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Introduction to the Case Studies

Delisle, Gilles Karnac Books ePub

INTRODUCTION TO THE CASE STUDIES

The following case studies were written by clinical psychologists with varying degrees of experience and mastery of the ORGT approach. Michel Dandenault, Ph.D. has been in private practice in Ottawa for twenty years, and recently completed the third level, the highest of the ORGT training program offered by the CIG. Guilhème Pérodeau, Ph.D., is a professor of psychology at the Université du Québec in Outaouais. She also recently completed the third level of the ORGT program and began private practice a few years ago. Finally, Dorothy Scicluna, D.Psy., has been in private practice in Malta for several years. Unlike the other two, she did not complete the clinical training program offered by the CIG, but was introduced to ORGT during an introductory workshop that I gave in Malta in March of 2009. None of the three are native anglophones.

The authors were asked to begin with a general framework featuring a multiaxial diagnosis and a structural diagnosis, as well as a global summary of the psychotherapy conducted in terms of the theory presented here. Apart from these minimal requirements concerning the structure of the presentation, each author was encouraged to express their personal vision, using their own style. The resulting texts were sometimes concretely detailed, sometimes global and abstract. Sometimes the diagnosis was described in detail, while sometimes the author chose to more deeply explore symptom reproduction in psychotherapy.

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Chapter Thirteen - Jade

Delisle, Gilles Karnac Books ePub

CHAPTER THIRTEEN

Jade

A case study presented by Dorothy Scicluna 1

Jade came to psychotherapy unaware of her non-embodied self. Throughout her journey she retrieved most aspects of herself, became aware of her views of Self and Others, and has figured out that she deserves to be happy.

Anamnesis

Jade calls for an appointment. She says that she was referred by an ex-client of mine. This is October 2008. I see her in private practice. She comes for her first session and she reminds me of a diligent school girl. Dark curly brown hair pulled back in a pony tail, no trace of makeup, rosy freckled cheeks, fair skin, small features, and dark blue eyes. She wears dark clothes. She will keep regular Friday appointments. She is a teacher in a secondary school reputed to be a difficult school. She says she has no trouble controlling the students.

The first session will feel like a warm session and that will be the last of its kind before a long time. At the time of writing this part of the report it is August 2009 and some warm sessions have reoccurred. I must admit, holding Jade during her therapeutic journey was a struggle.

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CHAPTER SIX: Self-esteem issues

Delisle, Gilles Karnac Books ePub

The concept of self-esteem has captured the attention of a good number of contemporary theoreticians. More often associated with narcissism in the psychoanalytic tradition, self-esteem has also been studied and commented on from a humanistic-existential angle, notably by Nathaniel Branden (1984). Among contemporary psychodynamic authors, the work of McWilliams (1994), Johnson (1987, 1994), Gabbard (1994), as well as Gunderson and Phillips (1998), offers a useful developmental point of view based on Kohut’s or Kernberg’s ideas. Before addressing the theme of the development of self-esteem, let us explain the parameters of our field of interest. When writing about self-esteem, I shall refer to the developmental issue as it has been studied since the 1970s, by humanistic psychologists, as well as those of the psy-chodynamic school, such as Kohut. When I use the term narcissism and its derivatives, I shall rather be referring to the pathological indicators of the phenomenon.

The concepts of narcissism and of self-esteem are so often linked in contemporary theory that it is easy to jump to conclusions, one of which is to link wounded self-esteem and narcissistic vulnerability with the pathology of the same name. But all personality structures have a narcissistic function: to protect self-esteem through certain specific defences.

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Chapter Three - Integration in Psychotherapy: Epistemological and Methodological Considerations

Delisle, Gilles Karnac Books ePub

CHAPTER THREE

Integration in psychotherapy: epistemological and methodological considerations

In the first chapter, we saw that several authors had serious reservations about the theoretical foundations of Gestalt therapy. At the end of our review, we shared this critical perception and immediately dissociated ourselves from a defence of the 1951 theory that held that any “limits” found by critics were only a result of a superficial reading of the 1951 work. Monument though it may be, the Perls, Hefferline, and Goodman theory of the Self is not an untouchable museum piece in a glass box (Gagnon, 1993): it needs to be revised and extended (From, 1984, cited by Bouchard & Derome, 1987). Our aim here will be to revise the theory while at the same time respecting its characteristic conceptual structures, to complete it without denaturing it. To this end, we attack the central weakness of the theory, the absence of concepts necessary for an understanding of underlying pathologies, of development, and of individual differences. Gestalt therapy draws its strength from phenomenological roots that have an existential, humanistic colouring. This is the heritage that we must respect.

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CHAPTER SEVEN: Treating self-esteem issues

Delisle, Gilles Karnac Books ePub

We shall address the treatment of self-esteem issues from the multiple viewpoints of relational psychotherapy. The difficulties in making contact that lie at the heart of these pathologies will be understood and worked through from two points of view. These perspectives, adopted and practised in the pluralist vein of contemporary psychoanalysis, are those of Kohut and Kernberg. Historically, they have been involved in rather a conflict-ual relationship, of which it may be said, if one is not constrained by institutional loyalty, that it says as much if not more about politico-institutional as about clinical disagreement. From Kohut’s point of view, narcissistic pathology is the result of arrested development. We imagine that the person who manifests this pathology has been hindered in his normal need to idealize and de-idealize. This point of view is very near to our thinking about the evolution of personality disorders. In reality, personality disorder results from the mixture of risk and resilience factors, in both the biological and the social spheres. When risk factors are greater than resilience factors, the process of development is interrupted or perverted. We begin, in fact, with the two perspectives already described earlier: Kohut’s which considers failure as arrested development and Kernberg’s who sees it as a perversion of this process.

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