SPT-Fall2014

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Psychotherapy: Lives Intersecting By Louis Breger. 2012. Reviewed by Phillipe Kleefield, New York University Psychotherapy and psychoanalysis are words that can conjure mixed feelings about the usefulness of their processes, whether they are worth the expensive undertaking, and other similar introspective thoughts, all of which lead to the central question: are psychotherapy and psychoanalysis really for me? Whether psychoanalysis is a good choice is the central question that I believe has prompted and informed Louis Breger to write his book, Psychotherapy: Lives Intersecting. This book involves an exploration through the lens of those patients that he has treated in the past, including what is unique in his psychotherapeutic analysis, what “worked” for his patients, and for whom his therapy was not an ideal fit. Breger orients his book toward patients that might be considering psychotherapy, in addition to other psychotherapeutic clinicians, as a means of juxtaposing his less orthodox, more relational form of psychotherapy in contrast to more traditional psychoanalysis as advocated by theorists such as Sigmund Freud. Through the long-term follow up of his patients, Breger offers an insightful and honest analysis of what his more successful patients found important about his therapeutic style (he also addresses the responses of those that didn’t find him particularly useful), allowing for readers to carve their own path in coming to a conclusion about whether psychotherapy and psychoanalysis might be a useful journey. The final chapters of Breger’s book are what I find to be the most important in his book. These chapters illustrate what it is that Breger’s psychotherapy entails and subsequently what specifically works about his form of psychotherapy. In addition to the positives of his work, there is also an account of what some didn’t find useful. Breger believes that the following characteristics are what makes his form of therapy effective: stressing not to push patients to analyze the transference but instead come to their own conclusions in their own time; being a personal and open therapist; fostering a relationship with patients such that this relationship cures prior unhealthy experiences; acknowledging mistakes; disclosing of personal information as long as it benefits the patient; having a sense of humor; allowing for and cultivating patients to undergo other forms of therapy while in psychotherapy; advocating for co -construction of insight and interpretation; and having flexible fees. Psychotherapy: Lives Intersecting advocates for a less orthodox model of psychotherapy and psychoanalysis in which the therapist doesn’t simply serve as a projection onto which a patient can place his own thoughts and feelings but can also interact in a more active way. Breger does a good job of delineating what made his style of therapy particularly effective; however, the reader should come to the decision by himself or herself of which therapeutic style would be most useful. Stop Eating Your Heart Out By Meryl Hershey Beck. 2011. Reviewed by: Mona Zohny, Hunter College In Stop Eating Y our Heart Out, Meryl Hershey Beck offers readers a 21-day program that will help “release [them] from [their] emotional dependence on food” (xix). This self-help book is a valuable resource for both sufferers of eating disorders, such as binge eating disorder (BED) and compulsive overeating (COD), or people that want to change their unhealthy relationship with food. Beck is a self-proclaimed “(recovered) food junkie” (xvi). She says that “food was the glue that kept [her] together” (xvi). She has also been treating patients with BED and CO for over 20 years. Her experiences enabled her to create a practical plan encompassing all of the beneficial techniques she has discovered throughout the years. This book contains an array of tools for dealing with emotional eating that includes journaling, meditation, creative visualization, energy techniques, and conscious living. In the first chapter, Beck tells the story of her struggles with food. For years she was a closet eater and yo-yo dieter. She recalls the inception of her eating habits during her childhood and provides insight as to why she began over eating to fill the emptiness inside her. This awareness was something she had developed through her recovery. Chapter’s Two through Eight cover three days of the plan so that the book progresses chronologically. Chapter Two is about becoming self-honest. Readers can take a mini-assessment to see if they have emotional eating problems. The assignments for the first three days involve writing your eating history, which involves reflecting on the past to see when and how the emotional eating began; keeping a food mood diary (for all 21 days of the program), which includes writing down all food eaten along with your mood at the time and the relevant circumstances; and keeping a journal since the focus of this book is the emotional aspects of overeating. The remaining chapters discuss finding support, spirituality, energy techniques, going within (oneself), personal housecleaning, conscious living, and a review, respectively. Beck approaches the issue of emotional eating from every angle. Throughout the book, she touches upon the influence Alcoholic Anonymous groups have had on support groups for eating problems, since emotional eating can be considered a food addiction. These 12-step programs have influenced the program that Beck has developed in this book. She uses some of the same activities including a simplified version of a moral inventory assignment used in AA groups, which involves taking a look at “character traits that have outlived their usefulness” in order to free oneself from them (p. 141). Another interesting concept that Beck learned about during a 12-step program is the idea of one’s Inner Child. The Inner Child is a “metaphor for the precious child we all were who often had unexpressed feelings and unmet needs” (p. 115). The assignments Somatic Psychotherapy Today | Fall 2014 | Volume 4 Number 2 | page 104
