PREFACE
My thanks are due to innumerable people who have helped me in many
different ways during eighteen months of intensive work, to handle a vast
amount of material in a short space of time. First, I am tremendously grateful
for the opportunities afforded by the University of Bristol library and, latterly
by the Bodleian Library, Oxford, and the library of the Tavistock Clinic,
London. In particular I should like to thank the staff of the Inter-Library Loans
Service at Bristol University, who have tracked down obscure items for me
from libraries all over Britain. Without them it would have been impossible to
obtain essential resources. My second debt is to all those experts I have
consulted, both formally and informally, regarding different subject areas.
Especially I would like to thank Dr Christopher Dare, Consultant Psychiatrist,
the Bethlem Hospital and the Maudsley Hospital, London, who gave extensive
advice on the psychoanalytic entries; Miss Sally Box, Principal Social Worker
in the Adolescent Department of the Tavistock Clinic, London, who advised
on the Kleinian entries; Dr Glin Bennet, Consultant Senior Lecturer in the
Department of Mental Health, University of Bristol, who advised on the terms
relating to Jungian psychotherapy; Dr Dougal McKay, Director of Psychological Services to the Bristol & Western Health Authority, who advised on
behaviour therapy, the cognitive therapies and social learning approaches; Dr
Andrew Treacher, Lecturer in Mental Health at the University of Bristol, who
advised on personal construct theory, social influence theory, outcome studies
and many of the entries relating to general psychology; and Mr Philip Kingston,
Lecturer in the Department of Applied Social Studies, University of Bristol,
who advised on the entries relating to family, marital and systems therapy. Two
colleagues have made particular contributions to the specialist areas of
psychological tests and philosophical concepts. Mr Peter Gardner, Principal
Psychologist for the County of Avon, has contributed the entry under
personality tests and assessment and many of the entries on psychological tests;
and Mr David Watson, Lecturer in the Department of Social Administration,
University of Bristol, has contributed much of the opening descriptions of the
following entries: epistemology, causality, phenomenology, Cartesian and the
theory of types. I am particularly grateful to Dr R.D. Hinshelwood for his
comments on the manuscript as a whole and for his expert help with the
psychoanalytic entries, to Dr Malcolm Pines for his help with entries relating to
group psychotherapy and to Mr Andrew Samuels for his assistance with entries
relating to analytical psychology. Any errors that remain in the text are of
course my own.
I would also like to thank all the many friends and colleagues who have
PREFACE
loaned, advised about or given me books and articles from their own
libraries. Next, I would like to thank Mrs Sheila Salisbury for typing and
word-processing the manuscript with exceptional care and for taking such
an interest in it, Philippa Brewster, editor at Routledge & Kegan Paul, for
keeping me sane in the early days with regular doses of encouragement, and
Elizabeth Taylor for her detailed work on the typescript. And finally, all my
friends whom I mainly deserted for a whole year and especially Oi, who put
up with it all and only complained when every room in the house was
covered with papers and books.
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ABRAHAM, KARL
A
A-historical
Approaches
to
psychotherapy
which
de-emphasise the use of the patient''s history
in either diagnosis or treatment or both. Most
therapies which are described as a-historical
use the term relatively, since some form of
history taking is often found helpful even
though perhaps not at the beginning of contact
with the patient. The term is used to distinguish those psychotherapies (psychoanalysis
and the depth psychologies) which connect the
patient''s psychopathology with the past and
especially with his early experiences of
infancy; and those therapies which focus on
the presenting problem (behaviour therapy) and
on the here and now events of current interaction with the therapist and with his
significant others.
The distinction is quite hard to maintain
since analysts would argue that the analysis of
the transftrence and the focus on the patient''s
free associations are both here and now
emphases; and Jungians would want to claim a
future-directed, teleological aspect to their
therapy which supersedes in importance the
historical exploration. However, these cannot
be described as a-historical in the same way
since the purpose of both is to link the present
with the patient''s past and to enable him to
gain insight into the way he is impeded by its
influence. Systemic therapies such as family
therapy tend to be a-historical as they afford
opportunities for exploring the ''horizontal''
network of current relationships in vivo which
tends to reduce the need to examine ''vertical''
networks of past relationships. This would
not, however, be true of transgenerational
family therapy or psychoanalyticfomily therapy.
