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The Efficacy of Psychodynamic Psychotherapy

by

Jonathan Shedler, PhD

University of Colorado Denver

Please click on the link below to go to Dr. Shedler's webpage and to view his article entitled: The Efficacy of Psychodynamic Psychotherapy.

Link to Dr. Shedler's website.

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Frank and Renee Summers

invite you

to join independent producers Kathy Berger and Ines Sommer

for a special screening of an 11-minute trailer. Please help them raise finishing funds for

 

Beneath the Blindfold

Beneath the Blindfold is a human rights documentary that movingly tells the personal stories of torture survivors from around the globe. The film explores the toll that torture takes on the individual and society at large. The survivors in this film are immigrants and political asylum seekers in the United States, where they struggle to make new lives for themselves and heal their deep physical and psychological wounds. As we follow them in their daily lives, we are witness to their stories of despair but we are also inspired by their courage and resilience.

Sunday, November 22

4:00 p.m.

                                      2126 Orrington Ave.

                                                Evanston

                                     R.S.V.P. 847-869-5291

All donations for completion of Beneath the Blindfold are tax deductible as provided by law. Media Process Educational Films Inc., a 501 C(3) not-for-profit organization, has graciously agreed to be the fiscal sponsor. All checks should be made out to Media Process Educational Films.

 

If you are unable to attend but would still like to donate, please mail your checks (made out to Media Process Educational Films) to Kathy Berger, 574 Ingleside Park, Evanston, IL 60201.  

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Scientific Program Committee
 
presents
 
Scientific Programs 2009-2010
Tuesday Evening Presentations at 7 pm
National Louis University, 122 S. Michigan Avenue
Room 5006
Chicago, Il
 
Admission is free
CE Credits for Physicians, Psychologists and Social Workers
 
 
 

Chicago Psychoanalytic Society Listing of Events

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The University of Indianapolis is proud to introduce a new book by
Dr. David Downing and Dr. Barry Weber
 
Object Relations and Self Psychology
 
Object-relations and Self-psychology: A User-friendly Primer is a much-needed primary text that is a strong introduction to complex theories.  The book anchors developmental theory and associated treatment methods alongside the DSM-IV-TR to assist clinicians and students more familiar with this tool in translating these ideas into psychoanalytical ones.  The reader will develop an appreciation for the DSM's limitations, finding theories in the author's text to be of greater clinical value, as the authors articulate the complexity of the lived experience and internal worlds of the persons they treat in their consulting rooms - considerations generally absent in the emphasis on observable behaviour and treatment-by-manual we commonly find today.  The authors introduce the reader to a dynamic theory that produces results and offer a wealth of citations to point readers in directions that build on new foundations they will receive.  While not written exclusively as a text on short-term psychoanalytical psychotherapy, clinicians working in this modality also will find it an invaluable resource.

click here to download book summary

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State University of New York Press announces a new book by 
Richard D. Chessick

THE FUTURE OF PSYCHOANALYSIS.

THE FUTURE OF PSYCHOANALYSIS explores the contemporary problem of multiple theories of psychoanalysis and argues for a return to a more classical position based on Freud's work.Using his training in psychiatry, psychoanalysis, and philosophy, Richard D. Chessick examines the special combination of hermeneutics and natural science that characterizes Freud's psychoanalysis, and investigates what goes on in the mind of the psychoanalyst during the psychoanalytic process. He maintains that while relativistic and intersubjective theories of psychoanalysis have value, they have gone too far and generated a plurality of theories removed from Freud, which has led to chaos in the field. THE FUTURE OF PSYCHOANALYSIS challenges these trends and places this debate in the context of current mind/brain controversies and unresolved questions about human nature.

Click here to email a request for this book

Click here to enter the SUNY Press website

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Routledge announces two new titles from
Christopher Bollas
THE INFINITE QUESTION
and its companion volume,
THE EVOCATIVE OBJECT WORLD

In his latest book Christopher Bollas uses detailed studies of real clinical practice to illuminate a theory of psychoanalysis which privileges the human impulse to question. From earliest childhood to the end of our lives, we are driven by this impulse in its varying forms, and The Infinite Question illustrates how Freud's free associative method provides both patient and analyst with answers and, in turn, with an ongoing interplay of further questions.

In The Evocative Object World Christopher Bollas builds on Freud's account of dream formation, combining it with perceptive clinical, theoretical and cultural insights to show how the psychoanalytical method can provide a rich understanding of what has traditionally been regarded as 'the outside world'.

bollas_books_advert.jpg

Click here to link to the Routledge Psychoanalytic catalog

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THE CHICAGO PSYCHOANALYTIC SOCIETY

 PRIZE IN APPLIED PSYCHOANALYSIS

The Chicago Psychoanalytic Society is pleased to announce its $500 Prize in Applied Psychoanalysis for essays in the humanities and social sciences that impact and extend psychoanalytic thought. The prize will be awarded yearly and is open to members of CPS, as well as to non-psychoanalyst scholars in the greater Chicago area.

