ISSN 1359-3706
Feedback greatly appreciated: Email [if your HTML browser doesn't support "mailto:" then use a mail package and send to: C.Evans@sghms.ac.uk]
It is now two years since the last conference by the sea, and this year there is a programme which is packed and varied - with a few new twists - as well as all the regular features which make Ravenscar such a popular and valuable forum. For anybody who fancies a dip before breakfast, the hotel has also recently opened a small indoor swimming pool.
There are four paper sessions:
Our visiting speaker is John Clarkin from Cornell Medical Centre in New York, and he is delivering the keynote address on Intervention with bipolar disorder: treatment research in the era of health care reform. He is also taking a workshop on developing psychodynamic treatment for borderline personality disorder.
Other workshops are with John Birtchnell on his "Interpersonal Octagon"; Colleen Heenan and Anna Madill on supervision and the use of discourse analysis; John and Marcia Davis with Thomas Schroder on developments with the international study of therapist difficulties, coping strategies and boundary maintenance; Jim Watson on audit and survival; and John McLeod on qualitative approaches to research.
There are also poster presentations (with the manic half hour of "just-a-minute" presentations), computer demonstrations, erudite panel discussions and open feedback from all the workshops. Anthony Ryle will be receiving his Career Achievement Award at the Conference Dinner, and Glenys Parry has agreed to give a short talk to update us all on the Department of Health strategic review of psychotherapy. Needless to say, the food and hospitality will be exemplary, and a conference photograph will be taken and available as a transitional object.
A £25 deposit secures a place - we are already well-subscribed this year - and the balance of £215 (for SPR members) is due by the end of February. Please encourage colleagues to come and join SPR: the reduction for members is the same as a year's dues, and we always welcome new blood. There is a £40 reduction for sharing a room, and for students and anybody particularly hard up, registration by itself costs £120 and delegates have stayed in the local youth hostel in the past. Enquiries or further copies of the programme from Debbie Kirby-Mayers 0161 442 6291.
Rex Haigh [Pages 1 to 2 in printed version] [return to index]
This is a small edition of Network rushed out to try to get Michael Barkham's announcement about nominations out as we should and to get a last minute reminder in about Ravenscar. Putting it together got delayed by various crises in my job so both pieces are very late: apologies to Michael and Rex. Talking of late, apologies to David Shapiro. His letter arguing for psychotherapy research in the Guardian (replying to an article titled "Affliction all in the mind"!) should have gone in the last edition but I mislaid my copy. The letter is still topical so I'm including it and hope it will stimulate a regular column promoting a campaign for psychotherapy research ("campaign corner").
Another piece may start a regular corner: I've put together something on Email and the Internet. This is very sketchy so I'd strongly enourage other users to tell us more.
People are taking up the challenge to review books; many thanks to Colleen and Gary. I haven't had time to collect a new pile of books to review so send me details of books you'd review and I'll see if I can get them (British publishers are generally O.K. if you've got a 'phone number, publishers from other countries can be difficult). There should be a new list of books in the next edition and a piece describing the structure of SPR(UK), its posts and current post-holders and how to get hold of us. Apologies to those who suggested books and not heard from me: you will. The ten or so people who offered to do the Linehan books should know by now that those went to the first person who'd offered (who then backed out and they're on their way to the second person!) Those who offered to review books but didn't include the hostage cheques should read the small print!
This is my third edition of Network, I had some feedback on the last two and I envisage doing about another three before I think it would be healthy for the steering group to canvass for new blood. That makes this mid-term in my eyes and I'd much appreciate feedback and letters for publication if anyone has the energy and time. I don't have illusions about how precious time is so anything received is much appreciated.
All submissions by mail should be sent to:
Section of Psychotherapy, Dept. of Mental Health Sciences, St. George's Hosp. Med. School, Cranmer Terrace, London SW17 0REPlease put submissions on a DOS format 3½" or 5¼"diskette if you can. I can cope with most WP file formats though Word for Windows, RTF, Word Perfect 5.1 or ASCII are preferred. The 'phone and 'fax number is:
0181 - 725 2540If you are 'faxing a submission from 'fax software please don't use italics and please do use a large font: nothing less than 12 point. If you're 'faxing from a conventional machine the dislike of italics applies and please use an even larger font if you have that sort of control of your typography: 14 point or more and please try to feed the paper as squarely as you can! The character recognition software I use appreciates large fonts and I don't have secretarial support so if I can use OCR it helps. Email should be sent to:
C.Evans@sghms.ac.ukMy ability to with MIME attachments and enclosures is improving but is still unreliable so send things as ASCII copy but try sending me the MIME attachment as well if you have it one of my preferred formats so I can try to work out more about what's going wrong with our MIME.
