Abstract Planning and Perceptual Chunks: Elements of Expertise in Geometry

We present a new model of skilled performance in geometry proof problem solving called the Diagram Configuration model (DC). While previous models plan proofs in a step-by-step fashion, we observed that experts plan at a more abstract level: They focus on the key steps and skip the less important ones. DC models this abstract planning behavior by parsing geometry problem diagrams into perceptual chunks, called diagram configurations, which cue relevant schematic knowledge. We provide verbal protocol evidence that DC's schemas correspond with the step-skipping inferences experts make in their initial planning. We compare DC with other models of geometry expertise and then, in the final section, we discuss more general implications of our research. DC's reasoning has important similarities with Larkin's (1988) display-based reasoning approach and Johnson-Laird's (1983) mental model approach. DC's perceptually based schemas are a step towards a unified explanation of (1) experts' superior problem-solving effectiveness, (2) experts' superior problem-state memory, and (3) experts' ability, in certain domains, to solve relatively simple problems by pure forward inferencing. We also argue that the particular and efficient knowledge organization of DC challenges current theories of skill acquisition as it presents an end-state of learning that is difficult to explain within such theories. Finally, we discuss the implications of DC for geometry instruction.     

Wittgenstein on Happiness: Harmony,Disharmony and Antitheodicy

This paper investigates Wittgenstein's remarks on happiness and harmony in the context of Wittgensteinian antitheodicy. Philosophers of religion inspired by Wittgenstein's philosophy often criticize theodicies seeking to justify apparently meaningless evil and suffering within God's overall harmonious plan. The paper analyses Wittgenstein's early views on happiness as harmony with the world, examining whether they are incompatible with an antitheodicist approach abandoning the very project of theodicy by acknowledging a certain kind of disharmony. However, antitheodicy may also, at the transcendental meta‐level, be considered a “harmonious” way of “seeing the world aright,” which raises a reflexive problem for any Wittgenstein‐inspired antitheodicy.     

The Problem of Self‐Torture: What's Being Done?

We commonly face circumstances in which the cumulative negative effects of repeatedly acting in a certain way over time will be significant, although the negative effects of any one such act, taken on its own, are insubstantial. Warren Quinn's puzzle of the self‐torturer presents an especially clear example of this type of predicament. This paper considers three different approaches to understanding the rational response to such situations. The first focuses on the conditions under which it is rational to revise one's prior intentions. The second raises the possibility of a fundamental disconnect between the rational assessment of an extended pattern of choices and the assessment of the individual choices that make up that pattern. I show that neither adequately addresses the underlying issues. I propose a third approach, according to which the rational assessment of the “self‐torturer's” choices is guided, not by any plan or intention the he has actually adopted, but by the plan or plans it would have been reasonable for him to adopt from the outset. The larger significance of this conclusion is brought out through the identification of conditions under which one's past choices can non‐derivatively constrain the rational response to one's present circumstances.     

Introduction

Abstract

Managed health care policy has created dramatic changes in current clinical practice, and all too frequently, impacts the overall treatment plan. Clinicians making referrals for emergency hospitalizations can no longer rely on an in-patient, safe, holding environment. Rather the hospital's relationship and stance with managed care insurance providers determines the length of the hospitalization and the case management plan for patients, instead of the patient's need.     

Property and economic planning in Fichte's contractualism

My paper reconstructs Fichte's property theory and political economy in Foundations of Natural Right and The Closed Commercial State. Fichte's theory of property requires the rejection of the classical liberal theory of property rights. Fichte's alternative theory of property, in conjunction with his republican account of the state's role in guaranteeing individual rights, further requires the rejection of a market economy in favor of a planned economy. For Fichte's view entails the normative necessity of a political economy in which the production and transfer of goods and services, across large sectors of the economy, are mandated by the state in advance in accordance with an economic plan. As a result, Fichte reconceives his contractualism as necessarily including the negotiation of a state‐enforced plan for economic activity. Thus, Fichte's new theory of property in Foundations of Natural Right has extremely wide‐ranging implications for the rest of his political and economic thought. The negotiation of fair terms of political association characteristic of classical contractualist thought becomes in Fichte's hands the negotiation of an economic plan that defines each individual's socioeconomic rights. I conclude with some brief remarks on the sense in which Fichte's theory serves as a cautionary tale for later socialists.     

Freud

The author explores the evidence-base and selection criteria for a short-term supportive dynamic approach for patients whose psychological mindedness and quality of object relationships is low. Illustrating this approach with a case example he outlines the central features of Supportive Dynamic Therapy. He describes a psychodynamic conceptual and developmental framework that can be used to guide the therapist's interventions and responses, and modulate the patient's anxiety. A dynamic focus presented in the form of a central issue is shown to have a significant function both in containing the patient's anxiety, and in giving shape to the therapist's efforts to support the patient's ego-strengths and adaptive abilities. The therapeutic work can be seen to result in an alteration in the trajectory or reiterating pattern of the patient's life.     

