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Psychoanalytic Psychotherapy最新文献

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Three sessions of intensive short-term dynamic psychotherapy (ISTDP) for patients with dissociative seizures: a pilot study 解离性癫痫患者三次强化短期动态心理治疗(ISTDP)的初步研究
IF 0.8 Q4 Psychology Pub Date : 2022-02-10 DOI: 10.1080/02668734.2021.2018623
Javier Malda Castillo, E. Beton, Conor Coman, Beth Howell, C. Burness, J. Martlew, L. Russell, Joel Town, A. Abbass, G. Perez Algorta, Sophie Valavanis
Intensive Short-Term Psychodynamic Therapy (ISTDP) has demonstrated promising evidence for the treatment of several Functional Neurological Disorders (FND) including dissociative seizures. However, its implementation in secondary mental health and specialist services within the English National Health Service (NHS) is scarce. The aim of this pilot study was to explore the estimates of the therapeutic effects of a 3-session course of this treatment as well as establish safety and acceptability for a complex patient group. The study followed a mixed methods case series design and recruited 18 patients from secondary adult mental health care and specialist neurology services. Participants completed self-report outcome measures at the start, at the end and 1 month following the completion of therapy. Three open-ended questions examined their therapy experiences qualitatively and these were analysed through thematic analysis. All participants who started the treatment (N = 17) completed the intervention and attendance rates were very high (95%). No serious adverse effects were observed and the CORE-OM and BSI showed improvements both at the end of the treatment and at follow-up. Healthcare utilisation was also reduced, including acute medications, A&E attendances and crisis-line usage. The results provide preliminary support for the safe use of ISTDP in this complex group of participants, but further evidence from controlled and randomized studies is warranted.
短期强化精神动力疗法(ISTDP)已被证明是治疗包括解离性癫痫在内的几种功能性神经疾病(FND)的有希望的证据。然而,它在英国国家医疗服务体系(NHS)的二级心理健康和专家服务中的实施很少。这项试点研究的目的是探索这种治疗的三个疗程的治疗效果的估计,并确定复杂患者群体的安全性和可接受性。这项研究采用了混合方法的病例系列设计,从二级成人心理健康护理和神经专科服务中招募了18名患者。参与者在治疗开始、结束和完成治疗后1个月完成了自我报告结果测量。三个开放式问题定性地考察了他们的治疗经历,并通过主题分析进行了分析。所有开始治疗的参与者(N=17)都完成了干预,出勤率非常高(95%)。没有观察到严重的不良反应,CORE-OM和BSI在治疗结束和随访时都有所改善。医疗保健的使用率也有所下降,包括急性药物、急诊就诊和危机热线的使用。该结果为ISTDP在这一复杂的参与者群体中的安全使用提供了初步支持,但有必要从对照和随机研究中获得进一步的证据。
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引用次数: 3
The Fitzjohn’s Unit 菲茨约翰单位
IF 0.8 Q4 Psychology Pub Date : 2022-01-02 DOI: 10.1080/02668734.2022.2025888
David L. Bell, Birgit Kleeberg
This article provides a description of the development and work of The Fitzjohn’s Unit a specialist service, housed within the Adult Department of the Tavistock and Portman NHS Foundation Trust, providing psychoanalytic psychotherapy for patients suffering from the more complex/serious disorders many of them having been unwell for many decades. The paper describes the patients treated, the model of care and also aims to show how this work can illuminate more general consideration such as the nature of the psychoanalytic attitude and the relation of psychiatry to psychoanalysis
这篇文章描述了菲茨约翰单元的发展和工作,这是一项专业服务,位于塔维斯托克和波特曼NHS基金会信托的成人部,为患有更复杂/严重疾病的患者提供精神分析心理治疗,其中许多人已经不适了几十年。本文描述了治疗的病人、护理模式,并旨在展示这项工作如何能够阐明更普遍的考虑,如精神分析态度的本质以及精神病学与精神分析的关系
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引用次数: 0
‘When I nod my head, hit it’: leadership and followership in the orchestral environment “当我点头时,就开始”:管弦乐环境中的领导力和追随力
IF 0.8 Q4 Psychology Pub Date : 2022-01-02 DOI: 10.1080/02668734.2022.2028887
L. Hartland-Rowe
Expanding on an interdisciplinary event that was part of the Tavistock Centenary celebrations, this paper explores experiences of leadership and followership in the orchestral context. Drawing on a sample of literature from a range of sources exploring organisational life in the orchestra including organisational psychology, music education, social semiotics and sociology, and with reference to psychoanalytic and systems psychodynamics frameworks, the paper makes links between experiences of leadership and followership in the orchestra and work in the NHS.