Chris Evans [Page 2 in printed version] [return to index]
It may seem early to be asking for nominations for the next UK Vice-President but we have the system whereby elections are held mid-way through the incumbent's term in order for the incoming VP to have a 2-year period as UK Vice-President elect in which to learn whatever needs to be learned to survive their 4-year term. The actual term of office runs from immediately following the international meeting held in the summer of the year they take office. I started by 4-year term following the Pittsburgh meeting in the summer of 1993 and hence this summer will see me half-way through my term, which signals the time for an election.
The constitution is absolutely clear that there must be a contested election, meaning that at least two people must be nominated, seconded and agree to run for election. Hence, I want to ask members for nominations. At this juncture, there is sufficient time to talk individually with people who might be interested so I am hoping that some people will contact me suggesting names. If there are people who might be willing to stand themselves, then if they can let me know, I am quite sure I can find people who will be happy to nominate them. The point is I want to make it as easy as possible for the names of people who are willing to run to come forward.
The requirements are simple. That nominees should be members of SPR(UK). Beyond that, I think it both reasonable and understandable that people running for this position should have a history of involvement at some level with the UK organisation (e.g. attending meetings) and have a commitment to the central role of psychotherapy research. It is important to remember that it is the Society for Psychotherapy Research. Hence, people running for office need not be die-hard researchers themselves, but they need to be able to argue for research having a central role in the field of psychotherapy practice. The rewards include helping to shape a unique organisation, seeing the Ravenscar meeting continue to flourish, working with some enchanting people, and attending the international meeting each year. Indeed, the latter is a requirement and funding this requires discussion by the Steering Group but it is clear that we cannot and should not rely on the UK Vice-President to secure their own funding to attend the meeting. This will have to carried by the dues for members. Hence, no one should exclude themselves from running for office on this basis.
The term of office, apart from the 2-year "elect" position, will run start following the international meeting at Oslo in 1997. Hence, when considering nominations, please take into account that the actual task is well over 2 years away. So, no looking in your diaries and saying "I'm busy on that day!" In terms of progressing this, I recognise that the meeting at Ravenscar is a useful time for people to approach me or other members of the Steering Group to suggest names. Hence, I would like to ask members to approach me either by 'phone, mail, or at the conference suggesting names of possible candidates. If people would just like to find out more about what the post entails, then please do contact me. This time scale will take us to the end of March. If insufficient names come forward, then it gives me enough time to start telephoning people before the summer....
Please give this some thought. Whoever takes over in 1997 really will be leading SPR(UK) into the 21st century. And can I recommend it? Well, mid-way through my term I feel a whole lot better than Bill Clinton does!
I look forward to hearing from you at:
Michael Barkham MRC/ESRC SAPU Department of Psychology The University Sheffield S10 2TN Tel: 0114-275-6600In the last issue, I noted that a line had been drawn under the Social and Applied Psychology Unit in Sheffield. What, no more Sheffield, and son of Sheffield, studies? Well, no. But what is Sheffield's loss is Leeds' gain as David Shapiro took up the post of Professor of Clinical Psychology at Leeds University in January this year (a post jointly funded by the University and Leeds Community and Mental Health Trust). Most importantly, David is to establish a Psychological Therapies Research Centre (PTRC) which will incorporate both the continued MRC programme of research as well as work commissioned by the Trust. PTRC's mission is the development of knowledge-based psychological therapies for the NHS. Arrangements are in place for trust clinicians to be seconded to PTRC one day per week to take part in research programmes, and later this year Gillian Hardy, Anne Rees and myself will also be migrating to Leeds. I also understand that some new clinical psychology posts will be coming up. Check out the Bulletin [of the BPS I assume - Ed.!].
