Review of Transformative relationships: The control-mastery theory of psychotherapy.

Reviews the book, Transformative relationships: The control-mastery theory of psychotherapy by George Silberschatz (see record 2005-00928-000). This book is an edited text that thoroughly reviews theory, research, and practice on control-mastery theory, a psychodynamic method developed at the San Francisco Psychoanalytic Institute. Overall, this is an impressive research program summarized in this chapter in a very accessible manner. The research program is a good case study of an effort to build an evidence-based treatment close to clinical reality. In addition, the book as a whole is probably the best way to get a summary of all aspects of control-mastery theory as well as a clear and interesting exposition of different aspects of the theory, research, and practice. One important clinical implication of the testing concepts is that the meaning of a therapist's interventions will vary depending on what specific pathogenic beliefs the client is testing. Control-mastery theory is highly case specific; a technique that is helpful to one client may not be appropriate or helpful to another. How effective the therapy is will be determined not by the technique used but by the extent to which the therapist can disconfirm the client's pathogenic beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Time on my hands: The dilemma of the chronically late patient.

In this article the author discusses the problems and dilemmas created by patients who are chronically late for analytic hours or frequently absent from them. The discussion focuses on a single case study, in which this phenomenon was a predominant feature of the analytic process. The author explores some of the issues, dynamic and defensive, underlying such behavior as well as motivational components involving unresolved oedipal issues and powerful unsatisfied narcissistic needs. The temporal difficulties of patients such as this one demonstrate the role of time as a point of conjunction of aspects of the analytic relation involving the temporal dimension of the real structure of the analytic situation and its intersection with transferential and alliance considerations. The analytic task is to balance the temporal requirements of the analytic process against the array of the patient's infantile and narcissistic needs on one hand and legitimate claims for autonomy and freedom on the other. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment, psychotherapy, and assessment: A commentary.

This article, a commentary, discusses questions and issues generated by 7 articles (see records 2006-22003-002, 2006-22003-003, 2006-22003-004, 2006-22003-005, 2006-22003-006, 2006-22003-007, 2006-22003-008) on the relationship between attachment theory and research, and psychotherapy and clinical assessment. The issues include the following: attachment-based therapeutic interventions for adults and child-caregiver dyads, change in attachment status as an outcome goal of therapeutic intervention, attachment pattern as a moderator of treatment outcome and therapeutic approach, clinical use of attachment measures, narrative/discourse and self-report measures of attachment patterns, and application of attachment theory to new areas. In the discussion of each of these issues, suggestions are made for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comments on "The necessary and sufficient conditions of therapeutic personality change."

This commentary describes the impact of Carl Rogers' classic article (see record 2007-14630-002) on the field of psychotherapy in general and on control-mastery theory and research in particular. The relevance of Rogers' model in the current psychotherapy literature and debates is addressed as are some of the limitations of the model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multidimensional content-analysis system applied to the analysis of therapeutic technique in psychotherapy with schizophrenic patients.

Describes a 5-dimensional content-analysis system for the study of naturally occurring spoken discourse about sociopsychological aspects of human life in use in a long-term, atheoretic study of psychotherapy. The ways in which decisions concerning research methodology are determined by the long-term, atheoretic character of the research are discussed. Empirical findings are presented concerning the reliability of the system's coding categories, the consistency of therapist verbal behavior as measured by the content-analysis system, and the sensitivity of the system to differences in therapeutic technique related to difference in theoretical orientation. The exploratory analysis to isolate a variable related to an aspect of therapeutic outcome is described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Transforming narcissism: Reflections on empathy, humor, and expectations. Vol. 28: Psychoanalytic inquiry book series.

