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Medium 9781855757561

Chapter One: The “Philosophical Origins” of CBT

Robertson, Donald Karnac Books ePub

CHAPTER ONE

The “philosophical origins” of CBT

Cognitive–behavioural therapy (CBT) is the predominant school of modern evidence-based psychological therapy. As the name implies, it employs both cognitive and behavioural interventions. Unfortunately, this name belies the fact that CBT is concerned with helping clients to deal with irrational or disturbing emotions, and to cultivate rational, healthy, and proportionate ones in their stead. The terms “cognitive” and “rational” also suggest to some people's minds that CBT must be a form of rationalization, or that it neglects emotion, intuition, or practical experience. However, in this sense of the word, CBT is probably anti-rationalist, in its emphasis upon the value of behavioural experiments and empirical observation. In other words, CBT emphasizes that, in so far as it is reasonable to do so, beliefs should be tested out in practice, in the laboratory of our personal experience.

Professor Keith Dobson, one of the leading authorities in the field of CBT, offers the following account of its “philosophical bases”, that is, the common assumptions shared by variations of cognitive–behavioural therapy.

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Medium 9781855750210

CHAPTER 3. Teaching theory and skills practice

Karnac Books ePub

We give below some general guide-lines for the use of role play, sculpting and video. These are universal modes of teaching and are integral to many of our exercises. We think they deserve special mention to enable teachers to maximise the learning possibilities of exercises.

It is important for trainees to get the feel of interviewing a family without the ethical problems of treating real clients as guinea pigs, yet giving them a chance of taking risks in trying out new ideas in a relatively safe context. We have come to see role play as not only a specific technique but also a general principle of teaching practice skills. It is an effective means for trainees to develop their skills and can often be far more involving than watching videotape of a real family. Course participants receive instant feedback either in their role as therapist or as a family member and realise what interventions they found helpful or unhelpful. We have found, however, that role play needs as careful thought and preparation as real therapy. On account of its central position in training, we have chosen to emphasise its format and offer some general guidelines to the teacher embarking on the use of role play in teaching.

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Medium 9781782413004

THE DECISION

Furey, Paul Karnac Books PDF

“FEEDBACK” - HERE COMES BAD NEWS

THE DECISION

When I hear the word feedback I always think something negative is about to be said. You and I both know that the sentence “I’m going to give her some feedback…” is not the announcement of a happy conversation. And yet, why not?

So when my client said that he thought that I was a ‘feedback kind of guy’, I guess he was right in so much as I do it a lot. But what he maybe didn’t understand when he said it was that it is something that I do consciously. It is not effortless.

Think of the last time you got some feedback from your boss or a col-

I think about the words carefully every time - especially in trying

Think of the last time you got some feedback about something positive.

Struggling to remember? You wouldn’t be alone.

feeling that I am having about that thing and why I might be having it. This all takes just a few seconds now - it used to take a lot longer.

It’s the many practices that I have had at this game that makes it look effortless.

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Medium 9780946439492

E

Laplanche, Jean; Pontalis, Jean-Bertrand Karnac Books ePub

= D.: ökonomisch.–Es.: económico.–Fr.: économique.–I.: economico.–P.: econômico.

Qualifies everything having to do with the hypothesis that psychical processes consist in the circulation and distribution of an energy (instinctual energy) that can be quantified, i.e. that is capable of increase, decrease and equivalence.

I. Psycho-analysis often evokes the ‘economic point of view’. Thus Freud defines metapsychology* as the synthesis of three standpoints–the topographical*, the dynamic* and the economic. The last ‘endeavours to follow out the vicissitudes of amounts of excitation and to arrive at least at some relative estimate of their magnitude’ (1). The economic point of view consists in taking into consideration the cathexes*– their movement, the variations in their intensity, the antagonisms that arise between them (cf. the notion of anticathexis*), etc. Economic considerations are brought forward by Freud throughout his work; in his view, there can be no complete description of a mental process so long as the economy of cathexes has not been assessed.

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Medium 9781782200543

Chapter Eight - Psychoanalytic Hypotheses

Chetrit-Vatine, Viviane Karnac Books ePub

Generally speaking, and in the wake of Freud, we understand the capacity for responsibility for the other, let us say, concern for the other, as deriving from guilt, itself the heir of the oedipal complex. Furthermore, as we saw at the outset, in Part I, the word “narcissism” attached to “ethics” seems, for Freud, to have a pejorative connotation, and from time to time he regards ethics as illusory. Would it be true to say that such narcissism takes over from the sadistic injunctions of a persecuting superego?

For Klein, this capacity for responsibility is the fruit of innate maturity, aided by a favourable environment. It results from the infant's gaining access to the depressive position, thus allowing for the transformation of an early, cruel superego, present from birth, into a less sadistic and less persecuting superego. It can be understood as the capacity to repair the potential harm done to the object, an object that is not only hated but ultimately loved as well.

For Winnicott, building on Kleinian hypotheses, the capacity to be “concerned” results from a transformation, brought about by a “good enough mother”, of the child's primary and innate guilt. This capacity, the capacity for concern, develops from the infant's “unexperienced, yet very present sense of guilt”. However, he posits that the mother, as an environmental object, contains, handles, and holds this sense of guilt. In so doing, she enables the infant to “contribute”; she gives him or her the possibility of making reparation. For Winnicott, the infant, owing to his natural lack of respect, his ruthlessness (and not because he is endowed with primary hate), is capable of attacking the mother, of ill-treating her. However, it is not the infant's task to contain the guilt thus activated. It is for the mother to fulfil this function, at least partially. In this sense, she is the one who helps the infant “contribute something to making reparation”. It is this internalised contribution that will help the child achieve a sense of responsibility. In Winnicott's terms (1963), the mother enables the child to use her. Winnicott developed his concept of “the use of an object” further. (I referred to this in Part II; see Winnicott's (1964) article, “The use of an object, and relating through identifications”.) With this use of the object and with his concept of “primary maternal preoccupation”, he is referring to a natural maternal order. For me, this maternal order (in the human being), which I have designated by the term “matricial space”, is aroused by the child's exigency for an adult world that assumes a position of asymmetrical and ethical responsibility for him. In other words, it is not natural. But let us not get ahead of ourselves.

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