Despite evidence suggesting that binge eating disorder (BED) is the most prevalent eating disorder, and one with the least difference in prevalence between men and women experiencing eating disorders, research specifically focusing on men struggling with BED is limited. This qualitative study explored men’s experiences and understanding of BED. Six men who had received a diagnosis of BED and had engaged in psychological treatment were interviewed, and the data were analysed using interpretative phenomenological analysis (IPA). Three superordinate themes emerged. The first theme highlighted men’s experiences with binge eating and struggles in understanding the functionality of BED in their lives. The second theme revealed how having experienced BED prevented these men from conforming to masculine stereotypes, which impacted their sense of masculinity. The third theme focused on the men’s experiences of seeking and receiving treatment. Findings appear to be unique experiences for men struggling with BED, for example, a compounded feeling of flawed masculinity due to not being able to attain a ‘macho’ physique, perceiving binge eating as a socially acceptable behaviour for men and a unique insight into their treatment needs. The potential implications of the findings for clinical practice are discussed, where a gender sensitive focus is recommended.
: In this article, I celebrate and critique the evidence base for relationally-orientated therapy. The central role played by the therapeutic relationship in effective therapy is now supported by an impressive evidence base, but it is mostly quantitative evidence that is privileged. This article attempts a small corrective to widen the lens by presenting 5 categories of qualitative evidence: Qualitative meta-analyses of client experiences of therapy; case studies; qualitative studies of clients’ experience; qualitative studies of therapists’ experience; and discursive studies of interactions and language use. The richness, relevance, and resonance of qualitative methodology is demonstrated by exemplar studies which highlight a special role for exploring under researched areas. However, qualitative researchers face confounding epistemological and methodological challenges in trying to capture the impossible complexity, ambivalence, variability, and ambiguity of relational therapy experiences across different cultural contexts. No methodology (qualitative, quantitative or mixed) can hope to do justice to these questions on its own and both critical reflexivity and humility are needed.
Thematic analyses can take multiple forms, some of them systematic, others intuitive. In practice, published research that involves thematic analysis comes is all sorts of shapes and styles: some good, some bad, and some just plain ugly. In this article, I attempt to clarify the nature and practice of thematic analysis. I offer concrete examples of what I consider to be good practice, highlighting instances where I think the thematic analysis has been conducted in an appropriately rigorous way, yielding rich, informative findings. First, different types of thematic analyses are identified and contrasted. The second section considers the stages and process of conducting an analysis. The third section explores four key criteria to evaluate thematic analysis: Rigour, Resonance, Reflexivity and Relevance – the 4 R’s. Throughout, I emphasise that there is no one way to do thematic analysis. The form of analysis engaged depends on the research and methodological context as well as on the type of data collected, the researcher’s own preferences, and what is required by others (e.g., the journal, examiners).
We have developed a method utilizing video material to facilitate the psychotherapeutic process we call VideoTalk. In this method, which uses schema therapy as a theoretical framework, patients make videos at home in various emotional situations following the therapist’s detailed instructions. They then watch the videos together with the therapist making observations about the patient and how they speak about themselves and other people. The aim of this article is to describe five patients’ personal experiences of psychotherapy consisting of 15 video-assisted sessions. We used mixed methods methodology consisting of material-based content analysis of patient interviews done after the therapy and changes in symptoms measured by psychological symptom scales. Based on the symptom scales, this outcome study found that all participants benefited from the VideoTalk therapy. ‘Gaining bodily self-awareness and insight’, ‘Thinking more clearly and with self-compassion’, and ‘Challenges associated with the technology and practicalities of video work’ were found to be the main categories in the content analysis. After some minor technical difficulties, the patients found the video method workable. The results showed a wide range of self-observations, which began to be positively integrated into the patients’ lives and to increase their overall wellbeing. In the course of VideoTalk therapy, patients face painful emotions and may begin to create a new kind of connection between their own insulated internal world and the surrounding world.
The creative, non-fiction approach of ‘lyric essay’ is used to flesh out my heuristic experience. My essay builds on some earlier heuristic research conducted about my experience, over a lifetime, of musculoskeletal pain. That research questioned whether suffering is a conscious choice, even if pain is inevitable. This lyric essay – utilizing a mosaic of critical review, description, metaphor and montage - is a phenomenological reflection on my process of writing the pain which strives to better convey a palpable sense of my embodied experience of pain and bodily alienation. Following a literature review and an exploration of the nature of lyric essays, a personal narrative and critical discussion evaluates how my experience of the writing process, and the use of lyric essays, may contribute to the field of psychotherapy. As a raw, impromptu, reflective account of pain across the life span, the essay contains a detailed snapshot of my lived experience. It contrasts how a child relates to negative experiences, and how an adult, trained in psychotherapy, might choose to process her emotions. The approach of lyric essays is offered as an in-depth way to explore therapists’ own experience and that of their clients.
