Brian Rasmussen

AN INTERSUBJECTIVE PERSPECTIVE ON VICARIOUS TRAUMA AND ITS IMPACT ON THE CLINICAL PROCESS

This paper suggests that intersubjectivity theory provides a valuable metatheoretical framework to understand the dynamic interplay of vicarious traumatization within clinical practice. Practice implications of this view shift our attention to what lies between the therapist and client, the impact of working with traumatized clients, as well as the need for clinical supervision. With an emphasis on context, mutuality, reciprocal interaction, affect regulation, emotional understanding, countertransference, cotransference, and empathy, intersubjectivity theory provides an additional perspective on trauma, the clinical process, and its impact on the therapist.

Masculinities, Work, and Retirement Among Older Men Who Experience Depression

The high incidence of depression among older men has been linked to numerous factors. In this qualitative descriptive study of 30 older, Canadian-based men who experienced depression, we explored the connections between participants’ depression, masculinities, work, and retirement. Our analyses revealed three thematic findings. The recursive relationship between depression and work was reflected in depression impeding and emerging from paid work, whereby men’s careers and work achievements were negatively impacted by depression amid assertions that unfulfilling work could also invoke depression. Lost or unrealized empires highlighted the centrality of wealth accumulation and negative impact of many participants’ unfulfilled paid work aspirations. Retirement as loss and the therapeutic value of work reflected how masculine ideals influenced men to continue working to avoid the losses they associated with retirement. The findings confirm the need to support men’s work-related transitions by affirming a diversity of masculine identities beyond traditional workman/breadwinner roles.

A contemporary Kleinian contribution to understanding racism.

This article applies a contemporary Kleinian understanding to the problem of racism and, in particular, to microaggressions. The article contributes to the social work literature on racism by (1) moving closer to an explanatory model of the relation between the social and the psyche; (2) adding depth and structure to the concept of unconscious racism; and (3) highlighting a range of Kleinian concepts, such as projection, projective identification, splitting, developmental positions, envy, and reparation, that contribute to understanding the internal and external dimensions of racialized encounters. The dynamic interaction of the psyche and the social is central to understanding racism and to effective antiracist intervention strategies.

A Fine Balance: Instructor Self-Disclosure in the Classroom.

ABSTRACT This paper explores the issue of the instructors self-disclosure within a classroom. Theoretically, the paper offers a broad relational framework from which we discuss dynamics regarding the instructors inevitable use of self-disclosure and its impact on the student-instructor relationship and the learning process. Further, we survey the literature from the clinical and supervisory domains for relevant ideas. We recommend that instructors judiciously and reflectively self-disclose in the classroom. Conscious awareness of the dynamics of self-disclosure helps to monitor the effectiveness of this activity. A fine balance between thoughtful restraint and genuine openness helps to facilitate this goal.

THE DIFFERENTIAL USE OF METAPHOR IN PSYCHOTHERAPY

Metaphor is seen to play a significant role in psychoanalytic theory and technique. While acknowledging this view, this paper examines the differences in which individuals of varying developmental profiles, experience, comprehend and use metaphor in the context of psychotherapy. Differences in the capacity to play, adaptively regress, regulate affect, maintain ego boundaries, and symbolize, are found to affect capacities to employ those figures of speech in words or phrases literally denoting one type of object or idea but used in place of others by suggesting likenesses or analogies. A rationale for differential use of interventions involving metaphor is offered.

No Refuge An Exploratory Survey of Nightmares, Dreams, and Sleep Patterns in Women Dealing With Relationship Violence

This exploratory survey examined the dreams, nightmares, and sleep patterns of 30 women who were dealing with relationship violence. The sample of women was taken from two transition homes and a family counseling center. The findings indicate that 50% of the sample experienced nightmares on a weekly basis. Some of the dream images included drowning, being chased, being killed, or killing others. Slightly more than half (56%) experienced a recurring dream. Most women had trouble falling asleep and, on average, slept for 6.1 hours per night. Implications for practice and future research are discussed.

Resurrecting Erich Fromm

Erich Fromm (1900–1980) was once a world‐famous psychoanalyst and sociologist. His writings, spanning six decades, placed him among the most prolific and well‐known analysts of his generation. In this paper, we outline Fromms major themes and theoretical contributions. His unique attempts to synthesize depth psychology and a critical perspective on modern social forces make his work central to social works mission of alleviating oppression, fostering social justice, and facilitating emotional healing and personal growth. In resurrecting Fromm, we hope to stimulate thought about some of the complex theoretical problems that inform practice. “The understanding of the unconscious of the individual presupposes and necessitates the critical analysis of his (sic) society.” Erich Fromm (1959/1963, p. 116)

Therapists' Perspectives on Optimal Treatment for Pathological Narcissism.

This study used Q methodology to explore clinicians’ perspectives regarding optimal psychotherapy process in the treatment of pathological narcissism, a syndrome of impaired self-regulation. Participants were 34 psychotherapists of various disciplines and theoretical orientations who reviewed 3 clinical vignettes portraying hypothetical cases of grandiose narcissism, vulnerable narcissism, and panic disorder without pathological narcissism. Participants then used the Psychotherapy Process Q set, a 100-item Q-sort instrument, to indicate their views regarding optimal therapy process for each hypothetical case. By-person principal components analysis with varimax rotation was conducted on all 102 Q-sorts, revealing 4 components representing clinicians’ perspectives on ideal therapy processes for narcissistic and non-narcissistic patients. These perspectives were then analyzed regarding their relationship to established therapy models. The first component represented an introspective, relationally oriented therapy process and was strongly correlated with established psychodynamic treatments. The second component, most frequently endorsed for the panic disorder vignette, consisted of a cognitive and alliance-building approach that correlated strongly with expert-rated cognitive–behavioral therapy. The third and fourth components involved therapy processes focused on the challenging interpersonal behaviors associated with narcissistic vulnerability and grandiosity, respectively. The perspectives on therapy processes that emerged in this study reflect different points of emphasis in the treatment of pathological narcissism, and may serve as prototypes of therapist-generated approaches to patients suffering from this issue. The findings suggest several areas for further empirical inquiry regarding psychotherapy with this population.

The Use of Emotions in Social Work Education.

The role of emotions, although central to social work practice, has been relatively neglected in the process of teaching and learning social work. This article explores how social work educators can incorporate an understanding of the role of emotions in both the teaching and practice of social work. Attention is drawn toward evolutionary and developmental perspectives, emotional regulation, and the current treatment of emotions in the educational context. Further, the article explores the role of optimal emotional arousal in the learning and retention of social work curriculum and its concurrent relational implications for practice.

The Status of Psychiatric Inpatient Group Therapy: Past, Present, and Future

This article examines the history, current conditions, and future possibilities of psychiatric inpatient group psychotherapy. Attention is directed toward exploring the purpose, structure, theoretical perspectives, and empirical research of inpatient group therapy. Trends in inpatient care are contextualized within a historical perspective and current politics of care. Future challenges to the viability of inpatient groups, including fiscal pressures, high patient acuity, shorter stays, and pressures for evidence-based practices, are considered.