Hospital Suicides: Lawsuits and Standards

ABSTRACT: Based on personal experience as an expert witness in litigation following Hospital Suicides, the following recommendations are made: every hospital should have a Suicide Prevention Committee which establishes written guidelines after surveying security areas and talking with staff and patients. Reasonable treatment requires that each patient be evaluated for suicide risk, that a treatment plan be formulated, and that staff follow the treatment plan according to the hospital's own policies.     

Advanced Spatial Skills and Advance Planning: Components of 6-Year-Olds' Navigational Map Use

Two domains of cognitive development that have captured significant research attention are children's spatial cognition and children's planning skills. Children's ability to use maps for navigational purposes is a task in which these domains necessarily intersect. This study was designed to examine 6-year-olds' complex route formation and reorientation skills. Thirty-six kindergartners navigated through a large-scale environment using a map. Participants were required to plan their own routes to end-points designated only on the maps. Success at navigation, as well as route length and types of error, were assessed. The results indicate that kindergartners are able to use maps to plan and execute routes, and that they demonstrate advance planning skills by reliably selecting optimally efficient routes.     

An Accuracy Based Approach to Higher Order Evidence

The aim of this paper is to apply the accuracy based approach to epistemology to the case of higher order evidence: evidence that bears on the rationality of one's beliefs. I proceed in two stages. First, I show that the accuracy based framework that is standardly used to motivate rational requirements supports steadfastness—a position according to which higher order evidence should have no impact on one's doxastic attitudes towards first order propositions. The argument for this will require a generalization of an important result by Greaves and Wallace for the claim that conditionalization maximizes expected accuracy. The generalization I provide will, among other things, allow us to apply the result to cases of self‐locating evidence. In the second stage, I develop an alternative framework. Very roughly, what distinguishes the traditional approach from the alternative one is that, on the traditional picture, we're interested in evaluating the expected accuracy of conforming to an update procedure. On the alternative picture that I develop, instead of considering how good an update procedure is as a plan to conform to, we consider how good it is as a plan to make. I show how, given the use of strictly proper scoring rules, the alternative picture vindicates calibrationism: a view according to which higher order evidence should have a significant impact on our beliefs. I conclude with some thoughts about why higher order evidence poses a serious challenge for standard ways of thinking about rationality.     

Cancer and the body: Reflections from a Lacanian perspective

This paper discusses psychotherapeutic work with cancer patients using a Lacanian approach to illness. In the first part of the paper, some of Lacan's notions of the body are discussed. In the second half, Lacan's understanding of the body is used to show how an appreciation of Lacan's work might enhance clinical/psychotherapeutic work with cancer patients.     

Timmermann,Forschler, and The Attempt to Bridge the Kantian‐Consequentialist Gap

Scott Forschler defends R. M. Hare's rationalist‐universalizing‐utilitarian moral approach against Jens Timmermann's critique of it. He argues that Timmermann fails to see that Kant's ethical rationalism might be consistent with utilitarianism, and argues that Timmermann merely assumes that Kant's deontology follows logically from his ethical rationalism. In Forschler's estimation, it has not been established that either Kant's or Hare's ethical rationalism is inconsistent with utilitarianism. This article, however, argues that, in his response to Timmermann on behalf of Hare's rationalist‐universalizing‐utilitarian approach, Forschler has overlooked something very significant at the foundational level of Hare's moral approach, and that this oversight undercuts his response to Timmermann. The analysis also invites a metaethical investigation of preference satisfaction as it is found in Hare's moral approach. The article uncovers some fundamental metaethical presuppositions in Hare's normative approach, presuppositions overlooked by Forschler.     

Structural Solutions to Social Dilemmas: A Field Study on Commuters’ Willingness to Fund Improvements in Public Transit1

The present field study examined commuters’(N= 152) willingness to fund improvements in public transit. Consistent with Samuelson's (1993; Samuelson & Messick, 1995) multiattribute evaluation model of structural change in social dilemmas, support for the transit plan was higher when it was perceived to be (a) effective at reducing congestion and pollution, (b) personally beneficial, and (c) fair in terms of taxes and benefits. Also consistent with predictions, these relationships were moderated by individual differences in social value orientation (MClintock, 1968) and the consideration of future consequences (CFC; Strathman, Gleicher, Boninger, & Edwards, 1994). Prosocials responded more to the perceived fairness of the plan, while proselfs responded more to the plan's effectiveness in reducing congestion. Low CFCs responded more to the plan's personal benefits and effectiveness in reducing congestion, while high CFCs responded more to the plan's effectiveness in reducing pollution.     

The predictive power of Holland's investigative personality type and consistency levels using the self directed search

Using the Self Directed Search (SDS), the predictability of Holland's Investigative personality type and the three levels of consistency were assessed. A sample of male Investigative subjects (N = 171) who completed the SDS as freshmen in 1970 was sent a questionnaire 4 years later. The questionnaire asked subjects to state their academic major, occupational plan upon graduation, and occupational plan 5 years hence. Hypotheses concerned the predictability over a 4-year college period of (1) one-, two-, and three-letter SDS and most recent daydream codes and (2) Holland's three levels of consistency. Results indicated that, for Investigative-type freshman males, the SDS has moderately high efficiency in predicting, 4 years later, their ultimate major and their immediate and future vocational plans. The differential predictability of Holland's three consistency levels was supported in 20 of the 27 tests applied.     

