Pragmatic Case Studies in Psychotherapy

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July 10, 2019 -- From the Editor 



The Effect of Integrating Music Listening With an Attachment- And Affective-Focused Short-Term Psychotherapy in an Individual With Relational Trauma: The Case of “James”

*** G. Paul Blimling, Albany Medical College, Albany, NY


*** Karen Riggs Skean, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, NJ

*** Richard Harrison, Vancouver Couple & Family Institute, and University of British Columbia, Vancouver, Canada

*** Ben Adams, Rawson-Neal Psychiatric Hospital, Las Vegas, Nevada


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        "James," a never married 58-year-old man (a hybridized case formed from multiple cases in the caseload of the therapist author, Dr. Paul Blimling) came to therapy—his first time—in a very distressed state.

        James was behaviorally defending—through explosively angry, unprovoked outbursts at others and by excessive drinking—against severe internal depression precipitated by intensely traumatic, early family-of-origin experiences. In a vicious circle, as James pushed people away more and more, he became increasingly isolated and depressed, with growing symptoms of low mood, fatigue, apathy, decreased appetite, insomnia, difficulty concentrating, suicidal ideation, and "numbing out" through extensive alcohol consumption—further fueling his drive to isolate himself from others. For many years James had been a copy editor, before retiring due to physical disability. James had a history of only a few and transient romantic relationships. 

        Just before entering therapy, the one positive figure in James’ life, his older sister "Janice," had died suddenly and unexpectedly from a suspected brain aneurism. Janice’s daughter refused to have any contact with James in the family’s mourning process unless he sought therapy, which he reluctantly agreed to do.

        On top of all his other burdens, James was assigned in therapy to Blimling, a young 26-year-old practicum student whom James contemptuously dismissed as "just a kid" who had nothing to offer.   

        The case study of James describes how Blimling, with stops and starts, broke through James’ barriers to help him to healing. Blimling’s tools were Diana Fosha’s model of Accelerated Experiential Dynamic Therapy (AEDP) and the integration of music listening, the latter leveraged by one of James’ few strengths: his intellectual interests and fund of cultural knowledge generally, and of art and music, specifically.  

        Blimling’s case study is followed by commentaries, from three varying perspectives. The first is by Dr. Karen Riggs Skean, who taught Blimling about the AEDP model in a graduate course on short-term dynamic psychotherapy. Next is a discussion by Dr. Richard Harrison, a close colleague of Fosha’s with expertise in AEDP developed over 20 years of experience as a clinician, educator, supervisor, and group facilitator. The third commentary is by Ben Adams, a relatively recent clinical psychology doctoral graduate whose theoretical orientation is less oriented to AEDP than is Skean’s and Harrison’s, and who has a particular interest in tracing the connection between the integration of psychological healing and music all the way back to our hunter-gatherer ancestors.  

            Web links to the five pieces of music and lyrics used in the therapy are presented in an Appendix, including Bill Withers’ Lean on Me; William Walton’s The Death of Falstaff; Don McLean’s American Pie; Stromae’s Papaoutai; and the Quantic Soul Orchestra’s Pushin’ On.


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Vol 15, No 2 (2019)

Table of Contents

Case Study

The Effect of Integrating Music Listening With an Attachment- And Affective-Focused Short-Term Psychotherapy in an Individual With Relational Trauma: The Case of "James" Abstract PDF
G. Paul Blimling 116-166
Integrating Client-Chosen Music in Relational Trauma Treatment: Pathways to the Heart Abstract PDF
Karen Riggs Skean 167-174
A Bridge Over Troubled Water: Commentary on Paul Blimling’s Case of "James" Integrating Music Listening into AEDP Abstract PDF
Richard Harrison 175-197
Self-Selected Music for Relational Trauma: Commentary on the Psychotherapy Case of "James" Abstract PDF
Ben G Adams 198-205
Facing the Music: Further Thoughts on Integrating Music into Psychotherapy Abstract PDF
G. Paul Blimling 206-213