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Posttraumatic Stress Disorder (PTSD)
Published in Judy Z. Koenigsberg, Anxiety Disorders, 2020
Developing a client’s arrested self-structures and facilitating a client’s ability to make use of interpretive material requires that a therapist empathically understand a client’s worldview (Gilbert & Orlans, 2011; Kohut, 1977). After two years of the self-psychology part of the therapy, Roberta expressed a wish to continue further self-exploration in therapy. During the self-psychology phase, the therapist helped Roberta to work on individuation and self-compassion, and to rid herself of the guilty feelings that somehow she was responsible for the bad events that befell her. Roberta began to understand her need for a selfobject to validate her unique experiences and challenging past, and how her own experiences are distinct from her mother’s history of trauma. As she continued to recover, Roberta felt less vulnerable, less stressed, more able to connect with friends, and her flashbacks receded. At the end of the third year of therapy, Roberta, although somewhat vulnerable to anxiety, blamed herself less for the events of her life, and seemed to develop a more cohesive and strengthened sense of self, with her self-esteem spiraling downward less frequently.
Integrative Psychotherapy for Holistic Neurorehabilitation
Published in Giles N. Yeates, Fiona Ashworth, Psychological Therapies in Acquired Brain Injury, 2019
Functionally, cognitive deficits and developmental delays produce a slow learning curve in adopting compensations. There is meager detail in note-taking in the datebook and fluctuating scores on a structured format to complete home chores (i.e., the Home Independence Checklist [HIC]; Klonoff, 2010). They have difficulty with problem solving and setting priorities (e.g., doing homework versus attending social events). An enduring theme is to frame therapeutic expectations as ‘work ready’ behaviours, through accountability and integrity training, as these individuals are inevitably hungry to drive and work. This includes ‘theoretical integration’ of cognitive rehabilitation, skill building through modelling and guidance by older milieu peers and therapists, implementing ‘Professional Behaviours’ logs with specific ‘do’s’ and ‘avoids’ for proper self-monitoring of communication pragmatics and placing patients on ‘probationary status’ with specific contingencies to be eligible for program participation and eventual work and school endeavours (Klonoff, 2010). Self-psychology principles are extracted for corrective emotional experiences through good self-object experiences, empathic attunement and positive mirroring and idealising transference relationships. This regulates self-esteem, develops self-discipline and creates self-worth, inner resiliency and psychological wellbeing (Klonoff, 2014; Kohut, 1984). Mindfulness and ACT constructs infuse a value-driven existence and help patients envision a meaningful and fulfilled future (Hayes, Strosahl, & Wilson, 2003; Pollak, Pedulla, & Siegel, 2016).
The therapist–client relationship
Published in Rebecca L. Haller, Karen L. Kennedy, Christine L. Capra, The Profession and Practice of Horticultural Therapy, 2019
Self-psychology, developed by Heinz Kohut (1984), proposes that people generally think of themselves as a self. The quality of self-experience ranges from cohesiveness to fragmentation. Kohut hypothesized that, as social beings, humans acquire a sense of self through significant relationships. Kohut suggested when a person is accurately seen and understood, they feel whole and cohesive. While Kohut focused primarily on human relationships, his model illuminated the growth that chemically dependent county jail inmates experienced through their participation in the San Francisco Sheriff’s Department’s Garden Project. Many of the Garden Project’s students came from fragmented families and communities. They had endured multiple traumas and family disruptions and were provided with little support or understanding for how these experiences had an impact on their sense of self. Kohut noted that drugs are often used to numb pain and provide a temporary experience of cohesion (Kohut and Wolf 1978). Working in the garden provided these students with a new coherent identity as part of nature. Their capacity to co-create life emerged as the seeds they planted grew into food and flowers, which were given to those in need within their communities. Students who participated in the Garden Project exhibited increased hope and the desire to change: key factors in determining the readiness for addiction treatment (Rice and Remy 1998).
Clinical Practice Theories for Medical Social Work with Veterans
Published in Smith College Studies in Social Work, 2018
Katharine Bloeser, Rachel Stewart
Self-psychology can provide an important organizing framework for our work with Jane and the physician–patient dyad. As a theory, self-psychology lends itself to applications to individuals with chronic illnesses (Garrett & Weisman, 2001). Heinz Kohut, the originator of self-psychology, asserted that in order for the self to achieve cohesiveness and a sense of self-worth, key experiences must occur in an individual’s life. These experiences include twinship (a sense of likeness or sameness with others) and mirroring (experiences confirming our own greatness or positive traits; Goldstein, 2001). According to Kohut, also essential to the human experience is the need to move from dependence to independence (Kohut, 1984). For adults, the onset of illness may represent a move backward, from independence to dependence. This experience, combined with lack of twinship or mirroring can cause discord in the lives of those with chronic illness.
Cognitive-behavioral counseling and self-perception of male clients receiving methadone maintenance treatment
Published in Alcoholism Treatment Quarterly, 2018
Naseibeh Elahei Roudposhti, Amir Jalali, Behnam Khaledi Paveh, Nader Salari
Furthermore, a colleague researcher collected the questionnaires before and after the intervention. The self-perception scale included 10 items. The participants were asked to respond to each statement using expressions including extremely high, high, medium, low, extremely low, and no self-perception. In this test, the scores ranged from zero (no self-perception) to five (extremely high). Self-perception Scale contains 10 items (Porhossein, 2010). The scale was developed by Porhossein (2010) according to Damon and Hart’s (1982) cognitive development theory (Damon & Hart, 1982). The questionnaire is the shortened form of a 30-item Self-perception Scale. Accordingly, total scores of self-perception test range between 0 and 50. The test consists of two components: Psychological Self: It includes Items 1, 4, 5, 8, 9, and 10. Self-psychology refers to describing self in terms of inner and psychological features.Social Self: It includes Items 2, 3, 6, and 7. Social self refers to describing self in terms of social and interactive features so that others play a role in describing the self.
Extending the Use of the SCORS–G Composite Ratings in Assessing Level of Personality Organization
Published in Journal of Personality Assessment, 2018
Michelle B. Stein, Jenelle Slavin-Mulford, Samuel Justin Sinclair, Wei-Jean Chung, Michael Roche, Christy Denckla, Mark A. Blais
Theorists have defined what constitutes personality organization in a number of ways. Contemporary psychodynamic theorists posit that it is a set of enduring, mostly unconscious psychological structures that dynamically organize mental processes and contents into a coherent organization (Gamache et al., 2009; Koelen et al., 2012). In particular, Westen (1996) described personality structure as the “interacting cognitive, affective, and motivational processes that guide an individual's response in various situations … the tendency to respond cognitively, affectively, conatively, or behaviorally in particular ways under particular circumstances” (p. 401). He identified three central aspects of personality, which integrate “major schools of thought in contemporary psychoanalysis” (Westen, 1995a, p. 507). First, people need to possess the psychological (i.e., cognitive, affective, and behavioral) resources to adapt to their environment and to manage internal and external presses (ego psychology). Second, unconscious and conscious motives are required to direct thought and behavior (i.e., fear, wishes, values, conflicts, consciousness of motives, notable compromise formations; classical theory). Third, people need to have the capacity to adapt to their interpersonal environment (i.e., experience of self and other and capacity for relatedness). Here, people's thoughts, feelings, motives, and behaviors involving themselves and others are of importance (object relations and self-psychology; social cognition and attachment).