本文在塔维斯托克百年庆典的跨学科活动的基础上,探讨了管弦乐背景下的领导力和追随者体验。本文引用了一系列探索管弦乐队组织生活的文献样本,包括组织心理学、音乐教育、社会符号学和社会学,并参考了精神分析和系统心理动力学框架,将管弦乐队的领导和追随者经验与NHS的工作联系起来。
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引用次数: 0
Pandemic: challenges in care and recovery 大流行:护理和康复方面的挑战
IF 0.8 Q4 Psychology Pub Date : 2022-01-02 DOI: 10.1080/02668734.2021.2022743
D. Sinha
Our experiences through the pandemic have to be viewed by reflecting on the year and a half that has been, but also what we have learnt through this experience, with a view to taking forward. The article intends to approach this topic, from a health and social care perspective coming from the author working in The Tavistock and Portman NHS Foundation Trust, a healthcare organisation, but also importantly, from a relational perspective in how we interact organisationally, as a health & social care system that is part of a wider society in this city, across the UK and the wider world. The article not only comments on systemic inequalities that have become stark in the pandemic, but also identifies corrosive and deliberate counter narratives to the themes of care and courage in this period. It concludes that the pre-existing silos of separation between the privileged and dispossessed have prevented survival and wellbeing in the wider society. The process of recovering from the pandemic is not just about the restoration of physical wellbeing but also the creation of healthier conditions in society that actively vitiate against the scourge of everyday sadism.
我们必须通过反思过去的一年半来看待我们在大流行病方面的经验,而且还要反思我们从这一经验中学到的东西,以便继续前进。这篇文章打算从健康和社会护理的角度来探讨这个话题,从作者在塔维斯托克和波特曼NHS基金会信托工作的角度来看,这是一个医疗保健组织,但更重要的是,从关系的角度来看,我们如何在组织上互动,作为一个健康和社会护理系统,是这个城市更广泛社会的一部分,在英国和更广阔的世界。这篇文章不仅评论了在大流行病中变得明显的系统性不平等,而且还指出了对这一时期的关怀和勇气主题的腐蚀性和故意的反叙述。它的结论是,先前存在的特权阶层和被剥夺者之间的隔离阻碍了更广泛社会的生存和福祉。从大流行病中恢复的过程不仅是恢复身体健康,而且是在社会中创造更健康的条件,积极消除日常虐待狂的祸害。
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引用次数: 0
Editorial 社论
IF 0.8 Q4 Psychology Pub Date : 2022-01-02 DOI: 10.1080/02668734.2022.2049064
P. Cundy
In part 2 of this special issue we continue our series of papers from the celebration events for the centenary of the Tavistock Clinic. Exploring the theme of inequalities, the first paper in this issue is entitled ‘Pandemic: challenges in care and recovery’ by Dinesh Sinha. It has long been known that economic disadvantage is linked to higher rates of mortality and poorer access to healthcare (Black, 1982). More recent evidence has suggested that industrialised societies with the greatest income differentials (such as the UK and USA) have the poorest health and social development (Wilkinson & Pickett, 2009). The COVID-19 pandemic, which delayed the Tavistock centenary celebrations, has highlighted once again the inequalities in health within our society. Using the lens of everyday sadism, Sinha identifies corrosive and deliberate counter narratives to the themes of care and courage in this period. He describes how the pre-existing silos of separation between the privileged and dispossessed have prevented survival and wellbeing in the wider society. He cautions health and social care workers about the possible lapse into masochism and bravery as defences against exhaustion and the guilt of having survived when thousands of our colleagues have not. He highlights the need for awareness of our own feelings of guilt and aggression, so that they do not vitiate our capacity to care. Sinha suggests that the process of recovering from the pandemic is not just about the restoration of physical wellbeing but also the creation of