The word "bioethics": the struggle over its earliest meanings.

An article by Warren Reich in the December 1994 issue of this journal concludes that the word "bioethics" and the field of study it names experienced a "bilocated birth" in 1970/1971 under Van Rensselaer Potter, at the University of Wisconsin, and André Hellegers, at Georgetown University. Further historical inquiry confirms (1) that there were, from the start, some major differences -- even clashes -- between the Potter and the Hellegers/Georgetown understandings of bioethics; and (2) that the Hellegers/Georgetown approach came to be the more widely accepted meaning of the term, while Potter's idea of bioethics remained largely marginalized. However, this inquiry also results in a third, unanticipated, conclusion: that Hellegers (in contrast to the dominant model offered by the Georgetown scholars) actually proposed a global approach to bioethics, bringing his vision much closer to Potter's evolving view than previously has been acknowledged.     

Contemporary theories of group psychotherapy: a systems approach to the group-as-a-whole.

The author discusses how subgroups represent the basic focus of the systems-centered group therapist. Particular attention is given to boundary issues and to how therapy takes place by facilitating the process of discriminating, communicating, and integrating perception of differences in the apparently similar and similarities in the seemingly different. Communication occurs at the boundaries between systems at all levels of the hierarchy: the group, the subgroup, and its members. Clinical vignettes are provided to illustrate important process issues, such as work with difficult patients, levels of intervention, and group resistance and defense.     

Relational ecologies of psychotherapy: The influence of administrative attachment on therapeutic alliance

There is now vast and multi-faceted empirical literature on the impact of relational dynamics in psychotherapy, and relationality is a central theme within contemporary psychoanalytic theories. Yet, there is virtually no literature addressing the relational dynamics around outpatient psychotherapy that influence the wider therapeutic alliance, that is the relational dynamics that unfold between clients and administrative office staff in making initial contacts and appointments, completing paperwork, negotiating payment, discussing insurance coverage, working through crisis calls, and the myriad of other forms of interaction which serve to form the relational ecology of psychotherapy. Milieu therapy or the use of supportive and structured therapeutic environments has been given significant attention in inpatient settings; however, administrative relational factors or administrative staff characteristics have seemingly been ignored in outpatient psychotherapy and psychoanalysis literatures. Many outpatient clinical practice settings involve multiple levels and dimensions of relationality between clients, administrative personnel, and therapists which shape the potential for secure continuous containment and various forms of attachment to psychotherapeutic space. In this paper, we describe several clinical illustrations of relational dynamics between clients and office staff which influence therapeutic alliance and outline the contours of our emerging idea of administrative hospitality based on relational psychoanalysis, attachment theory, symbolic anthropology, and stigma research. In doing so, we draw on our collective experience working in several outpatient clinics and insights from our current context in an urban outpatient training clinic which emphasises psychodynamic practice. Our goal is not a comprehensive analysis of the relational ecology of psychotherapy but to offer an initial exploratory account of some of the administrative relational dynamics in and around outpatient psychotherapy which go beyond the therapist-client dyad. The anthropological concept of liminality is connected to relational psychoanalytic theories to describe the important dynamics of transitional space in an overall process of relational transformation.     

The group psychotherapy movement at the millennium: some historical perspectives

Although almost a century old, group psychotherapy has experienced an unprecedented expansion over the last 50 years. By the 1970s, human helping groups had found application in virtually all the human services, including the media. The growth of professional organizations for group work specialists was accompanied by a burgeoning literature and by accelerated research endeavors. The recent advent of the managed health care "revolution" has shaken the very foundations of this prospering group psychotherapy movement. Undue pressure from third-party payers for greater accountability and for cost-containment has come to threaten the traditional autonomy and dedication to quality of care by group therapy practitioners. Professional organizations have begun to meet these challenges by educational endeavors addressed at insurers, legislators, and the public. Current training programs and literature for clinicians have focused on the need for a new "business orientation" and on less costly group treatment measures (i.e., short-term and combined). Given group therapy's proven effectiveness, coupled with its practitioners' flexibility, the movement is bound to regain its secure footing at the dawn of the new millennium.     

Belief in conspiracy theories: The influence of uncertainty and perceived morality

In the present research, we examined people's tendency to endorse or question belief in conspiracy theories. In two studies, we tested the hypothesis that the perceived morality of authorities influences conspiracy beliefs, particularly when people experience uncertainty. Study 1 revealed that information about the morality of oil companies influenced beliefs that these companies were involved in planning the war in Iraq, but only when uncertainty was made salient. Similar findings were obtained in Study 2, which focused on a bogus newspaper article about a fatal car accident of a political leader in an African country. It is concluded that uncertainty leads people to make inferences about the plausibility or implausibility of conspiracy theories by attending to morality information. Copyright © 2012 John Wiley & Sons, Ltd.     

