Mental, physical, or sexual abuse in close personal relationships commonly results in trauma that is very different from the trauma of accidents, illness, or war. Making creative use of attachment theory to explicate the multifaceted outcomes of trauma, this book provides a powerful conceptual framework and a concise, masterly review of a huge knowledge base. Encyclopedic in scope and scholarly in its up-to-the-minute survey of research findings.
Combining years of research, teaching, and experience treating trauma survivors, Dr. Jon G. Allen offers compassionate and practical guidance to understanding trauma and its effects on the self and relationships. Coping With Trauma is based on more than a decade of Dr. Allen's experience conducting educational groups for persons struggling with psychiatric disorders stemming from trauma. Written for a general audience, this book does not require a background in psychology. Readers will gain essential knowledge to embark on the process of healing from the complex wounds of trauma, along with a guide to current treatment approaches.In this supportive and informative work, readers will be introduced to and encouraged in the process of healing by an author who is both witness and guide. This clearly written, insightful book not only teaches clinicians about trauma but also, equally important, teaches clinicians how to educate their patients about trauma.Reshaped by recent developments in attachment theory, including the importance of cumulative stress over a lifetime, this compelling work retains the author's initial focus on attachment as he looks at trauma from two perspectives. From the psychological perspective, the author discusses the impact of trauma on emotion, memory, the self, and relationships, incorporating research from neuroscience to argue that trauma is a physical illness. From the psychiatric perspective, the author discusses various trauma-related disorders and symptoms: depression, posttraumatic stress disorder, and dissociative disorders, along with a range of self-destructive behaviors to which trauma can make a contribution.Important updates include substantive and practical information on ; Emotion and emotion regulation, prompted by extensive contemporary research on emotion - which is becoming a science unto itself. Illness, based on current developments in the neurobiological understanding of trauma. Depression, a pervasive trauma-related problem that poses a number of catch-22s for recovery. Various forms of self-destructiveness - substance abuse, eating disorders, and deliberate self-harm - all construed as coping strategies that backfire. Suicidal states and self-defeating aspects of personality disorders. The author addresses the challenges of healing by reviewing strategies of emotion regulation as well as a wide range of sound treatment approaches. He concludes with a new chapter on the foundation of all healing: maintaining hope.This exceptionally comprehensive overview of a wide range of traumatic experiences, written in nontechnical language with extensive references to both classic and contemporary theoretical, clinical, and research literature, offers a uniquely useful guide for victims of trauma, their family members, and mental health care professionals alike.
Distilling years of experience in educating psychiatric patients and their families about depression, Jon Allen has written a practical book that addresses the challenges depressed patients face on the road to recovery. Allen advocates approaching depression by focusing on the importance of hope, and he helps patients understand depression through two simple ideas: catch-22 and stress pileup. This book conveys how the symptoms of depression impede all the things depressed persons must do to recover, thus defusing self-criticism while encouraging patients to take satisfaction in small steps toward improvement. And the concept of stress pileup encompasses a developmental perspective respecting the full range of accumulated biological, psychological, and interpersonal stresses that play into depression. This broad understanding helps patients become more compassionate toward themselves and puts them in a stronger position to make use of professional care. Coping With Depression is written for a general audience, including depressed persons and their family members, as well as professionals seeking a readable integration of current knowledge that they can use to educate their patients. Although written in nontechnical language, the book provides a sophisticated and comprehensive understanding of the psychological development of depression, the neurobiology of the illness, and the full range of evidence-based treatment modalities. All material is buttressed by extensive references to theoretical, clinical, and research literature. Coping With Depression emphasizes the concept of agency, encouraging readers to take an active role in their recovery. Countering today's trend toward exclusive reliance on antidepressant medication, the book employs the perspective of developmental psychopathology to integrate psychosocial and neurobiological knowledge. The book explains how biological vulnerability is intertwined with stress stemming from insecure attachment, childhood adversity, stressful life events, emotional conflicts, and problems in close relationships. Going far beyond the "chemical imbalance," the author illustrates how the experience of depression is linked to changes in patterns of brain activity as evidenced by neuroimaging studies. Coping With Depression will help readers • understand the development of depression from a biopsychosocial perspective• appreciate how depression is compounded by related conditions, including bipolar disorder, anxiety disorders, substance abuse, personality disorders, general medical conditions, and suicidal states• understand how recovering from depression entails working on many fronts, including improving physical health, participating in pleasurable activities, countering negative thinking, resolving internal conflicts, and-above all-establishing more stable and secure attachment relationships• become knowledgeable about the treatment options that facilitate coping, including cognitive-behavioral, interpersonal, and psychodynamic psychotherapy as well as medication and combined treatment• appreciate the centrality of hope in recovery from depression and the challenges to hope that depression poses To maintain hope, patients, their family members, and clinicians must face the seriousness of the illness of depression and the daunting obstacles to recovery, including catch-22 in all of its manifestations. Throughout the book, Allen reiterates the theme of agency: depressed persons can use their intelligence to understand their illness and do something to recover and remain well, making use of help from others along the way.
