Therapeutic Action

This book discusses how to write about the process of psychic change without betraying either love or science. It investigates the concepts of subjectivity and objectivity that are appropriate for psychoanalysts, the concepts of internalization and of transference.

How do we position ourselves, moment by moment, in relation to our patients and how do these positions inform both what we come to know about our patients and how we intervene? Do we participate as neutral object, as empathic self-object, or as authentic subject? Do we strive to enhance the patient's knowledge, to provide a corrective experience, or to work at the intimate edge? In an effort to answer these and other clinically relevant questions about the process of psychotherapeutic change, Martha Stark has developed a comprehensive theory of therapeutic action that integrates the interpretive perspective of classical psychoanalysis (Model 1), the corrective-provision perspective of self psychology and those object relations theories emphasizing the internal 'absence of good' (Model 2), and the relational perspective of contemporary psychoanalysis and those object relations theories emphasizing the internal 'presence of bad' (Model 3). Model I is about knowledge and insight. It is a one-person psychology because its focus is on the patient and the internal workings of her mind. Model 2 is about corrective experience. It is a one-and-a-half-person psychology because its emphasis is not so much on the relationship per se, but on the filling in of the patient's deficits by way of the therapist's corrective provision; what ultimately matters is not who the therapist is, but, rather, what she can offer. Model 3 is about relationship, the real relationship. It is a two-person psychology because its focus is on patients and therapists who relate to each other as real people; it is about mutuality, reciprocity, and intersubjectivity. Whereas Model 2 is about 'give' and involves the therapist's bringing the best of who she is into the room, Model 3 is about 'give-and-take' and involves the therapist's bringing all of who she is into the room. As Dr. Stark repeatedly demonstrates in numerous clinical vignettes, the three modes of therapeutic actionDknowledge, experience, and relationshipDare not mutually exclusive but mutually enhancing. If, as therapists, we can tolerate the necessary uncertainty that comes with the recognition that there is an infinite variety of possibilities for change, then we will be able to enhance the therapeutic potential of each moment and optimize our effectiveness as clinicians.

TABLE OF CONTENTS: 1. Modes of therapeutic action 2. Intervention as assessment 3. Creating opportunities for self reflection 4. Bringing defenses and unconscious mental content into awareness 5. Interaction structures in the transference countertransference 6. Supportive approaches: The uses and limitations of being helpful 7. Studying psychoanalytic therapy 8. Case studies.

Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.

At the last Annual Representative Meeting of the British Medical Association a motion was passed that `certain additional cannabinoids should be legalized for wider medicinal use.'' This report supports this landmark statement by reviewing the scientific evidence for the therapeutic use of cannabinoids and sets the agenda for change. It will be welcomed by those who believe that cannabinoids can be used in medical treatment. The report discusses in a clear and readable form the use and adverse effects of the drug for nausea, multiple sclerosis, pain, epilepsy, glaucoma, and asthma.

A one-of-a-kind guide specifically for rehabilitation specialists! A leader in pharmacology and rehabilitation, Charles Ciccone, PT, PhD offers a concise, easy-to-access resource that delivers the drug information rehabilitation specialists need to know. Organized alphabetically by generic name, over 800 drug monographs offer the most up-to-date information on drug indications, therapeutic effects, potential adverse reactions, and much more! A list of implications for physical therapy at the end of each monograph helps you provide the best possible care for your patients. It’s the perfect companion to Pharmacology in Rehabilitation, 4th Edition!

Standard medicinal chemistry courses and texts are organized by classes of drugs with an emphasis on descriptions of their biological and pharmacological effects. This book represents a new approach based on physical organic chemical principles and reaction mechanisms that allow the reader to extrapolate to many related classes of drug molecules. The Second Edition reflects the significant changes in the drug industry over the past decade, and includes chapter problems and other elements that make the book more useful for course instruction. New edition includes new chapter problems and exercises to help students learn, plus extensive references and illustrations Clearly presents an organic chemist's perspective of how drugs are designed and function, incorporating the extensive changes in the drug industry over the past ten years Well-respected author has published over 200 articles, earned 21 patents, and invented a drug that is under consideration for commercialization

The only comprehensive work to cover all aspects of diuretic agents, the book discusses the pharmacology and toxicology of diuretic agents as well as the physiological effects. Experts in the field present the principles and experimental approaches for the study of interactions between pharmacologic compounds in relation to specific target organs. Diuretic Agents contains information on the mechanisms of action and application of diuretics, and details FDA regulations and pharmaceutical industry guidelines. Written by experts in the field Covers all aspects of diuretic agents Includes information on the mechanisms of action and application of diuretics

This book presents a series of perspectives on the therapeutic potential of the ritual and clinical use of the Amazonian hallucinogenic brew ayahuasca in the treatment and management of various diseases and ailments, especially its role in psychological well-being and substance dependence. Biomedical and anthropological data on the use of ayahuasca for treating depression, PTSD, and substance dependence in different settings, such as indigenous contexts, neo-shamanic rituals, contemporary therapeutic circles, and in ayahuasca religions, in both South and North America, are presented and critiqued. Though multiple anecdotal reports on the therapeutic use of ayahuasca exist, there has been no systematic and dense reflection on the topic thus far. The book brings the therapeutic use of ayahuasca to a new level of public examination and academic debate. The texts in this volume stimulate discussion on methodological, ethical, and political aspects of research and will enhance the development of this emergent field of studies.

How do we position ourselves, moment by moment, in relation to our patients and how do these positions inform both what we come to know about our patients and how we intervene? Do we participate as neutral object, as empathic self-object, or as authentic subject? Do we strive to enhance the patient's knowledge, to provide a corrective experience, or to work at the intimate edge? In an effort to answer these and other clinically relevant questions about the process of psychotherapeutic change, Martha Stark has developed a comprehensive theory of therapeutic action that integrates the interpretive perspective of classical psychoanalysis (Model 1), the corrective-provision perspective of self psychology and those object relations theories emphasizing the internal "absence of good" (Model 2), and the relational perspective of contemporary psychoanalysis and those object relations theories emphasizing the internal "presence of bad" (Model 3). Model I is about knowledge and insight. It is a one-person psychology because its focus is on the patient and the internal workings of her mind. Model 2 is about corrective experience. It is a one-and-a-half-person psychology because its emphasis is not so much on the relationship per se, but on the filling in of the patient's deficits by way of the therapist's corrective provision; what ultimately matters is not who the therapist is, but, rather, what she can offer. Model 3 is about relationship, the real relationship. It is a two-person psychology because its focus is on patients and therapists who relate to each other as real people; it is about mutuality, reciprocity, and intersubjectivity. Whereas Model 2 is about "give" and involves the therapist's bringing the best of who she is into the room, Model 3 is about "give-and-take" and involves the therapist's bringing all of who she is into the room. As Dr. Stark repeatedly demonstrates in numerous clinical vignettes, the three modes of therapeutic action-knowledge, experience, and relationship-are not mutually ex