Michael Barkham [Pages 3 and 4 in printed version] [return to index]
The following letter from David Shapiro was published in the Guardian 26.ii.94
"A significant and growing number of psychotherapists, chiefly those with backgrounds in broader disciplines such as clinical psychology and psychiatry, are already engaged in the evaluative research advocated by Madeleine Bunting. The Society for Psychotherapy Research, is an international, multi-disciplinary organisation whose 1,000 members are committed to the scientific study and improvement of psychotherapy in all its forms.
Opening psychotherapy and psychotherapists to public scrutiny and accountability is of course part and parcel of this mission.
In this country, psychotherapy research is supported by such agencies as the Medical Research Council and the Mental Health Foundation. Psychotherapy researchers are winning their long-term campaign to persuade all psychotherapists of the necessity and benefits of research in this field.
But research costs money. Psychotherapies are disadvantaged, in comparison with drug treatments, by the relative absence of commercial incentive to develop more effective psychological treatments. Resources for research hold the key to meeting the massive public demand for proven, safe, and effective psychotherapies."
[Page 4 in printed version] [return to index]
Email is just a way of passing information from one computer to another. Those of us based in Universities will generally find that its Computer Unit has a high quality telephone link into the Joint Academic NETwork (JANET) which links academic institutions in this country. Some of us are also lucky enough (it cost me some money and hassling) to have a network connection direct from a PC on our desk to the Computer Unit and then into JANET. JANET is linked at a number of points to other national networks which collectively form the Internet. This Internet has been the topic of much journalism of late as its anarchic quality has attracted attention.
Basic Email enables people to exchange messages provided they know each other's addresses (mine is C.Evans@sghms.ac.uk). There are a number of catches. One is a consequence of the topsy turvy way the Internet has grown so that outside the U.K. my address is: C.Evans@sghms.ac.uk (JANET is the only network to parse addresses from country down to local domain in left to right). The next problem is also historical: the Internet evolved out of the various educational nets with some paradoxical support from the military, so availability to people outside these sectors, has come late and is still a bit of a mess. If you are in the academic world you can get onto the Internet through service providers. You connect to them using a MODEM (MODulator/DEModulator, piece of hardware which plugs between a 'phone socket and a computer) and terminal emulation program (TERMINAL is provided free within Windows). Suitable MODEMS start at about £150 now although there is a range from probably about £50 up to about £500 depending how much speed you want. The other thing you need is a 'phone number where you can have an account, an Internet address and a reliable way to put messages into and out of the Internet. The two main providers serving the U.K. are Compuserve (0800 289 458 for help) and CIX (01492 641 961). Both charge monthly fees as well as charges for all usage which will total around £8-20 per month depending how heavily you use Email and their other services. The U.S. based Compuserve is still the best source of computer support and information and its Email/Internet interface is a small and relatively recent priority in its services. The British CIX is more recent, has less extensive commercial computer support but is cheaper I think. Both will give you pretty reliable Email and both have friendly programs to handle the nitty gritty technological things and to hide you from raw terminal emulation which can be pretty crude. There are a number of other companies now joining this market but specialising purely in Internet interfacing and these may become a better bet than the old two. (I'm trying to persuade Rex Haigh to co-write a piece for Network about his experiences with Greenet but I think our failure to write it reflects the learning curve he experienced! More on this in the next issue? Or perhaps someone else who uses dial-up Email and Internet resources would like to submit something: you have my Email address!)
Basic Email messages only provide the "ASCII" character set which can be limiting if you are exchanging a lot of mail with people who need accented characters (my Austrian and German colleagues find this a pain and are increasingly accepting with very good grace the conventions of "Guenther" for "Günther" etc.). ASCII has no italic, no bold, no differnt fonts or font sizes and pretty unpredictable Email handling of word-wrapping etc. so those of us who have grown accustomed to the beauties of modern wordprocessing feel a bit limited. There is also no way to send binary data (e.g. program files) as Email without some coding and uncoding having to be done on them. (However, coding/decoding programs are in the public domain so this is a nuisance, not a complete handicap.)
