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Treating Affect Phobia : A Manual for Short-Term Dynamic Psychotherapy - Leigh McCullough

Treating Affect Phobia

A Manual for Short-Term Dynamic Psychotherapy

Paperback Published: 31st December 2002
ISBN: 9781572308107
Number Of Pages: 365

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This hands-on manual from Leigh McCullough and associates teaches the nuts and bolts of practicing short-term dynamic psychotherapy, the research-supported model first presented in Changing Character, McCullough's foundational text. Reflecting the ongoing evolution of the approach, the manual emphasizes "affect phobia," or conflict about feelings. It shows how such proven behavioral techniques as systemic desensitization can be applied effectively within a psychodynamic framework, and offers clear guidelines for when and how to intervene. Demonstrated are procedures for assessing patients, formulating core conflicts, and restructuring defenses, affects, and relationship to the self and others. In an easy-to-use, large-size format, the book features a wealth of case examples and write-in exercises for building key clinical skills. The companion website (www.affectphobiatherapy.com) offers useful supplemental resources, including Psychotherapy Assessment Checklist (PAC) forms and instructions.

'This is the training manual that teachers and practitioners of short-term dynamic therapy have been eagerly anticipating. It is the first psychodynamically oriented volume that expertly guides the novice through emotion-focused, time-sensitive psychotherapy in an explicit, step-by-step fashion. The manual is enhanced by very useful exercises that allow therapists to try out their interventions and compare them to the authors' expert responses. This volume represents a new and exciting development in the teaching, learning, and practice of psychodynamic/integrative therapy in general, and brief psychotherapy in particular.' - Stanley B. Messer, PhD, Dean, Graduate School of Applied and Professional Psychology, Rutgers University 'This carefully reasoned and researched manual starts with the simple assumption that many people are afraid of their own emotions, offers easy ways to identify whatever is being expressed or even suppressed, and explains clearly the authors' suggestions for treatment.' - Donald L. Nathanson, MD, The Silvan S. Tomkins Institute and Department of Psychiatry and Human Behavior, Jefferson Medical College 'This work is an extraordinary synthesis of depth and practicality. It is as clear, concrete, and richly exampled a treatment manual as I have seen, yet it depicts not a simple or mechanistic therapy but one that goes to the very heart of human feeling and experience. Incorporating a profoundly integrative vision, Treating Affect Phobia will be of great value not only to psychodynamically oriented therapists but to anyone in the field who appreciates the accumulating evidence for the central role of affect - and fear of affect - in our lives.' - Paul L. Wachtel, PhD, Doctoral Program in Clinical Psychology, City College and the CUNY Graduate Center, New York

