Martin Lotz

LONG-TERM ANALYTIC GROUP PSYCHOTHERAPY WITH OUTPATIENTS. EVALUATION OF PROCESS AND CHANGE

This doctoral thesis is the result of Steinar Lorentzens research on the effect of psychotherapy based upon his intensive clinical work with groups. Steinar Lorentzen is fully trained both as a psychoanalyst and a group analyst. He works in private practice in Oslo, where, for 10 years, he has conducted three long-term groups. All three groups had the same time schedule, meeting once a week for 1.5 hours, the average time with the groups being 32 months. The groups had the same therapist, Steinar Lorentzen, but in one of the groups, he worked together with an experienced social worker, a woman with full group-analytic training and long experience in psychiatry and group therapy. The method was classical analytic group psychotherapy, as outlined by Foulkes. This indicates that the therapist is intellectually active, but remaining in the background, and that interpretations are used as the main interventions, especially with focus on group phenomena. Sixty nine patients attended the groups and only two dropped out. The research schedule consisted of a number of questionnaires applied at the start, after the end and at a one-year follow up. Steinar Lorentzen summarizes the problems of this type of research thoroughly and in a concise and clear style. He discusses the influence of strict demands on formalities, i.e., referring to standardized interventions or using alternating therapists. Such demands are of questionable value as they usually lead to a higher number of dropouts. The degree of pathology at the start was measured by the two questionnaires, GAF (Global Assessment of Functioning) and SCL-90 (Symptoms Check List 90). In this material, the mean score for GAF and the Global Severity Index in SCL90 were 57.4 and 1.13, respectively. Both numbers Copyright

The moment and the next step

In psychoanalytical theory, the immediate future of the analysand has not been in the focus of interest. However, there is a change in the basic assumptions concerning the psychoanalytic process. Change is no longer seen as an inevitable automatic effect of insight into the unconscious. This is especially pertinent in the case of defect pathology. The author asks whether this altered view of the process will be followed by a change in technique. The question is: must change occasionally be stimulated by inspiration, suggestions and assessments from the analyst. While interpretation of the unconscious is still the major focus of analysis, some consideration of the next step of the analysand may also be part of our concern.

MENTAL SURVIVAL STRATEGIES AFTER EXTREME TRAUMATISATION. DOCTORAL THESIS BY SVERRE VARVIN. COPENHAGEN: MULTIVERS ACADEMIC, 2003

Sverre Varvin has had the unique opportunity to study a small group of severely traumatised people during psychoanalytic psychotherapy, and has approached this task with great courage and with incredible energy. While Varvin maintains that psychoanalysis offers the most comprehensive theory of interaction between development, the formation of personality, the relation between the body and the mind and the interaction of the individual with the environment, he is still of the opinion that a fruitful theoretical interaction with neighbouring disciplines is necessary (attachment theory, neuroscience, cognitive science, anthropology, semiotics). Although he thus seems, in the strict sense, to keep psychoanalytic theory apart from other disciplines, he confronts the challenges of this complex field and makes an effort to integrate it. In the first part of the book, Varvin virtually builds up the concepts he wants to work with, discusses them and defines them. He then combines these concepts with classical psychoanalytic theory and fits them together into a new frame of reference. The first part of his book forms a convincing beginning of a truly modem psychoanalytic theoryespecially concerning the theory of trauma. Varvin states that trauma is a complex event occurring beyond normal horizons. It is defined retrospectively, and while it has had an effect on development, it is now being considered as a developmental disturbance in itself. He underlines the seemingly ubiquitous strong feelings of shame and somatic reactions to severe trauma. It seems that the traumatised have lost their ability to draw on experience and to look forward. The traumatized person always reacts in the manner of a sort of frozen mobility, as if he were still in the traumatic state. Furthermore, Varvin states that the traumatic bodily and affective experiences disturb the protective devices of the ego. The reminiscences of the traumatic experiences haunt the extremely traumatized person. They return as flashbacks, as bodily memories in the form of sensations, as pain and reactions in the autonomic nervous system, and as behavioural patterns. All these disCopyright ~) 211114 ---THE--SCANDINAVIAN PSYCHOANALYTIC REVIEW !SSN 0106-230/