Download the Full Version of the Ebook with Added Features ebookname.

com

Mentalization Based Treatment for Adolescents A

Practical Treatment Guide 1st Edition Trudie
Rossouw

https://ebookname.com/product/mentalization-based-treatment-
for-adolescents-a-practical-treatment-guide-1st-edition-
trudie-rossouw/

OR CLICK HERE

DOWLOAD NOW

Download more ebook instantly today at https://ebookname.com

Instant digital products (PDF, ePub, MOBI) available
Download now and explore formats that suit you...

Brain Based Therapy with Children and Adolescents Evidence

Based Treatment for Everyday Practice 1 New Edition John
B. Arden
https://ebookname.com/product/brain-based-therapy-with-children-and-
adolescents-evidence-based-treatment-for-everyday-practice-1-new-
edition-john-b-arden/
ebookname.com

Bronchial Asthma A Guide for Practical Understanding and

Treatment 5th Edition M. Eric Gershwin

https://ebookname.com/product/bronchial-asthma-a-guide-for-practical-
understanding-and-treatment-5th-edition-m-eric-gershwin/

ebookname.com

Lithium Treatment of Mood Disorders A Practical Guide 6th

Edition Mogens Schou

https://ebookname.com/product/lithium-treatment-of-mood-disorders-a-
practical-guide-6th-edition-mogens-schou/

ebookname.com

Wind Energy Explained Theory Design and Application Second

Edition J. F. Manwell

https://ebookname.com/product/wind-energy-explained-theory-design-and-
application-second-edition-j-f-manwell/

ebookname.com
A Combined MRI and Histology Atlas of the Rhesus Monkey
Brain in Stereotaxic Coordinates 1st Edition Kadharbatcha
S. Saleem
https://ebookname.com/product/a-combined-mri-and-histology-atlas-of-
the-rhesus-monkey-brain-in-stereotaxic-coordinates-1st-edition-
kadharbatcha-s-saleem/
ebookname.com

Fuzzy Logic and Hydrological Modeling 1st Edition Zekai

Sen (Author)

https://ebookname.com/product/fuzzy-logic-and-hydrological-
modeling-1st-edition-zekai-sen-author/

ebookname.com

Geotechnical Aspects of Underground Construction in Soft

Ground 2nd Edition Mohammed Elshafie

https://ebookname.com/product/geotechnical-aspects-of-underground-
construction-in-soft-ground-2nd-edition-mohammed-elshafie/

ebookname.com

Radiation Inactivation Of Bioterrorism Agents 1st Edition

L. G. Gazso

https://ebookname.com/product/radiation-inactivation-of-bioterrorism-
agents-1st-edition-l-g-gazso/

ebookname.com

Captain America and the Struggle of the Superhero Robert

G. Weiner

https://ebookname.com/product/captain-america-and-the-struggle-of-the-
superhero-robert-g-weiner/

ebookname.com
Breton Grammar 2nd Edition Roparz Hemon

https://ebookname.com/product/breton-grammar-2nd-edition-roparz-hemon/

ebookname.com
Mentalization-Based Treatment
for Adolescents

Mentalization-Based Treatment for Adolescents (MBT-A) is a practical guide for child

and adolescent mental health professionals to help enhance their knowledge, skills
and practice.
The book focuses on describing MBT work with adolescents in a practical way
that reflects everyday clinical practice. With chapters authored by international
experts, it elucidates how to work within a mentalization-based framework with
adolescents in individual, family and group settings. Following an initial theoretical
orientation embedded in adolescent development, the second part of the book
illuminates the MBT stance and technique when working with young people, as
well as the supervisory structures employed to sustain the MBT-A therapist. The
third part describes applications of MBT-A therapies to support adolescents with a
range of presentations.
This book will appeal to therapists working with adolescents who wish to develop
their expertise in MBT as well as other child and adolescent mental health professionals.

Trudie Rossouw, MD, is a Consultant Child and Adolescent Psychiatrist, fully

registered with the General Medical Council. She has over 20 years of experience
treating the full range of child and adolescent mental health conditions.
Dr Rossouw currently works as a consultant child and adolescent psychiatrist at
the Priory Hospital, North London and in her own child and adolescent mental
health service, the Stepping Stones Clinic in London.

Maria Wiwe, MA, is a Clinical Psychologist and Psychotherapist and qualified

MBT-A therapist, supervisor and trainer as well as a certified MBT-F practitioner.
Together with Trudie Rossouw, Maria is training and assessing new MBT-A su-
pervisors at the Anna Freud National Centre for Children and Families. She is an
experienced lecturer and supervisor in MBT-A and has written several books on the
subject in Swedish.

Ioanna Vrouva, PhD, DClinPsy, is a Clinical Psychologist, MBT-A therapist and

supervisor, and an Honorary Research Associate at UCL. She works in North
London in a CAMHS team for the National Health Service and in private practice.
Mentalization-Based
Treatment for Adolescents

A Practical Treatment Guide

Edited by Trudie Rossouw,

Maria Wiwe, and
Ioanna Vrouva
First published 2021
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
52 Vanderbilt Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2021 selection and editorial matter, Trudie Rossouw, Maria Wiwe and
Ioanna Vrouva; individual chapters, the contributors
The right of Trudie Rossouw, Maria Wiwe and Ioanna Vrouva to be
identified as the authors of the editorial material, and of the authors for
their individual chapters, has been asserted in accordance with sections 77
and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced
or utilised in any form or by any electronic, mechanical, or other means,
now known or hereafter invented, including photocopying and recording,
or in any information storage or retrieval system, without permission in
writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and explanation
without intent to infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record has been requested for this book

ISBN: 978-0-367-34101-5 (hbk)

ISBN: 978-0-367-34103-9 (pbk)
ISBN: 978-0-429-32392-8 (ebk)

Typeset in Bembo
by MPS Limited, Dehradun
Contents

Contributors vii
Foreword xi
P ET ER F ONAG Y
Acknowledgements xx

Introduction 1
TRUD IE ROS S O UW , MA R IA W I W E , A N D I O A N N A VRO UVA

SECTION I
The concept of ‘mentalization’ and relevant
neurobiological changes in adolescence 9

