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Can We Talk?

by Mary Jo Barrett, Katy Butler

It is the end of innocence--the day we enter the land beyond the rulebook. A client wants to give us diamonds. Another invites us to dinner. Another notices that we've stopped wearing a wedding ring, and we wonder how much to tell her. A client moves forward as if to hug us, and then gives us a open-mouthed kiss. Simple dicta no longer seem sufficient.

One way or another, all therapists face similar questions about therapeutic boundaries: Should we accept the gift? How much do we self-disclose? What ...

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  • A-303 Ethics with Soul

    Instructor: Ofer Zur
    CE Credits: 6
    In our litigious age of risk management, reduce unnecessary anxiety while bringing more soulfulness and clinical integrity back into your practice.
    Note: This course fulfills many state board requirements for training in ethics and risk management.

  • A-216 Shhh! The Ethical Dilemmas No One Talks About

    Instructor: Mary Jo Barrett
    CE Credits: 4
    Explore the ethical dilemmas we face around such issues as self-disclosure, sexuality, gifts, and dual relationships.


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  • OL-115 Shhh! The Ethical Dilemmas No One Talks About

    Authors: Mary Jo Barrett, Arnold Lazarus, Jay Efran, Michael Hoyt, and others
    CE Credits: 2
    Explore the Big Four of ethical trouble spots: self-disclosure, sexuality, gifts, and dual relationships.
    Note: This course fulfills many state board ethics requirements

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Beyond Talk

by Mary Sykes Wylie

A brilliant, thirty-something architect named Frank went to see Minnesota psychologist Patrick Dougherty because he'd never been able to sustain a successful, lasting relationship. Charming and voluble, he talked nonstop about his work, his social life, his multiple affairs, what he thought about art, architecture, music, politics, and the general state of the world. Several times during the first two sessions, Dougherty--who makes use of qigong breathing techniques in his clinical work--asked Frank to ...

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20 Weeks to Happiness

by Richard Handler

If Thomas Jefferson were a psychology graduate student today, he'd probably think of himself as a positive psychologist. It was Jefferson, after all, who began the Declaration of Independence with the statement that human beings aren't only created equal but "endowed by their Creator with certain unalienable Rights, [and] that among these are Life, Liberty and the pursuit of Happiness." Happiness was the word he chose, not pursuit of power or economic gain.

Jefferson didn't formally study happiness. ...

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The Limits of Talk

by Mary Sykes Wylie

Bessel van der Kolk likes to introduce his workshops on Post-Traumatic Stress Disorder (PTSD) with medical film clips from World War I showing veterans diagnosed with what was then called "shell shock." In these dramatic and riveting clips, one soldier sits hunched over on his hospital cot, staring blankly ahead, responding to nothing and nobody until the single word "bomb" is said, whereupon he dives for cover underneath the small bed. Another man lies almost naked on the bare floor, his back rigidly arched, ...

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Discoveries from the Black Box

by Mary Sykes Wylie, Richard Simon

The human brain is a wet, coconut-sized, walnut-shaped organ, the color of raw liver and the consistency of an overripe peach. Comprised of billions of nerve cells, each connecting electrochemically with an average of 10 thousand others, it's the most complex biological entity known on earth. The number of possible interconnections among its neurons exceeds the estimated number of atoms in the universe. Just as remarkably, it can make such intricate and baffling self-transformations that many insist it ...

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The Big Moment

by David Waters

Psychotherapy Networker.

It was the kind of tense stalemate between an angry, critical father and an increasingly withdrawn teenage son I'd seen many times through the years. Greg was a single parent who seemed to regard every exchange with his shy, 14-year-old son, Tad, as an opportunity for a "corrective experience." But they were both bright and articulate, and therapy started off with both of them readily agreeing to spend more time together.

Having contact isn't the same as making contact, ...