Flying dreams are termed ‘gravity dreams,’ along with dreams that include falling, climbing, descending and floating through air, water and stairs. Enormous wave dreams are also considered to be gravity dreams. Phenomenological studies looking at flying dreams are scarce, and this area of dreaming remains largely unexplored, despite gravity dreams being listed as one of the most commonly reported dreams. This study uses phenomenologically-orientated qualitative thematic analysis to explore the idiographic experience of the embodied self during an unassisted gravity dream. Six gravity dreamers were interviewed. Thematic analysis uncovered six major themes: ‘Boundaries;’ ‘Not of this world;’ ‘Being more than oneself’; ‘Temporality’ (the sense of infinity or forever in the dream); ‘Locus of control’ and ‘Gravity Dreaming as a Process’ (in terms of learning to fly over time or a history of gravity dreaming). Four of the participant dreams described were lucid in nature. The discussion suggests that explorations of existential experiences enable us to push the boundaries of research, generating new ways to practice psychotherapy and greater understanding of how our experiences shape the formation of both therapist and therapy.
Therapist self-disclosure (TSD) is an issue shrouded in debate, risk, and uncertainty. However, it can also serve as a useful therapeutic tool for those who decide to ‘take the plunge’. Given the paucity of research on person-centred counsellors’ perspectives of TSD, this study sought to explore two person-centred counsellors’ lived experiences of self-disclosing personal information to clients during therapy. Semi-structured interviews were conducted, which were recorded and transcribed. A hermeneutic phenomenological approach was adopted to allow an in-depth examination of the counsellors’ subjective, pre-reflective lived experiences. Four main themes emerged: ‘An internal battle’; ‘Levelling the playing field’; ‘Normalising experiences’; and ‘I’m human too’. Each theme is described in detail with reference to relevant phenomenological concepts. Within the analysis, the implicit power of TSD is revealed - particularly in relation to its potential to ‘level the playing field’, but also in terms of the position of power held by the practitioner. Potential implications for practitioners are touched upon within the discussion. Also explored within the discussion are the ways in which TSD may serve to facilitate a range of therapeutic goals - including strengthening the therapist-client relationship - which could have direct clinical implications for therapists; particularly, person-centred counsellors.
I am delighted with the contributory articles in this issue which are written by therapists drawn from the modalities of integrative psychotherapy, existential psychotherapy, counselling psychology and gestalt therapy. The articles address, in turn, therapist development toward integration, the evolution of an integrative training programme, trainee reaction to sexual attraction from clients, grief and mediation.
This study explored how trainee therapists react to and handle client sexual attraction (SA) in their work. Qualitative interviews were conducted with 12 volunteer trainees of counselling psychology and psychotherapy who responded to an advert. Transcripts were analysed using constructivist grounded theory (GT). The conceptual stages developed highlight the difficulties trainees experience in relation to client sexual attraction: conflicting feelings and anxious professional beliefs encapsulated in moralistic reactions, culminating in defensive handling of sexual attraction. These psychological conditions seem to be a strategy for professional survival. The trainee experience is captured in the core category: Moralistic Responses to Sexual Attraction and Defensive Handling, associated with a climate of fear that client sexual attraction could potentially influence the therapist into behaving unethically. The study found that trainees believe that professionalism is free of sexual feelings whether these are client, therapist or mutual.
Between February 25 and 26, 2012, around thirty Gestalt Therapists from five European nations (Sweden, Denmark, Fin- land, The Netherlands and the UK) gathered together to engage in an experientially based learning weekend on research in gestalt therapy. The event was organised by the Swedish Association for Gestalt Therapy - SAG Board and its energetic chair Jojo Tuulikki Oinonen. The weekend was facilitated by Ken Evans, former President of the European Association or Gestalt Therapy and co-author with Linda Finlay of Relational Centred Research in Psychotherapy: exploring meanings and purpose. (Finlay and Evans, 2009).
This paper presents a Model for working with the dying and the bereaved within the Maltese context arising from my years of prac- tice in oncology and palliative care. The use of self is an important element. Self, from a Gestalt perspective, indicates cohesion over time – Integrity, and openness to change at the contact boundary – Growth (Yontef, 1993), two important characteristics in the Model. The interplay between the psychotherapeutic and the spiritual and religious is addressed, within a culture where the Roman Catholic Religion is a dominant tradition. The Model advocates that, apart from practising presence and inclusion, a practitioner needs to be prepared to stay with the client in the long space between Withdrawal and Sensation, with its dearth of figure-formation. This requires a deep level of conviction that sustains the practitioner in the ‘between’ to allow a natural, positive figure to emerge, with the resulting growth of both practitioner and client.
This paper explores the personal and meaning-filled experience of what one woman’s tattoos subjec- tively mean to her in the context of her life. Merging a dialogical-relational Gestalt theoretical base with a relational-hermeneutic phenomenological approach, I collected data by interviewing my participant in a 45 minute open-ended depth interview exploring her life experience. Analysis based on iterative re- readings of the transcript drew on narrative, reflexive and creative metaphorical forms. Findings reveal that my participant’s experience of her tattoos seems to link - in simple but profound ways - with grief. Having been confronted by the ending of two of the biggest relationships with males (her father and ex-husband), she made the somewhat unconscious choice to mark the transitioning between the roles of daughter and ex-wife and reclaim her own sense of skin. Her tatoos of two lizards seem to symbolise and represent her African home, sexuality, resourcefulness, survival and ultimately a reclaiming of her own self.