Trusting in Psychotherapy is an important book that fills a lamentable void: although virtually everyone—therapists, students, and patients alike—believes that trust is the foundation of psychotherapy, the topic has been neglected in the psychiatric literature, to the detriment of the therapeutic relationship. The author, who brings five decades of study and practice to the enterprise, posits that cultivating trusting psychotherapy bonds—especially for patients who have experienced developmental trauma in close relationships—is complex, challenging, and a critically important topic for examination. Whereas therapists are inclined to focus on patients' problems with trust, the author argues that trusting cannot be understood apart from trustworthiness and that therapists should give equal attention to the task of becoming trustworthy to their patients. Blending developmental science and ethical thought in an interdisciplinary spirit, the author draws on contemporary writings of philosophers to elucidate the concepts of trust and trustworthiness. What it means to trust in the practice of psychotherapy; the many facets of trusting and trustworthiness; attachment relationships, both secure and insecure; the central role of hope in trust; and the ethical-moral basis of trusting and trustworthiness—these and other topics are addressed with competence and care. Intellectually engaging and designed to provoke thought, the book: • Offers a broadly developmental perspective, reflecting the belief that attachment trauma plays a profound role in many severe psychiatric disorders and emphasizing that the resulting and pervasive distrust and social alienation pose significant obstacles to developing therapeutic connections.• Provides an overview of the professional literature on developing expertise in conducting psychotherapy, with discussion of current research.Addresses the proliferation of new therapies in the context of competing schools of thought and what this proliferation means for the therapist caught between science and practice, academics and clinicians. • Is aimed chiefly at psychotherapists, yet its conversational, generally nontechnical style makes it accessible to those who are not mental health professionals, including patients who might wish to listen in on the conversation and families who desire a more complete understanding of the therapeutic process.• Includes key points at the end of each chapter to help the reader stay oriented and focused on the most important concepts. Trusting in Psychotherapy argues persuasively that we should shift the balance of our efforts from developing therapies to developing therapists, a view that deserves to inform mental health research and thought leadership.
This book brings together the latest knowledge from attachment research and neuroscience to provide a new approach to treating trauma for therapists from different professional disciplines and diverse theoretical backgrounds. The field of trauma suffers from fragmentation as brands of therapy proliferate in relation to a multiplicity of psychiatric disorders. This fragmentation calls for a fresh clinical approach to treating trauma. Pinpointing at once the problem and potential solution, the author places the experience of being psychologically alone in unbearable emotional states at the heart of trauma in attachment relationships. This trauma results from a failure of mentalizing, that is, empathic attunement to emotional distress. Psychotherapy offers an opportunity for healing by restoring mentalizing, that is, fostering psychological attunement in the context of secure attachment relationships-in the psychotherapy relationship and in other attachment relationships. The book gives a unique overview of common attachment patterns in childhood and adulthood, setting the stage for understanding attachment trauma, which is most conspicuous in maltreatment but also more subtly evident in early and repeated failures of attunement in attachment relationships.