So you can exchange mail quickly, often for free, and you can fairly easily transfer files of information or even programs by Email. Is there anything else? Well, there is: an Email equivalent of circular letters: LISTSERVers, programs set up by long suffering computer units which will automatically copy a letter sent to them to all the people who have registered on that list. There are lists devoted to psychotherapy and excellent lists dealing with statistics. These enable you to put a question to several hundred people. If you're lucky you hit someone who did their Ph.D. on just the problem that's crippling you and have a solution with references and wit within days of your asking. On stats lists I got that sort of response for about half my sensible questions. The hit rate on softer information areas seems to me to be much, much lower but the culture is probably still developing for those.
There are other advantages to the Internet. Particularly the developing repositories of information in "World Wide Web" (WWW) form. The article about the EPCA elsewhere in this edition is an example of this: I just captured most of the information in it from a personal construct related WWW resource. I will write more about this in the next edition, by which time I hope Network will be appearing in WWW as well as in paper form.
Chris Evans [Pages 4 and 5 in the printed version] [return to index]
PinPoint 3 for Windows. Longman Logotron, 124 Cambridge Science Park, Milton Road, Cambridge CB4 4ZS (01223 425558)
PinPoint is described by its manufacturers as: "Forms design and publishing, data collection, analysis and presentation. The single solution giving you the competitive edge." They have gone from version 1.1 to version 3 (I think) and the list price of version 3 is £499 ex VAT for a single copy, a licence for three users would cost £1200 then £200 per user thereafter. Greater discounts are apparently negotiable for large numbers e.g. for F.H.S.A.s, D.H.A.s, trusts etc. Version 1.1 is still available for £299 and an educational discount is available on v1.1 making it £129 and may be available for v3 at £299. The program allows the creation of data entry forms which can be used for computerised data entry or can be printed on paper. Questions can take the following forms:
There were some oddities about formatting but I didn't find it hard to produce a reasonable questionnaire for the Hospital Anxiety and Depression Scales. There were aspects of the editor which seemed crude compared to wordprocessors I use routinely. One major limitation was the inability to save the form in any general WP format such as RTF, another was that there was no way to import the basic text to make up a questionnaire. One thing I did was PinPoint's ability to export the form as a Windows executable which can be used to collect up to 20 sets of answers. The data collected can be easily imported back into PinPoint. This is surely one of the ways forward for forms handling. The other is probably optical character recognition and PinPoint has options to print questions in ways suited to OCR marking systems (it says).
PinPoint has quite extensive and fairly friendly options for cross-tabulation and graphing of data and can perform a reasonable range of calculations on stored data including IF-THEN-ELSE constructions. It is particularly strong on date calculations which are weak in many stats. and database packages. It can import data in comma and tab delimited formats (CSV & TSV) from ASCII files and can also import from DBase II/III/IV and from Paradox files (I'm unclear what variants). It can only export data in CSV and TSV formats which seemed extraordinarily rigid to me. The lack of export options gave me the impression that Longman Logotron have little faith in their own product: they're limiting its import and export for forms and limiting its export options for data. This means users not already wedded to word processors or forms packages for their forms, or to stats/graphics packages for analyses, will easily become locked in with the product.
Although seducing users into a lasting embrace has advantages, it also has problems. I use a number of stats. and graphics packages and the Microsoft Office group of products so I already have ways of doing some of things that PinPoint does. However, I'm also dissatisfied with these established ways and looking for a better way of handling q'aire production, data collection, entry and validation, and data analysis. PinPoint is strong on these processes and links them in one continuous and logical sequence. Furthermore its designers prioritised user friendliness but I often found they had hit on ways of doing things, and on priorities about what to implement, that didn't feel friendly or intuitive at all to me. I'd need months to get proficient using it (which is not unreasonable for a product covering so many needs) but felt reluctant to spend that time while it was difficult to get information out in the formats I wanted (RTF for the raw forms and at least DBF for the data). I can see strong arguments for services unconcerned about sophisticated statistical analyses, and needing to harmonise forms handling and data collection, to standardise on PinPoint. For me it's too statistically limited and too rigid.
I would be interested to hear of users who have used it more. Longman Logotron claim 55,000 users and put particular emphasis on health services. I'd also be interested to hear from users who may have covered the PinPoint functions using a combination of a dedicated forms package and a graphics/database package (or packages). For me the search for the chimerical perfect single psychotherapy research package continues!
