From anger to inspiration: Uprooting hatred on the lonely road to peace
Ivan Milton
One of the most troublesome emotions in the work of psychotherapy is anger. In this article, IVAN MILTON draws on Buddhism and the work of Paul Ekman to illustrate how anger, as a primary human emotion, has some evolutionary advantage both for us as a species and as individuals. He considers how the two sides of anger—it’s survival value and it’s potential for harm—can be reconciled. Anger gives positive energy to responding to injustice, but problems arise when anger transforms into hatred. In Buddhism, anger is seen as a major obstacle to human flourishing, being characterised as one of the three poisons that contaminates and destroys our peace of mind. Anger with the desire to harm is seen as our worst enemy, the real cause of all our suffering—and the only enemy worth defeating. It is for these reasons that it is so important to tame and manage our anger more effectively. The practice of tolerance and patience when engaging our enemy brings long-lasting happiness and peace of mind for everyone.
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From the inside out: The therapist’s attachment patterns as sources of insight and impasse by David Wallin
David Wallin
In this chapter from the recent book, ‘Clinical Pearls of Wisdom’, DAVID WALLIN highlights how the impact of the therapist’s own troubling origins and attachment patterns tends to be slighted in the clinical literature and clinical practice, despite the fact that the primary creative instrument of the therapist is a self whose resources and liabilities are forged in the crucible of personal history. He suggests that the therapist’s attachment patterns are often shaped by trauma, and in so doing, challenges the conventional view that the vulnerabilities in the therapeutic couple reside in the patient. Wallin argues that while this ‘fiction’ may serve the hopes of the patient and the self-protective needs of the therapist, it diverts attention from the important reality that it is the interaction of the attachment patterns of both partners—their strengths and vulnerabilities, their integrations and dissociations—that ultimately determines the extent to which a new and healing attachment relationship will develop in psychotherapy. When enactments engage the core vulnerabilities of the patient and the therapist, there is a risk of rupture, to be sure, but there is also the potential to provide the patient with a corrective relational experience and the therapist with a chance to further his or her own ever-unfinished psychological work.
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Is the theoretical rationale upon which CBT is founded ‘evidence-based’?
George Magdulski
In the current literature, countless studies demonstrate the efficacy of cognitive behavioural therapy using randomised controlled clinical trials. In this article, GEORGE MAGDULSKI, explores whether it is appropriate to apply the scientific evidence-based model to psychotherapeutic interventions. While not disputing the evidence that CBT ‘works’, Magdulski raises important questions of whether it works in the way it is purported. He concludes that the literature does not support the view that an initial cognitive appraisal gives rise to an emotional response. It is suggested that some urgent theoretical reconsideration is needed for the CBT community to preserve its evidence-based status.
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Record keeping in psychotherapy
Robert King
On being asked for an expert opinion on the quality and adequacy of notes maintained by a practitioner, ROBERT KING found that neither interrogation of relevant codes of practice, nor a search of wider published literature provided much guidance. In fact, there is remarkably little written on the subject of clinical records in psychotherapy. This article seeks to open up discussion on this topic and make some recommendations that might assist practitioners navigate this difficult territory. While codes of practice recommend the keeping of confidential, adequate, essential and relevant records, there is little to guide a practitioner as to what is ‘essential and relevant’, or how to strike a balance between records that meet the test of adequacy, but do not contain material that is unnecessary, irrelevant or inaccurate. More clarity is needed on the benefits and risks associated with record keeping. A minimum set of requirements are proposed with reference to three separate elements within a record of psychotherapy. Consideration is also given to record keeping in the context of supervision.
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The efficacy of psychodynamic psychotherapy
Jonathan Shedler
Empirical evidence supports the efficacy of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as ‘empirically supported’ and ‘evidence-based’. In addition, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends. Finally, non-psychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings.
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The renaissance of western politics: The 'good-enough' leader, relational economics and an empathic policy
Andrew Samuels
Over the past fifteen years the Jungian analyst, Professor Andrew Samuels, has worked as a political consultant to leading politicians, their advisers, parties and activist groups. In this article, he argues that personal growth, change, transformation, therapy or analysis, all depend on the ability to imagine a utopic move out of the social and political conditions in which we find ourselves. If psychoanalysis is to engage with the public sphere, the time has come to break some boundaries and learn how to transit the divides between the ‘forbidden zones’ of: clinical office and street; spirituality and politics; ‘above’ and ‘below’; ‘inner’ and ‘outer’; being and doing; extraversion and intraversion; feminine and masculine approaches to life. Samuels provides a psychoanalytic exploration of: the contemporary ‘political disease’ of hierarchical, heroic leadership and the need for a new story of the father; how the inner world works when it comes to economics—from economic sadism to relational economics; denationalizing the psyche; and the theme of sacrifice.
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