Peter Buckley

Evangelical religion and meditation: psychotherapeutic effects.

Members of a religious sect, the Divine Light Mission, were evaluated for psychological effects of their experience in the group, in order to study systematically the psychotherapeutic effect of evangelical religious experience. Responses given by 119 members to a multiple choice questionnaire reflected a significant decline in the incidence of neurotic symptoms and of alcohol and drug use, from the period prior to joining to that immediately after joining. This lower incidence persisted over the course of membership, an average of 21 months. Responses relating to ritual meditation indicated frequent transcendent experiences. Symptom decline was found to correlate significantly with group-related activities and attitudes, and with specific aspects of the ritual meditation. Case examples are given from a group of subjects who were given psychiatric interviews in order to clarify the nature of the psychological effects. These findings are discussed with regard to their implications for psychotherapy.

Development of a scale for the measurement of symptom change in an outpatient clinic

A brief 21-item symptom rating scale, the Psychiatric Outpatient Rating Scale (PORS), was developed for use in outpatient clinics. On the basis of its initial use with 86 patients, it was shown to have high internal and interjudge reliability and evidence of concurrent and construct validity. Scores on the PORS correlated significantly with the Global Assessment Scale and with the number of sessions of psychotherapy. For a subsample of 45 patients rated on the PORS at the beginning and termination of psychotherapy, seven symptoms revealed highly significant improvement. The PORS appears to be a potentially useful measure of change in outpatient clinics.

Determinants of object choice in adulthood: a test case of object-relations theory

A clinical example of the effects of the absence of the father during the early childhood of a male analysand and its consequences for his later object choice is presented. This patients biological father left the household when the patient was only a few months old, and his mother did not remarry until he was five years of age. Unconscious fantasies of the lost father, with whom the patient had no contact in reality, and longing for him organized the patients drives and determined his self-identity as well as his later object choice. The patient developed both a positive and negative identification with the lost father. The identification was with a fantasy object not a real one. The case highlights the need to use a precise term in talking of the object, namely the mental representation of the object which may or may not be built up out of experiences with the real object.

Altered States of Consciousness During Psychotherapy: a Historical and Cultural Perspective

This paper reviews the frequent phenomenon of altered states of consciousness in disparate cultural psychotherapeutic contexts. The historical antecedents of contemporary Western psychodynamic psychotherapy are examined and the central importance of altered states in the therapeutic effects of religious institutions such as the Dionysian rite and the Asclepia is illustrated. The continued presence of this phenomenon in Western psychotherapy from Mesmerism to psychoanalysis is shown. The use of trance states in the healing rituals of non-Western societies is examined and further evidence is found for the frequency of this phenomenon in culturally variegated therapeutic settings. The ubiquitous nature of the altered state phenomenon in such widely varied cultural contexts suggests the possibility of its being a universal component of psychotherapy.

Fairbairn and the Origins of Object Relations.

W. R D. Fairbairn (1889-1965) is an arresting figure in the evolution of psychoanalytic thought, one who stands out even in a discipline forged by radical thinkers. Living in Scotland and thus working in relative seclusion from the larger analytic community, he published a series of papers beginning in 1940 which delineated an object relations model of developmental psychology and pathogenesis that provides a stark contrast to classical drive theory, which it repudiates altogether. Fairbairn asserted that “the object and not gratification is the ultimate aim of libidinal suiving.” From this crucial starting point he proceeded to construct a theoretical edifice that illuminates our understanding of borderline and narcissistic states, the develop ment of the personality, and thc nature of therapeutic action. Traditional psychoanalytic circles paid little attention to this work when it first appeared, but gradually over the years has arisen a growing recognition of the importance of his ideas and of the prophetic manner in which they heralded later psychoanalytic innovations such as self psychology. Fairbairn’s legacy is well served by the editors of the book under review; they have compiled a volume of papers, both previously published and new, that explicate Fairbairn’s concepts and apply them to psychoanalytic theory and the clinical setting. One is left with an awareness of how central Fairbairn’s concepts are to much of current clinical debate and how extensive his contribution has been to the growth of psychoanalytic thinking. In their introduction, James S. Grotstein and the late Donald B. Rinsley highlight Fairbairn’s belief that normal human relationships are fundamentally interpersonal and not, like their pathological equivalents, internalized: “A nonpathological relationship with a real person . . . does not require internalization because the interpersonal interaction is inherently satisfying. In contrast, an intolerably ambivalent relationship results in a splitting of one’s attitude about the person such that the rejected part of that person is transformed into the status of an internal object” Thus, on this view, the more unsatisfying an object is in reality, the more the child is forced to internalize it in order to both deny and control its real and imagined malevolence. (Fairbairn had recourse to one of his frequent theological