healthier conditions in society that actively mitigate the scourge of everyday sadism. The next paper, ‘Under fire in the consulting room’ by Carine Minne, describes her work with patients at the Portman Clinic. The clinic traces its history back to 1933, when the ‘Psychopathic Clinic’ was founded by Edward Glover at the West End Hospital for Nervous Diseases. It was established as the clinical arm of the Institute for the Study and Treatment of Delinquency (ISTD), earlier founded in 1931 as the Institute for the Scientific Treatment of Delinquency. The Institute had been inspired by the work of Dr. Grace Pailthorpe, a psychiatrist and psychoanalyst, who worked in Birmingham and Holloway Prisons. There, she became interested in the personality of women prisoners and in 1932 published Studies in the Psychology of Delinquency. In her article Minne uses clinical vignettes with patients such as a woman who was convicted of infanticide. She illustrates situations when the therapist realised there was a sudden unexpected rise in the ‘temperature’ of a patient’s mind. She likens this to the ignition of a fuse and discusses why this may have Psychoanalytic Psychotherapy, 2022 Vol. 36, No. 1, 1–3, http://dx.doi.org/10.1080/02668734.2022.2049064
在本期特刊的第二部分中,我们将继续我们的系列论文,这些论文来自塔维斯托克诊所百年庆典活动。本期的第一篇论文探讨了不平等的主题,题为“流行病:护理和康复中的挑战”,作者是Dinesh Sinha。人们早就知道,经济劣势与较高的死亡率和较差的医疗保健机会有关(Black, 1982年)。最近的证据表明,收入差距最大的工业化社会(如英国和美国)的健康和社会发展最差(Wilkinson & Pickett, 2009)。2019冠状病毒病大流行推迟了塔维斯托克百年庆典,再次凸显了我们社会中健康方面的不平等。辛哈用日常虐待狂的镜头,识别出这一时期关心和勇气主题的腐蚀性和故意的反叙述。他描述了先前存在的特权阶层和被剥夺者之间的隔离如何阻碍了更广泛社会的生存和福祉。他告诫卫生和社会护理工作者,他们可能会陷入受虐和勇敢,以抵御疲劳和负罪感,因为我们的数千名同事都没有活下来。他强调,我们需要意识到自己的内疚和攻击性,这样它们才不会削弱我们关心他人的能力。辛哈认为,从大流行病中恢复的过程不仅是恢复身体健康,而且是在社会中创造更健康的条件,积极减轻日常虐待狂的祸害。下一篇文章是卡琳·明(Carine Minne)的《咨询室里的战火》(Under fire in The consultation room),描述了她在波特曼诊所(Portman Clinic)治疗病人的工作。这家诊所的历史可以追溯到1933年,当时爱德华·格洛弗(Edward Glover)在伦敦西区神经疾病医院创立了“精神病诊所”。它是作为犯罪研究和治疗研究所(ISTD)的临床部门而成立的,ISTD成立于1931年,当时是犯罪科学治疗研究所。该研究所的灵感来自于在伯明翰和霍洛威监狱工作过的精神病学家和精神分析学家格蕾丝·佩尔索普博士的工作。在那里,她对女性囚犯的性格产生了兴趣,并于1932年出版了《犯罪心理学研究》。在她的文章中,Minne使用了病人的临床小插曲,比如一个被判杀婴罪的妇女。她举例说明了治疗师意识到病人的思想“温度”突然意外上升的情况。她把这比作导火索的点燃,并讨论了为什么这可能有精神分析心理治疗,2022年第36卷,第1期,1 - 3页,http://dx.doi.org/10.1080/02668734.2022.2049064
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引用次数: 0
Under fire in the consulting room 诊室着火了
IF 0.8 Q4 Psychology Pub Date : 2021-12-06 DOI: 10.1080/02668734.2021.2005671
C. Minne
A slow match is a very slow-burning fuse presenting only a small glowing tip whereas a quick match is one, which once ignited, burns at top speed. In this paper, I will present a number of clinical vignettes to illustrate situations when the therapist realised there was a sudden unexpected rise in ‘temperature’ of a patient’s mind and why this may have occurred. A fuse was lit but was it a slow or a quick one? I will relate this ignition to the possibility of premature interpretations, or a failure to notice how anxious the patient was in the presence of the terrifying object-therapist and also, patients’ unexpected responses to external interferences during a session. Descriptions of how these situations unfolded during sessions are given, and how, upon reflection, these could have been diffused differently. The emphasis will be on how best to maintain a psychoanalytic stance but also how to clinically judge when a session must be terminated in order to protect patient and therapist from exploding ‘bombs’ inadvertently ignited by patient or therapist. The importance of supervision and consultation with colleagues will be stressed.