Personal sources for theories of psychotherapy: A bid for eclecticism

Personality and psychotherapy theorists choose certain elements to emphasize in their theories. A major, though usually unrecognized, source for such elements is the personal life of the theorist. Examples are drawn from nine theorists in the areas of family experiences, personal relationships, special experiences, and significant clients. The overall thesis is that an eclectic orientation to psychotherapy may be most appropriate since: (a) all theories emphasize certain elements (and ignore others), which is (b) often aided by (and limited by) the theorist's own life and experiences. Thus, if the client's personal life resembles the theorist's personal life, then the emphases developed by that theorist are most likely to be helpful to that client.     

The struggle to listen: continuing reflections, lingering paradoxes, and some thoughts on recovery of memory

This paper offers a further expansion of the author's continuing endeavor to highlight and explore subtle distinctions and lingering paradoxes in how we listen, and to reconsider their profound implications for clinical work and discovery. Several perhaps commonplace clinical moments are used to sharpen illumination on psychic experience that might otherwise remain outside conscious awareness, whether in the domain of the repressed or in other mnemonic realms, such as "implicit" or "procedural" memory. It is suggested that added dimensions of these different levels of memory may, through our struggle to listen, be ultimately knowable.     

Bilingualism and systemic psychotherapy: some formulations and explorations

Bilingualism has risen dramatically due to increased migration patterns all over the world. This paper offers an overview of the current literature dealing specifically with bi- and multilingualism, and identifies a gap in systemic and family therapy literature about the subject of bilingualism. In the light of this, the author proposes a working definition of bilingual families. Some case examples illustrate different aspects of working systemically with a bilingual family and highlight potential challenges for a therapist, such as the assumption of more knowledge and expertise. The tools suggested relate to a rethinking of some modernist ideas regarding hypothesizing, and both the use of a social constructionist perspective and of self of the (bilingual) family therapist. A case is made for the exploration of meanings of difference including the lingua-cultural one. The author ends with a plea to start including more specific cultural issues such as bilingualism in systemic therapy practice.     

Observations on some aspects of current psychoanalytic theories

The competing theories in the psychoanalytic marketplace today should be judged on their merits, not on the basis of the authority of whoever first proposed them. What is valid in each theory should be included in any formulation of a psychoanalytic theory of mental development and functioning. Since psychoanalysis, as part of psychology, is a branch of natural science, pluralism in theory is to be avoided in psychoanalysis as in every branch of science. The psychoanalytic method is a valid one of studying a particular aspect of brain functioning. The method and the theories based upon it are as "organic" as is the case with any of the other neurosciences. Any valid psychoanalytic theory of mental functioning and development should include the following conclusions: (1) Unconscious mental processes are omnipresent and of great importance in mental functioning; (2) Thoughts are as causally related to one another as are other events in the universe; (3) Mental functioning is a developmental phenomenon with describable, sequential features; and (4) A major role in mental functioning and development is played by conflicts over the sexual and aggressive wishes that characterize mental life during the period from three to six years of age, and by the compromise formations that result from those conflicts. The last of these conclusions, though disputed by many, is abundantly supported by evidence that is not dependent on the use of the psychoanalytic method, as well as by evidence furnished by the use of the psychoanalytic method. There is also much evidence to support the assertion that any psychoanalytic theory that attributes language-dependent thoughts to a child whose brain is not yet mature enough to be capable of language is to be considered invalid, as are any observations made by the psychoanalytic method (= clinical observations) that are influenced by such an invalid theory. In psychoanalysis, as in every other branch of science, an observer--no matter how astute and how experienced--who subscribes to an invalid theory will be led astray by that theory, sooner or later, in one way or another.     

Rating ability in performance judgments: The joint influence of implicit theories and intelligence

The purpose of this study was to approach the issue of rating ability by examining the influence of rater implicit theories and rater intelligence on rating outcomes. Using the inferential accuracy model (Jackson, 1972), raters were identified as either possessing a normative or idiosyncratic implicit theory of the occupation of college instructor. In a laboratory setting, 50 normative and 50 idiosyncratic raters judged the videotaped performance of either a good or poor lecturer. Results showed that (a) intelligence was positively related to rating accuracy and to possessing a normative implicit theory, (b) rater type moderated the relationship between intelligence and rating accuracy, and (c) controlling for intelligence, normative raters committed stronger halo effects than idiosyncratic raters. These results were discussed in relation to furthering the understanding of rating ability.