(Added 21.iii.96): Mike Smith msmith@logo.com has pointed out to me that Longman logotron now have what looks like an impressive WWW site for PINPOINT at: http://www.logo.com/pinpoint Chris Evans [Page 6 in printed version] [return to index]
Cox, Trevor F. & Cox, Michael A.A. (1994) Multidimensional Scaling. (Monographs on Statistics and Applied Probability 59.) Chapman & Hall:London ISBN 0-412-49120-6 (hdbk.), 213pp. with 3½" diskette of DOS MDS programs and data £32.50
This is latest book in the authoritative series from Chapman & Hall. These books are at the approachable end of the definitive statements on stats. and I think Multidimensional Scaling (MDS) has much to offer psychotherapy research. MDS includes a number of related techniques for mapping data onto a single dimension (the origin of the "scaling" in the name) or into a multidimensional space (hence the "MD"). Some methods take symmetrical matrices of similarity or dissimilarity data, others take rectangular matrices of ratings or rankings of objects, another set handle multiple similarity or dissimilarity matrices which might arise when a variety of judges are asked to compare different things. The scaling methods can take a variety of approaches to the presumed level of scaling (ratio, ordinal) in the data and in the mapping, and can take different approaches to the handling of ties in both the data and the mappings. One of the oldest methods, known as "classical scaling" or "principal coordinate analysis" (PCO) is mathematically and logically very closely related to principal component analysis (PDA) but other methods are computationally vastly more complicated. PCO was used by the late Patrick Slater to extend his repertory grid/PCA methods to the exploration of disagreements between people as reflected in what he called "Logical Equivalence Matrices" (Slater, Chetwynd & Farnsworth, 1989). Other MDS methods have been used for the analysis of repertory grids (Rathod, 1981; van der Kloot, 1981) and underpin the "circumplex" models of affect and personality (e.g. Walters & Jackson, 1966; Rosenberg, Nelson & Vivekananthan, 1968; Widiger, Trull, Hurt, Clarkin & Frances, 1987) and also the "Facet Analysis" methods pioneered by Louis Guttman which have been vehemently championed at a Ravenscar meeting some years ago by David Canter.
That's a flavour of why this book might be important. How was it? I found large hunks pretty heavy going and much of the matrix algebra was quite beyond me. I felt I got a much more definite picture of the relationships between the different methods and their implementations in a variety of programs (I'm most familiar with ALSCAL which is present in various forms in SAS, SPSSX and in STATISTICA). The book sets a fine example in providing simple PC-compatible software to carry out many of these analyses and data from the examples used in the book. However, there was an error in my copy of the front end menu program. It wouldn't call the program which provides Shepard plots but SHEP_PLO runs fine from DOS command line. It looked as if menu program is trying to call SHEP_PL0 (that's what it says on its menu) so that seemed a bit of an own goal!
The other major problem is that the few examples considered are used only very sparsely and some seem to prove just how badly the methods have been used in published literature. I wanted some examples of good MDS practice exploring a single subject area (it wouldn't have to be psychotherapy research!) taken through the various types of data and different methods of analysis and perhaps moving into the inferential and Monte Carlo simulative methods that the authors themselves have pioneered. I guess you can't have everything. With the growing willingness to look at the complexity of therapists' perceptions of the therapy process and of their "texts" there is a crying need for these methods to be employed well. This book is good but the obvious only first step for those of greater mathematic ability than me.
References
Chris Evans [Pages 6 and 7 in the printed version] [return to index]
Frijda, N. H. (Ed.). (1993). Appraisal and beyond. The issue of cognitive determinants of emotion. A special issue of Cognition and Emotion. Hove, UK: Lawrence Erlbaum Associates.
This is a fascinating book. I have misgivings about aspects of cognitive therapies, particularly when they are advocated as the only psychotherapy for all sorts of problems, also when their practice sounds like a patronising re-education of faulty thinking without insight into the likely faults in the therapist's own thinking. I decided to read this book to challenge some of my prejudices. The book is a double issue of Cognition and Emotion. The original page numbering remains so the 168 pages run from 225 to 392. There is a clear introduction from Frijda explaining the basic idea that cognitive appraisal intervenes between experience (perception) and emotion. The other papers flow in a sensible sequence to a summary by Frijda.
