This hands-on manual from Leigh McCullough and associates teaches the nuts and bolts of practicing short-term dynamic psychotherapy, the research-supported model first presented in Changing Character , McCullough's foundational text. Reflecting the ongoing evolution of the approach, the manual emphasizes "affect phobia," or conflict about feelings. It shows how such proven behavioral techniques as systemic desensitization can be applied effectively within a psychodynamic framework, and offers clear guidelines for when and how to intervene. Demonstrated are procedures for assessing patients, formulating core conflicts, and restructuring defenses, affects, and relationship to the self and others. In an easy-to-use, large-size format, the book features a wealth of case examples and write-in exercises for building key clinical skills. The companion website (www.affectphobiatherapy.com) offers useful supplemental resources, including Psychotherapy Assessment Checklist (PAC) forms and instructions.

lgrsnf/Affect phobia.pdf

lgli/Affect phobia.pdf

nexusstc/Treating affect phobia/f2c0b7b3229647ddc903171503883c62.pdf

McCullough, Leigh, Kuhn MD Phd, Nat, Andrews, Stuart, Kaplan, Amelia, Wolf, Jonathan, Hurley, Cara Lanza, Kuhn, Nat, Hurley, Cara

Leigh McCullough, Nat Kuhn, Stuart Andrews, Amelia Kaplan, Jonathan Wolf, Cara Lanza Hurley, Cara Hurley

Leigh McCullough,Nat Kuhn,Stuart Andrews,Amelia Kaplan,Jonathan Wolf,and Cara Lanza Hurley

Leigh Mc Cullough, Nat Kuhn et al

Guilford Press; The Guilford Press

Guilford Publications Inc., New York, 2003

United States, United States of America

New York, New York State, 2003

January 24, 2003

New York, 2002

4, 20210428

producers:
Acrobat Distiller 8.0.0 (Windows)

{"isbns":["1572308109","2002155163","9781572308107"],"publisher":"Guilford Press"}

