Theory and technique in psychodynamic treatment of panic disorder. (1/73)

The authors elaborate psychodynamic factors that are relevant to the treatment of panic disorder. They outline psychoanalytic concepts that were employed to develop a psychodynamic approach to panic disorder, including the idea of unconscious mental life and the existence of defense mechanisms, compromise formations, the pleasure principle, and the transference. The authors then describe a panic-focused psychodynamic treatment based on a psychodynamic formulation of panic. Clinical techniques used in this approach, such as working with transference and working through, are described. Finally, a case vignette is employed to illustrate the relevance of these factors to panic disorder and the use of this treatment.(The Journal of Psychotherapy Practice and Research 1999; 8:234-242)  (+info)

Individual and large-group identity: parallels in development and characteristics in stability and crisis. (2/73)

A comprehensive understanding of international and interethnic conflict must include a psychological dimension. This paper explores concepts of individual and large-group identity, their inherent connection, and some essential large-group rituals that aim to repair and maintain them. Human psychological development not only involves dynamics associated with one's parents, family, and intimate environment, but also those of one's ethic, religious or national group. Although this may simply be called "acculturation", the evolution of large-group identity involves specific psychological processes. When a large group perceives that its identity is threatened, the group and its individual members typically experience anxiety which is then expressed in certain ritualistic behaviors that can range from benign to highly malignant. Social scientists, diplomats and others who seek to analyze social and political phenomena and formulate policies related to them could benefit from a better understanding of these aspects of human interaction.  (+info)

Countertransference and limits of therapy in war situation. (3/73)

Psychotherapy of war traumas and their specific emotional and psychological experiences is a challenge for the therapist. The two partners of the therapeutic dyad may undergo the same difficulties and suffer from the same anxieties, and be affected by the transference and countertransference processes. The conditions of neutrality that should be maintained in the treatment are thus prone to changes. The therapist may protect himself/herself from unconscious guilt, omnipotent fantasies and feelings of being overwhelmed by different modes of defenses. The historical and social context of the trauma have to be taken into account. A chronology to be introduced in the narrative is the first step in the process of reindividuation as the victim's identity has been attacked by the trauma as well as his/her physical integrity. The therapist may find in this intervention a reflection of his/her own needs. The aims of psychotherapy in war situations may be close to those of crisis intervention and at the same time deal with the reactivation of previous infantile traumas. The past plays a significant part in the readaptative process as much as it is relevant to the present. The therapeutic intervention is in essence a message of hope as it implies a potential future to be created.  (+info)

Therapists' responses during psychotherapy of holocaust survivors and their second generation. (4/73)

Human personality contains three layers of identity: the collective, the familial, and the individual, intra-psychic. All three have been directly traumatized and damaged in Holocaust (Shoah) survivors and indirectly through overt and covert transmission in their children. Survivors and the second generation usually contain a few of these identity components in a state of fragmentation, which become central in the therapeutic dialogue between therapists and the patients. When the therapist belongs to the same traumatized population there exists a unique complexity of an a priori countertransference. Sharing the same traumatogenic reality that the patient seeks to alleviate through therapy poses unique difficulties and challenges for the therapist. In working with survivors, pre-war intra-familial traumatizations are of little significance in the face of the massive traumas and death suffered in the Holocaust. In the case of the second generation, "ordinary" developmental impairments and difficulties cannot be fully understood without knowledge of the parents' war experiences and the resultant family atmosphere. Thus, every therapist has to examine both his knowledge and especially his responses not only about the Shoah as a massive trauma but the specific war history of both parents families. Self-knowledge and awareness are necessary to a far greater extent than usual if one is not to be shocked or surprised into acting out. The depth and degree of openness which therapists need when dealing with Holocaust survivors and their children are at least as important as clinical skills.  (+info)

Countertransference problems in the treatment of a mixed group of war veterans and female partners of war veterans. (5/73)