The first paper is from Smith and Lazarus and is a typical example of experimental work in this area: subjects were given simple vignettes of experiences and asked about their appraisals and about their emotions. Then the vignettewas elaborated a little to intensify or change the emotion (according to appraisal theories anyway) and similar questions repeated. They report data largely congruent with their theoretical model although they note that the sadness vignettes showed markedly less good fit than those for anger, guilt and fear/anxiety. They suggest a post hoc explanation for the poor fit in terms of social pressures censoring anger toward dying people. That's plausible but typical of the way, it seemed to this reader, in which there can be rather too much flexibility left about what is, and what isn't, in the basic model.
The second chapter by Reisenzein & Hofmann addresses very honestly and directly the problems of evaluating partial fit between theory and data. R&H show great thoroughness in sorting and matching techniques to show quite high conformity between reported emotions and their own model. The methods here are worth reading for anyone interested in researching how therapists may simplify case summaries.
The next chapter, by Parkinson & Manstead, is a trenchant, if rather repetitive, criticism of the methods used to develop appraisal theory. They argue that the data analysed are secondary reports, in relation to artificial, hypothesized situations or else recalled events. They suggest that the results tell us about the semantics and logics by which we use language to describe emotions and to rationalise them, but actually tells us little or nothing about "real-time" emotion (the use of computer/electronic media language through this paper intrigued me, it seemed to reflect a faith in an artificial intelligence model, but perhaps also a model in which the generally manipulated and controlled presentation of life experience was being acknowledged). They argue that the interpersonal and social, the interactive sequential, and the instrumental aspects of experience and emotion are ignored by existing cognitive appraisal models and their research methods. They see this as akin to nuclear physicists studying the lichen on the outside of a synchrotron rather than looking to see what happens inside it. Their last point about instrumentality links with their use of media words and seemed to locate their criticism within the "speech acts" school of discourse analysis. In this paradigm, interpersonal experience is offered to us by others to achieve things just as our responses, right down to our emotional responses, are also aimed at eliciting responses: such is seen to be the nature of social life and within it there are only repetitive patterns and structures of discourse, there are none of the rules or models the natural science paradigm implies, then seeks to find. P&M never go quite this far in their overt criticism of appraisal work, but I felt that extreme scepticism about the use of natural science methods in the human sciences was implicit. I think I have much to learn about how to repeatedly criticise a set of researchers while still getting published by them! My respect for cognitive theorists such as Frijda was immeasurably increased by finding this paper here.
The penultimate paper by Scherer offers data from a computer program. The program takes as input respondents' answers to 15 questions which tap the components of Scherer's model of cognitive appraisal. The questions are asked about a recalled situation in which the respondent had an emotion. The answers are used to calculate similarity between these answers answers predicted on the basis of his model for 14 emotions. The closest match is suggested by the program and then the second closest, these are compared with the emotions the respondent reported. The fit was generally quite good and the method is interesting and clearly potentially valuable for us exploring why therapists think they did/do things. However, here again I'd side with Parkinson & Manstead and argue that the questions are so far from my experiences of experiencing that I find it hard to see them as good handles on the real processes involved in feeling.
In the final paper by Frijda, a founder of the cognitive appraisal model, he too argues that its research methods have told us about the cognitive elaboration of emotion for verbal communication, not about "cognitive antecedents". He argues, plausibly, but essentially without data, that the truly antecedent cognitive appraisals are probably very simple, much more than current models would suggest. He appears also to say that emotional experiencing may be a parallel process to cognitive appraisal, though both processes might interact in their very high speed development. He also appears to say that emotions may sometimes be no more, nor less, than summary markers of a set of appraisals and response tendencies. He does report some data on self-reports of guilt and of shame which seem to blow huge holes in appraisal models. One problem is that people often report guilt about events without reporting they caused the event thus contradicting predictions of appraisal theories. One remembered event was from an adult woman who continued to feel guilty about not having said goodbye to her father, despite her mother's admonishment, when leaving for school one morning. The father had died suddenly and unexpectedly during the day. The father had sexually abused her. I can see that one might want to construe that as a piece of faulty learnt connection between experience and emotion and tell her, caringly and perhaps creatively, some ways to unlearn that. I can also see and respect Frijda's quite separate misgivings about what, if anything, her story tells us about the process by which guilt, or any other emotion, is experienced by her as a generic process of appraisal. However, I was left feeling that these clinical and research models will both fail to take on board the complexity of uniqueness and of membership of a social species in her story.
