Existential experience : the unfolding

This paper reports on a project concerned with the relationship between person and space in the context of achieving a contemplative state. The need for such a study originated with the desire to contribute to the design of multicultural spaces which could be used for a range of activities including prayer and meditation. Given that the words ‘prayer’ and ‘meditation’ are highly value-laden and potentially alienating for some people, it was decided to use the more accessible term ‘contemplative’. While the project is still underway,several findings have emerged that can be reported on and are of relevance to the conference both methodologically and substantively. Informed by phenomenological methodology, data were collected from a diverse group of people using photo-elicitation and interviewing. The technique of photo-elicitation proved to be highly effective in helping people to reveal their everyday lived experience of contemplative spaces. This methodological aspect of the project is described more fully in the paper. The initial stage of analysis produced two categories of data: varying conceptions of contemplation and contemplative space; and, common understandings of contemplation and contemplative space. From this it was found that achieving a state of contemplation involves both the person and the environment in a dialectic process of unfolding. The unfolding has various physical, psycho-social, and existential dimensions or qualities which operate sequentially and simultaneously. In the paper, these are labelled:the unfolding of the core; distinction; manifestation; cleansing; creation; and sharing, and have parallels with Mircea Eliade’s 1959 definition of sacred as 'something that manifests itself, shows itself, as something wholly different from the profane’. It also connects with the views of Nishida Kitaro from the Kyoto School of Philosophy on the theme of ‘absolute nothingness’: ‘the body-mind is dropped off and we are united with the consciousness of absolute nothingness’ (Kitaro in Heisig, 2001, p. 169). According to Marion (2005), ‘nothingness’ is defined by givenness. In the paper, this fold of givenness is interpreted in the context of the qualities of the environment that accomplish the act of coming forward into visibility through the dialectic relationship with a person. (Eliade, 1959, Heisig, 2001, Marion, 2002)

Psychotherapy in Australia : clinical psychology and its approach to depression

In Australia, clinical psychology training is dominated by cognitive and behavioral treatments (CBTs), although there is exposure to other theoretical orientations. Since 2001, over 20% of general medical practitioners (GPs) have received training in CBT, and psychiatry training increasingly incorporates CBT elements. Psychotherapy by medical practitioners is financially supported by universal health care funding with supplementation by patients and their private health insurance. Federally funded health benefits for up to 12 psychology consultations per year are provided on referral from GPs and psychiatrists, and initial take up has been very strong. Mrs. A would be a typical patient for such a referral. However, she would not fulfil criteria for priority access from state-funded mental health services. Mrs. A would probably consult a GP and receive antidepressants, although she may also access a range of other community support programs. Access to and acceptance of psychotherapy would be greater in urban areas, and if she were of Anglo-Saxon and non- indigenous origin.

No Exit

Jean Paul Sartre’s 1944 play No Exit comes alive in this new English adaptation by academics and theatre practitioners Caroline Heim and Christian Heim. It is the most complete articulation of the ideals of Sartre’s existentialism. No Exit is an absurdist play about three people who meet in hell. This new adaptation premiered at the World Psychotherapy Congress in Darling Harbour, Sydney in August 2011. The production integrated and extended Sartre's concepts of "The Gaze", "Love and Sadism" and "Nothingness." Post-performance discussions were held after the performances to explore the discourses of the play.

When individual child psychotherapy exacerbates family systems problems in child abuse cases : a clinical analysis

Children who have suffered physical or sexual abuse are as vulnerable as adult trauma victims to experience "secondary trauma", in which the reactions of the family or broader system exacerbate the child's difficulties. Three clinical cases (a 7 yr old male, an 8 yr old male, and a 7 yr old female) are presented that suggest that this secondary trauma can be made worse by either excessive or insufficient provision of individual child psychotherapy, and the way the system interprets and reacts to these clinical decisions. Types of secondary trauma and their interactions with clinical decisions are discussed. Ways of framing clinical decisions to minimize the potential secondary trauma are presented.

Ennui and Anomie : from existential dilemma to meaning

This background paper to a panel discussion by four QUT staff members explores depression, mood disorders, suicide and meaning in life.

Metacognitive narrative psychotherapy for people diagnosed with schizophrenia : an outline of a principle-based treatment manual

Schizophrenia is often characterised by diminished self-experience. This article describes the development and principles of a manual for a psychotherapeutic treatment model that aims to enhance self-experience in people diagnosed with schizophrenia. Metacognitive Narrative Psychotherapy draws upon dialogical theory of self and the work of Lysaker and colleagues, in conjunction with narrative principles of therapy as operationalised by Vromans. To date, no manual for a metacognitive narrative approach to the treatment of schizophrenia exists. After a brief description of narrative understandings of schizophrenia, the development of the manual is described. Five general phases of treatment are outlined: (1) developing a therapeutic relationship; (2) eliciting narratives; (3) enhancing metacognitive capacity; (4) enriching narratives, and; (5) living enriched narratives. Proscribed practices are also described. Examples of therapeutic interventions and dialogue are provided to further explain the application of interventions in-session. The manual has been piloted in a study investigating the effectiveness of Metacognitive Narrative Psychotherapy in the treatment of people diagnosed with schizophrenia spectrum disorders.

