scholarly journals Self-harm: a strategy for survival and nodal point of change

2006 ◽  
Vol 12 (5) ◽  
pp. 329-337 ◽  
Author(s):  
Jack Nathan

The author explores key issues related to psychotherapeutic work with people who self-harm. Particular attention is given to the powerful countertransference feelings that practitioners often experience in this work and the importance of managing these. Rather than maintaining a detached distance, therapists should emotionally engage with the patient's experience, creating a unique therapeutic relationship. The common patterns, functions and meanings of self-harm are discussed, with clinical vignettes that highlight the underlying dynamics of the behaviour. Self-harm is a survival stratagem, and methods for helping patients to find other ways to cope are suggested. One such is mentalisation, which can enhance the patient's capacity to think, not impulsively act. If patients learn how to assess more accurately their own and other people's states of mind, less destructive behaviours can emerge.

2018 ◽  
Vol 22 (1) ◽  
pp. 63-84
Author(s):  
John O'Connor

The art of psychotherapy has been defined as the capacity of the psychotherapist’s mind to receive the psyche of the patient, particularly its unconscious contents. This deceptively simple definition implies the enormously complex art of receiving the most disturbed, dissociated, maddening, often young and primitive, frightening, and fragmented aspects of the patient’s multiple ages and selves, in the hope perhaps that we might make available to our own mind, to the patient’s mind, and within the therapeutic relationship, whatever it is that we discover together, perhaps with the possibility that this may allow that these dissociated, fragmented, lost, and potentially transformative aspects of self might become more accessible to both therapist and patient. The complexity of this process is further intensified when cultural difference is an important aspect of therapeutic engagement. This paper will explore this rich and complex art. It will include exploration of psychoanalytic, relational, and transpersonal psychotherapeutic perspectives as they inform the potentials and mysteries of this deeply receptive process. The paper will consider the potential this receiving of the other might have for the growth of both the therapist and patient within the life span of clinical engagement and will include consideration of implications for cross cultural clinical work. Clinical vignettes illustrating and informing the ideas explored in this paper will be woven throughout the paper. Whakarāpopotonga Kua tautuhia te toi whakaora hinengaro ko te kaha o te hinengaro o te kaiwhakaora hinengaro ki te pupuri i te hinengaro o te tūroro, mātuatua nei ko ngā matū maurimoe. E tohu ana te tautuhinga ngāwari nei i te kaha uaua o te mahi pupuri i ngā maramara tirohanga, ngā tau, ngā whaiaro tini o ngā tūroro arā noa atu te wairangi, te noho wehe, te kārangirangi, he taiohi, he māori, whakawehiwehi, i runga i te wawata tērā pea ka tuwhera ki ō tātau ake hinengaro, ko tō te tūroro ki waenga hoki i te whakapiringa haumanu. E kene pea mā te mea ka kitea, e tuku ēnei tirohanga pūreirei, kongakonga, ngaro, ā, ngā tirohanga hurihanga whaiaro e whakamāmā ake ki te kaiwhakaora me te tūroro. Ka kaha ake te auatanga o tēnei hātepe i te mea ko te rerekētanga o te ahurea te wāhanga nui o te mahi haumanu. Ka wheraina e tēnei tuhinga te tirohanga toitaurea mōmona nei. Ka whakaurua te wherawherahanga o te wetewetenga hinengaro, te tātanga, me ngā tirohanga whakaoranga hinengaro wairua i te mea ko ēnei ngā kaiwhakamōhio i ngā pirikoko o tēnei hātepe toropupū tino hōhonu. Ka whakaarohia e te pepa nei te ēkene pea o te whakaurunga mai o tētahi kē atu mō te whakatipuranga o te kaihaumanu me te tūroro i roto i te wā huitahi ai. Ka whakaarohia ake anō hoki ngā hīkaro mō te mahi haumanu ahurea whakawhiti. Ka rarangahia ngā kōrero haumanu e whakaahua e whakaatu ana i ngā whakaaro tūhuraina i roto i tēnei tuhinga.


In Language Assessment Across Modalities: Paired-Papers on Signed and Spoken Language Assessment, volume editors Tobias Haug, Wolfgang Mann, and Ute Knoch bring together—for the first time—researchers, clinicians, and practitioners from two different fields: signed language and spoken language. The volume examines theoretical and practical issues related to 12 topics ranging from test development and language assessment of bi-/multilingual learners to construct issues of second-language assessment (including the Common European Framework of Reference [CEFR]) and language assessment literacy in second-language assessment contexts. Each topic is addressed separately for spoken and signed language by experts from the relevant field. This is followed by a joint discussion in which the chapter authors highlight key issues in each field and their possible implications for the other field. What makes this volume unique is that it is the first of its kind to bring experts from signed and spoken language assessment to the same table. The dialogues that result from this collaboration not only help to establish a shared appreciation and understanding of challenges experienced in the new field of signed language assessment but also breathes new life into and provides a new perspective on some of the issues that have occupied the field of spoken language assessment for decades. It is hoped that this will open the door to new and exciting cross-disciplinary collaborations.


Author(s):  
Roseanne Russell

The Q&A series offer the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans and suggested answers, author commentary and illustrative diagrams and flowcharts. This chapter presents sample exam questions about employment status. Through a mixture of problem questions and essays, students are guided through some of the key issues on the topic of employment status including definitions of employee and worker, the common law tests for determining whether a contract of employment exists, and discussion on the changing nature of the labour market including the gig economy. Students are also introduced to the current key debates in the area and provided with suggestions for additional reading for those who want to take things further.


