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The Psychotherapy of Hope

The Legacy of Persuasion and Healing

edited by Renato D. Alarcón, M.D., M.P.H., and Julia B. Frank, M.D.

Publication Year: 2011

Directly inspired by the work of Jerome D. Frank and his field-defining book Persuasion and Healing, this volume of essays by distinguished contemporary scholars broadly assesses the current state of research and practice in psychotherapy. Editors Renato D. Alarcón, a former student of Frank's, and Julia B. Frank, his daughter and coauthor, bring diverse perspectives to this work. Each chapter, based on one of the themes of Frank’s classic book, offers honest critique and fearless criticism of psychotherapy as it has evolved in the twenty-first century. Contributors update classical psychotherapeutic concepts such as demoralization, hope, meaning, rhetoric, and cultural variation and add new insight into how the neuroscience revolution affects our understanding of mental organization and psychotherapy. As Frank did in his own time, these authors challenge the claims made for the specificity or superiority of cognitive behavioral, psychodynamic, and other varieties of psychotherapy, providing an honest evaluation of the value and limitations of many competing approaches to diagnosis and treatment. They also focus attention on psychotherapies for special populations, including children, people with serious medical illness, and those with culturally and religiously diverse backgrounds. Like Persuasion and Healing, The Psychotherapy of Hope advocates not for any particular approach but for psychotherapy more generally grounded in principles of evolutionary biology, culture, narrative, and behavior change. It provides researchers, theorists, and practitioners of every level of training with a genuinely phenomenological approach to a wide range of psychiatric issues. Echoing Frank's voice, in particular his emphasis on the commonalities of suffering and the therapeutic power of hope, this book offers scholarly wisdom and practical advice on how to understand psychotherapy broadly—and to apply its basic principles to the greatest benefit of patients.

Published by: The Johns Hopkins University Press


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pp. vii-viii

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pp. ix-xiv

Jerry Frank was a great human being, a man I was privileged to know. Just how splendid he was will become evident to readers of these essays on facets of his life and career. As a medical scientist, he legitimized research on the effectiveness of psychotherapy, a fi eld many thought it impossible to undertake. ...

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pp. xv-xxii

The history of psychotherapy encompasses periods of solid and universal acceptance as well as times of discredit and obscurity. The fortunes of the field rise and fall in relation to developments in science and medicine, social organization, politics, and other approaches aimed at regulating ...

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pp. xxiii

We wish to express our warmest appreciation, first, to one another, and then to our contributors, who have taught us so much. We are especially grateful to Dr. Leon Eisenberg, a towering figure in the field, who died before the manuscript was complete. Wendy Harris, who shepherded the publication ...

A Note about Citations

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pp. xxiv


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1 Critical Thinking in the Design of Psychotherapy Research

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pp. 3-21

Great scientists observe the same phenomena as do other scientists investigating the same area. What differentiates Isaac Newton, Charles Darwin, Louis Pasteur, and Albert Einstein, say, from their fellow scientists? The biographies of these men reveal that, in comparison to their colleagues, they possessed ...

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2 Life Story as the Focus of Psychotherapy: The Johns Hopkins Conceptual and Didactic Perspectives

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pp. 22-33

Throughout his long career, Jerome Frank devoted himself to teaching as well as research. In chapter 8 of Persuasion and Healing (Frank and Frank 1991), he spelled out some implications of his ideas for the training of psychotherapists of many disciplines. This opened up new vistas for the psychiatrists, psychologists, ...

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3 Neural Substrates of Psychotherapy

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pp. 34-66

At the time Persuasion and Healing first appeared (1961), theories of psychotherapy emphasized the importance of human symbolic capacities - especially language and the manipulation of cultural symbols - in structuring or modifying inner experience and governing behavior. Psychiatrists and psychologists ...

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4 Restoring Meaning to Psychiatric Diagnosis and Psychotherapy in the Age of Evolutionary Biology

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pp. 67-87

In the third edition of Persuasion and Healing, Jerome Frank proposed that psychotherapy acts in the domain of meaning (Frank and Frank 1991b). Meaning, in this sense, connotes the ways in which patients interpret, explain, and make predictions from their daily experience. Explanations or predictions that are ...