Reviews the book, Transforming narcissism: Reflections on empathy, humor, and expectations. Vol. 28: Psychoanalytic inquiry book series by Frank M. Lachmann (see record 2008-01083-000). This book is a welcome addition to the conversation on working with self-pathology. Lachmann brings a personal, conversational voice to the dialogue; there is much here to benefit students and seasoned clinicians alike. It is not a treatment manual for narcissism, but rather Lachmann’s own transformational dialogue with Heinz Kohut. Using Kohut’s (1966) article “Forms and Transformations of Narcissism” as a starting point, Lachmann elaborates Kohut’s contention that archaic narcissism is transformed through psychotherapy into empathy, humor, creativity, wisdom, and acceptance of our transience. He focuses on the first three elements as a means as much as a product of transformation in therapy, and the latter two elements are discussed as hopeful outcomes of the transformational process therapy engenders. Although there are limitations in terms of this book’s utility as a treatment guide for interventions with patients with narcissistic disorders, as a series of reflections on transformational processes it is often quite compelling. Lachmann the therapist advocates using empathy, humor, and creativity, not to try to impress or demonstrate his cleverness, but rather as bridge to transformational intimacy with his patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Narcissism: Reflections on others' images of an elusive concept.

This review covers 3 works pertaining to narcissistic phenomena, primarily narcissistic disturbance but also, by implication, normal narcissism. Those of Bach and Johnson are discussions, more personal than systematic, of the conceptualization and treatment of narcissistic character disorders. Bach's is addressed primarily to a psychoanalytic audience; Johnson's, while leaning on psychoanalytic concepts, is addressed more to a general audience of psychotherapeutic practitioners. The third work, Nathanson's edited collection, discusses not narcissism but a closely related topic--perhaps its conceptual twin--shame. The purpose of this review, in addition to assessment of the merits of these 3 volumes, is to use these contributions to clarify current thinking about narcissism and narcissistic pathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The face of 2010: A Delphi poll on the future of psychotherapy.

A panel of 62 psychotherapy experts using Delphi methodology predicted psychotherapy trends in the next decade. The observers forecasted changes in theoretical orientations, therapeutic interventions, psychotherapy providers, treatment formats, and future scenarios. Cognitive-behavior, culture-sensitive, cognitive, and eclectic/integrative theories were predicted to increase the most, whereas classical psychoanalysis, solution-focused theories, and transactional analysis were expected to decline. Directive, self-change, and technological interventions were judged to be in the ascendancy. Master's-level psychotherapists along with "virtual" therapy services were expected to flourish. Forecast scenarios with the highest likelihood centered on expansion of evidence-based therapy, practice guidelines, behavioral medicine, and pharmacotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploring the structure of strength-related attitude features: The relation between attitude importance and attitude accessibility.

One of the most significant current controversies in the attitude literature involves the latent structure of attitude attributes related to their strength. Four studies were conducted to explore whether 2 strength-related attributes (importance and accessibility) are affected identically by various manipulations (which would suggest that they reflect a single latent construct) and whether the attributes cause one another (which would suggest they are distinct constructs). Three laboratory experiments and 1 survey study show that (a) repeated expression and personal relevance manipulations have different effects on importance and accessibility and (b) increased importance can cause heightened accessibility. Thus, these 2 attitude attributes appear to constitute related but independent constructs. These studies therefore help to illuminate the nature of attitude strength and the interplay of its sources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Beyond the therapeutic relationship: Behavioral, biological, and cognitive foundations of psychotherapy.

Reviews the book, Beyond the therapeutic relationship: Behavioral, biological, and cognitive foundations of psychotherapy by Frederic J. Leger (see record 1997-36714-000). Leger has tackled the very large task of presenting an integrative, eclectic theory of psychotherapy which specifies the behavioural, biological, and cognitive processes that underlie psychotherapeutic change. In doing so, he follows in the tradition of other integrationists who have strived to outline frameworks that can encompass the diversity of explanatory emphases and practices in the dozens of present-day psychological therapies. In part, Leger's goal in proposing a "higher-order theory" is to lessen the "confusion which threatens to overwhelm the field" and to hasten a "convergence of scientific opinion." Leger supports his higher-order theory by drawing from a massive amount of literature in areas as seemingly diverse as nonverbal interaction, cognitive science, physiology, neurology, and discursive psychology, as well as from his own clinical experience. And it is the scope of his knowledge and his attempt to focus the reader's attention on the importance of the often ignored influence of therapists' nonverbal behaviours and the frequently taken-for-granted effects of maximal client self-disclosure that are the most impressive features of the book. However, the reviewer feels that the book may not have much impact, first because there have been several previous attempts by other writers to propose models of eclectic psychotherapy or to develop frameworks for integrating diverse forms of psychotherapy, and second because the style in which it is written quickly becomes rather tiresome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research summary on the therapeutic relationship and psychotherapy outcome.

