This article explores ways in which the therapist's own spirituality can serve as a resource in couple therapy. Spirituality is defined as subjective engagement with a fourth, transcendent dimension of human experience. This engagement enhances human life and evokes corresponding behavior. Spiritually based therapy may be influenced by three assumptions: that God or a Divine Being exists, that human-kind yearns innately for connection with this Being, and that this Being is interested in humans and acts upon and within their relationships to promote beneficial change. In therapy these assumptions affect how the therapist listens and responds throughout sessions. The authors incorporate a case example illustrating the application of this fourth dimension in couple therapy.
We conducted a retrospective study of51 cases ofspontaneous transtemporal cerebrospinalfiuid (CSF) leakage in 48 adults who had presented to our tertiary care academ ic ref erral center between July 1, 1988, and June 30, 2002. All pati ents had undergone high-resolution temporal bone computed tomography, and 26 patients had undergone magnetic resonance imaging. All pati ents were treated with a middle f ossa craniotomy to repair the CSF fistulae. During a mean fo llow-up of 4.9 years, 46 of the 48 pati ents (95.8%) had expe rienced a complete cessation of CSF leakage (49 of 51 cases [96.1 %1). The 2 pat ients whose leakage recurred were successf ully managed with a subtotal petrosectomy with occlusion of the eustachian tube and obliterati on of the middle ear and mastoid. No pat ient developed meningitis.
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