Some forms of strategic therapy, brief therapy
and crisis intervention are almost entirely ahistorical, the best example being brief
symptom-focused therapy. Cooklin (1982)
discusses some of the issues involved in comparing historical with a-historical approaches
to the treatment of systems. Any discussion of
the two is inevitably value-laden, as those who
advocate an a-historical approach are often
concerned to move away from what they
perceive as the deterministic framework of
history, whilst those who underline the need
for using the patient''s historical context are
anxious to establish the logical and scientific
status of a deductively derived theory of
change.
COOKLIN, A. (1982) Change in ''here and now''
systems vs systems over time (in Bentovim, A.,
Gorell-Barnes, G. and Cookling, A. (eds),
Family Therapy: Complementary Frameworks of
Theory and Practice, Academic Press, London.)
See also Behavioural analysis, Phenotype.
A-symptomatic
Having no symptoms.
Abraham, Karl (1877-1925)
One of Freud''s earliest and most senior
collaborators, Abraham holds a foremost place
in the history ofpsychoanalysis. Born in Bremen
of Jewish parents, he studied medicine at
Freiburg and later joined the Vienna Psychoanalytic Circle along with lung, Adler,
Ferenczi and others. In 1910, he founded the
Berlin Institute which became one of the
foremost psychoanalytic training institutes.
Abraham was one of Freud''s most stalwart
supporters and the two men engaged in
regular correspondence over theoretical and
technical issues. He took an active part in
trying to keep Freud''s circle free of ''dissent'',
although Freud expressed concern at
Abraham''s zeal, pointing out that it was easier
for Abraham than for Jung, ''because of racial
kinship'', to remain consistent in his acceptance of Freud''s work. Abraham made
important contributions to the theory of
psycho-sexual development, subdividing the
oral stage into oral-dependent and oralaggressive; and the anal stage into analeliminative and anal-retentive. He had a
considerable influence on many psychoanalysts whom he analysed himself at the
Berlin Institute, including Helene Deutsch,
Karen Homey and Melanie Klein. He died in
1
ABREACTION
Berlin of a lung complaint in 1925, leaving his
major works to be collected together in 1948
and published as ''Selected papers on psychoanalysis''. His daughter, Hilde, became a wellknown analyst in London.
Abreaction
The release of emotional energy which occurs
either spontaneously or during the course of
psychotherapy and which produces catharsis.
Spontaneous abreaction usually occurs soon
after a traumatic event and this has the effect
of mobilising the individual''s coping behaviour
and hastening his re-adaptation to the new
situation. If spontaneous abreaction does not
occur, the affect attached to the memory of the
loss is repressed and is likely to produce symptoms of depression, withdrawal or other
neurotic presentations. The term was introduced by Breuer and Freud (1893) to describe
the release of emotion attached to a previously
repressed experience, and abreaction is still
considered to be an important element in the
therapeutic process not only within psychoanalytic therapies but also among many forms
of group p~ychotherapy,
encounter groups, Gestalt
therapy and those therapies that make use of
p~chodrama
and re-enactment to help the
patient integrate repressed material.
Not all abreaction leads to catharsis however, and sometimes the patient may be left
worse off than before following an abreaction.
The therapeutic inducement of abreaction
needs to take place in a protected setting with
the safeguards that the therapeutic relationships can afford. Barber (1969) has discussed
its use in hypnosis, and Wolpe (1973), in
behaviour therapy. Wolpe suggests that the
therapeutic effects obtained during abreaction
might be a special case of the non-specificfoaors
that operate in a proportion of cases receiving
any form of psychotherapy.
BARBER, T. X. (1969), Hypnosis: A Scientific
Approach (Van Nostrand, Reinhold &
Company, New York).
BREUER, J. and FREUD, S. (1893), ''On the
psychical mechanism of hysterical phenomena: preliminary communication'' (in
2
Studies on Hysteria, Standard Edition of the
Complete Psychological Works ofSigmund Freud,
vol. 2, Hogarth Press, London).
JUNG, C. G. (1928), ''The therapeutic value of
abreaction'' (Collected Works, vol. 16,
Roudedge & Kegan Paul, London).
WOLPE, J. (1973), The Practice of Behaviour
Therapy (Pergamon Press, New York).
See also Trauma.
Absent member manoeuvre
A form of resistance identified by Sonne et al.
(1962) in the context offomily therapy. A key
member of the family absents himself either
from the first session so that treatment cannot
begin or during a critical phase later on in the
treatment process. Family therapists vary in
their response. Some refuse to see the family if
the key member is absent; others prefer to
work with the resistance, using it as a means of
understanding the roles taken by individuals
and the way in which coalitions and alliances are
formed.