1 An introduction to mentalizing theory 11

HAIKO J ESS URU N

2 Adolescent brain development and the development of

mentalizing 25
P ATRIC K LUYTE N , S AS KI A MAL C OR PS , A N D PE TER F O NA GY

SECTION II
Clinical practice 41

3 MBT technique when working with young people 43

TRUD IE ROS S O UW

4 The structure of therapy 57

TRUD IE ROS S O UW

5 Working with parents and families of adolescents 74

NICOLE MU LLER A N D HO L LY DW YE R HA L L
vi Contents

6 Varifocal vision in a world of storm and stress. Supervising

MBT-A practice 90
HOLLY D W YE R H ALL AN D MA R I A W I W E

SECTION III
Specific applications 105

7 Working with adolescents who self-harm 107

MA RIA WIW E A N D TRUD I E R OS S O UW

8 Working with gender diverse young people and their

families 123
IOANNA VR O UVA, JA SO N MA L D O N A DO- PA G E, A ND
NICOLE MU L L E R

9 Conduct disorder – working with externalising behavioural

problems in teens and their families 136
SV ENJA T AU B N ER AN D S O PH I E HA USC H I L D

10 Working with at-risk mental states in adolescence 151

MA RK DA NGE RF IE L D

11 MBT-A group therapy with adolescents with emerging

personality disorders 166
NICOLE MU L L E R AN D HO L L Y D W YE R HA L L

12 AMBIT 181
HAIKO J ESS UR UN AN D D IC KO N B E VI N GT O N

Index 195
Contributors

Dickon Bevington, MBBS, MRCPsych, is Medical Director at the Anna

Freud National Centre for Children and Families, where he develops and
leads training in AMBIT and other MBT approaches and is a member
of the Mentalization-based Treatment for Families (MBT-F) team.
Dr Bevington is also a Consultant Child and Adolescent Psychiatrist in
Cambridgeshire and Peterborough NHS FT, where he leads CASUS, an
outreach service for complex substance-using youth, and he is also a Fellow
of the Cambridge and Peterborough CLARHC, a collaboration based in
Cambridge University dedicated to developing leadership and research in
health and social care.
Mark Dangerfield, PhD, is a Clinical Psychologist, Psychotherapist
(member of the EFPP and EuroPsy) and Psychoanalyst (member of the
Spanish Psychoanalytical Society and the International Psychoanalytical
Association). He is a Professor at the University Institute of Mental Health
(Ramon Llull University, Barcelona), an AMBIT Trainer at the Anna
Freud National Centre for Children and Families and an MBT-A
Supervisor. He has worked for over 25 years in paediatric hospitals and
mental health services in Barcelona, specialising in working with
adolescents and adults. He is the Director of the ECID project (Home
Intervention Clinical Teams) of the Vidal and Barraquer Foundation, a
pioneering project in Spain, where community outreach mental health
teams work with non-help-seeking young people with high
psychopathological risk and high risk of social exclusion, based on the
AMBIT model of the Anna Freud National Centre for Children and
Families.
Holly Dwyer Hall is a Child and Adolescent Psychoanalytic Psychotherapist,
Arts Therapist and an accredited MBT Practitioner with Adults, Families
and Adolescents and an MBT-A Supervisor and MBT- F Supervisor and
Trainer for the Anna Freud National Centre for Children and Families. She
has worked in the UK’s National Health Service in Child and Adolescent
Mental Health Services and as part of an Arts Psychotherapies Team
viii Contributors

providing group and individual Mentalization-based Arts Therapy for adults

with a diagnosis of borderline personality disorder. Holly was a lead trainer
and clinical supervisor with ICAPT, the International Centre for Arts
Psychotherapies at the CNWL NHS Foundation Trust and has lectured and
presented for Arts Therapies Courses and conferences in the UK and
internationally.
Peter Fonagy is Director of the Division of Psychology and Language
Sciences at UCL; Chief Executive of the Anna Freud National Centre for
Children and Families, London; is Senior Clinical Advisor in NHS England
on Children and Young People’s Mental Health; and holds visiting
professorships at Yale and Harvard Medical Schools. His clinical interests
centre on issues of early attachment relationships, social cognition,
borderline personality disorder and violence.
Sophie Hauschild is a Clinical Psychologist, MBT-A therapist in training
and research assistant at the Institute of Psychosocial Prevention, University
Hospital Heidelberg. Her research focuses on mentalization-based therapy
and mentalization-based training, conduct disorder and borderline
personality disorder.
Haiko Jessurun, MSc, is a Clinical Psychologist and Child and Adolescent
Psychotherapist in the Netherlands. Over the past 35 years, he has held
different positions in mental health care, as a therapist, team leader, and
manager. He is a Senior Lecturer on the Child and Adolescent Psychotherapy
training course and teaches MBT-A at the post-graduate course for Clinical
Psychologists. Furthermore, he is a PhD student at the University
of Technology, Eindhoven, researching the effects of chronic relative
underperformance. He completed MBT-A, MBT-F, AMBIT and MBT-P
training at the Anna Freud National Centre for Children and Families in
London, and he is an AFC recognised MBT-A supervisor. In the Netherlands,
he is actively involved in the expansion of AMBIT.
Patrick Luyten, PhD, is Professor of Clinical Psychology at the Faculty of
Psychology and Educational Sciences, University of Leuven (Belgium) and
Professor of Psychodynamic Psychology at the Research Department of
Clinical, Educational, and Health Psychology, University College London
(UK). His main research interests are disorders from the affective spectrum
(i.e., depression and stress- and pain-related disorders), and personality
disorders. In both areas, he is involved in basic research and interventional
research.
Saskia Malcorps is a Clinical Psychologist and PhD student at the faculty of
Psychology and Educational Sciences at the University of Leuven
(Belgium). Her research focuses on the role of mentalizing in the
development of children and adolescents at risk of psychopathology.
 Contributors ix

