Contemplating Raising Fees: An Exercise in Therapist Disquiet

This paper discusses the experience of psychodynamically oriented therapists in private practice as they contemplate raising their fees. Raising fees stirs up competing self-interest, transference-countertransference reverberations, financial fantasies and realities, ethical concerns, and uncomfortable as well as satisfied self-reflection. These dynamics are discussed under the following categories: exercise of power; incurring guilt; inappropriate entitlement; fear of loss; modeling of self-care; rapaciousness; unconscious factors; and self-esteem. A cautionary case example is provided. Six suggestions are offered to make therapists' contemplation of raising fees less stressful. The author hopes that this article will foster more open discussions among therapists about the tensions involved in raising fees and, in the process, lead to an enhanced understanding, acceptance, and detoxification of the feelings involved.

Psychodynamic personal predictors of alcohol addiction propensity for lawenforcement officers

The article is devoted to the study of personality predictors of alcohol addiction propensity of internal affairs bodies employees within innovative psychodynamic G. Ammon’s (psychoanalytic) approach and structural-dynamic concept of personality. The novelty of the research is the original author’s psychodiagnostic toolkit – Psychodynamically oriented personality questionnaire (POLO) «Resource» and an expert psychodiagnostic system for assessing and predicting the professional psychological health of lawenforcers based on the assessment of central self-functions of the individual rooted in the unconscious. The relevance of the study is due to a significant number of violations of job discipline and legality. That includes accidents committed by employees while intoxicated, often with serious consequences and criminal prosecution, as well as the fairly widespread and concealed cases of alcohol addictions among lawenforcement officers. Another important factor is lack of effective methods of psychodiagnostics, psychocorrection and psychoprophylaxis. The study is based on a comparative analysis of 2 representative polar groups of internal affairs officers: the one verified prone and another of not prone to alcohol abuse. The study revealed that employees prone to alcohol addiction demonstrate a number of reliable psychodynamic personality characteristics that can be viewed as predictors: destructive aggression, deficit fear, deficient internal self-delimitation, as well as the general predominance of destructive-deficient components of the personal self-structure; indicators of psychosomatic, behavioral and neurotic maladaptation, and the integral scale of the general socio-psycho-somatic problem of POLO «Resource». The practical significance of the study is determined by the development of psychodynamic predictors and a special psychodiagnostic scale of propensity for alcohol addiction based on the Resource POLO, which can be used as an effective psychodiagnostic tool when conducting screening and monitoring psychoprophylactic examinations of employees and individual psychocorrectional work within the framework of the psychological support system of employees.

Provision of Psychodynamic Psychotherapy in Austria during the COVID-19 Pandemic: A Cross-Sectional Study

The COVID-19 pandemic has brought massive changes in the provision of psychotherapy. To avoid or reduce the risk of infection, many therapists switched from face-to-face sessions in personal contact to remote psychotherapy, i.e., psychotherapy delivered by telephone or videoconferencing. This study examined the attitudes toward and practice of remote psychotherapy among Austrian therapists with a psychodynamic orientation at the onset of the pandemic as well as changes in the therapeutic process that were experienced by the therapists due to switching to a remote setting. A total of 161 therapists with psychodynamic orientation took part in an online survey. The results show that attitudes toward remote psychotherapy changed positively in psychodynamically orientated therapists and most are willing to switch to remote settings, if necessary. However, many therapists reported negative effects of remote psychotherapy and prefer seeing their patients in-person. The strongest changes were experienced with regard to transference/countertransference, the therapeutic process and the intensity of session. The analysis further revealed an overall decrease in the number of patients treated, indicating an undersupply of psychotherapy, at least during the first wave of COVID-19 infection in Austria. In summary, the experience during the first COVID-19 lockdown has led to an increase in remote psychotherapy and more openness toward these treatment modalities among psychodynamically oriented therapists. However, in-person therapy will remain the first choice for most therapists.

Narcissistic Personality Disorder: Are Psychodynamic Theories and the Alternative DSM-5 Model for Personality Disorders Finally Going to Meet?

Narcissistic Personality Disorder is the new borderline personality disorder of our current era. There have been recent developments on narcissism that are certainly worthwhile examining. Firstly, relational and intersubjective psychoanalysts have been rethinking the underlying concepts of narcissism, focusing on the development of self and relations to others. Secondly, in the DSM-5, the Alternative DSM-5 Model for Personality Disorders (AMPD) was presented for a dimensional evaluation of the severity of personality disorder pathology. The combined dimensional and trait conceptualization of NPD opened the door to new integrated diagnostic perspectives, including both internal and interpersonal functioning. Finally, Pincus and Lukowitsky encourage clinicians to use a hierarchical model of pathological narcissism, as it opens up opportunities for shared points of interest in empirical research from different scholarly perspectives. As for most non-psychodynamic clinicians and researchers the DSM-5 clearly bears dominant weight in their work, we will take the AMPD model for NPD as our point of reference. We will discuss the narcissist's unique pattern of self-impairments in identity and self-direction, and of interpersonal disfunctioning (evaluated by assessing empathy and intimacy). Subsequently, we will examine how contemporary psychodynamic theories and the hierarchical model of Pincus and Lukowitsky additionally inform or contradict the AMPD. For us, one of the big advantages of the AMPD is the use of structured clinical evaluations of disturbances of the self and interpersonal functioning and the dimensional evaluation of severity. As psychodynamically oriented therapists, we are enthusiastic about the opportunities for inclusion of psychodynamic concepts, but we also discuss a number of sticking points.