”Denne bog handler om et stort sundhedsproblem: traumer i tilknytningsrelationer – i yderste instans overgreb på og vanrøgt af børn. (…) Den voksende forståelse af den afgørende betydning af mentalisering – det at være opmærksom på mentale tilstande som tanker og følelser hos en selv og andre – sætter os mere specifikt i stand til at finde frem til det, som efter min opfattelse er nøglen til traumet og vejen til at komme sig: mentalisering i forbindelse med tilknytningsrelationer. Med inddragelsen af mentalisering vil tilknytningsteori og forskning give os et solidt grundlag for traumebehandling, som tilbyder terapeuter og patienter en klarere forestilling om, hvad vi foretager os.” Jon G. Allen i bogens prolog ”Allen styrer os behændigt gennem minefeltet af evidensbaserede terapier og når frem til ’traditionel terapi’, en ny kombination af mindfulness, mentalisering og tilknytningsbaseret terapi, der leverer den diagnostiske forståelse, som både terapeut og patient – implicit eller eksplicit – søger.” Peter Fonagy, leder af Anna Freud Centre, i bogens forord ”Jon G. Allen opfordrer på en yderst engagerende og nyttig måde terapeuter til grundige overvejelser, før de undervurderer værdien af ’traditionel terapi’, når de arbejder med klienter, som har været udsat for relationelle psykiske traumer. Men det, han beskriver, er meget mere end traditionel terapi; det er en kompleks (men særdeles praktisk) destillation af de centrale principper og praksisser, der gør alle de nyere ’evidensbaserede’ terapier effektive.” Julian D. Ford, University of Connecticut Health Center Jon G. Allen, ph.d, er ledende psykolog ved Menninger-klinikken og Helen Malsin Palley-professor i psykisk sundhedsforskning og professor i psykiatri ved Menninger-instituttet for psykiatri og adfærdsvidenskaber ved Baylor College of Medicine. Jon G. Allen har specialiseret sig i behandling af traumerelaterede lidelser og depression. Han er en produktiv forfatter og udgiver, der har skrevet bøger om traumer, depression og mentalisering.
This work covers the diagnosis and treatment of patients who have experienced traumas and subsequent dissociative disorders. An epidemic of these patients has caused controversy about their treatment. Clinicians from various disciplines offer specialised knowledge for effective treatments.
Mentalizing, the fundamental human capacity to understand behavior in relation to mental states such as thoughts and feelings, is the basis of healthy relationships and self-awareness. A growing evidence base supports the effectiveness of mentalizing-focused interventions in the treatment of borderline personality disorder. This volume explores wider applications, construing mentalizing as a core common factor in the effectiveness of psychotherapeutic interventions that cuts across treatment modalities and theoretical approaches ranging from psychodynamic to interpersonal and cognitive therapies.This book distills the burgeoning literature on mentalizing for clinicians of diverse professional backgrounds. The book is divided into two parts: Understanding Mentalizing fully explicates the concept of mentalizing and its foundations in developmental research and social-cognitive neuroscience; Practicing Mentalizing presents the general principles of psychotherapeutic interventions that promote mentalizing as well as a range of current clinical applications. Mentalizing is multifaceted - for example, pertaining to self and others as well as explicit and implicit processes - and links to myriad overlapping concepts including empathy, metacognition, theory of mind, mindfulness, and psychological mindedness. Two sides of research on the development of mentalizing in attachment relationships have significant clinical implications: interactions in secure attachment relationships enhance mentalizing and illuminate the conditions of optimal psychotherapeutic relationships; conversely, trauma in attachment relationships undermines the development of mentalizing and eventuates in developmental psychopathology that poses special challenges for psychotherapy. Neuroimaging is illuminating diverse brain regions that contribute to mentalizing capacity, including a ""mentalizing region"" in the medial prefrontal cortex that is consistently activated in mentalizing tasks; concomitantly, research on autism and psychopathy attests to the neurobiological basis of psychopathologies in which stable impairments of mentalizing are most conspicuous. In development and in psychotherapy, mentalizing begets mentalizing, as exemplified by a mentalizing stance that fosters inquisitiveness and curiosity about mental states in oneself and others; basic principles and clinical examples, including the use of transference, demonstrate the spirit and technique of mentalizing, capped off by a patient's first-hand account of mentalization-based treatment for borderline personality disorder. Attachment trauma is the wellspring of disrupted mentalizing capacity, and a focus on mentalizing provides an integrative framework for psychodynamic and cognitive-behavioral treatment of trauma as well as for parenting, family, and social-systems interventions directed toward interrupting the perpetuation of trauma in relationships. Psychoeducational interventions, including patient education and structured exercises, are employed to cultivate a therapeutic alliance around mentalizing; the book includes a straightforward explanation clinicians can use with patients, ""What is Mentalizing and Why Do It?"" In the chapter on mentalizing interventions, the authors propose to clinicians, ""You are already doing it."" If the effectiveness of treatment depends on therapists mentalizing and helping their patients do so more consistently and skillfully, clinicians of all persuasions can benefit from the extensive knowledge now available to hone further their attention to this vital therapeutic process.