Author(s):  
R. Peter Hobson

The aim of this chapter is to set out the psychoanalytic ideas and clinical principles on which Brief Psychoanalytic Therapy is founded. Topics include the centrality of intersubjective knowledge, the pivotal notion of transference, and the various ways in which a patient may affect a therapist’s emotional state. The clinical issues addressed range from varieties of communication and defence, contrasts between paranoid-schizoid and depressive position functioning, and the roles of countertransference and containment in the therapeutic endeavor. Overall, the chapter is concerned with the developmental potential of a therapeutic relationship in which the therapist is emotionally available and able to reflect upon the patterns of relatedness that a patient attempts to introduce into the therapeutic relationship, in part to avoid states of mind that are painful or conflictual.


Author(s):  
Sheila A. M. Rauch ◽  
Barbara O. Rothbaum ◽  
Erin R. Smith ◽  
Edna B. Foa

This chapter presents key assessment issues and recommendations to assist in patient selection and examination of response across the prolonged exposure-intensive outpatient (PE-IOP) treatment program. The authors discuss key issues including dissociation, suicide and self-harm risk, anger, moral injury, complex trauma, personality disorder, guilt, and comorbidity. Specific patient populations are discussed, including military, sexual assault, and traumatic brain injury populations. Discussion of a process for screening, assessment, and treatment planning using an interdisciplinary treatment team is presented.


2019 ◽  
Vol 27 (6) ◽  
pp. 344-355 ◽  
Author(s):  
Tin Yat Anthony Chow ◽  
Chi Keung Chan ◽  
Sze Hong Ng ◽  
Man Li Tse

Objective: The aim of this study was to report and analyse the poisoning data of Hong Kong Poison Information Centre in 2018. Methods: In 2018, all poisoning cases received by Hong Kong Poison Information Centre were retrieved from its database, Poison Information and Clinical Management System, for analysis. Results: A total of 3960 poisoned cases were analysed. There were 1770 male patients (44.7%), 2188 female patients (55.3%) and 2 sex-unspecified patients (<0.1%). The majority of cases (68.3%) were between 20 and 69 years old, and 9.9% involved children of 0–5 years old. The common causes of poisoning were suspected self-harm/suicidal attempt (36.6%), unintentional exposure (18.4%) and abusive substance use (11.1%). Excluding the common co-ingestant ethanol, the five commonest types of poison were benzodiazepines, paracetamol, Chinese herbal medicine, household products and zopiclone. Most patients were managed with supportive measures, while 13.5% and 13.7% of consultation cases were treated by decontamination and antidotes, respectively. The majority of cases had uneventful recovery; 0.8% resulted in death and 4.9% had major outcomes. A total of eight interesting cases were discussed. Conclusion: This 13th annual report provided the updated epidemiological information on poisoning pattern in Hong Kong and highlighted important changes in comparison with our previous reports.


Author(s):  
Carlo Delle Donne

Abstract The paper aims to examine the linguistic relationship between patients and physicians in the context of the therapeutic relationship. It focuses on the Hippocratic treatises and offers a detailed commentary of a controversial passage of Ancient Medicine par. 2.3. The dialogical model of Ancient Medicine is found to be centred on the patient’s experience; this same idealized model of relation is documented in Plato’s Laws. In the second part of the article the author examines some linguistic peculiarities of medical discourse, such as the use of comparisons and metaphors, and a passage from Galen’s On the Affected Parts that reports the case of a young patient and the difficulties inherent in the dialogue between patient and physician.


2017 ◽  
Vol 24 (5) ◽  
pp. 244-254 ◽  
Author(s):  
Yiu Cheung Chan ◽  
Chi Keung Chan ◽  
Chun Ho Ng ◽  
Sze Hong Ng ◽  
Kai Kee Lau ◽  
...  

Objective: To report and analyse the poisoning data of Hong Kong Poison Information Centre in 2016. Methods: In 2016, all poisoning cases received by Hong Kong Poison Information Centre were retrieved from its database (Poison Information and Clinical Management System) for analysis. Results: A total of 4096 poisoned cases were analysed. There were 1871 male patients (45.7%), 2203 female patients (53.8%) and 22 sex unspecified patients (0.5%). The majority of the cases (63.1%) were between 20 and 59 years old. Common causes for poisoning were suspected self-harm/suicidal attempt (36.3%), unintentional exposure (18.4%) and abusive use (13.1%). Excluding the common co-ingestant ethanol, the five commonest types of poisons were benzodiazepines, paracetamol, household products, zopiclone and Chinese herbal medicine. Most patients were managed with supportive measures, while 14.3% and 12.9% of them were treated by decontamination and antidotes, respectively. Majority of the cases had uneventful recovery; 1% resulted in death and 3.9% had major outcomes. Six interesting cases and three poisoning outbreaks were discussed. Conclusion: This 11th annual report provided the updated epidemiological information on poisoning pattern in Hong Kong and highlighted important changes in comparing with our previous reports.


1997 ◽  
Vol 78 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Geoffrey L. Greif

Mothers who live apart from their children are often mistreated and misunderstood. Clinicians are increasingly called upon to treat this growing population. The author describes some of the key issues facing these mothers: money and child support, visitation, relations with the father, relations with the child, court involvement, and the impact of the social system. Suggestions for assisting them in a therapeutic relationship are offered.


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