Which of the following concepts refers to the ability of an analyst to deal with repeated primitive transferences which evolve during psychotherapy without retaliation or abandonment of the patient?
B. The description in Question 41 refers to ‘holding’. Holding was proposed by Winnicot. While administering psychotherapy, the affective and cognitive dispositions of a therapist play an important part. The cognitive capacity of the therapist to maintain objectivity and focus on selected facts during a discourse is called ‘containing’ (proposed by Bion). The affective disposition of the therapist, which helps in restraining oneself from retaliating to negative transferences, is called ‘holding’. Working through refers to the process by which the therapist repeatedly elaborates the identified conflict throughout the therapy in order to enable the patient to recognize and deal with it effectively.
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Which of the following stages of change is most suitable to start acamprosate?
D. Patients must be abstinent at the time of initiation of acamprosate. In precontemplation phase the patient will simply refuse an intervention. While contemplating treatment the patient will be still drinking actively. When he acts to stop drinking he will need withdrawal support. This is the best time to start acamprosate so that he can have reduced craving, which will aid him to stay in maintenance mode and reduce the likelihood of relapses. An occasional single relapse need not result in discontinuation of acamprosate. Starting when the patient had already relapsed will not be an ideal strategy.
When asked to recall the attachment experience in childhood, a subject gives an unelaborated account, minimizing problems faced as a child.
Which of the following attachment style has this subject most likely had as a child?
B. This question tests one’s knowledge about Main’s Adult Attachment Interview. This is a 15-item, semistructured, psychodynamic interview of adults exploring one’s experience as a child. The attachment style one had as a child correlates with the type of responses given when answering this interview. Those who had secure attachment provide spontaneous and coherent answers with an ability to talk freely about negative experiences in childhood. Those who had an avoidant (insecure) pattern often minimize their experiences, do not elaborate on them, and do not use colourful metaphors during the discourse. Those who had insecure but ambivalent (enmeshed) attachment use multiple emotionally laden responses and ramble excessively. Broken continuity and interrupted logical fl ow of thoughts is seen in those who had insecure, disorganized attachment pattern. Multiple attachments are common and their presence can be detected without the need for a discourse analysis.
Deficits, disputes, and role transitions are identified in which of the following psychotherapies?
C. Interpersonal psychotherapy (IPT) was proposed by Klerman and Weissman. The theory behind IPT is the observation that the development and maintenance of depression occur in a social and interpersonal context. The outcomes of most psychiatric illnesses are influenced by the interpersonal relationships between the patient and significant others. The therapy takes place in three phases: identification of problems, targeted action, and consolidating gains. Major interpersonal problems can be classified as grief, role deficits, role disputes, and role transitions. Grief refers to loss of a relationship. Role dispute arises due to conflicts between the related individuals. Role transition refers to life changes, for example change in job, etc. Deficit refers to social impoverishment and inadequate relationships.
Which of the following therapies uses the terms ‘snags’, ‘dilemmas’, and ‘role repertoires’?
D. These terms are used in cognitive analytical therapy (CAT), founded by Ryle. CAT views behaviour in terms of a procedural sequence model. When a goal-directed activity is carried out, a sequence of mental components is involved. An important function is making and testing hypotheses for successful social interactions. Some times, in what are termed neurotic repetitions, these sequences fail and effective hypothesis testing does not take place. These are:
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