If you want a sample of how thorough the methods and the intellectual criticism can be in cognitive research into emotions then you may want to read this book. Sadly, this thoroughness and scepticism seem to me to be as far from the reports of cognitive therapy I read, as the best psychoanalytic theory and clinical papers are from purportedly psychodynamic psychotherapy research: the gaps between theories and research methods and clinical practices are different and the splits different as you would expect from differences between cognitive and psychoanalytic theories. However, there are big gaps and they don't look likely to disappear.
Chris Evans [Pages 7 to 8 in the printed version] [return to index]
Hunt, J. C. (1989) Psychoanalytic aspects of fieldwork (Sage University Paper Series on Qualitative Research Methods, volume 18). Sage:Newbury Park. ISBN 0-8039-3473-4 (pbk.), 93pp. £5.95
This book says: "Jennifer C. Hunt is Associate Professor of Sociology at Montclair State College and a Research Candidate in the full clinical training program of the Psychoanalytic Institute, Department of Psychiatry, New York University Medical Center." I'd not heard of "Research Candidate" trainees at psychoanalytic institutions, sounds a good idea to me. She has done her work on the police and the book is written for sociologists and anthropologists. She describes the Classical and Symbolic Interactionist theories of fieldwork and contrasts these with the greater appreciation of subjectivity in Existentialist theories but argues that neither incorporates unconscious determination.
She argues that dreams, parapraxes and associations should be recognised as crucial data. She illustrates this approach from her own work and a little from work of others. She further argues that these data provide interpretations of unconscious processes and structures of the respondents. Some of her own material seemed persuasive in relation to the police and there were also a couple of other vignettes that suggested that attention to classical analytical material can help the research process. Her material is framed as transference and, less commonly, as countertransference. The main problem, it seemed to me, was that you either accept or regard such interpretations as persuasive almost entirely in relation to your own experience of the analytic process. There are two prossible sceptical positions, each familiar to researchers of psychodynamic therapies. The first is total: "there is no such unconsciousness, you're mad" (usually framed a little more politely!) or the more subtle: "these thoughts throw a great deal of light on how you see your own mind but can't tell us much beyond that and are particularly suspect where you are working outside your own cultural origins". I thought that the book should have at least opened some of these arguments if only to clarify which of a variety of well rehearsed defensive positions Professor Hunt adopts.
My lesser complaint is Professor Hunt doesn't much utilise strong object relations theories to explain how these responses to others come about, sticking closer to an American variant of a drive/defence model I'd say. That leaves her, as she acknowledges, a bit exposed, working outside the traditional structure of the analytic session and without either a strong theoretical, or strong empirical set of methods by which we can evaluate her interpretations or pit them against others. I would interested to see someone use a rigorous Kleinian or Fairbairnian theory to frame her observations. I would have been even more interested to see her use methods described in the latest edition of Psychotherapy Research (volume 4(3/4) '94) to explore "transference" or to see her use psychometric and statistical techniques to assess inter-rater concordance in evaluating the vignettes or in matching them to interpretations.
In summary, this book is not central to psychotherapy research nor the final word in its own area but it is an interesting example of how much more seriously some other researchers can take psychoanalytic theories and methods than many S.P.R. researchers!
Chris Evans [Pages 8 to 9 in the printed version] [return to index]
Berman, L (1993) Beyond the Smile - the Therapeutic use of the photograph. London: Routledge. Pp.214. Paperback.
Berman has produced a fascinating account of both the rationale and technique of using photographs in psychotherapy - without advocating a sloppy eclectic style.
