British Journal of Psychotherapy最新文献

Background: We investigated the relationship between Laryngopharyngeal Reflux (LPR) and maxillary sinus mucosal thickness (MSMT), inferior turbinate mucosal thickness (ITMT), inferior turbinate width (ITW) and nasal septal body thickness (NSBT), which can be signs of chronic rhinosinusitis and allergic rhinitis.

Methods: The study, which included 87 patients, was designed as two groups. While 42 of the patients were included in the Laryngopharyngeal Reflux group, 45 were included in the control group. Age and gender information of the patients were noted. MSMT, ITMT, ITW and NSBT values were measured in patients who had Paranasal Sinus Computed Tomography. MSMT, ITMT and ITW were measured as right and left. Both groups were evaluated in terms of these values.

Results: Right ITMT, bilateral ITW and MSMT values were found to be significantly higher in the LPR group than in the control group (p < 0.05). MSMT values were higher in males (p < 0.05). The left-ITT and NSBT values were not significantly different between the LPR group and the control group, but both values were higher in the LPR group than in the control group (p > 0.05). In the LPR group, there were positive correlations between ITMT and ITW values of the right side; and left side separately (p < 0.05).

Conclusion: It has been shown that Laryngopharyngeal Reflux increases maxillary sinus mucosal thickness, inferior turbinate thickness and width, and nasal septal body thickness, which can be signs of chronic rhinosinusitis and allergic rhinitis. The negative effects of LPR on nasal and paranasal mucosa and structures were demonstrated in this study.

The current study draws on interviews with service users about their experiences to inform the practice of psychodynamic couple therapy for depression. Five participants, who had received at least six months of psychodynamic couple therapy in London (UK) for the treatment of severe distress and depression, completed a semi-structured interview. They were recruited using a purposive sampling technique. Data was analysed using a phenomenological approach to thematic analysis. Six themes were identified in relation to participants' experiences of couple therapy. Key aspects highlighted by participants include: the therapist, described as a ‘third person’, became a referee and mediated the communication within the couple, providing a different perspective, enabling a safe environment for reciprocal listening; the process of making links with the past enabled participants to understand their current behaviour as individual and dysfunctional areas as a couple; the therapist's ability to understand the couple as individuals rather than as a unified entity was key; therapist neutrality and capacity to empathise with the couple was valued by participants. The study highlighted the intertwined dynamic between relationship difficulties and depression. Participants were not able to make a clear distinction between these two experiences, and this microcosm may reflect the difficulties that clients face in accessing public services, which have historically held a more individualistic perspective of distress.

The author reflects on the experience of conducting an infant observation from their perspective of having a sight impairment encapsulated in the phrase ‘seeing feelingly’ taken from Shakespeare's play King Lear. The multi-sensory and somatic world of the infant is explored where sight is secondary to touch in early infancy and how this reflects something of the observer's way of experiencing the world. The impact of disability on how the author sees themselves and is seen by others is discussed in terms of the defences of projection, projective identification and disavowal. The COVID-19 pandemic and the necessity of remote observations via video link add another angle from which emotional connection is explored, leading the author to conclude that, although greater visual clarity was gained, emotional contact was diminished. The paradox of a sight-impaired person ‘observing’ challenges the privileging of the sense of sight, suggesting that a more multi-sensory approach could be of benefit to the conduct of infant observations. In addition, the very title ‘infant observation’ might deter others with sight impairment from participation.

The integration of non-verbal, creative/implicit processes into ongoing psychoanalytic treatment as a highly effective modality to process trauma, also understood as Mentalization as a core element in the correction of pathological thinking caused by trauma (Allen et al., 2008. Mentalizing in clinical practice. Arlington, VA: American Psychiatric Publication) will be presented. This clinical approach is designed to gain access to deeper unconscious, implicit, pre-verbal memories and material that may have been otherwise inaccessible for clinical processing on a purely verbal level. The author will offer an ongoing case study of a client who was initially resistant to direct verbal processing of traumatic memories. He will then demonstrate how the communication of implicit stimuli, in the form of photographs and drawings, can be structured as the primary initial communication of non-verbal material within this treatment. Images were presented by the patient at the beginning of each virtual session, allowed her to access traumatic material without triggering overwhelming anxiety allowing adequate affect regulation and enabling successful clinical processing of this previously inaccessible material. The author offers, from both a neurological and psychoanalytic perspective, demonstrations of clinical processing and intervention techniques that have, up until now, been utilized within the clinical fields of creative art therapy and psychoanalysis on an intuitive level without having a firmer foundation in demonstrable neuroscience. It is the intended purpose of this article to bridge this gap between previous intuitive interventions and neuroscientific research, within our clinical work.