Online Supportive Group as social intervention to face COVID lockdown. A qualitative study on psychotherapists, psychology trainees and students, and community people

Several psychological interventions have been activated to help people during the Coronavirus pandemic, and research highlights the crucial role of group interventions as a space for sharing and processing the psychological experiences linked to this emergency and the consequent changes in people’s lifestyles. In this context, psychologists are mostly providers of this kind of service more than users. This study aimed at investigating and comparing post-hoc the subjective experience of psychotherapists, psychology trainees & students, and individuals of the general population who participated in a psychodynamically-oriented supportive group intervention. Fifty-two subjects were enrolled to participate to focus groups aimed at exploring participants’ decision to participate, their perceptions on how the support group influenced their elaboration of the psychological effects of pandemic/lockdown, and their feedback on its utility. Transcripts of the focus groups were analyzed with the Linguistic Inquiry Word Count (LIWC). Differences in the use of words/linguistic categories between groups were tested through chi-square tests. Content analysis was conducted by independent judges who extracted the most relevant comments. Preliminary results showed the main features related to the crisis response, and how belonging to different social roles was associated with different ways of experiencing and sharing emotions. People react in different ways to traumatic events, and how people react may say a lot about how they cope with the event and the extent to which the event plays a role in the future. Clinical implications on the use of this data for future treatment planning are also discussed.

Psychodynamic determinants of value orientations of Suvorov Military School cadets of the MIA of Russia

The relevance of the study of the topic under consideration is a result of the need to improve the quality of profile pre-university training carried out on the basis of the Suvorov military schools of the Ministry of Internal Affairs of Russia. The priority direction of pre-university training is the formation and development of the motivational and personal orientation of Suvorov cadets for future educational and service-professional activities in the positions of cadets of departmental universities of the Ministry of Internal Affairs of Russia, and after graduation - in the positions of officer-specialists with higher education. The implementation of this training direction requires a scientific and methodological definition of a relevant research subject that determines its success. It seems expedient to study as such a subject the cadets’ value orientations and associated self-structural personal formations rooted in the unconscious. As a result of the study, the value-orientational hierarchy of Suvorov school cadets of different years of training was determined, as well as the relationship of the value orientations of the cadets with the resource of their psychological health, reflecting the ratio of constructive and destructive-deficient central (unconscious) personality functions, was established. The data obtained allow us to come to the conclusion about the determinative influence of unconscious mechanisms on the formation of values at the stage of pre-university training of the Suvorov school cadets. Key words: value orientations, cadets, Suvorov military school of the Ministry of Internal Affairs of Russia, general constructiveness, general destructiveness, psychological health resource, psychodynamically oriented personality questionnaire «Resource», professional self-determination.

Capturing the Unconscious—The “Psychoanalytic Core Competency Q-Sort”. An Innovative Tool Investigating Psychodynamic Therapeutic Skills

The Psychoanalytic Core Competency Q-Sort (PCC Q-Sort) is a newly developed empirical research tool that allows for the description and illustration of the ways psychodynamically-oriented psychotherapists work. It provides a simple, straightforward rating procedure utilizing a well-established q-sort method. The present pilot study describes the psychoanalytic core competency items and discusses the development procedure of the instrument as well as statistical analysis of ratings from psychoanalytic sessions, including inter-rater reliability as well as preliminary findings on possible construct validity. Additionally, a factor analysis was performed. Values were assessed by applying the PCC Q-Sort to 30 audio recordings of psychoanalytic sessions. The results of the present study indicate that the PCC Q-Sort is a reliable process research instrument that allows for a detailed investigation of psychotherapy processes in psychodynamic psychotherapies and change processes.

Psychometric Analyses of New Measures of False-Self Defense

The concept of the false-self defense has been widely used in psychoanalytic and psychodynamic literature, both in understanding processes of childhood development and in outlining personality defense mechanisms. This study presents a translation of this theoretical and clinical concept into empirical economical self-report scales assessing Self-Relatedness (16 items) and Environment-Directedness (14 items). The scales’ content judgment and psychometric analyses were carried out in three successive studies based on separate samples ( N = 226, 208, 176). The scales demonstrate good to excellent internal reliability and are normally distributed in a sample of university students. Results of Study 2 support the scales’ convergent, discriminant, and criterion construct validity. Study 3, comparing deaf and hard-of-hearing (d/hoh) students with controls, provides a partial support for the scales’ criterion group validity. The findings demonstrate the scales’ potential contribution to psychodynamically oriented research, as well as to research enriched by critical sociocultural perspectives.

Historical Overview of Personality Disorders

The purpose of this chapter is to provide an historical overview of the classification of personality disorders. The chapter will cover the first through the fifth editions of the American Psychiatric Association’s diagnostic manual, although emphasis will be given to the more recent editions. Considered in particular are the various components of the proposals for DSM-5, including the deletion of five diagnoses, the inclusion of a psychodynamically-oriented level of personality functioning scale, the replacement of specific and explicit criterion sets first with narrative prototype matching and subsequently with newly developed hybrid criterion sets, and the inclusion of a dimensional trait model. Covered as well will be the World Health Organization’s diagnostic system for the personality disorders, including a dimensional trait model along with a borderline pattern qualifier, which may in fact meet with final approval. Attention will be given in particular to controversies that beset each edition, particularly with respect to complexity and empirical support. The chapter concludes with suggestions for future editions.