Papers should not exceed 25 double-spaced pages, exclusive of references and bibliographical material. All artwork, including tables, figures, drawings and photographs, is to be submitted either as photographic slides or in a format that can be reproduced as a print-resolution graphic file. The entries should not have been previously published or submitted for publication.

The winning applicant will be awarded the Chicago Psychoanalytic Society Prize of $500. The award will be presented at the Chicago Institute for Psychoanalysis, where the winner will present her/his paper at a meeting that will be open to the public.

The committee will begin accepting submissions now. The deadline for submissions is July 1, 2007. Applicants will be informed of the results of the contest by October 1, 2007. The winning applicant will present his/her paper in the spring of 2008. Late entries can be entered in the next competition. 

Submissions should be sent to:

 Christine C. Kieffer, Ph.D.

Chair, CPS Prize in Applied Psychoanalysis

Chicago Psychoanalytic Society

122 South Michigan Avenue

Suite 1413

Chicago, Illinois 60603

Email: CCKPHD@aol.com

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National Coalition of Mental Health Professionals and Consumers, Inc.

coalition.jpg

Full April 2006 Coalition Report - click here to download

Coalition Application - click here.

Highlight from the April 2006 Coalition Report
 

From the President: Standing up for Our Craft

William A. MacGillivray, PhD, ABPP

 

I recently attended the Division of Psychoanalysis Spring Meeting. One of the featured speakers was Jane Fonda. I initially was quite resistant to the idea of attending this talk and annoyed at the presenters for organizing a panel that included someone who was asked to attend because of her “star power.” I was aware that she had recently written a memoir, which included a dramatic story of her investigation into her family history and the impact of her mother’s suicide on her life. But, what could Jane Fonda have to say about psychoanalysis? Well, she had quite a lot to say, nothing terribly original, but she quoted all the right people and addressed reasonably well the importance of a feminist voice in psychoanalytic thinking. What was more fascinating and truly eloquent, was her tribute to her therapist and the impact of therapy as a voyage of discovery. She observed that all her life she would have called herself a feminist, but it was only after therapy that she could feel it in her bones.

 

There was a lot more to her talk, but what I want to convey that seemed so exciting to hear was her insistence that psychotherapy, the “talking cure,” is a radical and life-changing experience. This simple observation struck me as quite novel in the context of the current crisis in our field. Psychotherapy is under assault. We all know that. What we are less aware of, I think, is the insidious nature of this assault on our work. Many therapists have internalized a negative view of the value their work. I realize this is a strong statement and I can evade objection further by insisting that this devaluation operates on an unconscious as well as conscious level (after all, I am a psychoanalyst!). Here is an example. Many of our professional organizations have tended to present our work in a more “positive” context, insisting that psychotherapy is not the only thing we do since we are involved in prevention and social action. My own Division of Psychoanalysis was recently featured in the Monitor on Psychology (the American Psychological Association monthly magazine) touting the outreach efforts of our members. The message seemed to be that we are good and valuable to the extent we are not “sitting behind the couch” and instead are out there working in other ways for social change.

 

I do not criticize the efforts of psychotherapists who perform crisis work during disaster, who help out in homeless shelters, or who spend quality time with a foster child. These and countless other service activities are important and vital. But they are not psychotherapy and they cannot replace psychotherapy in the lives of our patients. Returning to Jane Fonda’s “story,” it was psychotherapy that radicalized her, that transformed her life in ways she is only now beginning to explore. That’s what psychotherapy can do! Why are we not able to stand up for this core aspect of our identity? What keeps us from speaking out, from writing to our local papers, for example, whenever a new drug is touted as a cure, or whenever a quick technique is praised over the demands of time and patience?

 

In this article, I am going to suggest some of the external forces that have immobilized many of our colleagues, including the medicalization of emotional problems and, paradoxically, the very success of psychotherapy in the culture. In the next issue, Michaele Dunlap will address some of the internal forces especially the difficulty psychotherapists in collaborating with one another, with professional turf battles interfering with ability to work together. In that issue, I will also address another “internal saboteur” in the internecine battles between the practitioner and researcher.