Jason Maldonado-Page is a Senior Family and Systemic Psychotherapist,

Clinical Social Worker and Lecturer in the NHS and privately. He has held
specialist and senior clinical posts at several internationally renowned
London institutions and is an experienced lecturer in both social work
and systemic practice. Jason is particularly drawn to the use of self and how
we each make meaning from our lived experiences.
Nicole Muller is a Child and Adolescent Psychotherapist and Family
Therapist based at the Jutters, Child and Adolescent Mental Health
Service, part of the Parnassia Group in the Netherlands. She originally
trained as a Cognitive Behavioural Therapist and worked extensively with
Guided Affective Imagery before becoming interested in MBT, which she
has now used for many years in her work with children and adolescents
with attachment disorder, trauma, or emerging personality disorder, and
their families. She has co-written with an international team the book
“Mentalization-Based Treatment for Children: a time-limited approach” an
MBT treatment guide for work with children aged 5-12 years. She is
trainer and supervisor for MBT-C, MBT-A and MBT-F in the
Netherlands and London at the Anna Freud National Centre for
Children and Families.
Trudie Rossouw MD is a Consultant Child and Adolescent Psychiatrist,
fully registered with the General Medical Council. She has over 20 years of
experience treating the full range of child and adolescent mental health
conditions. Dr Rossouw currently works as a consultant child and
adolescent psychiatrist at the Priory Hospital, North London and in her
own child and adolescent mental health service, the Stepping Stones Clinic
in London. She is also a Psychoanalyst and qualified MBT-A therapist,
supervisor, trainer and course leader and an honorary senior lecturer at
University College London. Together with Peter Fonagy, she is the
founder of the MBT-A model. She has published the RCT on MBT-A
(Rossouw & Fonagy, 2012), and written extensively on self-harm and
MBT-A.
Svenja Taubner is Professor for Psychosocial Prevention at the University
Hospital in Heidelberg, Germany and Head of the Institute for Psychosocial
Prevention. She is a Clinical Psychologist, Psychoanalyst and MBT-A
supervisor and trainer. Her research focuses on conduct disorder, borderline
personality disorder, psychotherapy research and competence development
in mental health professionals. She was editor in chief of Mental Health &
Prevention, is editor of Praxis der Kinderpsychologie & Kinderpsychiatrie
and Psychotherapeut, and is President of the European Chapter of the
Society for Psychotherapy Research (SPR). She is setting up MBT services
in Germany.
x Contributors

Ioanna Vrouva, PhD, DClinPsy, is a Clinical Psychologist, MBT-A

therapist and supervisor, and an Honorary Research Associate at UCL.
She works in North London in a CAMHS team for the National Health
Service, and in private practice. She has co-edited the book “Minding the
Child: Mentalization- Based Interventions with Children, Young People,
and their Families”.
Maria Wiwe, MA, is a Clinical Psychologist and Psychotherapist and
qualified MBT-A therapist, supervisor and trainer as well as a certified
MBT-F practitioner. Together with Trudie Rossouw, Maria is training and
assessing new MBT-A supervisors at the Anna Freud National Centre for
Children and Families. She is an experienced lecturer and supervisor in
MBT-A and has written several books on the subject in Swedish.
Foreword
Peter Fonagy

Something dramatic, unacceptable and hard to understand is happening. The

scale and burden of the mental health problems experienced by our young
people represent a public health crisis. In the UK, we now have relatively
comprehensive and reliable information about the breadth and depth of mental
health difficulties experienced by children and young people (Sadler et al.,
2018). Overall, the prevalence of childhood mental disorder might have
increased from one in ten to one in eight over fifteen years. When segregated
by age, we find that in young women aged 17 to 19, this rate has increased to
24%. The adult morbidity survey (McManus, Bebbington, Jenkins, & Brugha,
2016), now six years old, similarly shows a substantial increase in the
prevalence of anxiety and depression in particular amongst the 18 to 25-
year-old cohort. Although less systematic, but impressive in terms of panel
size, the UCL Covid-19 community survey has revealed an even more
disturbing picture (Fancourt, Bu, Mak, & Steptoe, 2020). Week after week,
tens of thousands of UK residents were surveyed in relation to their
experiences during the national lockdown. The survey included two widely
used and highly reliable measures of depression (PHQ-9) and anxiety (GAD-7).
The overall level of mental health problems revealed a relatively reassuring
picture. However, focusing on the 18-29-year-old sample, the many thousands
of young people completing the survey showed mean levels of 10 and 8 on the
PHQ-9 and the GAD-7 respectively. The mean clinical cut-off for these
instruments are 10 and 8, respectively. Even adjusting for the abnormality of
the distribution of underlying scores in both these instruments, the prevalence
of anxiety and depression in this large panel survey would appear to be
above 40%.
I do not believe that anyone fully understands the reason why mental health
problems are so clearly focused in a young age group. There are many
explanations offered. The emergence and dominance of social media in the
lives of young people may be an important factor. Much has also been written
about disproportionality concerning gender. There is no doubt that social
pressures on young women are far greater (or have been at least until most
xii Foreword