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10 Best-Ever Anxiety-Management Techniques

by Margaret Wehrenberg

"I don't think I want to live if I have to go on feeling like this." I hear this remark all too often from anxiety sufferers. They say it matter-of-factly or dramatically, but they all feel the same way: if anxiety symptoms are going to rule their lives, then their lives don't seem worth living.

What is it about anxiety that's so horrific that otherwise high-functioning people are frantic to escape it? The sensations of doom or dread or panic felt by sufferers are truly overwhelming--the very same ...

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Trauma

The Limits of Talk: Bessel Van der Kolk Wants to Transform the Treatment of Trauma
By Mary Sykes Wylie
January/February 2004

The Politics of PTSD: How a Diagnosis Battled Its Way into the DSM
By Mary Sykes Wylie
January 2004

Bringing the War Home: The Challenge of Helping Iraqi War Vets
By Cecilia Capuzzi Simon
January/February 2007

Creating a Culture of Healing: Recovering from Trauma in War-Ravaged Gaza
By James Gordon
January/February 2007

Applying the Brakes: In Trauma Treatment, Safety Is Essential
By Babette Rothschild
January/February 2004

The End of Innocence: Reconsidering Our Concepts of Victimhood
By Dusty Miller
July/August 2003

 

 

 

Content Search Overview: Therapists, social workers, counselors and others found these articles helpful in learning more about the effects of trauma. People searching for information on the following terms and concepts found these articles helpful:

Trauma
Post Traumatic Stress Disorder (PTSD)
EMDR
Cognitive Therapy
Exposure Therapy
Antidepressants
Combat PTSD
Vicarious Trauma
Compassion Fatigue
Abuse Survivors
Mind/Body Techniques
Somatic Therapies
Somatic Experiencing
Mindfulness

Sample from: The Limits of Talk, by Mary Sykes Wylie

And what was the treatment that he felt was not really helping his patients to move on? It was standard talk therapy 101--helping them explore their thoughts and feelings--supplemented with group therapy and medications. During individual sessions with clients, he often focused intensely on patients' past traumas, in the interest of getting them to process and integrate their memories. "I very quickly went to people's trauma, and many of my patients actually got worse rather than better," he says. "There was an increase in suicide attempts. Some of my colleagues even told me that they didn't trust me as a therapist."

The fundamental conundrum of how trauma affects the mind and body that still plays out in treating trauma survivors was already crystallizing in van der Kolk's mind 20 years ago. "When people get close to reexperiencing their trauma, they get so upset that they can no longer speak," he says. "It seemed to me then that we needed to find some way to access their trauma, but help them stay physiologically quiet enough to tolerate it, so they didn't freak out or shut down in treatment. It was pretty obvious that as long as people just sat and moved their tongues around, there wasn't enough real change."

From Psychotherapy Networker, January/February 2004

 

Sample from: Creating a Culture of Healing, by James Gordon

Afterward, we share our drawings. Ali, a surgeon, quick-moving and humorous, begins. In his first drawing, he's alone and looks confused. In the second, his four children stand in front of an Israeli soldier, who's pointing his gun at them. "I live near an Israeli settlement," he says, "and, every day, when I leave the house, I worry that something will happen to my children before I come home. Two years ago," he adds matter-of-factly, "my house was bombed." In the final picture, the one that shows the "problem solved," he's joyfully playing with his children. The occupation is over and the Israeli soldiers have gone home. "I'm thankful to God," he concludes.

Several others hold up their own pictures of endangered children, assuring me that they didn't have to copy from each other. "This is our biggest concern," Mahmoud says. "Everyone worries about their children, every single morning when we leave for the hospital or clinic." They share memories of homes vacated on Israeli orders and destroyed, of bombs shaking their houses, of children bleeding in hospital emergency rooms. Later I think of the recent training we led in Israel, where health professionals drew their own pictures of vulnerable children traveling on buses or sitting in malls that might be attacked.

