Primary Process Communication

An unorthodox view of the function of primary process is presented with a view to enlarge, rather than diminish Freudian assumptions. One of the basic tenets of Freudian hypothesis was the supposed lack of influence of outside experience upon primary process functions. Yet we see demonstrated on a daily basis that primary process cognition is at work in any human interaction or experience. The mental structures of the self in interaction with the nonself is constantly monitored, added to, or subtracted from during contact with others. It is a prereflective mode that does not immediately rise into awareness. We give meaning to all interactions without necessarily reflecting upon them or even clarifying them to ourselves. Without allowing for such meaning to be integrated, we would lose or misinterpret large portions of our daily interactions. Flaws in communication occur every day and are demonstrable particularly in therapy when therapists are not attuned to their patients' emotional needs. It is demonstrated that nonverbal avoidance behavior of disturbed infants is the precursor for disturbed object relations of adults. Therefore, it makes no sense to interpret unconscious meanings—there are none. The difficulty lies in the inter-subjective realm and serves defensive modes. However, if patients present an inauthentic self, it is often difficult to decide if one is indeed in the presence of such a maimed self. The therapist's countertransference aids in detecting inaulhenticity. Ever-present, unconscious meaning analysis must be brought into consciousness by the therapist in order to further the therapeutic process.     

Primary obsessional slowness

Although most examples of slowness observed in patients with obsessional disorders can be regarded as secondary to checking rituals, it is suggested that there is a real but rare dysfunction in which the slowness is primary. The proposal is supported by information from standardized interviews and small scale experiments on 10 obsessional patients who were severely handicapped by their slowness. Unsystematic results encourage the hope that this type of disorder is moderately responsive to a simple therapeutic programme of prompting, shaping and pacing.     

Training Primary Care Psychologists

Primary care psychology is a new area that provides exciting opportunities for the field. This paper discusses the definition of primary care and the role of psychologists in primary health care. Educational programs developed by the author for pre- and postdoctoral training in primary care psychology are described.     

Rethinking Primary Religious Education

After a brief consideration of the history of religious education in England and Wales, this paper analyses developments under three main headings: pupils, religions and methods, and suggests that changes can be seen in the light if variations revolving around these three areas. The paper then describes the design of a new RE syllabus for Anglican primary schools in Wales using a life-of-founder approach and recommends the advantages of this approach for wider use.     

Primary Prevention and Assessment

Prevention is related to the need for a comprehensive assessment technology. The failure of training programs to prepare counselors for assessment is viewed as one of the major problems.     

Primary and secondary hypohedonia

Having shown taxometrically that there exists a hypohedonic schizotypal taxon in a college population, J. J. Blanchard, S. W. Gangestad, S. A. Brown, and W. P. Horan (2000) suggested that P. E. Meehl erred in revising his 1962 theory by postulating a normal-range individual differences variable of hedonic capacity that potentiates schizotypy into schizophrenia. The aversive drift and secondary anhedonia of Meehl's theory imply that the schizotypal taxon will generate hypohedonic taxonicity in an adult population. Psychometrically measurable hedonic disposition (as distinguished from genetic primary hedonic capacity) is "dragged along" by the schizogene, especially in the social domain. To choose between causal interpretations, it could be ascertained whether the schizotypal anhedonic taxon is composed of individuals who are schizotaxic on the basis of psychophysiological, cognitive, and soft neurologic indicators.     

Transgender Primary Medical Care

SUMMARY

Transgender medical care involves addressing general medical conditions and those related specifically to transgender issues. This article summarizes existing research in transgender medicine and provides guidance for family physicians and nurses in adapting standard primary care protocols relating to health maintenance, acute illness, and chronic disease management to address trans-specific clinical oncerns. Trans-specific issues in physical examination, health history, interpretation of laboratory tests, vaccination, screening, and treatment are explored, and the role of the primary care provider in caring for patients undergoing hormonal or surgical change is discussed.     

