The focus and re-focus of attention is represented everywhere in psychotherapy; nowhere more pointedly than in hypnosis, meditation and the gestalt concept of concentration. Expanding on these techniques, Dr. Polster offers three options for heightening attention in the ordinary therapeutic relationship: tight therapeutic sequences, the reconstruction of storyline and the spotlighting of selves. Each of these impels attention, helping to create an imbeddedness into previously squandered ingredients of the patient's life.
The proliferation of therapeutic groups, either self-help or professionally staffed, has dramatically expanded the applicability of psychotherapy. This development reflects society's increased willingness to deal communally with personal problems that were previously restricted to private psychotherapeutic sessions. Gestalt group therapy, with its original emphasis on the freshness and pungency of individual experience has also extended its perspective to group work. Dr. Miriam Polster describes how the gestalt approach enlivens group focus and interaction through its principles of awareness and experiment-and especially through its attention to the quality of the contact between group members.
The development and function of the self's capacity for intimacy is described through infancy, childhood and adolescence. The normal process of achieving intimacy is outlined. The illusions of intimacy of Disorders of the Self are then described with detailed clinical presentations of each diagnostic category. The therapeutic interventions necessary to deal with these defenses are then outlined.
As human beings age, we are bombarded with losses: of our professions, businesses or jobs; homes; health; ideals; friends; family members and partners. This address will offer special techniques, usable in brief or long-term therapy, to help aging clients find ways to honor their losses as well as their own integrity, as they continue to grow and to savor life.
The major emphasis in contemporary psychoanalytic psychotherapy is on the early and consistent interpretation of the transference. A growing attention to countertransference analysis, to the risk of "indoctrinating" patients, to character analysis, to the analysis of unconscious meanings in the "here and now" also are dominant trends. Significant controversies continue regarding the importance of the "real" relationship, the therapeutic versus the resistant aspects of regression, the role of empathy, and the relation of historical to narrative truth.
For the past half-century there has been a remarkable and continual evolution in the theory and practice of psychotherapy. Now that evolution shows signs of becoming a revolution. Many elements of these changes are, as yet, only scantily represented in the literature, but they are the stuff of bull sessions, the more liberated case conferences and solitary, sometimes fearful, experimentations. This transition comes about from a variety of influences, among which three are particularly worthy of examination for what they suggest about what is likely to emerge a half-century from now.
The traditional assumption that only insight into the causes in the past can bring about a change in the present makes us blind for what Alexander & French called "the corrective emotional experience," i.e., chance events in the present that may lead to almost immediate solutions. A great number of Erickson's surprising results could be considered the outcome of "planned chance events," often in the form of behavior prescriptions similar to interventions in hypnotherapy (e.g., "speaking the clients's language," prescribing resistance, the use of reframing, paradoxical interventions, etc.).
Supervision and therapy are isomorphic processes. What supervision teaches is the process of creating change in people, and the very teaching of this process is itself an attempt to create change in the supervisee. Like families, therapists tend to confine themselves to selected segments of their possible repertory. Thus a major goal of supervision can be the expansion of the therapist's use of self.
Existential psychotherapy is more properly viewed as a therapy informed by a sensibiity to existential issues, rather than as a discrete, self-contained school of therapy. It addresses the anxiety embedded in our consciousness of the parameters of existence, especially in our confrontation with death, meaninglessness, freedom, and isolation. I shall discuss these concerns, particularly those with the greatest relevance to everyday therapy practice. I shall discuss the implications of the existential sensibility for the conduct of therapy and the therapeutic relationship. Genuineness and authenticity are necessary.
Focusing is bodily attention, not to mere sensations but to an at first unclear, implicitly complex bodily sense-of a situation, problem, or aspect of life. Therapy deepens immediately with many clients if asked what physical sense comes in the middle of the body in relation to what is being worked on. With half a minute of repeated direct attention, clients can assign a "quality-word," e.g., "heavy," "fluttery," or "tight." Then small steps come to say the crux of the problem. Each brings a slight (later large) "shift" and release, a direct sense of validity, although further steps may again change the whole problem.