The massive shifts in emotions and upheaval of social roles women are likely to experience following the birth of a child have been well documented. And yet, it is still not possible to predict how each in- dividual woman will respond. This research explores one woman’s experience using a phenomenologi- cal, relational-centred research approach. My aim was to try to witness and ‘give voice to’ her unique, special and particular experience of life after delivery in a relatively unstructured interview. Analysis revealed four emergent themes: Protection-Desertion; Contact-Isolation; Belonging-Shame; and Anxi- ety-Ambivalence. Throughout the interview there was a sense that Kate wished to be seen as the same as other mothers, rather than as a ‘mother-with-deficits’. She goes to some lengths to hide herself from her family and professionals to give them no reason to doubt her ability.
For a significant proportion of therapists, the mere thought of writing up research academically and then perhaps striving to publish any writings is anxiety provoking. These therapists may be suffering from ‘Writer’s Block’ – a process, I suggest, that gets in the way of meaningful and relevant research being completed by practitioners which could help inform and develop our way of working. Through this review of the literature on Writer’s Block, intertwined by personal reflections on my own experience, I aim to explore possible causes and offer some tentative solutions.
The process of getting therapy supervision while working in a therapeutic community setting with persons suffering from chronic mental illness differ from those working in other clinical settings. In therapeutic communities, the demands on therapists are much more complex, multidimensional and result in significant emotional stress or ‘burn-out syndrome’. For this reason, the therapists need to undergo intensive training, supervision and personal work on a regular basis. The present article applies a descriptive-single case study method, focusing on the process of supervision of psychotherapists in a therapeutic community in India. We explore the process of practical training and supervision of psycho- therapists and describe our approach to developing a budding therapist’s skills and sense of autonomy.
This research explores the lived experience of the rupture in the relationship between Jenny (a pseud- onym) - an 18 year old, pregnant, unmarried, young woman in Britain in 1968 - and her mother. In a relational-centred research interview, Jenny shares her experience proceeding the rupture, the narrative point of the rupture itself and the occurring experience of her relationship after the rupture. Phenom- enological analysis reveals Jenny’s experience is one of shame and guilt in relation to her mother. She feels exposed, humiliated and ‘at fault.’ Jenny misses a shared sense of pride with her mother and in- stead experiences rejection not only of herself, but also through the new life she has created. She devel- ops a number of ways to protect herself from her own painful internal experience. Notably she protects her mother from criticism by taking responsibility for her mother’s feelings and behaviours. Yet there is a sense of a desperate internal confusion of experience as Jenny continually returns the question of the ‘why’ of her mother’s behaviour. The pain of rejection and isolation is felt deeply by Jenny within the relationship rupture with her mother. She feels her own deep sadness and loss as interwoven into her mother’s.
This study aimed to ‘give voice’ to the lived experience and perceptions of seven students (aged 15 to 17) who have used a therapeutic service in school. Group or individual interviews were employed, tran- scribed and then analysed using a phenomenologically-orientated relational research methodology. The students all expressed valuing a confidential one-to-one space where they could express and explore their worries and uncertainties. They benefitted from feeling understood and having their perspective validated as ‘normal’. The opportunity to express feelings that distracted them from learning at school opened up new skills of reflection, negotiation and being able to reach out for support. Through their therapeutic experiences they learned to invest in their own success and resist potentially destructive peer pressure. A short discussion raises wider issues around the provision of therapy in secondary school settings.
The articles in this issue are diverse in terms of their focus, style and substance. The authors, too, come from different fields of psychotherapy and they vary in their experience. What links the papers is that all the authors are all relatively new voices in our academic/research/writing world. For most, indeed, this is their first ever published paper.
Counselling psychology trainees, in the UK, are obliged to undertake a minimum of 40 hours of per- sonal therapy as part of their DPsych course requirements. This requirement creates some stress and remains controversial in the profession at large. This paper constitutes part of a wider doctoral study on how this mandatory therapy is experienced from the perspectives of both trainees and counselling psy- chologists who have trainees as clients. Interpretative Phenomenological Analysis (IPA) was employed to access the lived experience of four trainees and four qualified psychologists. Four overarching cate- gories common to the two groups were identified in the broader study: impact of mandatory therapy on therapeutic process; the therapeutic performance; the value of therapy and; boundaries. Whilst many trainees felt that therapy should remain a compulsory course requirement, they also highlighted that it costs them both emotionally and financially. I had not included questions regarding finance in my origi- nal interview schedules and did not anticipate that both trainees and therapists would mention finance so often and so fervently. Consequently in this paper, I am selectively focusing on the financial and emo- tional side of mandatory personal therapy. This article will concentrate solely on the findings related to the emotional and financial impact of mandatory personal therapy on trainees and their therapists.
This piece of qualitative research explores the impact of nicknames upon the researchers. The research shows that nicknames function positively and negatively, and can either disturb contact on the Gestalt Cycle or benefit contact. This research highlights its limitations, and suggests ways of building upon its findings.