recently) with conflicting roles of educational and professional success and an

effectively unchanged value system surrounding sexual roles in our society. Of
course, there is likely to be intersectionality amongst these risk factors. Gender
may have implications for social media use and women are far more vulnerable
in relation to the visually dominated social media most present in youth
culture than males.
Many of the general vulnerabilities associated with adolescence are
brilliantly reviewed in the first part of this book. But of course,
understanding development at both psychosocial and neurobiological levels
does not explain why, in England at least, the number of young people
presenting with mental health problems in 2019 alone increased by 15%. It
doesn’t explain why 50% of the young women who experienced diagnosable
mental health problems have self-harmed or made a suicide attempt. It doesn’t
explain why suicide rates are rising in this age group. This shift takes on a
catastrophic flavour if we fully recognise just how important adolescence is as
the period which defines people’s subsequent career, health and well-being
trajectories. If 75% of mental health difficulties manifest by the age of 18, as
some research suggests (Murphy & Fonagy, 2013), it is obvious that nothing
short of a radical transformation is needed, working across disciplines and
approaches to mental health to bring the best and most readily adapted
evidence-based intervention to our communities, to young people and their
families.
And this is where the wonderful collection of chapters in this book comes
in. The editors are to be warmly congratulated for providing a comprehensive
introduction to a common language which may be readily adopted by
clinicians, regardless of their orientation or primary training, by families
attempting to provide the best support to young people regardless of the
specific problem, by young people trying to find their way through their
increasingly complex social network and by the broader systems of schools,
communities and social institutions which are so evidently failing in mitigating
depression and anxiety in our young people.
This book proposes a generic, atheoretical and potentially extremely helpful
conceptual framework that is simple and obvious that it is hard to understand
why the clinical world of child and adolescent mental health services has been
relatively slow in adopting it. It is in keeping with a paradigm shift in the world
of psychosocial treatments that a number of us have noted (e.g., Fonagy &
Luyten, 2019). This shift is characterised by a decreasing emphasis on named
therapies defined by a set of technologies addressed to a particular clearly defined
group of patients. Difficulties in scientifically validating these groups have
contributed to this decline. Similarly, the idea of schools of psychotherapy has also
lost some currency. It used to be enough to say that a therapist was
psychodynamically or cognitive behaviourally trained and this would be a
kind of passport both in terms of accreditation but also defining their
“therapeutic nationality”.
 Foreword xiii

Meanwhile, balancing these declines, we can observe a rise in testable models

of intervention. In the first trial of mentalization-based treatments for adolescents
(Rossouw & Fonagy, 2012), we measured both a capacity for mentalizing and
security of attachment as possible mediators of treatment effects. Assuming that
mentalizing matters, enhancing this psychological capacity provides an
experimental framework for placing MBT under a microscope. There
should be and there will be more mediation and moderation studies. As several
chapters in this book clearly identify, the conceptual frame of mentalizing
provides a new form of diagnosis based on a kind of mechanistic functional
analysis. Different forms of mentalizing failure may lead to different
manifestations of mental disorder rooted in a common core of dysfunction
of social cognition associated with patterns of adaptation in types of child-
caregiver relationships. Mentalizing also represents an approach, in common
with other orientations such as ACT (Hayes, 2015) and compassion focused
therapy (Gilbert, 2019), where we may discern a move from nomothetic to
idiographic approaches. We need more than an effect size coefficient associated
with mean differences between two groups that differ principally in the
treatment to which they were exposed. We know that beneath the group
mean in a treatment trial are substantially different trajectories that correspond
to individual paths often reflecting deteriorations alongside the recovery even
when overall improvement predominates. All this opens the door to a kind of
‘personalized medicine’ approach to psychological therapies with elements of
therapy being used in combination configured to best fit an individual’s
presenting difficulties, creating an approach that integrates, or perhaps bridges,
different treatment orientations, settings and even cultures.
Does the approach presented in this book provide a key to understanding
the mental health problems our young people face? Mentalizing is rooted deep
in our evolutionary history when becoming bipedal drove our species towards
social living that in turn, required greater cognitive capacity (Dunbar & Sosis,
2018). Human babies are born markedly more immature than other primates.
Birth itself is painful and dangerous and requires social support from kin (Hrdy,
2013). Our species require long periods of essential safeguarding and care and
intense and protracted learning before the young human is ready to join the
community of approximately 150 individuals engaged primarily in foraging
with familiarity and reciprocal relationships between members of the group
(Dunbar & Sosis, 2018). Everyone within the group, not just close relatives,
has responsibility for protecting young humans. Relatives and other group
members are present all the time and children can roam freely seeking contact,
comfort, and play from whoever they choose.
Human sociality is explained by the unique capacity to share mental states with
and of others (Tomasello, 2019). When people are poised to interact, they
achieve interpersonal awareness through a meeting of minds. Mental states are
assumed by individuals within a social system to be joined or shared by everyone.
Philosophers of mind have named this category of mental events “jointly seeing
xiv Foreword

to it” (Tuomela, 2005). This feeling of we-ness underpins social collaboration.

Being part of a set of thoughts and feelings that are beyond one’s own is the
essence of humanity. Thinking together in this way creates a collective form of
social cognition called the “we-mode”. This we-mode provides the context in
infancy in which mentalizing develops. This is the context that spurs mentalizing
on in toddlerhood and moves play from a solitary activity to social collaboration.
This is the context in which peer relationships of middle childhood are formed
and families acquire their unique systemic properties. We-ness permeates the
social bonds of adolescence and the essential social support which peer groups
provide young people transitioning from dependence to selfhood. This is also the
core idea that runs through the therapeutic models and techniques described in
this collection of excellent reviews. We-ness is the distillation of the
mentalization-based approach to psychotherapy. Perhaps it goes beyond MBT
and motivates other therapeutic approaches such as DBT or ACT as well.
But what of the increased prevalence of adolescent mental disorder? Our
environment of biological adaptation, the social environment of the hunter-
gatherer, where we acquired the capacity to jointly see to something and share
our mutual understanding of mental states, is ecologically threatened in much
the same way as the thinning of the ozone layer threatens vital facets of our
physical environment. Mentalizing, according to this formulation, evolved in
and for adaptation to a community rather than one on one relationships. In
some ways, attachment theory may not have helped here. This theory, and our
early writings on mentalizing, emphasised a model of parent/caregiver
interaction that was essentially dyadic (Bowlby, 1969, 1973; Fonagy, Gergely,
Jurist, & Target, 2002). Drawing on attachment research, we emphasised the
dyadic: turn-taking, smooth completed interactions between infant and
caregiver, the reflection in the caregiver’s face of the child’s emerging affect,
etc. as the essential components or foundation stones upon which mentalizing
was built. In other words, we supported a cultural ideal of the infant as an agent
sensitised to use parental qualities and attributes as the primary referent of their
actions. In this account, when infants recognised the mother’s representation of
them as the central agent, this generated the sense of self-recognition which was
assumed to be at the heart of self-development not just in infancy but perhaps
also through adolescence and of adulthood. There is little doubt about the reality
of this, but it is a partial story. This dyadic experience might best be understood
as a part of a broader category of we-mode: perhaps self-focused dyadic
interaction is one special way of generating a sense of belonging and a sense of
self ? Perhaps among hunter-gatherers, different forms of we-mode were
emphasised in developing these aspects of identity, and perhaps they still are
in many non-Western societies. In societies more like hunter-gatherers’ and
different from ours, children and caregivers are engaged in multiple
simultaneous ongoing activities and very rarely in dyadic interactions (Keller,
2018). These support a cultural ideal that is quite different from the one which
prioritises the infant or child as the central agent, the focus of the caregivers’
Random documents with unrelated
content Scribd suggests to you:
 Priest, the dismissal.
He that by his presence in Cana of Galilee declared marriage to
be honourable, Christ our true God, through the prayers of his most
pure Mother; of the holy, glorious, and all-praised apostles; of the
holy god-crowned sovereigns and equals of the apostles,
Constantine and Helen; of the holy great martyr Procopius, and of all
the Saints, have mercy upon us and save us, as being good and the
lover of mankind.
 Chapter XI.
PRAYER AT THE TAKING OFF OF THE CROWNS
ON THE EIGHTH DAY.

