PSZICHOTERÁPIA
A professional journal of practice based on psychotherapeutic methods
A quarterly publication
32nd year, issue 4, November 2023.
CONTENTS
Editorial
Dániel Eörsi, Tibor Cece Kiss, Lili Valkó
STUDIES
Questions of practice
Petronella Nagy: Captive to traumas
Theoretical study
Tamás Dömötör Szalai: The psychotherapy of narcissistic personality disorder. A review on the related dysfunctions, intervention points, evidence-based methods, and therapeutic recommendations
Theoretical study
Tamás Halmai: Keep it positive? The role of positive psychology in university curriculums
Questions of practice
Ernst Knijff: Awareness instead of rules. Gestalt ethics – translated by: Dániel Vattay
WORKSHOP
Essay
András Holló: A psychotherapist in Psytopia
Comments
József Krékits: Therapy for lack of tradition? – Comment on András Holló: A psychotherapist in Psitopia
Domonkos Sik: What is less visible from the cave – From this side of „Psitopia” and beyond.
PROFESSIONAL LIFE
Interview
“I wish that all psychotherapists would be characterised by curiosity…” – Interview with György Purebl – Zsanett Kepics, Tibor Cece Kiss
Contest – Is the therapist human(?)
Melinda Sinkó: The outgrown sneakers
News
In memoriam Andor Harrach – Eörsi Dániel
Awards
Reviews
Conferences – Tamás Cseterki ♦ Tibor Cece Kiss ♦ Győző Hága ♦ Dániel Eörsi ♦ Lilla Hardi, Gábor Szőnyi
Book reviews – Tibor Cece Kiss ♦ István Tiringer
List of professional books and periodicals
Professional programs
Editorial announcements
STUDIES
QUESTIONS OF PRACTICE
Petronella Nagy
Captive to traumas
Past and unprocessed traumas can lead to the formation of victimhood-based identity. If the individual evaluates itself as the aggrieved party, this may later appear as a characteristic cognitive, affective and behavioral pattern in the sociocultural environment. Aggressive reactions and destructive behavior can be part of the complication, which can be understood from the victim’s perspective as a revenge for the past harm or a defense mechanism against future attacks. At the same time, it protects the individual from facing his losses and from taking personal responsibility to achieve change.
In this study, I analyze this dynamic in a domestic psychiatric ward’s large group event, in the framework of psychopathological, object relations theory and group analysis paradigms. We are going to observe how unprocessed traumatic experiences lived through on the individual and institutional levels may subserve retaliatory behaviors, such as an anarchic revolt to destroy the group. In connection with the case, I emphasize the personality structure of psychopathy, as well as the characteristics of the large group and the new type of institutional care, the high-security ward. The formation of high-security departments is an ongoing development, thus it can raise current and relevant questions for our professional environment. Finally, I will touch upon the constructive potential in destruction: the verbalization of destructive fantasies can promote autonomous aspirations, thus ultimately becoming part of development.
Keywords: high security department – large group – psychopathy – traumatization – destructive behavior
THEORETICAL STUDY
Tamás Dömötör Szalai
The psychotherapy of narcissistic personality disorder.
A review on the related dysfunctions, intervention points, evidence-based methods, and therapeutic recommendations
Narcissistic personality disorder affects up to 1-6 percent of society, and has been the focus of interest for numerous psychotherapeutic theories over the past more than 100 years. Despite this interest, uniform guidelines for its treatment have not been developed to date. In the absence of randomized, controlled trials and analyses comparing the effectiveness of different methods, besides approaches based on clinical consensus, general recommendations for personality disorders and proven methods for borderline personality disorder adapted to narcissistic personality disorder are generally recommended. Currently available studies support the effective use of transference-focused therapy, mentalization-based therapy, metacognitive therapy, a specialized form of cognitive-behavioral therapy for personality disorders, schema therapy, dialectical behavior therapy, and couple therapy. Key points of intervention focus on self and object representations, including self-esteem and typical relationship patterns, as well as on perfectionism, mentalization skills, and emotion dysregulation, with a special regard to the regulation of shame, aggression, and depressive reactions. The reduced internal control and emotion recognition, increased self-focus and negative reaction to emotional stimuli are often based on a neurobiological background, not on the client’s motivation. Basic psychotherapy recommendations include: working in a team-setting, a thorough exploration of comorbid disorders, both the overt and covert features of grandiose and vulnerable functioning, and the assessment of suicidal risk. It is recommended to specify the therapeutic limits in the contract and to identify a concrete problem related to reality that the client wants to change. Building a collaborative alliance with an inquiring attitude, highlighting key experiences related to self-evaluation and emotion regulation, including neglectful or traumatic backgrounds, and challenging the patient’s typical defenses or behavioral maneuvers are of paramount importance. Psychotherapy itself can cause fear in the client, while therapists commonly expose helpless, angry, judgmental and disconnected countertransferences – therefore extra attention shall be paid to the hidden damages in the therapeutic alliance.
Keywords: narcissistic personality disorder – psychotherapy – intervention – review
THEORETICAL STUDY
Tamás Halmai
Keep it positive?
The role of positive psychology in university curriculums
Positive psychology is one of the most promising approaches in modern psychology. It proposes a paradigm shift: while accepting negative feelings and emotions, it focuses on promoting a joyful, fulfilled life, well-being, positive relationships and engagement. Its origins date back to the humanistic tradition put forward by Rogers and Maslow, followed by the pioneering work of Mihaly Csikszentmihalyi and the theory of flow. In the last two decades, positive psychology has brought forward a number of interesting findings in areas such as the role of positive emotion, trauma and its potential consequences, as well as in the field of education. Positive education programs introduced in the United States in the 2000’s have produced remarkable results. On a primary and secondary school level, positive psychology programs can be a welcome extension of existing curriculums, however, they can also be readily applied as independent material. In my study, I am presenting a pilot university course, launched at Budapest Business University. Our course achieved popularity and success in bringing positive emotion, relationships and issues of self-awareness closer to students without prior psychological training. It provides the opportunity to promote relevant findings of modern psychology as a theoretical background. More importantly, participants were given the possibility of experiencing the practical use of positive psychology exercises; including mapping their personal strengths, and the active pursuit of joyful experiences, gratitude and flow. A wider application of such university programs can help students utilize the results of modern psychology and thus, facilitate their future success – in their professional as well as personal lives.
Keywords: positive psychology – university curriculums – state of joy – character strengths
QUESTIONS OF PRACTICE
Ernst Knijff
Awareness instead of rules. Gestalt ethics
Translated by: Dániel Vattay
This essay stretches the traditional forms in more than one aspect. Firstly, it only references philosophical literature – which did raise some questions when it was first published. Secondly, the author introduces definitions and considerations to ethical thinking which help us examine cases from a new viewpoint. The author introduces these based upon two important pillars of Gestalt therapy: Field Theory and Buber’s philosophy of Dialogue. Yet this paper goes beyond the specific bounds of Gestalt psychotherapy and presents cases where the relational aspects of therapy – or supervision – are unavoidable. Thus, we recommend this article wholeheartedly to any therapist who has encountered situations with clients which were hard to navigate or those professionals who cannot rule out facing such situations.
The editors
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