佛教思想对心理治疗观的影响

心理治疗的主要目的是减轻人们的心理痛苦。佛教如同任何宗教一样都有帮助人们减轻精神痛苦的作用。心理治疗源自西方的相对科学的体系,其理念重在以不同的方式帮助人们更好地适应环境,或更好地满足自己的需要。佛教中的理念引导人们应对心理痛苦的方式是接受放下,是一种人生态度。在心理治疗中渗入这一理念,会更有效地帮助来访者,至少在受佛教思想影响的中国文化背景下。本文将以心理治疗实践中的案例为例具体阐述佛教思想对心理治疗观的影响,并与心理动力学治疗和其他的心理治疗方法的一些理念进行比较。     

Reality,Dream, and Trauma

Comparing various psychoanalytic perspectives on envy and malignant envy, the author argues for a developmental reconsideration of envy that locates its emergence in the breakdown of intersubjectivity. This breakdown is connected with the inability of the mother/analyst to hold and contain the child's/patient's affective states such that the child/patient is deprived of being recognized as a subject. Moreover, the dyad is unable to experience fully the pleasure and enjoyment of a reciprocal, mutual, and intimate relationship. This developmental failure interferes with the patient's capacity to experience and act on her desire. Unable to to sustain a link with the other's mind, the child cannot take in and then hold on to good, pleasurable experiences. The author illustrates his argument with two clinical examples, those of a child patient and of an adult patient. The child case highlights the breakdown of intersubjectivity as a developmental precursor to envy, whereas the adult vignette emphasizes the relationship between destructive envy and the perversion of desire.     

Within a Hospital Setting

A psychoanalyst may function as an enlivening object, to awaken the growth of relatedness in patients whose curtailed object relations confine them to primitive forms of engagement. The model is informed by the insights of the child psychoanalytic psychotherapist Anne Alvarez in her treatment of disturbed youth. The idea of the analyst in an enlivening role is viewed within a contemporary context of expanded perspectives on the analyst's role and evolving notions of therapeutic action.     

Touching the Other's Suffering: Cross‐Cultural Challenges in Palliative Treatment Along Geopolitical Crossroads

The authors describe the cross-cultural considerations in caring for a Palestinian breast cancer patient by an Israeli heath care team. The processes that facilitated a metamorphosis from possible hostility to receptiveness based on historical cultural conflicts were rooted in professionalism, patient-centered care, and cross-cultural sensitivity, woven into the patient’s own health beliefs and affinity to traditional Islamic medicine.     

‘THE LONG GOODBYE’: COGNITIVE ANALYTIC THERAPY WITH CARERS OF PEOPLE WITH DEMENTIA

This paper discusses the use of Cognitive Analytic Therapy (CAT) with carers of people with dementia and raises the wider issue of service delivery and provision of psychological therapy services to carers. Carers experience loss and emotional pain ( McCurry, 2008 ; Miesen, 2006a ; Woods et al., 2003 ) while providing full‐time care to the person with dementia who has complex and changing needs. This frequently results in major depression and anxiety, increasing the possibility of referral to mental health services. Treating carers’ distress is vital not only for their mental health but to enable them to continue in their caring role, without which the current care system would collapse. This need is being addressed in Newham by the tertiary psychology service, Psychotherapy for Older Adults (PTOA), set up in 2006–07 to accept referrals of people over 65 with mental health problems. This paper outlines how the PTOA is well placed to identify and treat carers. We propose that CAT is an effective and flexible therapy in this setting, and illustrate this with a case study. Further research and models for psychotherapeutic service delivery for carers are required.     

Contemporary Psychotherapy Research: Implications for Substance Misuse Treatment and Research

This article provides an overview of the major findings of psychotherapy research and discusses the possible implications of these findings for substance user treatment researchers and practitioners. While the centrality of relationship for human change processes was historically understood, twentieth century research tended to see relationship and person variables as secondary to operationalized “mechanisms of action” unique to particular psychotherapies. Interestingly, recent meta-analytic investigations have uncovered the weakness of randomized controlled trials (RCT) comparison investigations that have, until recently, represented the “gold standard” for the field. There has been a resurgent interest in the “common factors” that appear to be important across many effective psychotherapies. In addition, psychiatric anthropologists have contributed important information about the problems of client noncompliance with mental health treatment that parallel quantitative investigations. Substance misuse researchers have also found that client characteristics, especially clients' readiness to engage treatment, are important to investigate. The importance of the “therapeutic alliance” and the characteristics of clients and clinicians have become central areas for study, rather than variables to be controlled or excluded. Emphasis on these factors may represent the future for research in psychotherapy and substance user treatment, especially if researchers and community practitioners can join together to overcome methodological feasibility and dissemination problems that plague effectiveness research. However, the continued attractiveness of comparative studies and treatment efficacy studies may represent longstanding epistemological assumptions and responses to economic incentives that will be difficult to challenge.     

Roots and routes to resilience and its role in psychotherapy: a selective,attachment-informed review

Developmental research on resilience is summarised and illustrated with a case example. Self-reflection, positive relationships, and agency foster resilience in the face of adversity. Attachment and resilience are related categories. The different patterns of attachment – secure, insecure-organised and insecure-disorganised – are manifest in different patterns of resilience, depending on prevailing environmental conditions. However, the greater the environmental adversity, the less will the resilience factors emerge. Clients tend to present for psychotherapy when resilience strategies have failed. The therapeutic relationship has neurochemical and relational characteristic mirroring the secure mother–infant bond. These foster mentalising, stress innoculation, affect co-regulation, self-esteem, and agency, forming the basis for enduring and more flexible resilience strategies.