Empathic relational bonds and personal agency in psychotherapy: Implications for psychotherapy supervision, practice, and research.

Although psychotherapy researchers have become increasingly interested in identifying common factors that contribute to effective therapeutic practices, across psycho-diagnostic categories and treatment approaches, relatively little attention to date has been focused on the impact of these research findings for psychotherapy supervision and training programs. To address this gap, in this article we describe key components of an integrative psychotherapy supervision and training program that focuses on the development of a strong therapeutic alliance as an empirically supported, common principle of change in psychotherapy. We review empirical research evidence that addresses the contributions of therapist empathic engagement for the development of secure, relational bonds, heightened client agency, and the development of strong therapeutic alliances, and we discuss the implications of these findings for therapy practice and supervision training. We conclude with specific recommendations for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of sign language interpreter and therapist moods on deaf recipient mood.

This study questions how the mood and affective reactions of the interpreter and the therapist affect the therapeutic process. Professional sign language interpreters are trained to be impartial conduits who neither add nor subtract from the primary dyadic relationship. This study revealed that despondent interpreter mood caused significant negative mood changes in the deaf participant even when the therapist mood was neutral/cheerful. Practicing psychologists need to consider the susceptibility of deaf clients to the nonverbal mood presentation of sign language interpreters and its implications on the therapeutic alliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In search of the unifying principles of psychotherapy: Conceptual, empirical, and clinical convergence.

The search for the principles of unified psychotherapy is an important stage in the advancement of the field. Converging evidence from various streams of clinical science allows the identification of some of the major domains of human functioning, adaptation, and dysfunction. These principles, supported by animal modeling, neuroscience, and developmental psychopathology, along with new theoretical constructs, are demonstrating that human functioning is best conceptualized as holistic and highly interrelated at all domain levels of the total ecological system. Incorporating these findings with evidence accrued over the past century of psychotherapy practice and study allows psychologists to begin to explore the development of a unified system of psychotherapy that is rooted in the clinical sciences. One such attempt to develop a unified framework is presented as a starting point. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The arbitrariness of the sign: Learning advantages from the structure of the vocabulary.

Recent research has demonstrated that systematic mappings between phonological word forms and their meanings can facilitate language learning (e.g., in the form of sound symbolism or cues to grammatical categories). Yet, paradoxically from a learning viewpoint, most words have an arbitrary form-meaning mapping. We hypothesized that this paradox may reflect a division of labor between 2 different language learning functions: arbitrariness facilitates learning specific word meanings and systematicity facilitates learning to group words into categories. In a series of computational investigations and artificial language learning studies, we varied the extent to which the language was arbitrary or systematic. For both the simulations and the behavioral studies, we found that the optimal structure of the vocabulary for learning incorporated this division of labor. Corpus analyses of English and French indicate that these predicted patterns are also found in natural languages. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Pursuing the kernel of truth in the psychotherapy of schizophrenia.

This article concerns the utility of pursuing the kernels of truth in the delusions of schizophrenic patients as a means of empathizing with their unique personal experience of events. Pursuing the kernel of truth implies listening for the real interpersonal experiences past and present that are represented within delusions, as opposed to focusing on derivatives of infantile fantasy. This orientation restores the rights of the schizophrenic person as a perceptive observer of events with a valid, although not commonly understood, point of view. A clinical case example is presented in which the delusion of being raped while others stand idly by both literally and metaphorically described a wide variety of interpersonal experiences which had shaped the patient's life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Making contact: Uses of language in psychotherapy.

Reviews the book, Making contact: Uses of language in psychotherapy by Leston Havens (see record 1986-97288-000). Drawing on ideas from psychoanalytic, existential, and interpersonal theories, the author has provided a thought-provoking and practical book about how to reach, affect, and influence the distant or absent patient through language. This book is not only thought-provoking and practical but also a pleasure to read; Havens possesses a graceful literary style that is vivid, witty, and filled with fresh metaphors. Havens avoids traditional terminology for describing the more disturbed patient in favor of a personal and less objectifying way of speaking. Havens has provided a framework for conceptualizing how language can be used in a disciplined and powerful way to locate the lost selves of our patients. By calling attention to how we speak, he reminds us that language, used empathically and authentically, is the most powerful tool we have to bridge the often wide chasm between us and our patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in the language of a schizophrenic patient during psychotherapy.

A method of linguistic analysis (Bousfield et al, 1958) is applied to the speech of a schizophrenic patient to demonstrate the changes that have occurred in the course of psychotherapy. The analysis showed that as the patient's behavior became less disorganized, so did his speech; however, the content of his speech revealed constriction of ideation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

中日手语手指语、词汇构成和句式表达的比较

通过对中日手语的界定,分析了两国手语在手指语、词汇构成、句式表达等方面的异同点,便于学习者理解和掌握中日手语的基本知识,对中日两国聋人之间的沟通和交流起到促进作用。     

Embracing figures of speech: The transformative potential of spoken language.