surrounding this concept involve developing and using a Nurturing Parent/ Healthy Adult part of oneself to create a dialogue with the Inner Child through which healing can occur. Beck explores the idea of energy techniques such as Emotional Freedom Techniques (EFT) and Rapidly Integrated Transformation Technique (RITT), which she developed with Robert Trainor Masci. These techniques involve tapping on certain pressure points and repeating a phrase. EFT usually involves one feeling while RITT encompasses many feelings at once. The goal is to neutralize negative emotions by affecting the flow of energy in the body. These techniques are used for patients with anxiety, depression, and eating disorders. The assignment provided in this book is designed to help emotional eaters curb their cravings. However, Beck encourages the use of these techniques whenever any negative emotions begin to surface and integrates them into other parts of the recovery process, like with the Inner Child work, since one’s Inner Child can bring up painful memories from the past. Beck’s Stop Eating Y our Heart Out is an easy to read book that serves as a practical tool for emotional eaters. This book does not focus on food. Instead, it dives into the feelings and thoughts associated with eating that influence negative behaviors like overeating. While the author used the concept that it takes 21 days to break a habit, she encourages readers to spend up to a week on a single assignment and to revisit assignments if necessary. The personal anecdotes of Beck’s experiences with emotional eating instill hope in the reader and make him or her feel like s/he is not alone in his or her suffering. Effective Clinical Practice in the Treatment of Eating Disorders: The Heart of the Matter. Edited by Margo Maine, William Davis, and Jane Shure. 2009 Reviewed by Phillipe Kleefield, New York University Margo Maine, William N. Davis, and Jane Shure, collective editors of Effective Clinical Practice In The Treatment of Eating Disorders: The Heart Of The Matter, seek to create an alternate framework for clinicians that counters the traditional “Medical-Model” paradigm in the treatment of women with eating disorders. Their framework takes as its central assumption that women require specialized therapeutic ideological constructs for effective treatment—“ a Feminist Frame”—that emphasizes relationships as fundamentally critical to the well being of women. Emphasizing connection, empathy, and “being present” in the therapeutic process in firm opposition to traditional clinical pedagogies of individuation, distance, and separation, Maine, Davis, and Shure have compiled practical articles by seasoned clinicians highlighting the qualitative component of eating disorders, and as such, effectively delineate not only the therapeutic theoretical framework they envision but also how it can be realized. The articles are clustered into three sections to best orient the clinician. In Effective Clinical Practices: Approaches, the theoretical crux of the book, four articles address the framework for how clinicians should think about and assess their female patients with eating disorders. Each article begins with a background for the respective therapeutic suggestion as evidenced by literature, followed by a clear description of what it entails, proceeded by a qualitative anecdote demonstrating this “in action”. For example, in “Beyond The Medical Model: A Feminist Frame for Eating Disorders”, Margo Maine explores “a Feminist Frame” as a construct in more detail, highlighting its emphasis on allowing women “to feel gotten”, its fostering of openness, its minimization of the power differential between clinician and patient, its emphasis on mutual growth within the therapeutic process, and how it should be realized. In “Wholeness and Holiness: A Psychospiritual Perspective”, Steven Emmett equates the experience of eating disorders to the pious, devotional and obsessional form that religion can take and suggests mobilizing these qualities in therapy in such a way that patients can become more spiritual and reengage their spirit away from the escapism that eating disorders engender. In “ Individual Psychotherapy for Anorexia Nervosa and Bulimia: Making a Difference”, William N. Davis outlines the two forms that eating disorders take – the diet as the distraction and the diet as allconsuming—and discusses how a clinician can engage patients through therapy such that the attachment to the eating disorder is replaced by one with the therapist and one outside themselves. In “Developing Body Trust: A Body- Positive Approach to Treating Eating Disorders”, Deb Burgard sees the adversarial relationship that women develop to their bodies as influenced by culture and social norms as something that can be fixed. Burgard advocates for women to “listen to their bodies” and understand that their bodies can regulate themselves and make up for any “mistakes” that may be perceived. The book’s second section, Effective Clinical Practices: Methods, offers articles addressing different therapeutic processes and the respective issues that might arise such that clinicians might be able to implement lessons from the larger “Feminist Frame” framework outlined in the first section of the book. Authors in this second section address countertransference in psychotherapy, family therapy, treating adolescents with eating disorders, and other practical topics that ultimately come to serve as reference guidebooks for clinicians to utilize in their practices, or at the very least reaffirm what they have already been doing. Each article is organized by clinical subdivisions that thoroughly outline the clinical concept at work in the therapeutic process that is outlined. Overall, this methods section serves as a comprehensive and thorough resource for practicing clinicians. The last section of this book, Effective Clinical Practices: Special Themes, is devoted to discussing more specific psychological underpinnings that exist as issues that clinicians working with individuals with eating disorders may encounter in treatment. While these issues may be more specialized, each article is still keenly practical and thoroughly all encompassing. The articles address diverse topics, including the role of shame and compassion in the development of eating disorders, the Somatic Psychotherapy Today | Fall 2014 | Volume 4 Number 2 | page 105
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