Teletherapy, by Jill Savege Scharff

Posted on Aug 29, 2017

The Teleanalytic Setting

Families with scattered members stay in touch, thanks to WeChat, Facetime or Skype.  Why not use the same technology to give patients access to a good analyst?  That is not so simple.  Insurance companies may not reimburse for teletherapy. States may not grant an exceptional license to an out-of-state provider for one patient (although many states are now forming an interstate licensure compact).  Skype and Facetime cannot claim to be HIPPA-competent: A breach in confidentiality could occur.  We could do harm.  These are all real concerns and could lead therapists to say no to a patient’s request for treatment at a distance.

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How Group Thinking can help us engage with and resolve individual and social conflict

I was born in a country that experienced many wars and is in a state of protracted conflict with its neighboring countries. The region surrounding my country is torn by conflicts, wars, and atrocities. In other parts of the world, we witness conflicts that result in great human suffering. Within my country, there are also many different cultural groups and subgroups: Arabs and Jews, Sephardic Jews and Ashkenazi Jews, immigrants from Europe, Africa, and America, the religious and the secular. There is a continuous tension between these subgroups that sometimes erupts into open hostilities.

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The logic of metaphor and the importance of therapeutic context

I hesitated long and hard before deciding that it was right to call this book a “handbook”. After all, I might be arousing the impression that the book presents a blueprint for psychotherapy and that it contains concrete instructions for the creation of a reproducible model. You will not, in fact, find any such blueprint or linear instructions here. At best you will be aware, when you have finished the book, that after every session you will need to start again, with a fresh outlook and from an attitude of active not-knowing.

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The Significance of Attachment for the Practice of Psychotherapy

I am sure we have all experienced clients who arrive early for therapy and who find it difficult to leave at the end of sessions, who seek out contact between appointments, and who become dysregulated by the therapist’s breaks. They may often be angry at what they perceive to be other people’s unfair treatment of them, or present themselves as helpless to influence their own situations. Such clients are the focus of this new short book.

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Telling the Story of the Linked Self: A Journey in Psychoanalysis

IPI faculty members presented a number of panels, presentations, and precongress workshops at the International Psychoanalytical Congress in Buenos Aires in July 2017.  At one of those panels, David Scharff and Lea Setton invited Roberto Losso, Juan Tubert-Oklander and Joachim Pichon-Rivière, to join them in presenting the ideas and applications of the late Enrique Pichon-Rivière.  Later they gathered to celebrate the launch of their edited book The Linked Self in Psychoanalysis: The Pioneering Work of Enrique Pichon-Rivière edited by Roberto Losso, Lea Setton, and David Scharff, in English for the first time (London: Karnac 2017). Enrique’s ideas are so original, and his early development so fascinating, that I wanted to share them widely, especially with young people who haven’t a clue about what a therapist or psychoanalyst actually does, or how an analytic approach can help.  So I got the idea of writing the story of Enrique as a story to read to our children and grandchildren.

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A Clinician’s Manual

The seeds for this book were sowed many years ago, when I became a psychiatrist and then a trained psychotherapist in the Conversational Model of psychotherapy, pioneered by the late Robert Hobson and Emeritus Professor Russell Meares. Having a busy clinical practice and an active teaching load left very little time for writing a book, though I published papers from time to time.

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An Analytic Journey into New Psychic Terrains

This book is a collection of texts written between 1983 and 2017. They could be read as a diary, the private diary of my life as a psychoanalyst. The texts in the book are all responses to questions that I have asked myself or that were sometimes put to me. They are thus inner dialogues, often with imaginary interlocutors. Others may well know how to write differently, but for me writing is always addressed to someone else, sometimes in order to contradict them. I have always had a rebellious spirit, as I was told even when I was a child. Later on, Pierre Marty, with whom I worked from the creation of the Paris Day Hospital for Psychosomatics until his death in 1993 used to call me ‘Mrs “Yes, Sir, but…” ‘.

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The First Ambush: Hijacking the Human Brain

‘Unbeknown to me at the time, the army’s training and/or indoctrination would come to shape my life, my decisions and my neurological processes for years to come. I suppose at the time we took it all in our stride and laughed it off. But we as people and in particular our brains were being prepared for the inhuman rigours and demands of traditional war fighting, closing with and engaging the enemy and by extension modern international conflicts’ – Ryan Hall, British infantry, 2000-2008

A major new report has just been published drawing on veterans’ testimony and around 200 studies from the last half-century to explore for the first time the effects of modern army employment on soldiers, particularly their initial training. The studies are mainly the work of military academic research departments in the UK and US, supplemented by research in other countries including Australia, Canada, Germany, and Norway. The report finds that army employment has a significant detrimental impact on soldiers’ attitudes, health, behaviour, and financial prospects. This is partly due to soldiers’ war experiences, but also to how they are recruited and trained, how they are conditioned by military culture, and how they re-adjust to civilian life afterwards.

It reveals how in the process of transforming civilians into soldiers, army training and culture forcibly alter recruits’ attitudes under conditions of sustained stress, leading to harmful health effects even before they are sent to war. Among the consequences are elevated rates of mental health problems, heavy drinking, violent behaviour, and unemployment after discharge, as well as poorer general health in later life.

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