The author draws on H. Loewald's theory of language and therapeutic action to elaborate two related senses in which psychoanalytic work requires embracing figures of speech. First, an inherent but frequently unacknowledged capacity of language is to embrace different modes of experience, particularly verbal and sensorimotor experience. Second, the figures or participants of the psychoanalytic conversation must and do embrace each other, with speech. Speech bridges separate individuals, thus enabling interpersonal connection. Examining the operation of spoken language in psychoanalytic treatment with case material, the author illustrates the clinical utility of mobilizing the transformative capacities of the spoken word and concludes that elucidation of these intrapsychic and interpersonal bridging capacities of language explicates the therapeutic action of the talking cure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Language access and theory of mind reasoning: Evidence from deaf children in bilingual and oralist environments.

This investigation examined whether access to sign language as a medium for instruction influences theory of mind (ToM) reasoning in deaf children with similar home language environments. Experiment 1 involved 97 deaf Italian children ages 4-12 years: 56 were from deaf families and had LIS (Italian Sign Language) as their native language, and 41 had acquired LIS as late signers following contact with signers outside their hearing families. Children receiving bimodal/bilingual instruction in LIS together with Sign-Supported and spoken Italian significantly outperformed children in oralist schools in which communication was in Italian and often relied on lipreading. Experiment 2 involved 61 deaf children in Estonia and Sweden ages 6-16 years. On a wide variety of ToM tasks, bilingually instructed native signers in Estonian Sign Language and spoken Estonian succeeded at a level similar to age-matched hearing children. They outperformed bilingually instructed late signers and native signers attending oralist schools. Particularly for native signers, access to sign language in a bilingual environment may facilitate conversational exchanges that promote the expression of ToM by enabling children to monitor others' mental states effectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergence and divergence of themes in successful psychotherapy: An assimilation analysis.

Theme convergence is the linking of seemingly unrelated problem domains as they advance through assimilation stages-a developmental sequence of cognitive and affective changes through which problematic content is hypothesized to pass during successful psychotherapy. Theme divergence is the contradiction or conflict of solutions to different problems, so that progress in one domain leads to stagnation or regression in another domain. An intensive qualitative method called assimilation analysis was used to examine theme convergence and divergence in a successful psychodynamic psychotherapy with a 20–yr–old female patient. Because specific problems often fail to progress monotonically, even in successful psychotherapy cases, it is suggested that clients' problems cannot be resolved in isolation; instead, they may influence each other toward resolution or stagnation in complex and unpredictable ways. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some disparate thoughts on the idea of a unified psychotherapy.

Psychotherapy unification is considered from a number of perspectives. Some origins of human tendencies to value unification are explored including innate "binding" phenomena in the brain and the effects on human thought of our ubiquitous use of metaphor. Possible disadvantages of premature attempts to unify disparate psychotherapy techniques are considered. An argument is advanced favoring case-by-case reconsiderations of "unifying" options. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Leading researchers' consensus on psychotherapy research findings: Implications for the teaching and conduct of psychotherapy.

We examined leading international psychotherapy researchers' views on psychotherapy outcome research. Participants completed a questionnaire on which they rated level of research evidence for or against various assertions about psychotherapy processes and outcomes. Participants rated how confident they were that the assertions were supported by psychotherapy research. Strong, or relatively strong, consensus was achieved on several of the questionnaire items. Areas for which relative uniformity of opinion does or does not exist have potential implications for the teaching and conduct of psychotherapy and for the science-practice interface in psychotherapy. Additionally, consensus about psychotherapy findings can be used as a yardstick by which to measure practicing clinicians' knowledge of the research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Variability in deaf children's spelling: The effect of language experience.

French-speaking hearing and deaf children, ranging in age from 6 years 10 months to 14 years 7 months were required to spell words including phoneme-to-grapheme correspondences that were either statistically dominant or nondominant. Of interest was whether the nature of linguistic experience (cued speech vs. sign language) and the precocity of such experience (early vs. late exposure) determines accuracy in the use of phoneme-to-grapheme knowledge. Cued speech is a system delivering phonemically augmented speechreading through the visual modality. Hearing and deaf children exposed to cued speech early at home relied on accurate phoneme-to-grapheme correspondences, whereas children exposed to cued speech later and at school only, and children exposed to sign language, did not. A critical factor in the development of the phonological route for spelling seems to be early and intensive exposure to a system making all phonological distinctions easily perceivable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Plea for a measure of understanding: The importance of intensive psychotherapy in the treatment of children with ADHD.

