Interrupting the reenactment cycle: psychotherapy of a sexually traumatized boy

Article Abstract:

It is commonly acknowledged that among the psychological consequences of childhood sexual abuse is the development of the need by the victim to reenact the trauma of the abuse. This is an attempt to gain mastery over the anxiety and conflicts brought on by the abuse. It has also been shown that sexual abuse causes both short- and long-term problems with regard to emotions, self-perception, and sexual behavior. A case is presented of an eight-year-old boy who had been forcibly subjected to anal and oral intercourse by his biological father at the age of three. The child began to develop behavioral problems that were severe enough to warrant hospitalization in a psychiatric facility. The boy was aggressive towards his mother's fiance, and exhibited sexualized behavior toward his younger sister, who had also been sexually traumatized by the father. While the boy evidenced a clear fear and mistrust of adult males, the hospital setting allowed him to gain control over his destructive feelings, which were accompanied by shame and guilt. The key aspects of the psychotherapy involved helping the boy to see that his need to reenact the trauma was a way of defending against his anxiety and confusion. The young abuse victim was also encouraged to explore both the positive and negative aspects of his feelings for his father. It is suggested that had the therapeutic approach been to prevent the boy from expressing his positive feelings towards his father, he would have remained incapable of resolving the implicit conflicts that were causing him to act out. Individual therapy gave the boy a context for the expression of his ambivalent feelings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Case studies, Services, Child sexual abuse, Sexually abused children

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Supervising the supervisors: the evolution of a psychotherapy supervisor's group

Article Abstract:

An important part of psychiatric training comes from supervisory experience in which a trainee or therapist reviews with another professional the cases and personal issues related to the work he is doing. This can help provide a better understanding of the therapist-patient relationship. This interaction is often offered or sought on an individual basis, but a group approach has been used as well. To investigate the merits of a group supervisory approach, two groups of 10 psychiatrists were formed and met every other week. The groups were nondirective and topics were spontaneous. An anonymous questionnaire administered nine months after the group began revealed that while participants found the group useful, they preferred a more focused approach including readings, case conferences, and discussion. Taking this advice, such a group was formed, which met for two years. However, there was constant turnover and a lack of interest in this format. Extracted from these two experiences is a format that is currently used. Groups begin with a case presentation, and the rest of the time (more than half) is devoted to spontaneous interaction. This meets the needs of both the more experienced therapists who prefer a less structured setting and the needs of newer therapists who prefer more structure. The role of the leader is that of facilitator rather than teacher or therapist. Supervision can be effective in the group setting as long as the needs of the individuals supervised are integrated into the structure of the group. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Education, Training, Psychotherapists, Psychiatrists, Psychotherapy, Group psychotherapy, Group counseling

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Integration of cultural awareness into psychotherapy

Article Abstract:

Psychotherapy by its very nature is inextricably bound to the culture in which it is developed and practiced. In the therapeutic situation, similarities of cultural background between therapist and patient may lead to assumptions by one about the other that are inaccurate; conversely, where cultural differences do exist, failure to understand the patient's cultural context may lead to different problems. Nevertheless, psychotherapy is a cross-cultural endeavor, in that many of the theories upon which it is based transcend the individual cultural distinctions that may separate patient and therapist. Some 'universal' working assumptions of psychotherapy include the notion that the therapeutic task is to understand what the patient is saying; patients as a group are either troubled or unhappy; and the desires and fears of the patient may be in conflict. The author stresses that it is the task of the psychotherapist to be aware of and engage cross-cultural differences, rather than ignore them. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Evaluation, Psychoanalysis, Psychiatry, Transcultural, Transcultural psychiatry

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