In Restoring Mentalizing in Attachment Relationships: Treating Trauma With Plain Old Therapy, Jon G. Allen, Ph.D., argues that the incorporation of mentalizing into attachment theory and research provides a solid foundation for trauma treatment, and offers therapists and patients a pathway to recovery. In plain language accessible to clinicians and laypeople alike, Allen describes trauma in attachment relationships, reviews the literature, and makes a compelling, evidence-based argument for the efficacy of psychotherapy. Specifically, the book: • Presents a comprehensive view of attachment trauma across diverse diagnostic conditions, directly linking these to the psychotherapeutic interventions that work best.• Allows therapists from different theoretical frameworks, by using these best practices, to treat patients with a wide range of problems and disorders.• Situates mindfulness and mentalizing as central to secure attachment, focusing clinicians' attention on these most critical dimensions of healing relationships.• Provides a thorough review of the research on attachment, mindfulness, and mentalizing, and evaluates the effectiveness of the most popular trauma treatments, thereby equipping clinicians to treat patients across the spectrum of trauma-related psychiatric disorders.• Employs a down-to-earth, conversational writing style that makes the book accessible to patients and family members as well as to professionals. Trauma can be the result of blatant events, such as violence, abuse, and neglect, or the subtle yet pervasive failure to connect. Both contribute to developmental psychopathology and cause lasting emotional pain. "Plain old therapy," according to Allen, is a valuable and proven resource for addressing trauma and treating patients with complex psychiatric disorders. This fascinating and eminently useful book should help to restore psychotherapy to its well-deserved stature.
At mentalisere vil sige at forstå adfærd som udtryk for mentale tilstande som tanker og følelser. Denne bog giver en udførlig redegørelse for begrebet mentalisering og dets anvendelse i klinisk praksis. Forfatterne lægger op til, at mentalisering betragtes som grundlaget for alle psykoterapeutiske handlinger, og ønsker med bogen at styrke fundamentet for psykoterapeutisk praksis. Udviklingen af interessen for mentalisering er sket i tre bølger. Den første bølge kom, da Uta Frith, John Morton og deres medarbejdere beskrev mentaliseringsvanskeligheder som det centrale psykologiske problem i forbindelse med autisme. Kort tid efter skabte Peter Fonagy, Mary Target og deres kolleger bølge nummer to ved at anvende mentaliseringsbegrebet i forbindelse med traumerelateret udviklingspsykologi, sådan som den kom til udtryk i borderline-personlighedsforstyrrelse. Nu er der så ved at danne sig en tredje bølge med henblik på at inddrage mentalisering i det kliniske arbejde med et bredere spektrum af forstyrrelser, behandlingsmodaliteter og teoretiske tilgange. Bogens første del er en grundig gennemgang af den forskningsmæssige og teoretiske litteratur af relevans for mentalisering, herunder dens mange aspekter og relationer til beslægtede begreber, dens udviklingsmæssige udspring i tilknytningsforhold og dens neurobiologiske forankring. Bogens anden del omhandler mentaliserende interventioner i psykoterapi, og hvordan disse anvendes i fx traumebehandling, terapi med børn og deres forældre, behandling af borderline-personlighedsforstyrrelse, psykoedukation og i forebyggelse af fx voldelig adfærd. Bogen henvender sig til faggrupper, der arbejder med mennesker, særligt i terapeutiske sammenhænge, herunder psykologer, psykiatere, psykoterapeuter. Den forsyner praktikere med alt, hvad de har brug for at vide om mentaliseringsbaseret behandling. Jon G. Allen, Peter Fonagy og Anthony W. Batemaner alle tre professorer og de største internationale kapaciteter inden for mentaliseringsbaseret terapi.
This book brings together the latest knowledge from attachment research and neuroscience to provide a new approach to treating trauma for therapists from different professional disciplines and diverse theoretical backgrounds. The field of trauma suffers from fragmentation as brands of therapy proliferate in relation to a multiplicity of psychiatric disorders. This fragmentation calls for a fresh clinical approach to treating trauma. Pinpointing at once the problem and potential solution, the author places the experience of being psychologically alone in unbearable emotional states at the heart of trauma in attachment relationships. This trauma results from a failure of mentalizing, that is, empathic attunement to emotional distress. Psychotherapy offers an opportunity for healing by restoring mentalizing, that is, fostering psychological attunement in the context of secure attachment relationships-in the psychotherapy relationship and in other attachment relationships. The book gives a unique overview of common attachment patterns in childhood and adulthood, setting the stage for understanding attachment trauma, which is most conspicuous in maltreatment but also more subtly evident in early and repeated failures of attunement in attachment relationships.