O Lord our God, who blessest the crown of the year, and permittest
these crowns to be put on them that are conjoined to one another by
the law of marriage, vouchsafing them to them as the reward of
chastity; for they are pure that are conjoined in the lawfully appointed
marriage that is from thee; do thou thyself also bless, in the taking off
of these crowns, them that have been conjoined together, and
preserve their union unbroken, that they may ever give thanks unto
thine all-holy name, of the Father, and of the Son, and of the Holy
Ghost, now and ever, and to ages of ages. Amen.
Priest. Peace to all.
O Lord, thy servants, having met in concord and accomplished the
order of marriage as at Cana of Galilee, and contracted the signs
according thereto, ascribe glory to thee, to the Father, and to the
Son, and to the Holy Ghost, now and ever, and to ages of ages.
Amen.
And the dismissal.
 Chapter XII.
THE ORDER FOR A SECOND MARRIAGE.

The priest beginneth, Blessed be our God.... Then, Trisagion. After

Our Father.... the troparion of the day.
Then, ectenia.
In peace let us pray to the Lord.
For the peace that is from above....
For the peace of the whole world....
For this holy temple....
For the servants of God, name, and, name, and for their protection
by God and mutual life, let us pray to the Lord.
That they may live together virtuously in unanimity, let us pray to
the Lord.
Help us, save us, have mercy....
Commemorating our most holy, most pure, most blessed....
For to thee is due....
Then, Let us pray to the Lord.
Priest, the prayer.
O God eternal, who bringest things that are divided unto unity, and
imposest upon these two an indissoluble bond of love, who didst
bless Isaac and Rebecca, and declare them to be the inheritors of
thy promise; do thou thyself also bless these thy servants, name,
and, name, directing them in every good work.
For a merciful and man-loving God thou art, and to thee we
ascribe glory, to the Father, and to the Son, and to the Holy Ghost,
now and ever, and to ages of ages. Amen.
 Priest. Peace to all.
Deacon. Bow your heads to the Lord.
Priest, the prayer.
O Lord our God, who hast espoused the church as a pure virgin from
among the gentiles; do thou bless these espousals, and unite and
keep these thy servants in peace and unanimity.
For to thee is due all glory, honour, and worship, to the Father, and
to the Son, and to the Holy Ghost, now and ever, and to ages of
ages.
Then the priest, taking the rings, giveth first the golden one to the
man, and the silver one to the woman, and saith to the man,
The servant of God, name, is betrothed to the handmaid of God,
name, in the name of the Father, and of the Son, and of the Holy
Ghost. Amen.
And in like manner to the woman, The handmaid of God, name, is
betrothed to the servant of God, name, in the name of the Father,
and of the Son, and of the Holy Ghost. Amen.
And he maketh a cross with the rings upon their heads, and
placeth them on the fingers of their right hands. Then the sponsor
changeth the rings of the bridal pair.
After this, the deacon. Let us pray to the Lord.
Priest, the prayer.
Master, Lord our God, who sparest all, and providest for all, who
knowest the secrets of men, having knowledge of all things; do thou
cleanse our sins, and pardon the transgression of thy servants,
calling them to repentance: vouchsafe unto them remission of
iniquities, cleansing of sins, pardon of voluntary and involuntary
transgressions, O thou that knowest the weakness of human nature,
thou Fashioner and Creator. O thou who didst forgive Raab the
harlot, and accept the repentance of the publican, remember not our
sins of ignorance from our youth up. For if thou, O Lord, shouldest
mark transgressions, who should stand before thee, O Lord? or what
flesh should be justified in thy sight? For thou only art just, sinless,
holy, of abundant mercy, plenteous beneficence, and repentest thee
concerning the evils of men. Do thou thyself, O Master, who claimest
thy servants, name, name, unite them to one another in love; give
unto them the conversion of the publican, the tears of the harlot, and
the confession of the thief, that, through repentance from all their
heart, performing thy commandments in unanimity and peace, they
may be counted worthy of thy heavenly kingdom.
For thou art the provider for all, and to thee we ascribe glory....
Priest. Peace to all.
Deacon. Bow your heads to the Lord.
And this prayer.
O Lord Jesus Christ, Word of God, who wast lifted up upon the
precious and life-effecting cross, and didst tear up the handwriting
that was against us, and deliver us from the power of the devil; do
thou cleanse the transgressions of thy servants, for, unable to bear
the burden and the heat of the day, and the burning of the flesh, they
are come to a second community of marriage, in accordance with
that which thou hast lawfully appointed by thy chosen vessel, Paul,
the apostle, saying, because of our low estate, It is better to marry in
the Lord than to burn. Do thou thyself, as being good and man-
loving, have mercy and pardon, cleanse, remit, and forgive our
debts; for thou art he that took our weaknesses on thy shoulders: for
there is none sinless, or without defilement for even one day of his
life: thou only art the one who didst bear flesh sinlessly, and thou
bestowest upon us eternal passionlessness.
For thou art God, the God of the penitent, and to thee we ascribe
glory, to the Father, and to the Son, and to the Holy Ghost, now and
ever, and to ages of ages.
People. Amen.
Let us pray to the Lord.
Priest, the prayer.
O holy God, who didst form man from the dust, and from his rib didst
