Psychoanalytic and psychodynamic therapies for depression. The evidence base.

David Taylor, a consultant psychotherapist at the Tavistock & Portman NHS Foundation Trust (120 Belsize Lane, London NW3 5BA, UK. Email: [email protected]), is the clinical lead of the Tavistock Adult Depression Study (a randomised controlled trial of 60 sessions of weekly psychoanalytic psychotherapy v. treatment as usual for patients with chronic, refractory depression). He is a training and supervising psychoanalyst at the Institute of Psychoanalysis. This article argues that the current approach to guideline development for the treatment of depression is not supported by the evidence: clearly depression is not a disease for which treatment efficacy is best determined by short-term randomised controlled trials. As a result, important findings have been marginalised. Different principles of evidence-gathering are described. When a wider range of the available evidence is critically considered the case for dynamic approaches to the treatment of depression can be seen to be stronger than is often thought. Broadly, the benefits of short-term psychodynamic therapies are equivalent in size to the effects of antidepressants and cognitive–behavioural therapy (CBT). The benefits of CBT may occur more quickly, but those of short-term psychodynamic therapies may continue to increase after treatment. There may be a ceiling on the effects of short-term treatments of whatever type. Longer-term psychodynamic treatments may improve associated social, work and personal dysfunctions as well as reductions in depressive symptoms

Fetishism and the social value of objects.

The idea of the fetish has a particular presence in the writings of both Marx and Freud. It implies for these two theorists of the social, a particular form of relation between human beings and objects. In the work of both the idea of the fetish involves attributing properties to objects that they do not 'really' have and that should correctly be recognised as human. While Marx's account of fetishism addresses the exchange-value of commodities at the level of the economic relations of production, it fails to deal in any detail with the use-value or consumption of commodities. In contrast Freud's concept of the fetish as a desired substitute for a suitable sex object explores how objects are desired and consumed. Drawing on both Marx and Freud, Baudrillard breaks with their analyses of fetishism as demonstrating a human relation with unreal objects. He explores the creation of value in objects through the social exchange of sign values, showing how objects are fetishised in ostentation. This paper argues that while Baudrillard breaks with the realism characteristic of Marx's and Freud's analyses of fetishism, he does not go far enough in describing the social and discursive practices in which objects are used and sometimes transformed into fetishes. It is proposed that the fetishisation of objects involves an overdetermination of their social value through a discursive negotiation of the capacities of objects that stimulates fantasy and desire for them

Three Styles in the Study of Violence

This is a postprint (accepted manuscript) version of the article published in Reviews in Anthropology 37:1-19. The final version of the article can be found at http://dx.doi.org/10.1080/00938150701829525 (login required to access content). The version made available in Digital Common was supplied by the author.Accepted Manuscripttru

Play and metaphor in clinical supervision: keeping creativity alive

This article explores the use of play and metaphor in clinical supervision. The intention is not to attempt to cover the whole area of play, or the use of metaphor in clinical supervision, but rather to highlight particular aspects of their respective roles in the service of learning about therapeutic work. The relevance of the arts - especially the visual arts - in relation to this is also discussed. A number of brief clinical vignettes are included by way of illustration. All names, and some identifying details, have been changed to preserve confidentiality. (C) 2010 Elsevier Inc. All rights reserved

Quantity over quality: a political economy of ‘active labour market policy’ in the UK

This article offers a critical evaluation of recent ‘active labour market policy’ (ALMP) initiatives in the UK, focusing on the coalition government's Work Programme and its immediate antecedents. ALMP exemplifies a supply-side employment strategy, reorienting the state away from supporting labour demand and towards promoting the ‘employability’ of individuals within existing labour market structures. The article locates the rationale for this policy agenda within the wider politics of economic growth. Belying its status as a pioneer of ALMP, the UK spends very little on supply-side labour market interventions relative to other European countries. This can be explained with reference to the type of ALMP interventions prioritised in the UK, which in turn is explained by the growth model that ALMP is designed to sustain. The UK's growth model requires an abundance of low-paid jobs in the labour-intense and volatile services sector. Ostensibly, ALMP fulfils this requirement by ensuring that individuals are immediately available for work, marginalising concerns about pay and job quality. Moreover, ALMP also serves to inculcate the desirability of certain behaviours at the individual level. The coalition government's approach demonstrates an intensification rather than transformation of previous practice, indicative of its support for resurrecting the UK's pre-crisis growth model

Combining scales to assess suicide risk

Authors posting Accepted Author Manuscript online should later add a citation for the Published Journal Article indicating that the Article was subsequently published, and may mention the journal title provided they add the following text at the beginning of the document: “NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Cardiovascular Echography. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Psychiatric Research, [VOL#, ISSUE#, (DATE)] DOI#”A major interest in the assessment of suicide risk is to develop an accurate instrument, which could be easily adopted by clinicians. This article aims at identifying the most discriminative items from a collection of scales usually employed in the assessment of suicidal behavior. Methods: The answers to the Barrat Impulsiveness Scale, International Personality Disorder Evaluation Screening Questionnaire, BrowneGoodwin Lifetime History of Aggression, and Holmes & Rahe Social Readjustment Rating Scale provided by a group of 687 subjects (249 suicide attempters, 81 non-suicidal psychiatric inpatients, and 357 healthy controls) were used by the Lars-en algorithm to select the most discriminative items. Results: We achieved an average accuracy of 86.4%, a specificity of 89.6%, and a sensitivity of 80.8% in classifying suicide attempters using 27 out of the 154 items from the original scales. Conclusions: The 27 items reported here should be considered a preliminary step in the development of a new scale evaluating suicidal risk in settings where time is scarce.This article was supported by the National Alliance for Research on Schizophrenia and Affective Disorders (NARSAD), Fondo de Investigacion Sanitaria (FIS) PI060092, Fondo de Investigacion Sanitaria FIS RD06/0011/0016, ETES (PI07/90207), the Conchita Rabago Foundation, and the Spanish Ministry of Health, Instituto de Salud Carlos III, CIBERSAM (Intramural 521 Project, P91B; SCO/3410/2004)

Argumentum ad misericordiam - the critical intimacies of victimhood

This article discusses the widespread use of victim tropes in contemporary Anglo-American culture by using cultural theory to analyse key social media memes circulating on Facebook in 2015. Since the growth of social media, victim stories have been proliferating, and each demands a response. Victim narratives are rhetorical, they are designed to elicit pity and shame the perpetrator. They are deployed to stimulate political debate and activism, as well as to appeal to an all-purpose humanitarianism. Victimology has its origins in Law and Criminology, but this paper opens up the field more broadly to think about the cultural politics of victimhood, to consider how the victim-figure can be appropriated by/for different purposes, particularly racial and gender politics, including in the case of Rachel Dolezal, and racial passing. In formulating an ethical response to the lived experience of victims, we need to think about the different kinds of critical intimacies elicited by such media