SONNE, J. et al. (1962), ''The absent member
manoeuvres as a resistance in family therapy of
schizophrenia'' (Family Process, vol. 1, pp. 44-
672).
See also Folie a deux.
Acceptance
A quality believed to be necessary for a
therapist to display in relation to the client, in
order to promote effective psychotherapy. Van
der Veen (1970) defines acceptance as ''valuing
or prizing all aspects of the client including the
parts that are hateful to himself or appear
wrong in the eyes of society''. Used interchangeably with unconditional positive regard by
client-centred therapists, the concept of acceptance enables the therapist to distinguish
between the client''s self and his behaviour - a
distinction which other schools of therapy, for
example behaviour therapy, would find difficult
to sustain. Acceptance involves the recognition by the therapist of the client''s worth
without necessarily implying either approval of
his behaviour, or an emotional attachment on
the part of the therapist.
ACTING OUT
DER VEEN, F. (1970), ''Client perception
of therapist conditions as a factor in psychotherapy'' (in Hart,]. T. and Tomlinson, T. M.
(eds), New Dimensions in Client Centred
Therapy, Houghton Mifflin, Boston).
VA~
See also Accommodation, Core conditions,
Empathy, Joining, Non-specific foctors, Relationship factors.
Accommodation
Term used to describe the need for the
therapist to adapt and harmonise his style and
techniques with each particular family or
client. The term is used mainly in the context
of fomi(y therapy but the process is relevant to
all modalities and is fundamental to the
creation of a therapeutic alliance. The therapist
responds to this need by developing joining
techniques and creating the core conditions of
the treatment process. Both these enable him
to move from a position of accommodation to a
position of challenge, promoting change,
insight and the acquisition of new skills for
problem solving interventions. In the context of
family therapy, accommodation lays the
groundwork and makes possible the restructuring interventions by which the family
system begins to change.
MINUCHIN, S. (1974), Families and Famiry
Therapy (Tavistock, London).
Accreditation
See Regulation (ofpsychotherapists).
Ackerman, Nathan Ward (1908-1971)
Pioneer offamiry therapy, Ackerman was born
into aJewish family in Bessarabia. He was one
of five children that survived infancy, the
family emigrating to the United States in 1912.
He studied medicine at Columbia University,
New York, and later psychiatry. Between 1937
and 1942 he was a candidate at the New York
Psychoanalytic Institute, working simultaneously as a psychiatrist for the Jewish Board
of Guardians. In 1937 he married Gwendolyn
Hill and they had two daughters. He became a
member of the American Psychoanalytic
Association in 1943, but in 1955 he helped
found the American Academy of Psychoanalysis which became a principal alternative
organisation for those who refused to confine
psychoana(ysis to being a medical speciality. His
approach to psychoanalysis was unorthodox
and creative and although he retained his links
with, and use of, psychoanalytic theory
throughout his life, his appreciation of the
wider social and cultural determinants of
psychological disturbance began to lead him
towards the treatment of the family as a group.
In 1960 he founded the Family Institute, New
York, and from then on he specialised in the
practice and teaching of family therapy. In the
same year, he co-founded, with Don Jackson,
the journal Famiry Process, which remains the
foremost family therapy journal in the world.
He left behind a huge legacy of books and
articles and also film material of his clinical
work. His best-known books are The Psychodynamics ofFamiry Life (1958) and Treating the
Troubled Famiry (1966).
Acting in
Term sometimes used as a contrast to acting
out to denote an intermediate form of expression, which lies midway between acting out on
the one hand and verbalisation on the other.
Body postures, facial expressions and the
patient''s whole repertoire of non-verbal
communication, adopted during the therapeutic
session, is thus described as acting in. The
term is also used to describe any behaviour that
occurs within the therapeutic session (as a
substitute for the work of verbalising repressed
material), as contrasted with that which occurs
outside the session.
DEUTSCH, F. (1947), ''Analysis of postural
Quarterry, vol. 16,
behaviour'' (P~ychoanarytic
pp. 195-213).
MAHL, G. F. (1967), ''Some clinical observations on non-verbal behaviour in interviews''
(J. ot'' Nervous and Mental Diseases, vol. 144,
pp. 492-505).
Acting out
The making conscious of unconscious
impulses and conflicts through action. Freud
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