Borderline Personality Disorder: Tailoring the Psychotherapy to the Patient explores the challenge of treating patients with borderline personality disorder. These patients make up a large segment of the difficult-to-treat population. The instability of their relationships, the intensity of their affective responses, and their proneness to paranoid reactions all contribute to their difficulty in working consistently and constructively in the psychotherapeutic situation. When one adds these difficult patient problems to the therapist's quandary about how expressive or supportive to be, therapists are indeed often confronted with a challenging therapeutic task. The book begins with a review of the clinical and research literature pertaining to the treatment of borderline patients. It presents a unique, empirically based intensive study of three borderline patients, based on transcripts of audiotaped therapy sessions. The research methodology is reviewed, and clinically oriented descriptions of the three patients, their psychotherapy processes, and their outcomes are included. Following an overall summary of results, conclusions regarding the differential indications for supportive versus expressive emphasis in psychotherapy are discussed. In their research, the authors recorded every psychotherapy session and studied a randomly selected group of sessions. Therefore, the reader is provided with increased insight into what is most effective with what kind of patient at a given point in the therapy process.
This technical and well-illustrated guide for archaeologists and conservators aims to `provide a methodology for the identification of the woody taxa used to manufacture artefacts recovered from archaeological excavations', to provide the anatomical descriptions of the taxa and to present a list of characters of the taxa. The guide is heavily illustrated with photographs, maps, and tables to allow easy identification.
"Tramping to Success" encapsulates what every person strives for: a life of challenge, purpose and success. Surviving through the Great Depression and the Dust Bowl years; prospering in business through determination and fortuitous choices; finding--and almost losing--a woman whose abilities, education and social knowledge provided the perfect complement to this Kansas farm-boy; traveling to every continent; reflecting on achievements and perceived failures--"The Life & Times of Jon B. Shastid" is a personal journey which mirrors the tribulations and successes of America in the 1900's. And is emblematic of what can be achieved in the 21st century.
"Tramping to Success" encapsulates what every person strives for: a life of challenge, purpose and success. Surviving through the Great Depression and the Dust Bowl years; prospering in business through determination and fortuitous choices; finding--and almost losing--a woman whose abilities, education and social knowledge provided the perfect complement to this Kansas farm-boy; traveling to every continent; reflecting on achievements and perceived failures--"The Life & Times of Jon B. Shastid" is a personal journey which mirrors the tribulations and successes of America in the 1900's. And is emblematic of what can be achieved in the 21st century.
This volume thoroughly revises and updates its predecessor The Petticoat Rebellion. A half dozen new chapters introduce many new recipes, historical vignettes, and continuing tales of our imaginary Fr re Gerard and Tante Suzanne as they create and develop today's world famous New Orleans Creole Cuisine. It carries the story forward to 1803 and takes a bit beyond. So brew yourself up a pot of good New Orleans chicory coffee and plan a few historical meals for your family of the new century.
The parenchymous remains of roots and tubers are increasingly becoming recognized as an important category of plant remain alongside seeds, fruits and wood charcoal. Identification is however frequently viewed as problematical and such important indicators of past diet are often left unidentified. This book describes the full range of anatomical and morphological characters used in the identification of the parenchymous remains of roots and tubers. Each of the characters is illustrated by photographs of modern and archaeological plant tissues and by line drawings. Further sections of the book also deal with the examination of archaeological tissues and the preparation of modern plant tissue reference collections.
Here, two energy professionals introduce low enthalpy geothermal energy as a ubiquitous alternative to less reliable renewable energy sources such as solar and wind power. They outline the working principles, attainable efficiency, and the carbon footprint of tapping into geothermal energy sources, including novel technologies such as using carbon dioxide as an underground heat carrier. Numerous cases studies from different countries and regions illustrate the state of the art in geothermal systems, as well as current environmental and economic challenges associated with this technology. A critical discussion of the potential of geothermal energy, taking into account its economics and societal impact, is included.