慢火柴是非常慢燃烧的导火索,只有一个小的发光尖端,而快火柴是一个,一旦点燃,燃烧的速度最快。在本文中,我将展示一些临床小插曲,以说明当治疗师意识到患者的思想“温度”突然意外上升时的情况,以及为什么会发生这种情况。导火索被点燃了,但它是慢的还是快的?我将把这种点火与过早解释的可能性联系起来,或者未能注意到患者在可怕的对象治疗师面前有多焦虑,以及患者在治疗过程中对外部干扰的意外反应。这些情况是如何在会议期间展开的描述,以及如何,经过反思,这些情况可以以不同的方式传播。重点将是如何最好地保持精神分析的立场,以及如何临床判断何时必须终止一个会话,以保护患者和治疗师免受患者或治疗师无意中点燃的爆炸“炸弹”。强调监督和与同事协商的重要性。
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引用次数: 0
Group dynamic interpersonal therapy (GDIT): adapting an individual interpersonal therapy to a group setting in an NHS IAPT service: a pilot study 群体动态人际治疗(GDIT):在NHS IAPT服务中适应个体人际治疗的群体设置:一项试点研究
IF 0.8 Q4 Psychology Pub Date : 2021-11-30 DOI: 10.1080/02668734.2021.2001685
Julie Folkes-Skinner, Letitia Collins
Dynamic interpersonal therapy (DIT) was developed for individual clients. This pilot project set out to evaluate if DIT could be adapted to group psychotherapy. Three consecutive groups were run in an NHS IAPT service over two years. Twenty-seven clients (10 men and 17 women, median age 34) were offered treatment. Groups were facilitated by accredited DIT therapists. Clients completed the PHQ9 and the GAD7 at assessment and then weekly. Scores were used to evaluate the impact of GDIT on client symptoms. Data collected during routine treatment was later analysed. The delivery of key aspects of the model that included the formulation of the IPAF and the Goodbye Letter were changed. Results suggest that DIT can be adapted to a group setting and that this way of working may have significant benefits for clients. 74% of patients (n = 19) who completed treatment were above Caseness on the PHQ9 (p = < .00001, d = 1.82) and 58% on the GAD7 (p = < .000001, d = 1.63). Only one client (5%) dropped out of treatment. Given the small size of the sample and no control, the reduction in client symptoms cannot be reliably attributed to GDIT. More research is needed.
动态人际治疗(DIT)是针对个人客户开发的。这个试点项目旨在评估DIT是否可以适用于团体心理治疗。连续三组在NHS IAPT服务中运行超过两年。27名患者(10名男性,17名女性,中位年龄34岁)接受治疗。小组由认可的DIT治疗师协助。患者在评估时完成PHQ9和GAD7,然后每周完成。评分用于评估GDIT对患者症状的影响。随后对常规治疗期间收集的数据进行分析。该模式的关键方面,包括IPAF的制定和告别信的交付都发生了变化。结果表明,DIT可以适应于群体环境,这种工作方式可能对客户有显著的好处。完成治疗的患者中,74% (n = 19)的PHQ9评分高于Caseness (p = < 0.00001, d = 1.82), 58%的GAD7评分高于Caseness (p = < 0.000001, d = 1.63)。只有一名患者(5%)退出治疗。由于样本量小且无对照,病人症状的减轻不能可靠地归因于GDIT。需要更多的研究。
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引用次数: 1
Psychoanalytic psychotherapy in the Russian Federation 俄罗斯联邦的精神分析心理疗法
IF 0.8 Q4 Psychology Pub Date : 2021-11-25 DOI: 10.1080/02668734.2021.1978527
C.A. Lemeshko, S. M. Babin, N. Semenova, Y.O. Fedorov, E.A. Kalinina, A.M. Koryoukin, D.V. Sevryougin
The article provides an overview of the current state of psychoanalytic psychotherapy in the NHS of the Russian Federation (RNHS). The authors discuss successful examples of the implementation of psychoanalytic methodology in psychiatry during the Soviet Union and the Russian Federation. Psychodynamically oriented professionals of the RNHS and outside of RNHS are mainly concentrated in large cities. Despite a long tradition and a growing body of evidence for efficacy, the medical community is hostile to psychoanalytic ideas in psychiatry. However, psychoanalytic psychotherapy is in great demand in a society.
