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The search for a relational home : an intersubjective view of therapeutic action
In this text, Chris Jaenicke gives the reader an inside view of what actually happens in psychotherapy and how change occurs. He describes how both participants - the patient and the therapist - feel, and how they affect each other. The reader is encouraged to vicariously partake in the process from the perspective of his or her own life experiences. The book describes the nature of therapeutic action through a radicalized version of intersubjective systems theory.
Book
Affect-Focused Psychodynamic Internet-Based Therapy for Adolescent Depression: Randomized Controlled Trial
Adolescent depression is one of the largest health issues in the world and there is a pressing need for effective and accessible treatments.
This trial examines whether affect-focused internet-based psychodynamic therapy (IPDT) with therapist support is more effective than an internet-based supportive control condition on reducing depression in adolescents.
The trial included 76 adolescents (61/76, 80% female; mean age 16.6 years), self-referred via an open access website and fulfilling criteria for major depressive disorder. Adolescents were randomized to 8 weeks of IPDT (38/76, 50%) or supportive control (38/76, 50%). The primary outcome was self-reported depressive symptoms, measured with the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR). Secondary outcomes were anxiety severity, emotion regulation, self-compassion, and an additional depression measure. Assessments were made at baseline, postassessment, and at 6 months follow-up, in addition to weekly assessments of the primary outcome measure as well as emotion regulation during treatment.
IPDT was significantly more effective than the control condition in reducing depression (d=0.82, P=.01), the result of which was corroborated by the second depression measure (d=0.80, P<.001). IPDT was also significantly more effective in reducing anxiety (d=0.78, P<.001) and increasing emotion regulation (d=0.97, P<.001) and self-compassion (d=0.65, P=.003). Significantly more patients in the IPDT group compared to the control group met criteria for response (56% vs 21%, respectively) and remission (35% vs 8%, respectively). Results on depression and anxiety symptoms were stable at 6 months follow-up. On average, participants completed 5.8 (SD 2.4) of the 8 modules.
IPDT may be an effective intervention to reduce adolescent depression. Further research is needed, including comparisons with other treatments.
International Standard Randomised Controlled Trial Number (ISRCTN) 16206254; http://www.isrctn.com/ISRCTN16206254.
Journal Article
A consultation model integrating psychoanalysis and psychophysiology in oncology
The experience of cancer may lead to affective dysregulation within the somatopsychic unit. This study outlines a psychological consultation model for cancer patients and their caregivers, integrating psychoanalytic psychology and psychophysiology. This study presents the proposed consultation model, consisting of five weekly sessions. The clinical psychologist assesses the individual’s current and past intrapsychic, interpersonal, and psychophysiological functioning, as well as the impact of cancer, through clinical interviews and a computerized multiparameter polygraph for biofeedback. Clinical actions that can be undertaken to achieve both assessment and treatment objectives are described. Our consultation model has the potential to enhance the diagnostic process, improving the precision of selecting psychological interventions and yielding outcomes in terms of secondary prevention by early identification of at-risk situations. These implications may result in the development of services that align with the demands and limitations of the public healthcare system.
Journal Article
Transference focused psychotherapy: Overview and update
This paper describes a specific psychoanalytic psychotherapy for patients with severe personality disorders, its technical approach and specific research projects establishing empirical evidence supporting its efficacy. This treatment derives from the findings of the Menninger Foundation Psychotherapy Research project, and applies a model of contemporary psychoanalytic object relations theory as its theoretical foundation. The paper differentiates this treatment from alternative psychoanalytic approaches, including other types of psychoanalytic psychotherapy as well as standard psychoanalysis, and from three alternative non-analytical treatments prevalent in the treatment of borderline patients, namely, dialectic behavior therapy, supportive psychotherapy based on psychoanalytic theory, and schema focused therapy. It concludes with indications and contraindications to this particular therapeutic approach derived from the clinical experience that evolved in the course of the sequence of research projects leading to the empirical establishment of its efficacy.
Journal Article
Psychoanalysis in times of technoculture: Some reflections on the fate of the body in virtual space
Because the individuals we see in our daily practices may be 'misusing' new technologies to manage their troubled relationship to reality, it is all too easy to adopt a dystopic view of these developments. Texting may be content poor or a way of not relating, but it can also be rich in its interpersonal significance, in the very act of making contact.2 For a discipline like psychoanalysis - one predicated on the fundamental human tension between the lure of the 'pleasure principle' and the dampener of the 'reality principle' (Freud, 1923) - the virtual is to the real what the copy is to the original: it is a reproduction that allows wishes to colonize reality.
Journal Article
Invasive Objects
The \"Director\" controls Ms. B's life. He flatters her, beguiles her, derides her. His instructions pervade each aspect of her life, including her analytic sessions, during which he suggests promiscuous and dangerous things for Ms. B to say and do, when he suspects that her isolated state is being changed by the therapy. The \"Director\" is a diabolical foreign body installed in the mind who purports to protect but who keeps Ms. B feeling profoundly ill and alone.
The story of Ms. B's analysis is one of many vivid illustrations presented in this collection of papers by Paul Williams, who shares his lifetime of experience working with severely disturbed patients. As the title suggests, the unifying thread of these papers is the investigation of serious mental disturbance, often characterized by the presence of intrusive and invasive thoughts and fantasies that originate in a traumatic past but which can colonize and destroy the rational mind. The diverse papers are grouped into two related sections. Part one is comprised of papers with a clinical orientation, including a summary of the analysis of Ms. B as well as a speculative paper on the psychosis and recovery of John Nash. In part two, applied psychoanalytic thinking is integrated with Williams' other professional passion, anthropology, in a paper that exemplifies generative thought through art, poetry, and tribal masks. Other papers in this section include a short essay that takes Freud-bashers to task, a reappraisal of the Rat Man, and a lively discussion of André Green's \"central phobic position\" in borderline thinking.
Whether engaging in the coconstructed therapeutic relationship or the implications for \"madness in society\" at large, Williams' diverse influences - psychoanalytic and otherwise - repeatedly come to the fore in an intellectually stimulating and clinically enriching way. It goes without saying that work with patients whose thinking is psychotic is a challenge,
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