FROM EXTENSION TO REVOLUTIONARY CHANGE IN CLINICAL PSYCHOANALYSIS: THE RADICAL INFLUENCE OF BION AND WINNICOTT

This paper addresses the radical departure of late Bion's and Winnicott's clinical ideas and practices from traditional psychoanalytic work, introducing a revolutionary change in clinical psychoanalysis. The profound significance and implications of their thinking are explored, and in particular Bion's conception of transformation in O and Winnicott's clinical‐technical revision of analytic work, with its emphasis on regression in the treatment of more disturbed patients. The author specifically connects the unknown and unknowable emotional reality‐O with unthinkable breakdown (Winnicott) and catastrophe (Bion). The author suggests that the revolutionary approach introduced by the clinical thinking of late Bion and Winnicott be termed quantum psychoanalysis. She thinks that this approach can coexist with classical psychoanalysis in the same way that classical physics coexists with quantum physics.     

Individual Therapy via the Phenomenon of Hope for Treating Chronic and Complex PTSD

Evidence-based treatment (EBT) supports different types of cognitive-behavioral therapy (CBT) for treating post-traumatic stress disorder (PTSD). Yet, a growing body of evidence shows a high therapy dropout rate and non-response rate among PTSD patients, especially patients with complex PTSD. A different, short-term therapeutic approach is therefore needed which combines CBT and psychodynamic therapy (PDT) because it is better for patients with chronic and/or complex PTSD to work with clarified stages and an end of treatment in mind. The patient's mental structure is conceptualized as a continuum, and functional problems are regarded as stemming from cognitive structures and unresolved developmental conflict. The five phases of the phenomenon of hope model proposed in an earlier article—a connection phase; an agency and pathway phase (developing a goal-oriented decision-making pattern and learning to plan toward goal achievement); a reconstruction phase; a phase of processing the conflict characteristic of PTSD by utilizing the natural power of hope; and a summary and separation phase—advance a short-term therapy that combines CBT and PDT techniques. This integrated therapy is based on notes that were kept relating to the case study of a chronic PTSD patient.     

The role of psychoanalytic assessment in the management and care of a psychotic patient

The pressure on mental health services to move patients on quickly, and the emphasis on the recovery model, can encourage a superficial assessment of the patient's difficulties. The author argues that a narrow definition of the medical model based on the presence or absence of symptoms ignores the deeper psychic structures that govern thinking and behaviour over time. A psychoanalytic assessment can offer a dynamic picture of deeper psychic structures in the patient's internal world. This is particularly important with psychotic patients who may successfully use denial and rationalization to cover up their underlying psychopathology. The developmental perspective inherent in the psychoanalytic view can also give a picture of the patient's propensity to repeat certain aspects of his/her psychopathology. In addition, a psychoanalytic approach may shine some light on the relationship between relapse and risk behaviour.     

Should Analytic Patients Be “Created”? Reflections on Arnold Rothstein's Psychoanalytic Technique and the Creation of Analytic Patients

Abstract

The five points of Arnold Rothstein's interesting monograph are each discussed and critiqued in this article. In particular, Rothstein is commended for his commitment to expanding the availability of an intensive, psychoanalytic treatment for a broad spectrum of patients who may often be very difficult to engage. Rothstein also accounts for difficulties in engaging analytic patients from obstacles in the attitudes of analysts such as a latent lack of conviction about the efficacy of psychoanalysis and from overly restricted stereotypes about the spectrum of appropriate patients. He recommends a flexibility of technique and accommodation to the needs of patients with which this author agrees.

Others of Rothstein's observations and recommendations seem more problematic. Specifically, issue is taken with his suggestion that analysts attempt to provide a trial of psychoanalysis for all nonpsychotic patients and to begin on a less intensive basis only within the frame or interpreting prospective patients' objections as a resistance. This author also disagrees with Rothstein's interpretation that patients resist the offer of a psychoanalysis out of a self-defeating masochistic enactment that needs interpretation. Case examples are provided that belie this overly generalized interpretation. Additionally, this author critiques the metapsychological assumptions underlying this particular mode of interpreting a reluctance to begin psychoanalysis.

While commending Rothstein's therapeutic goals and recommended flexibility of technique, this author would also stress a fundamental concern about the patient's conscious and unconscious experience of the analyst's agenda. In other words, rather than working toward the analyst's goal of establishing a psychoanalytic situation, emphasis is placed instead on the basic right of patients to proceed in a manner that respects their sovereignty over how intensively they may choose to work. Therefore, in contradistinction to Rothstein's suggestions, it is recommended that the analyst's primary focus should be to provide an availability to work on the patient's conflicts and developmental needs with a respect for the timing of their emergence and expression within a treatment frame that invites but does not prematurely elicit and confront. By proceeding in this way a patient's salient dynamics will be allowed to emerge “organically” instead of being hastened prematurely in reaction to the analyst's insistence on the Tightness of a particular schedule or manner of proceeding. This author believes that with this approach more, rather than fewer, patients will be able to accept the recommendation of an intensive psychoanalytic treatment.