Biomedical subjects

David Engle

Publications and source records attributed to David Engle.

4 recordsLinked to original sources

PubMed2002

A case illustration of resistance from a gestalt-experiential perspective.

The case of Victoria illustrates psychotherapy with a woman faced with a difficult and unexpected divorce. The authors present a summary of typical struggles faced by Victoria through three phases of therapy. The therapy focused initially on coping with the divorce, then moved to work on her career dissatisfaction, and finally to her efforts to develop a new relationship. The case presentation illustrates resistance as it manifested itself in both a behavioral manner and as in-session resistance to awareness of internal states. The behavioral mode of resistance is manifested by her inability to follow through on decisions made in therapy sessions and by her interruptions of ongoing therapy. A transcript of a typical in-session exchange illustrates the resistance to awareness. The authors also describe interventions intended to work with the resistance.

Adult↗

PubMed2002

A gestalt-experiential perspective on resistance.

The authors present background on the gestalt-experiential understanding of resistance, conceptualized to be either resistance to awareness or resistance to contact. The authors discuss why they do not use the term resistance and describe the phenomena as a client's self-protective attempt to avoid the anxiety necessitated by change. Such resistant behaviors occur outside a client's awareness and often result in an ambivalence or conflict about change. The authors also describe using in-session experiments as a way to engage with the client in exploring such a state of ambivalence or conflict. Finally, they respond to the case studies presented elsewhere in this issue and propose intervention strategies consistent with the gestalt-experiential perspective.

Adult↗

PubMed1988

Family dynamics and emotional expression among patients with chronic pain and depression.

Exploration of the relative roles of family dynamics and release of constrained, negative emotion in changing pain and depressive symptoms. Eighteen patients presenting mild to moderate depression and diagnoses of psychogenic pain disorder were randomly assigned to 1 of 2 treatment groups. One group was designed to facilitate the release of constrained and overcontrolled negative affect while the other was designed to provide information about pain and depression. Findings suggest that initial incongruity between patient's and significant other's ratings of family relationships retard changes in pain status and depressive symptoms. No significant differences were noted between patients who were taught to express negative feelings and those who were taught simply to understand those feelings. Results are discussed in terms of theories about family dynamics in the initiation and maintenance of pain conditions and in terms of the role of constrained affect as a precursor to both psychogenic pain and depression.

Chronic Disease↗

PubMed1987

Effects of therapeutically induced affect arousal on depressive symptoms, pain and beta-endorphins among rheumatoid arthritis patients.

The relationship among therapeutically induced affective arousal, depressive symptoms, pain and beta-endorphin levels were explored on 6 patients with chronic, active rheumatoid arthritis. An ABA, n of 1 study methodology was utilized, replicated 5 times. This procedure allowed the analysis of individualized changes across time in response to the therapeutic regimen. The results indicated that the treatment regimen activated the beta-endorphin system, particularly during the early and late phases of treatment. However, beta-endorphin response had little effect on reports of subjective pain. Depressive symptoms were affected positively by the treatment but were not strongly correlated to the beta-endorphin response. The results suggest that pain and depression represent independent systems and that beta-endorphin levels serve more as stress markers than analgesics in chronic, organic pain.

Adult↗