics and the espousal of particular psychiatric ideologies.³There has been less concern with the sociocultural characteristics of persons entering psychiatry. Specifically, to our knowledge no investigators have posed the question of what conceptions of psychiatry and expectations concerning psychiatry are characteristic of entering psychiatric residents. This question came forcefully to our attention in the course of a longitudinal study of professional socialization in four different training programs: one training program in internal medicine, one PhD program in biochemistry, and two training programs in psychiatry. (By professional