The author first sets photographs in context, drawing our attention to the ways in which images are constructed - both purposefully and unconsciously. We open the pages of not just magazines but also of family albums. She goes on to explain how to make use of photographs in therapy whether they are introduced by the client or they are our own intervention. Timing, exploration of feelings and interpretation of the image need to occur within a reflexive framework which accounts for transference and counter-transference material. Readers are offered an in depth vignette of this process with one client as well as numerous useful and insightful examples of how to enable clients to understand the nuances and paradoxes of photographs. Just as clinical material can be listened to on a number of levels, so too can photos be viewed from a number of different perspectives.
"Discovering the 'I' through the 'eye' of the camera" involves deconstructing past and current images and the reality which gave rise to them. Some clients may want to reconstruct these images by rearranging characters in the photographs. Berman makes suggestions as to who might benefit from using photographs; for instance, adoptive children, older people, sexually abused clients or clients with eating disorders, for example.
I thoroughly enjoyed reading this book - in fact I could hardly bring myself to put it down once I'd started. I also found myself looking at my own family album with a new perspective.
Colleen Heenan [Page 9 in the printed version]
Colleen Heenan, 11 Milford Place, Bradford, W. Yorks BD9 4RUQuinodoz, J.M. (1993) The taming of solitude -separation anxiety in psychoanalysis. Routledge:London. 211pp. £14.99.
This is the latest text (No. 20) from the new library of psychoanalysis. The adherence to Freud prevails throughout and Quinodoz offers a convincing re-reading of Mourning and Melancholia (Freud, 1917) highlighting Freud's use of the concept of 'object', placing it in the context of the work of Melanie Klein. This book then is an orthodox objects relations exegesis examing the role of separation anxiety in psychoanalysis. This in itself presents few difficulties, indeed the development of ideas is thoughtful and well written with recourse to clinical vignettes throughout. However, for a while I was left feeling I was reading a revivalist text rather than something new. This was until I reached chapter six when Quinodoz offers a wide range of psychoanlytic theories about separation anxiety including the theories of Fairbairn, Anna Freud, Winnicott, Kohut, Spitz, Mahler and Bolby. Quinodoz offers a neat, if not over ambitious, attempt to draw these theoreticians together under a post-Kleinian umbrella. In the end, though I like the project of theoretical convergence, there is too much arguing about fine tunings in psychoanalysis.
If I do have a problem with this text though it is it's applicability. For Quinodoz, the nuances of separation anxiety are such that he asserts that psychoanalysis should preserve the norm of seeing patients four or five times per week (p. 152). When Quinodoz talks about his four-times-a-week patients it leaves me feeling rather remote, that the psychoanalytic intelligentsia are distant and rather out of touch with the reality of psychoanalytic psychotherapy, in the public sector for instance. I admit that this remoteness is not always the case with books from the "New Library", for instance Segal's book (No. 12) is brilliantly accessible, but I feel less comfortable about Quinodoz. Personally I do favour a rather traditional adherence to psychoanalytic theory but I do not see out-patients four times a week and I do not see them on a couch. Maybe I should and perhaps I should ask if this would this make a difference? Would a more intensive treatment impact upon the length neccessary to influence a positive outcome, or indeed would a more intensive treatment in inexperienced hands like mine in fact be detrimental? Perhaps there are one or two tentative research questions here. There is, of course, an over-riding question about the reality of resources available that looms over such issues. But my concern about the remoteness of this text is couched in a much more specific concern that I have about the future of psychonalytic psychotherapy. Will the purist approach of the Institute of Psychoanalysis, that Quinodoz represents here, continue to filter down to practitioners in the public sector, or will psychoanalysis in the market place disappear in to an ever more élitist capsule that only the rich can ride. If this is the case then the influence of traditional psychoanlysis will in all likelihood decrease until it becomes a bygone remnant of better times. This is perhaps a rather fatalistic conclusion to a brief review of a buoyant psychoanalytic text book.
Gary Winship [Pages 9 to 10 in the printed version]
Psychotherapy Dept., 1 Princes Street, Reading, Berkshire RG1 4EGPlease pick up the 'phone now and ring Dr. Jane Knowles' secretary Sue Clarke on:
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and get the application form. Then write to me and tell me what you think of Network, or better still, write an article, a book review or a response to anything in this edition and send that to me [contact details]. [Page 10 in printed version] [return to index]