25 Chapters
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CHAPTER FIVE: Treating attachment issues

Delisle, Gilles Karnac Books ePub

Relational psychotherapy, with its roots in both Gestalt-therapy and object relations theory, essentially sees treatment of attachment issues as a reactivation and resolution of developmental processes. This reactivation has been shown to be fundamental in the treatment of attachment disorders. This is why it is necessary to identify the client’s relational issues outside the therapy room because they carry the imprints of the developmental issues that were not resolved at the attachment stage. In addition, it is necessary to reactivate these issues within the framework of the therapeutic work. This means that the therapeutic relationship, before it can be a reparative space, must be a space for reconstruction and attempting to make sense of what is unresolved. Levy, Orlans, and Winger (1999) describe this process as: revisit, revise, revitalize. In order for the therapist to be able to do this he must develop and maintain three fundamental competencies: reflexive competency, affective competency, and interactive competency.

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CHAPTER THREE: Object relations development theories: an overview

Delisle, Gilles Karnac Books ePub

Psychoanalysis has sometimes been accused of having become a hermetically sealed system, unwilling to be open to the influence of other approaches. However, even though its history is one of violent theoretical and clinical disputes, such as the huge disagreements between Melanie Klein and Anna Freud, contemporary psychoanalysis is nevertheless pluralistic. Its practice has evolved so much that today one might be justified in asking whether classical analysis in its present form may be threatened with extinction. However, regardless of how it is practised, psychoanalytic theory is today part of our universal heritage. We can reasonably selectively employ certain of its more illuminating points without actually having to adopt the whole of its theoretical basis, framework, and techniques.

In this chapter the reader will be given a quick summary of key psychoanalytic theories of development that will be used to inform the analysis of the essential issues of development in the following chapters. In a notable piece of work in 1983, Greenberg and Michell proposed that these diverse theories could be seen through the lens of their respective strengths and weaknesses, and additionally from the angle of their similarities. These authors approach the plurality of psychoanalytic theory using a preliminary epistemological differentiating tool to answer the question: what came first and what has grown out of it? Greenberg and Mitchell classify psychoanalytical theories of development under three major ideological lines: instinct or drive theories, relational theories, and mixed theories. While this system of classification is not unanimously accepted by the psychoanalytic community, for our purpose it will serve to underline one of the seminal points of object relations developmental theory.

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Chapter Ten - ORGT and Evidence-Based Practice

Delisle, Gilles Karnac Books ePub

CHAPTER TEN

ORGT and evidence-based practice

Marc-Simon Drouin, Ph.D. 1

Introduction

Object relation Gestalt therapy (ORGT), as developed in the writings of Gilles Delisle (1998, 2004) has become an influential model of therapeutic intervention, particularly in Quebec and in Europe. In recent years, a large number of therapists have been trained in ORGT, or have at least been introduced to its principal concepts through a series of seminars and didactic activities offered to mental health professionals. ORGT can be defined as a treatment of contact failures within various domains of experience by means of a hermeneutic dialogue: the approach was developed for the treatment of pathological personalities. This rigorous therapeutic model has substantial theoretical support and satisfies Mahrer's (1989) criteria for coherent psychotherapeutic models: a theory of human nature, a theory of psychotherapy, and a set of concrete operational procedures.

Delisle (2008) has shown that recent research in the neurosciences has given some support to the application of the ORGT model in the clinic. But in spite of this non-negligible validation, ORGT, along with several other psychodynamic and humanist models, has remained largely outside the mainstream of evidence-based psychotherapy.

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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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