Effect of mobile phone-based psychotherapy in suicide prevention : a randomized controlled trial in Sri Lanka

We conducted a randomized controlled trial to test whether a Brief Mobile Treatment (BMT) intervention could improve outcomes relative to usual care among suicide attempters. The intervention included training in problem solving therapy, meditation, a brief intervention to increase social support as well as advice on alcohol and other drugs, and mobile phone follow-up. The effect of the intervention was measured in terms of a reduction in suicidal ideation, depression and self-harm at Baseline, six and 12 months. A wait-list control group received usual care. A total of 68 participants was recruited from a Sri Lankan hospital following a suicide attempt. Participants who received the intervention were found to achieve significant improvements in reducing suicidal ideation and depression than those receiving usual care. The BMT group also experienced a significant improvement of social support when compared to the control group. However, the BMT group did not demonstrate a significant effect in reducing actual self-harm and most substance use, and differential effects on alcohol use were restricted to men. Although the present study was limited in revealing which component of the intervention was more effective in preventing suicide, it showed its efficacy in reducing suicide as a whole.

Existential place-making : the dialogical realms of design for dwelling with disability

The world of disability is often neglected or taken for granted in able-bodied society. Apart from the challenge that disability is a social construct (Linton, 1998, 2006; Longmore, 2003; Thompson, 1997) there is an impact on the people with disability that they either feel left out or they don’t belong in the larger community. The able-bodied community is also left with very little knowledge or no sensitivity towards people with disability. These internal whirlpools do not contribute to any community only to create larger gaps and higher differences between the groups of people. Peace (2010) claims that disability is something imposed on to a person on top of a physical impairment. Nord (2008) advocates that while environmental barriers and social attitudes are crucial aspects of a person’s experience, they can indeed disable a person. The study reported high-lights what is home for people with disability and their family members. The way the person with disability and family members without disability share the same home and nurture personal relationships with each other demands greater attention. This research sheds light on the intricate relationships that exists between the family members including person with disability and their built environment. These existential connections provide a holistic viewpoint and the glimpse into the lived experiences of homes for people with disability and their care-givers. Concepts of universal design or barrier free design have not been successful (Connell and Sanford, 1999) in revealing in-depth the nature of place-making for people with disability and their care-givers. Such studies fail to incorporate the holistic needs of individuals with disability and their family members in terms of their bodily, visceral, emotional, social, psycho-social, intuitive, spiritual and temporal needs, to name a few (Franz, Bitner, 2010). This paper reports on some preliminary findings on phenomena of dwelling for people with different kinds of disability and their care-givers sharing the same home from an interior design perspective.

Constructing subjects and making experts : reading the politics of the psychotherapy novel

This paper examines the ideological and political basis of the practice of psychotherapy in contemporary culture. Psychotherapy is argued to be both inherently political and intimately concerned with the construction of subjectivity. These arguments are examined through interrogating the representation of psychotherapy in the works of Lindner ( The Fifty-Minute Hour , Bantam, New York, 1955) and particularly in Yalom's fictional text Lying on the Couch (HarperPerennial, New York, 1996). The implications within psychotherapy for representing normality, negotiating power, and locating and constructing subjectivity are highlighted through the critical treatment of these texts.

A psychology student’s reflections on learning psychodynamic psychotherapy in the classroom

A graduate psychology student reflects upon the experience of learning psychodynamic psychotherapy exclusively in the classroom. The majority of undergraduate psychology students have scant, and frequently inaccurate, exposure to psychodynamic psychotherapy. This appears to heavily influence students’ choice of postgraduate programs, and to reduce the likelihood that they will expose themselves to psychodynamic therapy at any stage of their careers. It is hoped that the original insights provided by this reflection will inform the development of psychodynamic psychotherapy teaching material that can be imparted effectively in undergraduate programs, even when access to patients and supervisors is not possible, so that more students are inspired to study psychodynamic psychotherapy in postgraduate programs.

Mechanisms of change in psychotherapy for people diagnosed with schizophrenia : the role of narrative reflexivity in promoting recovery

Narrative reflexivity was investigated as a potential mechanism of therapeutic change during a 12 - 18 month trial of Metacognitive Narrative Psychotherapy for people diagnosed with schizophrenia. Participants were nine adult clients (8 male, 1 female) aged between 25-65 years (M = 44, SD = 12.76) with a diagnosis of schizophrenia consistent with DSM-IV criteria and seven female provisional psychologists aged between 25-29 years (M = 26.8 years, SD = 1.47 years). Recovery and narrative reflexivity were measured at three time points using the Recovery Assessment Scale (RAS) and the Narrative Processes Coding System (NPCS). Results were reported descriptively due to limited sample size (n = 9). The majority of clients (n = 7) reported an increase in recovery over the course of treatment. For six clients, an overall increase in recovery was associated with an increase in narrative reflexivity. This study provides preliminary support for narrative reflexivity as a potential mechanism of therapeutic change in the psychotherapy of people diagnosed with schizophrenia.