fashion woman, and yoke her unto him a helpmeet for him, because
so it was seemly unto thy majesty for man not to be alone upon the
earth; do thou thyself, now, O Master, stretch forth thy hand from thy
holy dwelling-place, and conjoin this thy servant, name, and this
thine handmaid, name; for by thee a woman is conjoined to a
husband. Yoke them together in unanimity, crown them in one flesh,
bestow on them fruit of the womb, and the gain of well-favoured
children.
For thine is the might, and thine is the kingdom, and the power....
And, taking the crowns, he crowneth the bridegroom, saying,
The servant of God, name, is crowned for the handmaid of God,
name, in the name of the Father, and of the Son, and of the Holy
Ghost.
In like manner he crowneth also the bride, saying,
The handmaid of God, name, is crowned for the servant of God,
name, in the name of the Father, and of the Son, and of the Holy
Ghost.
Then he blesseth them, saying thrice,
O Lord our God, crown them with glory and honour.
Then he saith the epistle and gospel, as they are written in the first
coronation. Vide page 67.
Then the deacon.
Let us all say with our whole soul....
O Lord Almighty, the God of our fathers....
Have mercy upon us, O God....
Furthermore let us pray for mercy, life, peace, health, salvation,
and visitation for the servants of God, names, and he
commemorateth whom he wisheth.
Exclamation. For a merciful....
Deacon. Let us pray to the Lord.
 Priest, this prayer.
O Lord our God, who, in thy saving providence, didst vouchsafe in
Cana of Galilee to declare marriage honourable by thy presence; do
thou now thyself preserve in peace and unanimity thy servants,
name, and, name, whom thou art well-pleased should be conjoined
to one another: declare their marriage honourable: preserve their
bed undefiled: be pleased that their mutual life may be unblamable,
and count them worthy to attain unto a ripe old age, keeping thy
commandments in a pure heart.
For thou art our God, the God to have mercy and to save, and to
thee we ascribe glory, with thine unbeginning Father, and with thine
all-holy, and good, and life-creating Spirit, now and ever, and to ages
of ages. Amen.
Deacon.
Help us, save us, have mercy....
That the whole day may be perfect, holy....
An angel of peace, a faithful....
Pardon and forgiveness of our sins....
What is good and profitable for our souls....
That the remaining time of our life....
A christian end of our life....
Having prayed for the unity of the faith, and the communion....
The priest exclaimeth,
And count us worthy, O Master....
People. Our Father....
Priest, For thine is the kingdom....
Amen.
Priest. Peace to all.
Bow your heads to the Lord.
 Then the common cup is brought, and the priest blesseth it, and
saith this prayer.
O God, who by thy might createst all things, and confirmest the
universe, and adornest the crown of all things created by thee; do
thou, with thy spiritual blessing, bless also this common cup given for
the community of marriage unto them that are conjoined.
With a loud voice,
For blessed is thy name, and glorified thy kingdom....
Then the priest, taking in his hand the common cup, giveth them to
drink thrice, first to the man, and then to the woman. And straightway
the priest, taking them, leadeth them in the form of a circle, and
singeth in tone v,
Rejoice, O Esaias, the virgin is with child, and bringeth forth a son,
Emmanuel, God and man: the orient is his name, whom magnifying,
we call the virgin blessed.
Another, tone vii.
O holy martyrs, who valiantly contended and are crown’d; pray ye
the Lord for mercy on our souls.
Glory to thee, Christ God, apostles’ boast and martyrs’ joy, whose
preaching was the consubstantial Trinity.
And, taking the crown from the bridegroom, he saith,
Be thou magnified, O bridegroom, as Abraham, and blessed as
Isaac, and increased as Jacob, walking in peace, and performing in
righteousness the commandments of God.
And, taking the crown from the bride, he saith,
And thou, O bride, be thou magnified as Sara, and rejoiced as
Rebecca, and increased as Rachel, being glad in thy husband, and
keeping the paths of the law, for so God is well pleased.
Let us pray to the Lord.
Then the prayer.
O God, our God, who wast present in Cana of Galilee, and didst
bless the marriage there; do thou bless also these thy servants, who,
by thy providence, are conjoined in the community of marriage.
Bless their incomings and outgoings, replenish their life with good
things, accept their crowns in thy kingdom unsullied and undefiled,
and preserve them without offence to ages of ages.
Choir. Amen.
Priest. Peace to all.
Bow your heads to the Lord.
And he prayeth.
The Father, the Son, and the Holy Ghost, the all-holy, and
consubstantial, and life-originating Trinity, one Godhead and
sovereignty, bless you, and vouchsafe unto you long life, well-
favoured children, progress in life and faith, and replenish you with
all the good things of the earth, and count you worthy of the
obtaining of promised blessings, through the prayers of the holy
God-bearing one, and of all the Saints. Amen.
Then they come and congratulate them, and they kiss one
another. And the dismissal is made.
He that by his presence in Cana of Galilee declared marriage to
be honourable, Christ our true God, through the prayers of his most
pure Mother; of the holy, glorious, and all-praised apostles; of the
holy god-crowned sovereigns and equals of the apostles,
Constantine and Helen; of the holy great-martyr Procopius, and of all
the Saints, have mercy upon us and save us, as being good and the
lover of mankind.
 Chapter XIII.
THE ORDER OF HOLY UNCTION SUNG BY
SEVEN PRIESTS ASSEMBLED IN A CHURCH OR
IN A HOUSE.