Introductionp. 1
Theory, Evaluation, and Formulation
Affect and Affect Phobia in Short-Term Treatmentp. 13
What Is an Affect Phobia?p. 13
Why This Therapy Focuses on Affectp. 14
The Definition and Classification of Affectp. 18
Adaptive versus Maladaptive Expression of Affectsp. 22
The Development and Treatment of Affect Phobias: An Introductionp. 24
The Importance of Anxiety Regulationp. 27
Goals of Treatmentp. 29
Chapter 1 Exercisesp. 32
Affect Phobia, Psychodynamic Conflict, and Malan's Two Trianglesp. 35
Reformulating Psychodynamic Conflict as Affect Phobiap. 35
Understanding Affect Phobias by Using Malan's Two Triangles: The Universal Principle of Psychodynamic Psychotherapyp. 37
Making Important Distinctions about Feelingsp. 44
Restructuring Affect Phobias through Systematic Desensitization: The Main Treatment Objectivesp. 46
Chapter 2 Exercisesp. 51
Assessment and Selection of Treatment for the Patientp. 55
Overview of the Initial Assessmentp. 55
How the DSM Multiaxial Assessment Guides Treatment Selectionp. 57
How to Rate the Global Assessment of Functioning (GAF) Scalep. 62
Indications and Contraindications for Short-Term Dynamic Psychotherapyp. 65
Using the GAF Scale to Tailor Treatment to Patients' Needsp. 68
The Supportive-Exploratory Continuum of Interventionsp. 72
Chapter 3 Exercisesp. 75
How to Formulate a Core Psychodynamic Conflict: Spotting Affect Phobiasp. 81
An Overview of the Formulation Processp. 81
Identifying Defenses: How Adaptive Feelings Are Avoidedp. 86
Identifying the Adaptive Activating Feelings: What Feelings Are Feared and Avoided?p. 88
Identifying Anxieties/Inhibitions: The Reason Why Adaptive Feelings Are Avoidedp. 89
Summarizing the Formulation in Terms of Affect Phobiap. 92
Examples of How to Formulate Core Conflictsp. 94
Identifying Pitfalls in Formulating Core Conflictsp. 98
Repetition to Revise and Refine the Formulationp. 101
Chapter 4 Exercisesp. 101
Defense and Affect Restructuring
Introduction to Part IIp. 109
Defense Restructuring, Section 1: Defense Recognitionp. 113
Overview of Defense Recognitionp. 113
Pointing Out Defenses against Phobic Affectsp. 119
Validating Defensesp. 122
Pointing Out Strengths That Exist Alongside Defensesp. 123
Managing Difficult Defensesp. 124
Repeating Interventions until Defenses Are Recognizedp. 130
Chapter 5 Exercisesp. 131
Defense Restructuring, Section 2: Defense Relinquishingp. 138
Overview of Defense Relinquishingp. 139
Identifying Consequences of Defensive Behavior: Costs and Benefitsp. 143
Distinguishing the Origin of Defenses from the Maintenance of Defenses: Then versus Nowp. 146
Grieving Losses Due to Defensesp. 148
Building Self-Compassion When There Is No Griefp. 149
Identifying the Secondary Gain of Defenses: Hidden Meanings and Rewardsp. 150
Repeating Interventions to Enhance Motivation to Give Up Defensesp. 156
Chapter 6 Exercisesp. 158
Affect Restructuring, Section 1: Affect Experiencingp. 167
Overview of Affect Experiencingp. 167
Exposure to Phobic Feeling/the Feared Affectp. 177
Response Prevention: Defense Restructuring as Neededp. 189
Identifying Pitfalls in Affect Experiencingp. 190
Repeating Interventions until Affect Phobia Is Desensitizedp. 193
Some Frequently Asked Questionsp. 195
Chapter 7 Exercisesp. 196
Affect Restructuring, Section 2: Affect Expressionp. 207
Overview of Affect Expressionp. 208
Building Expressive and Receptive Capacitiesp. 213
Bearing Interpersonal Conflictp. 215
Integrating Feelingsp. 216
Role Playing of Difficult Interactionsp. 217
Providing Information to Aid Expressionp. 218
Pitfalls in Affect Expressionp. 221
Repeating Practice until Affect Expression Flows Naturallyp. 223
Chapter 8 Exercisesp. 224
Self- and Other-Restructuring
Introduction to Part IIIp. 233
Self-Restructuring: Building Compassion and Care for Selfp. 237
Overview: Restructuring for a Positive Sense of Selfp. 238
Building Receptive Capacity to One's Own Feelingsp. 245
Changing Perspectives on the Self: Encouraging Patients to Imagine How Others See Themp. 250
Finding and Encouraging the Lost Voicep. 254
Encouraging "Parenting" of the Selfp. 255
Reducing the Externalization of Needsp. 256
Repeating Interventions until Phobias about Self-Feelings Are Desensitized and Self-Worth Improvesp. 258
Chapter 9 Exercisesp. 259
Other-Restructuring: Building Adaptive Inner Images of Othersp. 265
Overview: Restructuring Affect Phobias about Relationships with Othersp. 266
Building the Receptive Capacity to Others' Feelingsp. 274
Changing Perspectives: Viewing Others More Accurately and Compassionatelyp. 276
Identifying and Restructuring Addictive Attachmentsp. 279
Recovering "Lost Loves": Caring Persons in the Pastp. 281
Repeating Interventions until Phobias about Relationships Are Desensitizedp. 284
Chapter 10 Exercisesp. 285
Diagnostic Considerations and Termination
Treating Specific Diagnoses: The Relationship between DSM Diagnoses and Affect Phobiasp. 293
How Affect Phobias Underlie Diagnoses and Are Maintained by Primary and Secondary Gainp. 293
Integrating Nature and Nurture: The Biopsychosocial Modelp. 294
Using Axis I Diagnoses to Inform Treatment of Affect Phobiasp. 295
Using Axis II Diagnoses to Guide Treatment of Affect Phobiasp. 301
Conclusion: Focusing on Affect Phobias That Underlie Diagnosesp. 307
Terminationp. 308
Overview of Terminationp. 308
Assessing What Changes Have Been Madep. 313
Assessing Why Changes Have Been Madep. 316
Celebrating Progress and Acknowledging What Needs More Workp. 317
Exploring the Full Range of Feelings for the Therapistp. 318
Replacing the Loss of Therapyp. 321
Conclusion and Commencementp. 322
Answers to Exercisesp. 323
Referencesp. 353
Indexp. 357
Table of Contents provided by Rittenhouse. All Rights Reserved.

ISBN: 9781572308107
ISBN-10: 1572308109
Audience: Professional
Format: Paperback
Language: English
Number Of Pages: 365
Published: 31st December 2002
Publisher: Guilford Publications
Country of Publication: US
Dimensions (cm): 28.0 x 21.7  x 2.0
Weight (kg): 0.87