Contemporary clinical practice, ellen ruderman, carol tosone, 2013 3524

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Essential Clinical Social Work Series Series editor: Carol Tosone For further volumes: http://www.springer.com/series/8115 Ellen Ruderman • Carol Tosone Editors Contemporary Clinical Practice The Holding Environment Under Assault Editors Ellen Ruderman Chair, AAPCSW National Study Group Private Practice Encino, CA, USA Carol Tosone Silver School of Social Work New York University New York, NY, USA ISBN 978-1-4614-4123-6 ISBN 978-1-4614-4124-3 (eBook) DOI 10.1007/978-1-4614-4124-3 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2012952269 © Springer Science+Business Media New York 2013 This work is subject to copyright All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer Permissions for use may be obtained through RightsLink at the Copyright Clearance Center Violations are liable to prosecution under the respective Copyright Law The use of general descriptive names, registered names, trademarks, service marks, etc in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made The publisher makes no warranty, express or implied, with respect to the material contained herein Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Contents The World Outside: Its Impact on the Treatment Setting Ellen Ruderman The Erosion of the Sociopolitical Holding Environment and the Collapse of the Potential Space for Creative Repair Jeffrey Applegate 13 Grief and Loss in an Age of Global Trauma: Protest and Despair Versus Attachment and Reorganization Judith Kay Nelson 19 Integrating the Internal and External Worlds of Clinical Social Work: A Philosophical and Political Search Rosalyn Benitez-Bloch 29 Virtual Intimacy in the Therapeutic Space: Help or Hindrance? Carol Tosone 41 What Happens to Confidentiality When the Government Enters the Treatment Room via the PATRIOT Act, HIPAA, and Managed Care? Carole Bender 51 A Perfect Storm: The Influence of Outside Forces on Social Work Education Barbara Berger 61 73 Silence in the Clinical Hour: A Time to Speak Billie Lee Violette v vi Contents Real Experiences Revisited: The Significance of Attachment, Separation, and Loss in Adult Psychotherapy Pat Sable 85 Saving the World One Patient at a Time: Psychoanalysis and Social Critique Jennifer Tolleson 99 Index 117 10 Contributors Jeffrey Applegate, Ph.D School of Social Policy and Social Work, Practice, University of Pennsylvania, Philadelphia, PA, USA Carole Bender, JD, LCSW UCLA Luskin School of Public Affairs, Department of Social Welfare Center on Child Welfare, Los Angeles, CA, USA Rosalyn Benitez-Bloch, DSW National Study Group, AAPCSW, Former Faculty, USC and UCLA Schools of Social Work, Los Angeles, CA, USA Barbara Berger, Ph.D The Institute for Clinical Social Work, Chicago, IL, USA Judith Kay Nelson, Ph.D National Study Group, American Association of Psychoanalysis in Clinical Social Work, The Sanville Institute for Clinical Social Work and Psychotherapy, Berkeley, CA, USA Ellen Ruderman, Ph.D Chair, AAPCSW National Study Group, Private Practice of Psychoanalysis and Psychotherapy, Encino, CA, USA Pat Sable, Ph.D National Study Group, AAPCSW, USC School of Social Work, Los Angeles, CA, USA Jennifer Tolleson, Ph.D Smith College, Institute for Clinical Social Work, Burlington, USA Carol Tosone, Ph.D Silver School of Social Work, New York University, New York, NY, USA Billie Lee Violette, Psy.D National Study Group, AAPCSW, Psychoanalytic Institute of Northern California, San Francisco, CA, USA vii Chapter The World Outside: Its Impact on the Treatment Setting Ellen Ruderman In these uncertain times, external events have profoundly altered patients’ physical circumstances as well as their emotional states As therapists, we too are affected by pressuring outside forces—the economy, health care, threats to individuals’ rights, war—and we must be aware that our patients bring the same outside world with them when they cross our threshold into the treatment setting Therefore, as we help patients examine their pasts and their internal states, we must also include examination of the world outside and its effect on their lives Further, we need to explore the secondary impact of hearing their concerns upon us We can no longer ignore the elephant in the treatment room In 2008, the National Study Group of the American Association of Psychoanalysis in Clinical Social Work (AAPCSW) met in California to address this subject The exciting discussions that ensued focused on the questions: Shall we, as analysts and therapists, pursue a treatment course based only on theoretical underpinnings, or we become more attuned to and openly acknowledge the added existential anxiety which also affects our patients’ worlds? Is it possible to address the “inner” without also training the therapeutic lens on the “outer?” And can the inner and the outer stand alone, without the therapist becoming more attuned to the “real?” Following our initial meeting, the AAPCSW National Study Group set to work examining these dilemmas We concluded that neither therapists nor their patients can ignore the impact of what happens outside the treatment hour The challenge then becomes how to integrate those external events in our own inner processes, as we work with patients’ material and our own countertransference The AAPCSW National Study Group’s work culminated in a preconference day panel and series of presentations at the AAPCSW conference, “Memory, Myth and Meaning in a Time of Turmoil,” held in New York City in February 2009 The panel E Ruderman (*) Chair, AAPCSW National Study Group, Private Practice, Encino, CA, USA e-mail: ERuderman@aol.com E Ruderman and C Tosone (eds.), Contemporary Clinical Practice: The Holding Environment Under Assault, Essential Clinical Social Work Series, DOI 10.1007/978-1-4614-4124-3_1, © Springer Science+Business Media New York 2013 ...Essential Clinical Social Work Series Series editor: Carol Tosone For further volumes: http://www.springer.com/series/8115 Ellen Ruderman • Carol Tosone Editors Contemporary Clinical Practice... Group, Private Practice, Encino, CA, USA e-mail: ERuderman@aol.com E Ruderman and C Tosone (eds.), Contemporary Clinical Practice: The Holding Environment Under Assault, Essential Clinical Social... Los Angeles, CA, USA Jennifer Tolleson, Ph.D Smith College, Institute for Clinical Social Work, Burlington, USA Carol Tosone, Ph.D Silver School of Social Work, New York University, New York,
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