Factors that influence client outcome can be divided into four areas: extratherapeutic factors, expectancy effects, specific therapy techniques, and common factors. Common factors such as empathy, warmth, and the therapeutic relationship have been shown to correlate more highly with client outcome than specialized treatment interventions. The common factors most frequently studied have been the person-centered facilitative conditions (empathy, warmth, congruence) and the therapeutic alliance. Decades of research indicate that the provision of therapy is an interpersonal process in which a main curative component is the nature of the therapeutic relationship. Clinicians must remember that this is the foundation of our efforts to help others. The improvement of psychotherapy may best be accomplished by learning to improve one's ability to relate to clients and tailoring that relationship to individual clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Classic in Psychotherapy Integration Revisited: The Dynamics of Psychotherapy in the Light of Learning Theory.

Discusses the history of psychoanalytic treatment and the dynamics of psychotherapy. The essential psychodynamic principles on which psychoanalytic treatments rest have solid observational foundations: 1) during treatment unconscious (repressed) material becomes conscious; 2) the mobilization of unconscious material is achieved mainly by interpretation of material emerging during free association and by the patient's emotional interpersonal experiences in the therapeutic situation (transference); 3) the patient shows resistance against recognizing unconscious content; and 4) it is only natural that the neurotic patient will sooner or later direct his typical neurotic attitude toward his therapist. Current studies give encouragement and hope that we shall eventually be able to understand more adequately this intricate interpersonal process and to account for therapeutic successes and failures. In the field of psychotherapy the long overdue observation of the therapeutic process by nonparticipant observers is turning out to be the required methodological tool. At present, we are witnessing the beginnings of a most promising integration of psychoanalytic theory and practice of the psychotherapies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Guilty by mere association: Evaluative conditioning and the spreading attitude effect.

Five experiments investigated the phenomenon that attitude formation is not confined to the co-occurrence of an attitudinal object with an evaluated experience. The pairing of a target with a (dis)liked person not only affects the evaluation of the previously neutral person but spreads to other individuals who are (pre)associated with the target (spreading attitude effect). Exps 1 and 2 provided evidence for the spreading attitude effect in appetitive as well as aversive evaluative conditioning. Exp 3 showed that the spreading attitude effect is a robust phenomenon resistant to extinction. Exp 4 demonstrated that attitude spread can be transferred to 2nd-order conditioning. Finally, Exp 5 supports the notion that the spreading attitude effect is not dependent on cognitive resources. Implications for social as well as applied psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The interpretation of opinion statements as a function of message ambiguity and recipient attitude.

The purpose of this study was to replicate an earlier one by the author (Manis, 1960) to determine the validity that the interpretation of ambiguous statements permits of greater interpretation in the light of personal opinions than nonambiguous statements. College Ss having 3 opinions towards fraternity (positive, negative, neutral) were presented with statements regarding fraternities. Half the Ss were presented with nonambiguous statements, half with the same statements with every other word omitted (ambiguous). In general, the results supported the hypothesis. From Psyc Abstracts 36:04:4GD76M. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic Reactance as a Predictor of Outcome in the Treatment of Chronic Depression.

This study examined whether reactance would negatively influence treatment outcome in 347 patients diagnosed with chronic forms of depression and treated at 9 sites with either Nefazodone, cognitive-behavioral analysis system of psychotherapy (CBASP), or combination therapy. Contrary to our hypotheses, reactance positively predicted treatment outcome in CBASP on 2 of 4 scales. These effects were independent of the therapeutic alliance, which also positively predicted outcome. Reactance did not predict outcome in the groups receiving medication alone or in combination with CBASP. The findings suggest that reactance may be an asset in psychotherapy among chronically depressed individuals and that reactant patients can benefit from directive psychotherapy when therapists flexibly respond to perturbations in the therapeutic relationship. Results support the importance of Aptitude × Treatment interactions in psychotherapy outcome. The direction and significance of such interactions may vary with different forms of psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Dialogues on difference: Studies of diversity in the therapeutic relationship.