 

Medicalization of Our Society

This should come as no surprise to any of us. Our patients, our society, have been saturated with the notion that our emotional difficulties are lodged in our brains and that once our “chemicals” are balanced all will be well. The recent movie, A Beautiful Mind, illustrates the power of the medical model. In the movie, the implication is quite clear that John Nash, the brilliant mathematician who had been diagnosed with schizophrenia and suffered for years with mistreatment at the hands of the medical profession, including involuntary hospitalization, was successfully treated with medications and his return to sanity was achieved when he finally became “medically compliant.” In the PBS documentary, A Brilliant Madness, however, a markedly different story is told. We are informed that Nash stopped taking his medications long before he was “restored” to sanity and is still off drugs. More eloquent than that, the documentary ends with the words of John Nash on his cure: It was love that did it. Nash relates that throughout his illness it was the patient understanding of his wife and friends that eventually led him back to sanity. Even in this fine production, there was continued obeisance to the medical model; including stern warnings that Nash’s “refusal” to take his medication was a dangerous, albeit successful, decision. There was a particularly (unintentionally) funny scene as the narrator describes the onset of Nash’s delusions and the scene shifts to a picture of the brain, as if to insist, there are those pesky hallucinations!

 

There is little doubt that medicine has effected significant changes in people’s lives and the ability of life-saving drugs to stave off and even reverse physical conditions associated with cancer, heart disease, vascular illness, diabetes, etc., is truly remarkable. I also think few psychotherapists would argue that medications to relieve crippling symptoms of fear, anxiety, and emotional distress should not be available to our patients. But the data is in, psychotherapy works, more therapy works better than less therapy; patients’ controlling their therapy works better that others’ controlling the therapy. Patients may not get the immediate relief of medications; but psychotherapy brings sustained benefits beyond relief. And even psychoanalysis ends, while a lifetime regimen of multiple medications is truly interminable. As you can read in an article in this issue, the devastating side effects of medication continue and the new “atypical antipsychotics” have all too typical side effects that are life limiting, if not life shortening.

 

Here is another example. I recently attended a conference at Harvard Medical School on child and adolescent psychopharmacology and lecturer after lecturer proceeded to define and delimit the various childhood disorders refreshingly unconcerned that the diagnostic system they rely upon is hopelessly inaccurate. And how do researchers reconcile the fact that the diagnostic categories are hopelessly jumbled up? By solemnly invoking the concept of “comorbidity”: the disorder is in the patient and not in the language categories that define the same behavior as occurring in a range of diagnostic conditions. Worse was the routine tossed off line, “Of course, CBT will help with this condition.” Worst was presenting research indicating that long-term depth psychotherapy works best for bulimia with the sad conclusion, “…but managed care doesn’t pay for this.” Remember, this was at Harvard!

 

As psychotherapists, we can bemoan our fate and blame “the media” or “Big Pharma” for the neglect of the value of therapy in our society. Many of our psychiatrist colleagues have given up practice of psychotherapy altogether, citing the lack of reimbursement. Some of our colleagues attempt to cope by gaining prescription privileges, insisting that they will not go the way of the psychiatry (“The right to prescribe is the right not to prescribe.” Yea, yea). But the fault also lies with us, with our professional organizations and our own willingness to buck the tide and take a stand to protect psychotherapy.

 

The Dr. Phil Syndrome

Now, I don’t want to pick on Dr. Phil. For all I know he’s a great therapist. I have only seen him once. I do think, however, he is an exemplar of a particular mindset concerning psychotherapy. First, it should be fast, a sound bite between commercials. Secondly, it should be directive and superficial. Once again, I’m all for being directive and I cannot vouch for the profundity of my interpretations. The troublesome message that I think comes through with this commercialization of psychotherapy is that “anybody can do it.” This certainly has been the mantra of managed care industry as it willingly pays the same rates for “practitioners,” regardless of their level of training, their years of experience, and/or whether or not they have a mental health degree at all.

 

There is a peculiar confluence of interests with patients wanting a “quick fix,” since the culture continually informs them that this is their “right” and a natural progress of progress in all areas of their lives, and managed care, which preaches the same mantra for its own benefit. Even institutions that are not beholden directly to managed care have joined the zeitgeist that suggests that therapy can be both fast and delivered by “highly-trained” technicians.

 

Reclaiming Lost Ground

The National Coalition is the one organization that seeks to combat the external forces that devalue the practice of talk therapy in the name of both patients and therapists. We also maintain that all those who support the principles of privacy, access, quality and choice have a place in this struggle and we do not participate in organizational struggles and turf battles that can divide and weaken our message. If you are reading this article, you are already more or less committed to these goals. I want to challenge you, however, to put these goals into action. In the next issue of the newsletter, I will list some of the activities and projects I will ask you to get involved with. If we are to reclaim the lost ground and preserve the legacy given to us by Freud, Perls, Rogers and so many others, we need all of you to act.

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