By Jacques P. Barber
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Sample text
Continual feedback to improve recognition of depression may be helpful for some patients. Poor Capacity to Recognize Depression-Triggering Events Some depressed patients are not inclined to notice the events that set off their depression, or if they do notice them, they forget them quickly. The events may be external, or they may be a specific kind of thought. For example, Mr. Quinn did not recognize his trigger events, even though they became obvious to the therapist. These events were thoughts about interactions with others that he interpreted as lowering his self-esteem, as in this very apt example: Patient: I dreamt about her ...
Helplessness and Hopelessness States of helplessness and hopelessness are the most common conditions for depression, as explained by Freud's (1926/1959) theory and by Engel and Schmale's (1965) elaboration of the theory and confirmed by the studies in Luborsky (in press). The therapist can manage these states well by using two methods: 1. " Such a comment may help the patient to see the depression as a response to the helplessness and hopelessness, not just as an inevitable reaction to the situation.
Morse This chapter presents briefly the background and rationale for what the book intends to achieve. Developments in psychotherapy research and practice as well as changes in the patterns of delivery and reimbursement for mental health care have led us to conclude, along with many others, that psychodynamic psychotherapy is in a precarious situation. What follows are the recent developments responsible for our concerns. SOCIAL AND POLITICAL DEVELOPMENTS With the emergence of managed health care, such as health maintenance organizations (HMOs), and caps on reimbursement for inpatient and outpatient care, psychotherapists have become more aware of the importance of being recognized by the health alliances as providing a worthwhile, cost-effective service.