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5 Cultural Concepts in Persuasion and Healing

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pp. 88-106

In chapter 5 of Persuasion and Healing, Jerome Frank (1961) developed what was then considered a radical argument - that psychotherapy is essentially a culture-bound activity. In Euro-Western societies, the psychotherapy establishment claims, rightly or wrongly, to be applying science to human behavior. ...

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6 Deconstructing Demoralization: Subjective Incompetence and Distress in Adversity

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pp. 107-122

Demoralization may be viewed as a psychological state that occurs when the meaningful connections among cognition, emotion, and volition, or between the past and the present, or between the person and the environment are perceived as threatened or disrupted. Jerome Frank elaborated on this concept ...


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7 Depression, Demoralization, and Psychotherapy in People Who Are Medically Ill

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pp. 125-157

Jerome Frank's initial interest in the common features underlying different forms of psychotherapy led him to seek a common, measurable element among the many conditions that seemed to respond to such treatment (Frank 1972). Before about 1980, the prevailing typologies of distress - both theory based and ...

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8 Demoralization and Hope in Clinical Psychiatry and Psychotherapy

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pp. 158-177

The second edition of Persuasion and Healing (Frank 1973) defended the radical assertion that people seek psychotherapy largely because they feel demoralized, not because they have a mental illness. "Demoralization" referred to the distress felt by people aware of their failure to meet their own or others' expectations, ...

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9 Psychotherapeutic Communication in Medical Settings

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pp. 178-189

The conceptual blueprint for psychotherapy outlined in Persuasion and Healing has particular relevance for those who provide psychotherapy in medical settings (Frank and Frank 1991). This chapter explores how Jerome and Julia Frank's emphasis on the power of therapists' conceptual orientation, ...

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10 Psychodynamic Psychotherapy: From Psychoanalytic Arrogance to Evidence-Based Modesty

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pp. 190-214

Cognitive behavioral therapies dominate the evidence-based literature on psychotherapy, yet the majority of therapists still ascribe to methods loosely termed "psychodynamic." A brief review of recent history helps account for both the apparent eclipse and the hardiness of such therapy. ...

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11 Behavioral and Condition-Specific Approaches to Psychotherapy

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pp. 215-237

Specific psychotherapies are those that aim to relieve symptoms, complexes of symptoms, dysfunctional behaviors, or disorders, as well as general distress. Such therapies typically engage patients directly, without seeking to understand their nonconscious or cryptic symbolic lives. These treatments involve ...

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12 Weighing Evidence for Common and Specific Factors in Psychotherapy with Children

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pp. 238-258

Since publication of the first edition of Persuasion and Healing (1961), our understanding of the necessary ingredients of effective psychotherapy has grown substantially. In the main, the book's key insights about the centrality of empathic, healing relationships, informed by keen appreciation and respect for ...

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13 Contemporary Realities of Group Psychotherapy

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pp. 259-280

All editions of Persuasion and Healing: A Comparative Study of Psychotherapy (Frank 1961, 1973; Frank and Frank 1991) thoroughly explore the principles of group psychotherapy. Early experience as an army psychiatrist inspired Jerome Frank to join Florence Powdermaker in pioneering group psychotherapy ...

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14 Cultural Dynamics in Psychotherapy and Cultural Psychotherapies: Ingredients, Processes, and Outcomes

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pp. 281-309

Jerome Frank's definition of psychotherapy captures its essential sociocultural nature: "a healing relationship . . . [in which] the healer tries to bring about relief of symptoms . . . typically accompanied by changes in emotional state, attitudes, and behavior . . . The healing influence is exercised primarily ...

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15 Psychotherapy, Religion, and Spirituality

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pp. 310-326

Even today, mutual suspicion, ambivalence, and at times overt hostility characterize the relationship between theories supporting psychotherapy and those that underlie religious healing. Such tension is a legacy of the early modern period, when Freud's effort to explain human suffering in secular and scientific ...

List of Contributors

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pp. 327-328


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pp. 329-343

E-ISBN-13: 9781421404271
E-ISBN-10: 1421404273
Print-ISBN-13: 9781421403045
Print-ISBN-10: 1421403048

Page Count: 336
Illustrations: 4 halftones, 4 line drawings
Publication Year: 2011