AIM: Analysis of countertransference problems in the treatment of a heterogeneous group of war veterans. METHOD: The method used in this work was psychodynamic clinical observation and analysis of countertransference phenomena in group therapy. RESULTS: In the beginning of our work, we faced with a regressive group, which was behaving as it was re-born. The leading subject in the group was aggression and the need for hospitalization to protect them and their environment from their violence. With the development of group processes, a feeling of helplessness and lack of perspective appeared, together with suicidal ideas, which, because of the development of group cohesion and trust, could be openly discussed. With time, the group became a transitional object for its members, an object that gave them a feeling of safety but also a feeling of dependence. CONCLUSION: The role of the therapist is to support group members in becoming independent. The therapist's function is in controlling, containing, and analyzing of the destructive, regressive part and in encouraging the healthy parts of the patient. With the integration of good therapeutic process, the healthy parts of the patient gain control over his or her regressive parts.  (+info)

Psychoanalytic psychotherapy with migrant war victims: transference and countertransference issues. (6/73)

This report raises questions about the relevance of the psychoanalytic theory and method with migrant war victims, and addresses the issue of personal limits of the psychotherapist who treats these often very ill patients. A clinical vignette and its psychoanalytic understanding introduce the question of transference and counter- transference in the therapeutic work with traumatized war victims. Psychological treatment of war victims is a very important issue. On the one hand, patients who have been tortured or otherwise traumatized are often considered to be reluctant to accept psychological help, even if they are severely disturbed. On the other hand, the psychotherapists who agree to work with such patients must be prepared to face very specific difficulties. Psychoanalytic psychotherapy may be very efficient in treating war victims, but requires not only motivated but, above all, well-trained therapists. Otherwise, the therapist may become the next victim of the patient's trauma and, for his or her own sake, work towards immediate repression instead of working through the traumatic event ending up in the repetition compulsion.  (+info)

Complexity of therapist's feelings in the work with war-traumatized patients. (7/73)

AIM: To present the complexity of therapist's feelings and emotions in the work with war-traumatized persons and the importance of psychological mechanisms taking place in such circumstances. METHODS: The method of psychoanalytical psychotherapy was used, adapted to the work with war-traumatized persons. The therapy sessions were held once a week and lasted for 50 minutes. The patients were given transference interpretations differing from customary transference interpretations. They were modified to provide support, aiming at overcoming of the feelings overwhelming each patient. RESULTS: The diversity of the therapist's feelings amalgamated into countertransference was one of the most important psychological mechanisms in the therapy procedures, and served as an indicator of the patient's feelings in the procedure. It was related to the processes of projective identification as a framework of the complex patient-therapist relationship CONCLUSION: + In the work with a war-traumatized patient, it is inevitable that the patient's feelings are partly shared by the therapist through projective identification. This can lead to the "burnout" syndrome and threaten the boundaries of the therapist's psychological system. The role of the therapist includes not only knowledge but also the personal experience of work on himself. Through the process of therapy and by using interpretations as the powerful tool, the therapist is capable to accept such traumatic feelings and help the patient overcome them, but also to remain within the framework of his role.  (+info)

Countertransference and empathic problems in therapists/helpers working with psychotraumatized persons. (8/73)

Countertransference in therapists working with patients with posttraumatic stress disorder (PTSD) differs from countertransference in other psychotherapeutical settings. In this article we discuss the specificities of counter- transference in treating PTSD patients and its relation to empathy. The most difficult countertransference problems occur in treating multiply traumatized patients. Countertransference may occur towards an event (e.g., war), patients who have killed people, as well as to colleagues who avoid treating PTSD patients, or towards a supervisor who avoids, either directly or indirectly, supervision of therapists working with PTSD patients. Our recommendation for the prevention of problems in treating PTSD patients include : 1) careful selection of the therapist or helper, both in the personality structure and training; 2) prevention by debriefing and team work and peer supervision; and 3) education - theoretical, practical, and therapeutical.  (+info)

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