Clinicians working with children and adolescents diagnosed with attention-deficit hyperactivity disorder can help these patients by interpreting unacknowledged or forgotten feelings as well as by considering conscious and unconscious family dynamics. Adverse psychosocial events and the awful feelings produced by them as well as conflicting and frightening internal states should not be overlooked or underestimated. Current treatment models may be perpetuating a child's sense of not being understood. It is not surprising that a therapist's empathic understanding and interpretation is an essential part of helpful treatment and necessary to help these patients take over their own affect-regulating functions. For this to come about, the short-term, symptom-oriented models dictated by current practices need to be reconsidered. (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)     

Review of Beyond the reflection: The role of the mirror paradigm in clinical practice.

Reviews the book, Beyond the reflection: The role of the mirror paradigm in clinical practice by Paulina Kernberg, Bernadette Buhl-Nielsen, and Lina Normandin (see record 2007-00911-000). This modestly presented volume overflows with insight and new ways of looking at the mirroring experience for children and adolescents. Kernberg and her collaborators present the rich history of the image, metaphor, and pervasive role of the mirror in human experience; they carefully describe the "subjective experience of wonder, admiration, and an objective dimension of truth" in the mirror paradigm (2006, p. xv). For the psychotherapist, Kernberg's work provides a rich resource; the review of past and current research and theorizing about the mirroring function of mothers and primary caregivers is thorough and up-to-date with the most recent advances in neuroscience, attachment theory, and infant research. From Freud to Lacan, from Winnicott to Stern, and from Schore to Gergely, Kernberg presents a sweeping exposition of the various images of the mirror. This volume is worthwhile if only for its presentation of this body of recent research. But there is so much more to be found here. While this is not the first time that Kernberg has presented us with her work with mirror observation and interviews (Kernberg, 1984, 1987), this volume integrates the research about early mother- child experience, and the mirroring paradigm in the psychoanalytic theories about child development, with the phenomenology of child and adolescent psychotherapy. The clinician will find a useful application of the theory to clinical practice and diagnosis that is hard to find in the literature. Beebe and Lachmann (2002) have accomplished this integration between infant research and adult treatment, but Kernberg's application of her research and the demonstrated correlation between the findings of mirror experience, attachment histories, and clinical experience is a rare and welcome addition to the literature. There are also valuable links made between the findings around mirror experience and children's trauma histories. This reader came away feeling that a tremendous debt is owed to the authors for helping to ground clinical theory and practice in substantial current research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repression, accessibility, and the translation of private experience.

This article explores two underlying assumptions of the structural deficits approach to psychoanalytic psychotherapy (e.g., Gedo, 1984; Kohut, 1984); (a) that the analyst must gain a knowledge of the patient's intrapsychic capacities through empathetic processes, and (b) that inaccessible memories are split off or repressed from expression within the analytic hour because the patient lacks the adequate intrapsychic capacities and structures to tolerate their associated affects. These assumptions are discussed within the context of contemporary views of multiple modes or forms of memory, repression, and the question of accessibility. It is concluded that the mechanisms of repression can operate at the stages of initial encoding as well as the retrieval stage and, consequently, that traumatic memory contents appearing to be relatively inaccessible may be so (a) because of active repression at the time of retrieval or (b) because a minimal number of associative connections have been established with other contents in memory. Thus, a greater portion of private experience is preconsciously available than would be suggested by the deficits approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social problem solving and depressive symptoms over time: A randomized clinical trial of cognitive-behavioral analysis system of psychotherapy, brief supportive psychotherapy, and pharmacotherapy.

Objective: Depression is associated with poor social problem solving, and psychotherapies that focus on problem-solving skills are efficacious in treating depression. We examined the associations between treatment, social problem solving, and depression in a randomized clinical trial testing the efficacy of psychotherapy augmentation for chronically depressed patients who failed to fully respond to an initial trial of pharmacotherapy (Kocsis et al., 2009). Method: Participants with chronic depression (n = 491) received cognitive-behavioral analysis system of psychotherapy (CBASP; McCullough, 2000), which emphasizes interpersonal problem solving, plus medication; brief supportive psychotherapy (BSP) plus medication; or medication alone for 12 weeks. Results: CBASP plus pharmacotherapy was associated with significantly greater improvement in social problem solving than BSP plus pharmacotherapy, and a trend for greater improvement in problem solving than pharmacotherapy alone. In addition, change in social problem solving predicted subsequent change in depressive symptoms over time. However, the magnitude of the associations between changes in social problem solving and subsequent depressive symptoms did not differ across treatment conditions. Conclusions: It does not appear that improved social problem solving is a mechanism that uniquely distinguishes CBASP from other treatment approaches. (PsycINFO Database Record (c) 2011 APA, all rights reserved)