Anxiety and Repression in Attention and Retention

High- and low-anxious college students (as determined by scores on the Taylor Manifest Anxiety Scale; A. W. Bendig, 1956) and repressors (low anxiety and high scores on the Marlowe–Crowne Social Desirability Scale; D. P. Crowne & D. Marlowe, 1964) were compared on 3 cognitive tasks. High-anxious participants more often spelled the negative emotional meaning of ambiguous homophones (e.g., pane/pain) and forgot more of their free associations to emotional cue words than did the low-anxious participants. The repressors also detected the emotional meaning of the homophones but unlike the anxious, the repressors did recall their associations to the emotional words. In a working memory task using nonemotional items, the moderately anxious participants recalled fewer words than did the low- and high-anxious participants. The results confirm that both trait anxiety and repression affect information processing at a variety of stages but not in the same way. Repressors were sensitive to, and retentive of, negative emotional stimuli.     

Object Relations Theory and Technique Applied to Sex and Marital Therapy

This paper demonstrates integrating psychoanalysis and behavioral techniques in sexual and marital therapy. It particularly illustrates how Fairbairn's (1943) concept of the return of the repressed can help a couple reclaim lost unconscious parts of themselves, and extensive use of countertransference during sex and marital therapy.     

Herbert Rosenfeld in Italy, 1978–1985

Abstract

In this paper, the author attempts to shed some light on Herbert Rosenfeld’s thought and his way of working when was in Italy during 1978–1985. In particular, the author would like to show, in a sketchy way, the evolution of his thought, with specific regard for the new way in which he looked at clinical practice at that time. In the author’s opinion, the Rosenfeld that he and his group met and got to know in Italy was able to open new horizons in clinical practice, implicitly questioning some of his own or his circle’s previous viewpoints.     

Not Practising Theology

Many pastors are prepared for a vocation they do not practice while they are performing a ministry they have not learned. While providing pastoral care they are eager to help, support, and comfort but they hesitate to theologize, to practice theology. At least three considerations may offer an explanation for this paradoxical fact: 1. Most pastors consider theology to be static and historical instead of dynamic and interactional; 2. Students of theology never learn to practice theology, therefore, as a minister, they prefer to listen and refuse to speak; 3. Many ministers mask a lack of courage and motivation in publicly professing what they privately believe, by providing therapeutic help to those who are in pastoral need.     

“A Failure of Curiosity”

ABSTRACT

This essay discusses the clinician's defense against and resolution of the experience of boredom in the countertransference as an incident of projective identification in the treatment of a woman with dissociative identity disorder. The essay details the inner mind of the therapist as she discovers both her own feelings and judgements of those feelings. As the essay progresses, she begins to grasp the significance of her discomfort in informing the therapeutic process. We watch as this material is made use of to move forward a stalled therapy into new territory.     

Self-Disclosure and Vulnerability

Abstract

Based on the theoretical assumption and clinical observation that projective identification is a natural, constant element in human psychology, clinical material is used to illustrate how projective identification centered transference states create situations where acting out of the patient's phantasies and conflicts by both patient and therapist is both common and unavoidable. Because they are more obvious, some forms of projective identification encountered in clinical practice are easier for the analyst to notice and interpret. Other forms are more subtle and therefore difficult to figure out. Finally, some forms, whether subtle or obvious, seem to create a stronger pull on the analyst to blindly act out.

In some psychoanalytic treatments, one form of projective identification might embody the core transference. In other cases, the patient might shift or evolve from one level of this mechanism to another. Some patients attempt to permanently discharge their projective anxiety, phantasy, or conflict into the analyst. There is a patent resistance to re-own, examine, or recognize this projection. Some of these patients are narcissistic in functioning, others are borderline, and many attempt to find refuge behind a psychic barricade or retreat (Steiner 1993). In other forms of projective identification, the patient enlists the analyst to master their internal struggles for them. This occurs through the combination of interpersonal and intra-psychic object relational dynamics. This “do my dirty work for me” approach within the transference can evoke various degrees of counter-transference enactments and transference/counter-transference acting out.

Another form of projective identification, common in the clinical setting, is when a patient wants to expand the way of relating internally, but is convinced the analyst needs to validate or coach the patient along. This is why such a patient may stimulate transference/counter-transference tests and conduct practice runs of new object relational phantasies within the therapeutic relationship. Over and over, the patient may gently engage the analyst in a test, to see if it is ok to change their core view of reality. Depending on how the analyst reacts or interprets, the patient may feel encouraged to or discouraged from continuing the new method of relating to self and object. The patient's view of the analyst's reactions is, of course, distorted by transference phantasies, so the analyst must be careful to investigate the patient's reasoning and feelings about the so-called encouragement or discouragement. This does not negate the possible counter-transference by the analyst in which he or she may indeed be seduced into becoming a discouraging or encouraging parental figure who actually voices suggestions and judgment.

All these forms of projective identification surface with patients across the diagnostic spectrum, from higher functioning depressive persons to those who are more disturbed paranoid-schizoid cases. Whether immediately obvious or more submerged in the therapeutic relationship, projective identification almost always leads to some degree of acting out on the part of the analyst. Therefore, it is critical to monitor or use the analyst's counter-transference as a map towards understanding the patient's phantasies and conflicts that push them to engage in a particular form of projective identification.     

Anxiety sensitivity as a specific and unique marker of anxious symptoms in youth psychiatric inpatients

We addressed several questions regarding the relation of anxiety sensitivity to anxious symptoms among 47 youth psychiatric inpatients (18 boys, 29 girls), ages 9–17 (M = 14.23, SD = 1.89). Participants completed measures of anxiety sensitivity, anxious and depressive symptoms, trait anxiety, and positive and negative affect; chart diagnoses were available. Consistent with hypotheses, we found that (a) anxiety sensitivity was associated with anxious symptoms, even controlling for trait anxiety and depressive symptoms; and (b) anxiety sensitivity displayed symptom specificity to anxious versus depressive symptoms (i.e., was associated with anxiety controlling for depression but not with depression controlling for anxiety). Furthermore, regarding factors of anxiety sensitivity, we obtained mixed support for our prediction that phrenophobia would be associated with both depression and anxiety, whereas fear of physical arousal would be associated with anxiety but not depression. Implications for the construct validity of anxiety sensitivity were discussed.