A table is prepared, and on this they place the holy gospel and a
dish of wheat, and on the wheat an empty oil cruet, and round it in
the wheat seven twigs wrapped with cotton wool for the anointing;
and they give tapers to all the priests. And, all standing round the
table vested in phelonia, the first of the priests taketh the censer with
incense, and censeth the table upon which the oil is round about,
and all the church, or the house, and the people; and, standing
before the table, looking towards the east, he beginneth,
Blessed be our God.... And Trisagion. O most holy Trinity.... Our
Father.... For thine is the kingdom.... Lord, have mercy, xii. O come,
let us worship.... thrice.
And psalm cxlii. O Lord hear my prayer....
Glory. Both now. Alleluia, thrice.
And the deacon, the ectenia.
Again and again in peace let us pray to the Lord.
Help us, save us, have mercy....
Commemorating our most holy, most pure, most blessed....
Priest. For to thee is due....
Choir. Amen.
And straightway they sing Alleluia in tone vi.
 Verse i. O Lord, rebuke me not in thine anger, neither chasten me
in thy fury.
Verse ii. Have mercy upon me, O Lord, for I am weak.
Then troparia.
Have mercy upon us, O Lord, have mercy upon us; for, destitute of
all defence, we sinners offer unto thee, as Master, this prayer, Have
mercy upon us.
Glory.
O Lord, have mercy upon us; for we have put our trust in thee. Be
not exceedingly wroth against us, neither remember our
transgressions; but, as being loving-kind, look now upon us, and
deliver us from our enemies: for thou art our God, and we are thy
people, we are all the work of thy hand, and we call upon thy name.
Both now.
Open unto us the gates of loving-kindness, O blessed God-
bearing one, that we perish not who put our trust in thee, but through
thee may we be delivered from calamities; for thou art the salvation
of the christian race.
After this, Have mercy upon me, O God....
And the canon, whereof the acrostic is,
A song of prayer oil by Arsenius.
Ode i. Irmos. Tone iv.
Through the red sea’s depth....
O Master, who with oil of loving-kindness dost mortals’ souls and
bodies alway tranquilize, and them that faithful be preserv’st with oil;
do thou thyself now have compassion upon those approaching thee
by means of oil.
The earth, O Master, is of thy mercy full. Therefore to-day anointed
with thy sacred precious oil, in faith we pray thee to bestow thy
mercy that surpasseth thought on us.
Glory.
 O lover of mankind, who mercifully thine apostles didst command
to minister thy priestly unction on thine ailing servants; do thou, at
their entreaties, through thy seal, have mercy upon all.
Both now.
O only pure one, who didst bear the boundless sea of peace, by
thine entreaties alway unto God, thy servant free from ailings and
from griefs, that he may magnify thee ceaselessly.
Ode iii. Irmos.
In thee thy church is glad....
Thou that alone art wonderful to faithful men, merciful Christ, grant
from on high thy grace to him that suffereth grievously.
O Lord, who once, for thy divine token that the flood had ceas’d,
didst shew an olive branch, in mercy save the afflicted one.
Glory.
With a lamp of light divine, in mercy lighten him, O Christ, who
now, in faith through the anointing, to thy mercy maketh speed.
Both now.
O Mother of the Maker of all things, look from on high with favour,
and release, by thine entreaties, the sufferer from his bitter pain.
Kathisma, tone viii.
Like, The pastoral reed....
Thou that art a divine river of mercy, a depth of abundant
sympathy, O compassionate one; manifest the divine streams of thy
mercy, and heal all: let the springs of wonders flow plenteously, and
wash all; for, ever betaking ourselves to thee, we fervently entreat
thy grace.
Another, tone iv.
Like, Thou that wast lifted up....
Physician and helper of them that are in sufferings, redeemer and
Saviour of them that are in sicknesses; do thou thyself, O Master
and Lord of all, grant healing unto thine afflicted servant: have
compassion and mercy upon him who hath greatly offended, and
deliver him, O Christ, from iniquities, that he may glorify thy divine
power.
Ode iv. Irmos.
Seeing thee lifted up....
Thou, Saviour, that, as myrrh corruptless, dost, through thy grace,
thyself outpour and cleanse the world; compassionate be, yea,
merciful to him, who doth, in faith divine, the body’s sores anoint.
With the tranquility of thy mercy’s seal, O Master, sign now the
senses of thy servants, and make the way thereto accessless and
approachless to all opposing powers.
Glory.
Thou who dost bid that thy divine hierurgists be call’d to them
whose strength hath fail’d, and these by prayer and unction with
thine oil to save; do thou, O lover of mankind, save, by thy mercy,
the afflicted one.
Both now.
Most holy and God-bearing ever-virgin, strong shelter and
defence, thou ladder and thou wall, have mercy and compassion on
the sufferer; for he hath fled to thee, and thee alone.
Ode v. Irmos.
Thou, Lord, my light....
Thou, good one, that art mercy’s depth, do thou, O merciful, have
mercy, in thy mercifulness divine, on him that suffereth; for thou art
loving-kind.
Sanctifying unspeakably from on high, O Christ, our souls and
bodies with the divine impression of thy seal, with thine own hand
heal all.
Glory.
 O most good Lord, who, through thine untold love, acceptedst
myrrh-anointing from the sinful woman; compassionate thy servant.
Both now.
All-praised, pure, and most good Queen, have mercy upon them
that are anointed with the oil divine, and save thy servant.
Ode vi. Irmos.
I will sacrifice unto thee with the voice....
O lover of mankind, who shewest by thy words anointing is for
kings, and this performest by highpriests; save thou the sufferer by
thy seal, for thou art loving-kind.
Let no communicating act of bitter demons touch his senses who
is sign’d with the divine anointing, Saviour; but with the safeguard of
thy glory him surround.
Glory.
Stretch from on high thy hand, O lover of mankind, and sanctify
thine oil, and grant this to thy servant, Saviour, for healing and
deliverance from all sicknesses.
Both now.
Mother of the Creator, thou, in thy sacred temple, hast appear’d a
fruitful olive tree, whereby the world appeareth fill’d with mercy.