From Psychotherapy Networker, January/February 2007


Sex

Erotic Intelligence: Reconciling Sensuality and Domesticity
By Esther Perel
May/June 2003

In the Mood: Desire Seldom Comes to Those Who Wait
By Michele Weiner-Davis
May/June 2003

Pathways to Sexual Intimacy: Revealing Our Many Selves in the Bedroom
By Richard Schwartz
May/June 2003

Satori in the Bedroom: Tantra and the Dilemma of Western Sexuality
By Katy Butler
March/April 1999

What Is This Thing Called Love? The Answers Are Being Discovered in the Laboratory
By Pat Love
March/April 1999

The Evolution of Modern Sex Therapy
By Katy Butler
March/April 1999

Beyond Viagra: Why the Promise of Cure Far Exceeds the Reality
By Barry McCarthy
May/June 2004

Passionate Marriage: Helping Couples Decode the Language of Their Sexuality
By David Schnarch
September/October 1997

 

 

 

Content Search Overview: Therapists, social workers, counselors and others found these articles helpful in learning more about sexual issues. People searching for information on the following terms and concepts found these articles helpful:

Sexual Issues
Erectile Dysfunction
Sex Addiction
Arousal
Premature Ejaculation
Sex Therapy
Orgasmic Disorders
Sexual Disorders
Foreplay
Sexual Abuse
Sexual Violence
Pleasure
Eroticism

Sample from: Erotic Intelligence, by Esther Perel

It always amazes me how much people are willing to experiment sexually outside their relationships, yet how tame and puritanical they are at home with their partners. Many of my patients have, by their own account, domestic sex lives devoid of excitement and eroticism, yet are consumed and aroused by a richly imaginative sexual life beyond domesticity--affairs, pornography, prostitutes, cybersex, or feverish daydreams. Having denied themselves freedom and freedom of imagination in their relationships, they go outside, to reimagine themselves with dangerous strangers.

Yet the commodification of sex--the enormous sex industry--actually hinders our potentially infinite capacity for fantasy, restraining and contaminating our sexual imagination. The explicitness of sexual products undermines the power of mystery, the voyeuristic pleasures of the hidden. Where nothing is forbidden, nothing is erotic. Furthermore, pornography and cybersex are ultimately isolating, disconnected from relations with a real, live, other person.

A fundamental conundrum in marriage, it seems to me, is that we seek a steady, reliable anchor in our partner, and a transcendent experience that allows us to soar beyond the boundaries and limitations of our ordinary lives. The challenge, then, for couples and therapists, is to reconcile the need for what's safe and predictable with the wish to pursue what's exciting, mysterious, and awe-inspiring. That challenge is further complicated when the partners are on opposite sides of this divide.

From Psychotherapy Networker, May/June 2003

 

Sample from: The Evolution of Modern Sex Therapy, by Katy Butler

Modern sex therapy often begins with instruction in "sensate focus." The pressure to have an orgasm, keep a firm erection or prolong intercourse is taken away. Instead, individuals or partners are told to set aside time to caress themselves or each other in a relaxed environment, without trying to achieve any sexual goal. Once anxiety is lowered, sex therapy often proceeds successfully, especially in treating the following common problems:

Vaginismus. Vaginismus is the spastic tightening of the vaginal muscles and can make intercourse impossibly painful. It can be so severe that not even a Q-tip can be inserted in the vagina, and some women with vaginismus have never, or rarely, completed sexual intercourse in the course of years of marriage. Often the result of physically painful experiences like childbirth, painful intercourse, rape or molestation, it is a learned fear response. Therapy involves teaching the woman to relax and breathe while gently inserting the first of a graduated series of lubricated rods, starting with one as small as is necessary for comfort. In ensuing weeks, the woman uses incrementally thicker rods and then inserts her partner's finger and finally his penis into her vagina. Nothing is forced, and insertion is always under the control of the woman.

From Psychotherapy Networker, March/April 1999

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