Reviews the book, Studies of diversity in the therapeutic relationship by J. Christopher Muran (see record 2006-11731-000). This book has taken the opportunity to begin with dialogue among clinicians with different theoretical perspectives on issues of diversity, including psychoanalytic, cognitive– behavioral, and humanistic viewpoints. In introducing the book, Muran sets the stage for the dialogues with an open discussion of his own culturally diverse background. He also describes the diversity characterizing his professional training in cognitive– behavioral psychotherapy and psychoanalysis, which in part contributed to his recognition of a need for this dialogue across perspectives. The book is divided into eight dialogues consisting of one psychoanalytically oriented writer or set of writers, followed by comments on this essay by two theorists from different and overlapping theoretical points of view. The final component of each dialogue consists of the author’s reply to the comments. The dialogues address eight separate topics including race, social privilege and multiple identities, homosexuality, intersection of race and gender in psychotherapy with African American men, identity in psychotherapy with Latino clients, role of stereotypes in psychotherapy with Asian Americans, Middle Eastern identity and psychotherapy, and communication and metacommunication in psychotherapy. One of the intriguing features of this book is that the dialogue is in written form, giving the reader the advantage of reading it several times to better engage with each author’s point of view. Because the format resembles that of an oral presentation of a single paper followed by discussions of the paper, I found myself wanting to ask questions of each of the authors. Several of the authors appear to have been enriched through this dialogue,because the very nature of this exchange parallels the concept of mutual influence that lies at the heart of relational psychoanalysis. The quality of dialogue across the different sections of this book is rich and complex and highlights the critical need for ongoing dialogue on cultural difference and similarity in the discipline of psychology, not to mention our broader society. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screen time: Clinical notes regarding Meissner's (2006) chronically late patient: Reply to commentary by M. H. Spero.

Responds to the comments made by Moshe Halevi Spero (see record 2008-00996-014) on the current author's original article, Time on my hands: The dilemma of the chronically late patient (see record 2006-20697-003). First of all, I would like to express my gratitude to Professor Spero for his thoughtful, penetrating and thought-provoking commentary on my chronically late patient. Whenever one's efforts elicit such a sensitive and probing reflection, the effect can hardly be anything but gratifying. Spero's reflection brings to bear a deconstructive perspective that effectively captures the uncertainty, ambiguities, and conflicting pressures created in an analytic process that had become abbreviated, fragmented, diffused, frustrated, and constantly hovering seemingly on the brink of disruption. His approach thoughtfully probes the periphery and penumbra of significance surrounding the playing out of events in this analytic process, and his inquiry thus brings into focus a number of salient issues that could not be engaged or whose meaning could not be effectively ascertained because of the dissolute quality of the analytic effort. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

American Psycho: Malignant narcissism on the screen.

Presents an interpretation of American Psycho (1990). The film is described as a screen illustration of malignant narcissism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immigration and the psychodynamics of class.

Numerous psychoanalytic contributors have theorized about the substantive role played by cultural factors in organizing individual identity. In addition to individual and family dynamics, issues related to class, race, religion, and other cultural themes also exert a vital presence in the treatment setting. These social forces define experience in profound ways from which it is impossible that form an inextricable part of an individual's psychology. Societal values, norms, and forces are carried and represented, forming an ever-present backdrop to our psychological lives. They thus become, perforce, part of the treatment process whether or not the therapist or analyst is aware of their presence. In prior work I have explored the topic of the immigrant's construction of self as it relates to social class (Ainslie, 2009). I argue that one of the variables that shape an immigrant's psychology is his or her social class position in his or her country of origin. In the present contribution, I seek to extend this exploration of the topic of social class and the psychology of immigration through three vignettes that capture aspects of how social class becomes represented in the experience and therapeutic treatment of immigrants. (PsycINFO Database Record (c) 2011 APA, all rights reserved)