本文概述了俄罗斯联邦国家医疗服务体系(RNHS)精神分析心理治疗的现状。作者讨论了在苏联和俄罗斯联邦期间精神分析方法在精神病学中的成功实施。RNHS和RNHS以外的心理动力学专业人员主要集中在大城市。尽管有着悠久的传统和越来越多的疗效证据,但医学界对精神病学中的精神分析思想持敌对态度。然而,精神分析心理治疗在一个社会中需求很大。
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引用次数: 0
Psychodynamic factors in tinnitus aurium 耳鸣的心理动力学因素
IF 0.8 Q4 Psychology Pub Date : 2021-11-08 DOI: 10.1080/02668734.2021.1988683
E. Seidl, D. Schwerthöffer, O. Seidl
Tinnitus aurium is the conscious perception of an acoustic sensation in the absence of a corresponding external stimulus. Besides other psychological factors, psychodynamic factors play an important role in the disease. This study evaluated patients with tinnitus who attended the tinnitus outpatient clinic at the ENT Department of LMU Munich. In addition to a physical examination, in a psychodynamic interview the trigger situations, parents’ parenting style, relation to hearing personality, and individual conflict dynamics associated with the onset and course of tinnitus were examined. We included 99 patients diagnosed with tinnitus. Besides organ-related triggers, we identified conflict-laden stresses as trigger situations. 53% of the patients described themselves as sensitive to noise before the start of the tinnitus. Compared with the general population, patients with tinnitus showed less overt aggressiveness (P < .001) and more social orientation (P < .001) and state and trait anxiety (P < .001). Inhibition of aggression was a major psychodynamic factor in the development of tinnitus. A conflict of autonomy was found in the majority of cases. The results underline the importance of psychodynamic factors in tinnitus. We were able to put the individual psychological factors into a meaningful overall context.
耳鸣是在没有相应的外部刺激的情况下对声音感觉的有意识感知。除其他心理因素外,心理动力因素在该病中起重要作用。本研究评估了在慕尼黑大学耳鼻喉科耳鸣门诊就诊的耳鸣患者。除体格检查外,在心理动力学访谈中还检查了耳鸣发病和病程相关的触发情况、父母的养育方式、与听力人格的关系以及个体冲突动力学。我们纳入了99名诊断为耳鸣的患者。除了器官相关的触发因素外,我们还确定了冲突压力作为触发因素。53%的患者称自己在耳鸣开始前对噪音敏感。与普通人群相比,耳鸣患者表现出明显的攻击性降低(P < 0.001),社会取向增加(P < 0.001),状态焦虑和特质焦虑增加(P < 0.001)。攻击抑制是耳鸣发病的主要心理动力因素。在大多数情况下发现了自治冲突。结果强调了精神动力因素在耳鸣中的重要性。我们能够将个体心理因素置于有意义的整体背景中。
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引用次数: 1
In the footsteps of Bick: continuing the legacy of infant observation 跟随比克的脚步:继续婴儿观察的遗产
IF 0.8 Q4 Psychology Pub Date : 2021-10-02 DOI: 10.1080/02668734.2021.1986741
D. Daws, Alexandra de Rementeria
The authors, both child psychotherapists but from different generations, describe the legacy of Esther Bick in their learning, teaching and clinical practice. In telling two very personal stories about the importance of infant observation in their work, they span 60 years and trace the arc of Bick’s legacy over that period.
两位作者都是儿童心理治疗师,但来自不同的时代,他们在学习、教学和临床实践中描述了埃斯特·比克的遗产。他们讲述了两个非常个人的故事,讲述了观察婴儿在他们工作中的重要性,他们跨越了60年,并追溯了比克在那个时期留下的遗产。
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引用次数: 0
期刊
Psychoanalytic Psychotherapy
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