Therefore save the sufferer by the touching of thy prayers.
Condakion, tone ii.
Like, Seeking the things above....
Thou that art the fountain of mercy, O thou that art most good, do
thou deliver from every calamity them that with fervent faith fall down
before thine unspeakable mercy; and, O thou that art loving-kind,
taking away their ailings, do thou grant unto them thy divine grace
from on high.
Ode vii. Irmos.
The abrahamic children in the furnace....
 Thou, Saviour, that alone art God, who in thy mercy and
compassions, healest the spiritual passions and bodily wounds of all;
physician be thou for this sufferer with disease, and make him whole
thyself.
Since with anointing oil the heads of all anointed are, so give to
this one joy of gladness, Christ, granting the mercy of thy redemption
unto him that seeketh this, for thy rich mercy’s sake, O Lord.
Glory.
Thy seal, O Saviour, against demons is a sword, and prayers of
priests a fire that burneth passions of the soul. Therefore in faith we
praise thee, we, who have healing gain’d.
Both now.
O thou, the Mother of God, who didst conceive within thy womb, in
wise befitting God, him that doth all things hold within his hand, and
flesh didst give to him unspeakably; we pray thee, Be thou gracious
to this suffering one.
Ode viii. Irmos.
With hands extended, Daniel....
O Saviour, have mercy upon all, according to thy mercy mighty
and divine; for, for this cause, we all are gather’d here to image forth
in mystic wise the condescension of thy mercies, and to bring the
unction with the oil in faith unto thy servant, whom visit thou likewise.
With thy mercy’s streams, O Christ, and by thy priests’ anointing
wash away, as Lord the loving-kind, the pains and wounds, and
overwhelmings of affliction of him tormented with the stress of
sufferings, that he, being sav’d, may praise thee with thanksgiving.
Glory.
The sign of condescension from on high and of tranquility being
drawn on us, O Master, through thy godlike mercy; do thou thy
mercy not withdraw, nor him reject who ever crieth faithfully, O bless
the Lord, all ye his works.
Both now.
 Glorious as a crown, O pure one, nature hath gain’d thy sacred
giving-birth, which crusheth hosts of foes, and mightily doth vanquish
them. Therefore, with festal brightness crowned through thy grace,
we thee extol, O most extolled Queen.
Ode ix. Irmos.
Unquarried rock....
Look down from heaven, O compassionate one, and shew thy
mercy unto all; and thine assistance and thy strength bestow on him
who now approacheth thee through the divine anointing by thy
priests, O lover of mankind.
O Saviour, thou most good, we have, rejoicing, seen the oil divine,
which, through thy godlike condescension for them that are
recipients, thou thyself accepted hast, and typically hast given to
them that have participated in the font divine.
Glory.
O Saviour, be compassionate and have mercy: deliver out of
dangers and afflictions—deliver from the arrows of the evil one the
souls and bodies of thy servants, and heal them, as the Lord, the
merciful, by thy divine anointing.
Both now.
Accept thy servants’ songs and prayers, O Virgin, and, by thy
supplications, from sufferings and from ills deliver us, even us who to
thy sacred shelter us betake, O thou most pure.
It is very meet....
Exapostilarion.
Like, He hath visited us....
In mercy, O thou good one, with thine eyes regard our prayer,
ours, who to-day are gather’d in thy holy temple to anoint with oil
divine thy suffering servant.
Then stichera, tone iv.
Like, Thou hast given a sign....
 Thou hast given thy grace through thine apostles, O good
physician, lover of mankind, to heal the wounds and sicknesses of all
men through thy holy oil. Therefore, as being loving-kind, him that
now faithfully to thy mercy hieth sanctify, have mercy upon him, and
cleanse him from all sickness, and count him worthy of thy
corruptless sweetness, Lord.
O lover of mankind incomprehensible, who, with thine unseen
hand, as being loving-kind, sealest our senses with thine oil divine;
look down from heaven, and give to him that faithfully betaketh him
to thee, and asketh pardon of iniquities, healing of soul and body,
that he may glorify thee lovingly, and magnify thy might.
Through the anointing with thine oil, and through the touching of
thy priests, O lover of mankind, hallow thy servant from on high, free
him from sicknesses, cleanse him from soul’s defilement, wash him,
O Saviour, and deliver him from scandals manifold; tranquilize his
grief, remove his hindrances, and banish his afflictions, as being
merciful and loving-kind.
Glory. Both now. Theotokion.
O most pure royal palace much extoll’d, I pray thee, cleanse my
mind defil’d by every kind of sin; and make it a meet dwelling-place
for the most holy Trinity, that I thy worthless servant, being sav’d,
may magnify thy might and mercy measureless.
Then, Trisagion. O most holy Trinity.... After Our Father.... For
thine is the kingdom....
Then troparion, tone iv.
Thou that alone art quick to help, O Christ, make manifest from on
high a speedy visitation to thine ailing servant: deliver him from
sicknesses and bitter pains, and raise him up, that, without ceasing,
he may praise and glorify thee, through the God-bearing one’s
entreaties, O thou sole lover of mankind.
And after these the deacon, or the first of the
priests, saith this ectenia.
In peace let us pray to the Lord.
Welcome to our website – the ideal destination for book lovers and
knowledge seekers. With a mission to inspire endlessly, we offer a
vast collection of books, ranging from classic literary works to
specialized publications, self-development books, and children's
literature. Each book is a new journey of discovery, expanding
knowledge and enriching the soul of the reade

Our website is not just a platform for buying books, but a bridge
connecting readers to the timeless values of culture and wisdom. With
an elegant, user-friendly interface and an intelligent search system,
we are committed to providing a quick and convenient shopping
experience. Additionally, our special promotions and home delivery
services ensure that you save time and fully enjoy the joy of reading.

Let us accompany you on the journey of exploring knowledge and

personal growth!

ebookname.com