Includes bibliographical references (p. 353-355) and index

Cover 1
Half Title Page 4
Cover 6
Copyright 7
Dedication 8
About the Authors 10
Preface and Acknowledgments 12
Contents 16
Introduction 20
Part I. Theory, Evaluation, and Formulation 30
1. Affect and Affect Phobia in Short-Term Treatment 32
I. What Is an Affect Phobia? 32
II. Why This Therapy Focuses on Affect 33
III. The Definition and Classification of Affect 37
IV. Adaptive versus Maladaptive Expression of Affects 41
V. The Development and Treatment of Affect Phobias: An Introduction 43
VI. The Importance of Anxiety Regulation 46
VII. Goals of Treatment 48
Chapter 1 Exercises 51
2. Affect Phobia, Psychodynamic Conflict, and Malan’s Two Triangles 54
I. Reformulating Psychodynamic Conflict as Affect Phobia 54
II. Understanding Affect Phobias by Using Malan’s Two Triangles: The Universal Principle of Psychodynamic Psychotherapy 56
III. Making Important Distinctions about Feelings 63
IV. Restructuring Affect Phobias through Systematic Desensitization: The Main Treatment Objectives 65
Chapter 2 Exercises 70
3. Assessment and Selection of Treatment for the Patient 74
I. Overview of the Initial Assessment 74
II. How the DSM Multiaxial Assessment Guides Treatment Selection 76
III. How to Rate the Global Assessment of Functioning (GAF) Scale 81
IV. Indications and Contraindications for Short-Term Dynamic Psychotherapy 84
V. Using the GAF Scale to Tailor Treatment to Patients’ Needs 87
VI. The Supportive–Exploratory Continuum of Interventions 91
Chapter 3 Exercises 94
4. How to Formulate a Core Psychodynamic Conflict: Spotting Affect Phobias 100
I. An Overview of the Formulation Process 100
II. Identifying Defenses: How Adaptive Feelings Are Avoided 105
III. Identifying the Adaptive Activating Feelings: What Feelings Are Feared and Avoided? 107
IV. Identifying Anxieties/Inhibitions: The Reason Why Adaptive Feelings Are Avoided 108
V. Summarizing the Formulation in Terms of Affect Phobia 111
VI. Examples of How to Formulate Core Conflicts 113
VII. Identifying Pitfalls in Formulating Core Conflicts 117
VIII. Repetition to Revise and Refine the Formulation 120
Chapter 4 Exercises 120
Part II. Defense and Affect Restructuring 126
Introduction to Part II 128
5. Defense Restructuring, Section 1: Defense Recognition 132
I. Overview of Defense Recognition 132
II. Pointing Out Defenses against Phobic Affects 138
III. Validating Defenses 141
IV. Pointing Out Strengths That Exist Alongside Defenses 142
V. Managing Difficult Defenses 143
VI. Repeating Interventions until Defenses Are Recognized 149
Chapter 5 Exercises 150
6. Defense Restructuring, Section 2: Defense Relinquishing 157
I. Overview of Defense Relinquishing 158
II. Identifying Consequences of Defensive Behavior: Costs and Benefits 162
III. Distinguishing the Origin of Defenses from the Maintenance of Defenses: Then versus Now 165
IV. Grieving Losses Due to Defenses 167
V. Building Self-Compassion When There Is No Grief 168
VI. Identifying the Secondary Gain of Defenses: Hidden Meanings and Rewards 169
VII. Repeating Interventions to Enhance Motivation to Give Up Defenses 175
Chapter 6 Exercises 177
7. Affect Restructuring, Section 1: Affect Experiencing 186
I. Overview of Affect Experiencing 186
II. Exposure to Phobic Feeling/the Feared Affect 196
III. Response Prevention: Defense Restructuring as Needed 208
IV. Identifying Pitfalls in Affect Experiencing 209
VI. Repeating Interventions until Affect Phobia Is Desensitized 212
VI. Some Frequently Asked Questions 214
Chapter 7 Exercises 215
8. Affect Restructuring, Section 2: Affect Expression 226
I. Overview of Affect Expression 227
II. Building Expressive and Receptive Capacities 232
III. Bearing Interpersonal Conflict 234
IV. Integrating Feelings 235
V. Role Playing of Difficult Interactions 236
VI. Providing Information to Aid Expression 237
VII. Pitfalls in Affect Expression 240
VIII. Repeating Practice until Affect Expression Flows Naturally 242
Chapter 8 Exercises 243
Part III. Self- and Other-Restructuring 250
Introduction to Part III 252
9. Self-Restructuring: Building Compassion and Care for Self 256
I. Overview: Restructuring for a Positive Sense of Self 257
II. Building Receptive Capacity to One’s Own Feelings 264
III. Changing Perspectives on the Self: Encouraging Patients to Imagine How Others See Them 269
IV. Finding and Encouraging the Lost Voice 273
V. Encouraging “Parenting” of the Self 274
VI. Reducing the Externalization of Needs 275
VII. Repeating Interventions until Phobias about Self-Feelings Are Desensitized and Self-Worth Improves 277
Chapter 9 Exercises 278
10. Other-Restructuring: Building Adaptive Inner Images of Others 284
I. Overview: Restructuring Affect Phobias about Relationships with Others 285
II. Building the Receptive Capacity to Others’ Feelings 293
III. Changing Perspectives: Viewing Others More Accurately and Compassionately 295
IV. Identifying and Restructuring Addictive Attachments 298
V. Recovering “Lost Loves”: Caring Persons in the Past 300
VI. Repeating Interventions until Phobias about Relationships Are Desensitized 303
Chapter 10 Exercises 304
Part IV. Diagnostic Considerations and Termination 310
11. Treating Specific Diagnoses: The Relationship between DSM Diagnoses and Affect Phobias 312
I. How Affect Phobias Underlie Diagnoses and Are Maintained by Primary and Secondary Gain 312
II. Integrating Nature and Nurture: The Biopsychosocial Model 313
III. Using Axis I Diagnoses to Inform Treatment of Affect Phobias 314
IV. Using Axis II Diagnoses to Guide Treatment of Affect Phobias 320
V. Conclusion: Focusing on Affect Phobias That Underlie Diagnoses 326
12. Termination 327
I. Overview of Termination 327
II. Assessing What Changes Have Been Made 332
III. Assessing Why Changes Have Been Made 335
IV. Celebrating Progress and Acknowledging What Needs More Work 336
V. Exploring the Full Range of Feelings for the Therapist 337
VI. Replacing the Loss of Therapy 340
VII. Conclusion and Commencement 341
Appendix. Answers to Exercises 342
References 372
Index 376

This hands-on manual for short-term dynamic psychotherapy emphasizes "affect phobia," or conflict about feelings, and reflects the ongoing evolution of the approach first presented in Changing Character (1997), by McCullough. Demonstrating procedures for assessing patients, formulating core conflicts, and restructuring defenses, affects, and relationship to the self and others, the manual includes a wealth of case studies and written exercises. The book may be used as a clinical resource and text for teachers, students, and practitioners. Topics include affect phobia, psychodynamic conflict, and Malan's two triangles; defense recognition and relinquishing; and building compassion and care for self. Annotation (c)2003 Book News, Inc., Portland, OR (booknews.com)

2023-02-06