The Symptom-Context Method: Symptoms as Opportunities in Psychotherapy
From a leading pioneer in short-term psychotherapy and psychotherapy research comes this innovative examination of a long-neglected topic—symptom formation in the context of clinical practice. Symptoms, psychological and psychosomatic, are what motivate many patients to come to treatment, yet this is the first and only collection and analysis of recurrent symptoms in psychotherapy; it leads to a new theory of the necessary conditions for symptom formation.
Those who have examined symptom conditions have typically done so retrospectively through patient recall, or, less frequently, through behavioral recordings made by the patient near the time the symptom occurs. Both of these methods make interpretations of symptom onset conditions questionable because of the problem of memory distortion and subjectivity.
In this volume, Dr. Luborsky describes the symptom-context method of gathering data as symptoms arise in vivo in the psychotherapy session. Transcripts of sessions are examined in light of each patient's symptom versus nonsymptom (control) segments, using controlled clinical ratings, scoring methods (both psychological and physiological), and background context.
Throughout the volume, Dr. Luborsky draws from several theory bases and presents new and updated empirical data from recurrent phobias, depressions, and psychosomatic disorders, as well as from more common behaviors such as recurrent laughter and forgetting. Using themes and techniques from the Core Conflictual Relationship Theme method he also pioneered, Dr. Luborsky compares this methodology with the symptom-context method, improving the ability to identify those relationship patterns that are most prominent in the occurrence of symptoms in several different disorders.
The Symptom-Context Method enables practitioners and researchers to reexamine some of the most important clinical material that patients present and to do so in creative ways that are adaptable to any theoretical or practice orientation.
Acknowledgments: Sources of Support and Supportiveness
I. Guide To The Symptom-Context Method
- The Symptom-Context Method: Its Origins and Uses and Why Clinicians and Researchers Need It
- A Guide to the Symptom-Context Method
II. The Onset Conditions For Psychological Symptoms
- The Context for Momentary Forgetting
—Lester Luborsky and Jim Mintz
- The Context for Momentary Forgetting: Studies of Groups of Patients
—Lester Luborsky, Harold Sackeim, and Paul Crits-Christoph
- The Context for Sudden Depressive Mood Shifts
—Lester Luborsky, Barton Singer, John Hartke, Louis Diguer, Paul Crits-Christoph, and Christopher Peterson
- Stalking the Elusive Contexts of a Phobia With a Modified Symptom-Context Method
—Lester Luborsky, Louis Diguer, Suzanne Johnson, David A. Seligman, Scott Friedman, and Rachel Kabasakalian-McKay
III. The Onset Conditions For Psychosomatic Symptoms
- The Context for Stomach Ulcer Pains
- The Context for Migraine-Like Headaches
—Lester Luborsky, Arthur Auerbach, and A. Thomas McLellan
- The Context for Absence Epilepsy Episodes (Petit Mal)
—Lester Luborsky, John P. Docherty, Louis A. Gottschalk, Thomas C. Todd, Peter N. Knapp, Allan F. Mirsky, Andrea Wagner, Armand Siegel, and Stuart Rosenthal
- The Context for Premature Ventricular Contractions of the Heart
—John P. Docherty, Hoyle Leigh, Paul David, Lester Luborsky, Louis Diguer, Rachel Kabasakalian-McKay, Scott Friedman, Suzanne Johnson, and Louis A. Gottschalk
IV. The Onset Conditions For Nonsymptomatic Behaviors
- Laughing Matters in Psychotherapy: How to Read Their Context
—Lester Luborsky, Louis Diguer, Suzanne Johnson, David A. Seligman, Kelly Schmidt, Scott Friedman, and Rachel Kabasakalian-McKay
- A Symptom-Context Study of Family Therapy: What Makes Suzie Cry?
—Paul Crits-Christoph, Lester Luborsky, Ellen Gay, Thomas C. Todd, Jacques P. Barber, and Ellen Luborsky
- The Context for Children's Touching of Treasured Objects: Bunnies, Bears, and Blankets
- The Context for Touching the Mouth Area During Psychoanalytic Sessions
—Louis A. Gottschalk
V. Therapeutic Uses, Theories, And A New Theory Of The Conditions For Symptom Formation
- A Guide to Therapeutic Uses of Symptom-Context Methods
- Classical Theories of Symptom Formation: Freud, Engel and Schmale, Goldstein, Angyal, and Seligman
—Lester Luborsky and Gerald Aronson
- Looking Ahead to a New Symptom-Context Theory of How Psychological and Psychosomatic Symptoms Form
About the Author
One must stand in awe of a scientific investigator who, over a 50-year period, has persisted in efforts to develop and implement a research method for testing hypotheses about how psychological or physiological symptoms emerge in the course of psychotherapy. Eschewing the hasty criticisms of clinicians, starting with Freud, that quantitative methods cannot contribute to our understanding of the phenomena reported by psychoanalysts or other clinicians on the basis of continuing psychotherapeutic interventions, Luborsky outlines the value of a rigorous, statistically based procedure. Labeled the symptom-context method, this approach is presented in this volume.
—Contemporary Psychology®, 1997, Vol 42, No 12
This remarkable volume, which summarizes and integrates Luborsky's five decades of research in symptom formation in psychotherapy, is sure to become a landmark…it is a "must read"…This book will likely leave you filled with ideas for research, with enthusiasm about its potential for narrowing the gap between psychotherapy researchers and practitioners, and with admiration for the talents of a brilliant researcher.
—Psychotherapy Research, 7, p. 314-317, 1997
The strength of this book is the rigorous application of a specific technique to a variety of psychological and physiological events …the extensive data make it clear that Luborsky's conclusions are externally validated rather than based on the clinical impressions that may often be misleading.
—Journal of Psychotherapy Practice and Research, Vol 7, No 3, Summer 1998