Since Freud, clinicians have understood that disturbing memories contribute to psychopathology and that new emotional experiences contribute to therapeutic change. Yet, controversy remains about what is truly essential to bring about psychotherapeutic change. Mounting evidence from empirical studies suggests that emotional arousal is a key ingredient in therapeutic change in many modalities. In addition, memory seems to play an important role but there is a lack of consensus on the role of understanding what happened in the past in bringing about (...) therapeutic change. The core idea of this paper is that therapeutic change in a variety of modalities, including behavioral therapy, cognitive-behavioral therapy, emotion-focused therapy, and psychodynamic psychotherapy, results from the updating of prior emotional memories through a process of reconsolidation that incorporates new emotional experiences. We present an integrated memory model with three interactive components – autobiographical memories, semantic structures, and emotional responses – supported by emerging evidence from cognitive neuroscience on implicit and explicit emotion, implicit and explicit memory, emotion-memory interactions, memory reconsolidation, and the relationship between autobiographical and semantic memory. We propose that the essential ingredients of therapeutic change include: reactivating old memories; engaging in new emotional experiences that are incorporated into these reactivated memories via the process of reconsolidation; and reinforcing the integrated memory structure by practicing a new way of behaving and experiencing the world in a variety of contexts. The implications of this new, neurobiologically grounded synthesis for research, clinical practice, and teaching are discussed. (shrink)

Intersubjectivity refers to the variety of possible relations between perspectives. It is indispensable for understanding human social behaviour. While theoretical work on intersubjectivity is relatively sophisticated, methodological approaches to studying intersubjectivity lag behind. Most methodologies assume that individuals are the unit of analysis. In order to research intersubjectivity, however, methodologies are needed that take relationships as the unit of analysis. The first aim of this article is to review existing methodologies for studying intersubjectivity. Four methodological approaches are reviewed: comparative self-report, (...) observing behaviour, analysing talk and ethnographic engagement. The second aim of the article is to introduce and contribute to the development of a dialogical method of analysis. The dialogical approach enables the study of intersubjectivity at different levels, as both implicit and explicit, and both within and between individuals and groups. The article concludes with suggestions for using the proposed method for researching intersubjectivity both within individuals and between individuals and groups. (shrink)

_Intersubjective Processes and the Unconscious _looks at how the minds of the therapist and the patient interact with each other in a profound and unconscious way: a concept first described by Freud. This book expands Freud’s ideas further and examines how these have been greatly elaborated by contributions from the Kleinian School as well as from the work of Bion. It explores how, together, patient and therapist co-create a narrative through these unconscious intersubjective processes. Topics of discussion include: the unconscious (...) dimensions of intersubjective processes an historical overview of Freudian, Kleinian and Bionian contributions an integrated theory of the nature of unconscious intersubjective processes the central importance of dreaming in intersubjective processes the clinical implications of this intersubjective model The author offers in-depth clinical examples and case vignettes to illustrate the application of these principles when working with trauma, countertransference dreams and supervision. As such, this book will be invaluable to all psychoanalysts and psychotherapists interested in the topic of intersubjectivity as well as those who want to learn more about the interactional dimensions of Freud, Klein and Bion. (shrink)

"The Making of a Psychotherapist is a new look at the psychological processes involved in the therapist's work. It is essential reading for all those therapists who regard education as a lifelong process, and who are constantly ready to reexamine themselves and their work." "In the first part of The Making of a Psychotherapist, "Personal Qualities," the author reminds us that the word psychotherapy means healing the soul. He follows Melanie Klein's view that the individual has moral responsibility for the (...) state of his own mental health, and that it is the psychotherapist's role to demonstrate this to his or her patients. He then goes on to discuss the traditions and practice of psychotherapy, the psychotherapist's education, the analyst's inner task, imagination and curiosity of mind, mental pain and moral courage, self-esteem in analyst and patient, and the transference." "In the second part, "Professional Dilemmas," the author discusses values and his conviction that the disease of moral amorphism has caught hold of the psychotherapy movement."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

This study begins from the observation that there is almost a complete absence of research studies in Music Therapy that address the salient elements of creative clinical practice. The most important questions to the practicing clinician--such as the source of the Music Therapist's clinical music and the interaction between the meaning of this music and therapeutic growth--are ones that the prevailing, traditional research philosophy is not prepared to illuminate. The result is a schism between research and practice that renders this (...) research irrelevant to the majority of working clinicians. ;Since, it is argued, research exists to serve clinical practice, the present author advocates for the establishment of a new conceptual foundation for research that will ensure its relevancy to actual clinical practice. There are four components to this task addressed in this study: the philosophy of science guiding traditional research is explicated; next, a theory-neutral portrait of creative clinical practice is presented; the traditional philosophy is then critiqued in terms of its adequacy for investigating clinical practice; and lastly, a new conceptual foundation is offered that will support research efforts geared to uncovering the inner mechanisms of creative clinical practice. (shrink)

There has been enormous progress in psychotherapy research. This has culminated in recognition of several treatments that have strong evidence in their behalf. Even so, after decades of psychotherapy research, we cannot provide an evidence-based explanation for how or why even our most well studied interventions produce change, that is, the mechanism(s) through which treatments operate. This chapter presents central requirements for demonstrating mediators and mechanisms of change and reviews current data-analytic and designs approaches and why they fall short of (...) meeting these requirements. The role of the therapeutic alliance in psychotherapy and cognitive changes in cognitive therapy for depression are highlighted to illustrate key issues. Promising lines of work to identify mediators and mechanisms, ways of bringing to bear multiple types of evidence, recommendations to make progress in understanding how therapy works, and conceptual and research challenges in evaluating mediators and mechanisms are also presented. (shrink)