Tolerance as a Primary Virtue

The commonly perceived tension between authentic moral and ethical action and action involving tolerance is held to be the illusory product of an unduly individualistic frame of thought. Moral and ethical actions are produced not by independent individuals but by participants in cultural traditions. And even the wholly routine continuation of a single homogeneous tradition must always and invariably involve mutual tolerance: participants must interact not as independent individuals but as tolerant members. Tolerance deserves recognition, accordingly, as a primary virtue, not merely compatible with authentic moral and ethical action, but required by it. An explicit rhetoric enjoining tolerance needs to be understood as performative discourse employed to change, or else to sustain, the systems of tolerances in which all cultures, whether simple or differentiated, homogeneous or diverse, unified or fragmented, invariably consist. This revised version was published online in August 2006 with corrections to the Cover Date.     

Learning-Theoretical Aspects of Primary Dysmenorrhea

Abstract

Women suffering from severe primary dysmenorrhea (PD) show a typical behaviour pattern characterized by flight, avoidance, inactivity and helplessness. The question is if there is a common mechanism of origin in all those individual women who display such PD behaviour. A learning-theoretical model is presented concerning the origin of the connection between the stimulus of menstruation and the response of PD behaviour in women with severe PD: — Women have an increased physiological arousal premenstrually and during menstruation. — Women have a tendency to label the increased arousal negatively for two reasons: (1) Because of negative attitudes towards menstruation acquired from the social environment. (2) Because women have a lack of knowledge about their genitals and their functions, there is a lack of correct labelling of menstruation. Inexplicable arousal is mostly labelled as something “wrong”. — The negatively labelled increased arousal pre- and intermenstrually leads to an increased receptivity for conditioning. — The increased receptivity for conditioning means an increased proneness to react with a specific response to a certain stimulus, i. e. with PD behaviour as a response to the stimulus of menstruation. — Premenstrually highly anxious women are more receptive to conditioning than women who are not anxious premenstrually. The experience of PD makes the woman anticipate menstruation with anxiety, which thus forms the basis of a vicious circle. The validity of this theoretical model needs to be tested in experimental research.     

原发性醛固酮增多症的临床实践与分析

探讨原发性醛固酮增多症(原醛)临床特点及诊治方面的经验,以早期诊断、根治,改善预后.对确诊的原醛53例临床资料(临床特征、实验室检查、影像学检查、病理类型、治疗情况)进行回顾性研究.男女比为1:1.65,30～49岁年龄段最多.50.9%高血压首发,15.1%低钾血症首发,并发高心病9.4%,尿毒症1.9%,脑卒中13.2%.肾素-血管紧张素-醛固酮(RAA)系统激素检查,血浆醛固酮/血浆肾素活性比值(ARR)＞200者80.7%,ARR＞400者占半数,血浆醛固酮(PAC)＞140pg/ml者占84.6%.CT及MRI阳性率高.术后病理肾上腺皮质腺瘤占85%,结节性增生占15%(其中原发性肾上腺增生占12.5%).手术后血压及血钾均较前改善,非手术者口服安体舒通有效.原醛是可治性内分泌性高血压之一,建议高血压和/或低血钾者应常规检查RAA系统激素,并争取行影像学检查,以使原醛得到早期诊治,改善预后.     

自我激励初探

激励，是管理心理学的核心内容。千百年来，外在激励一直居主导地位。“人”一直是处于被激励的状态。本文提出了自我激励的概念，并从自我激励的产生、内涵、运作、原则和手段等几个方面逐一展开论述探讨。     

原发性醛固酮增多症的临床实践与分析

探讨原发性醛固酮增多症(原醛)临床特点及诊治方面的经验,以早期诊断、根治,改善预后。对确诊的原醛53例临床资料(临床特征、实验室检查、影像学检查、病理类型、治疗情况)进行回顾性研究。男女比为1：1.65,30～49岁年龄段最多。50.9%高血压首发,15.1%低钾血症首发,并发高心痛9.4%,尿毒症1.9%,脑卒中13.2%。肾素-血管紧张素-醛固酮(RAA)系统激素检查,血浆醛固酮/血浆肾素活性比值(ARR)＞200者80.7%,ARR＞400者占半数,血浆醛固酮(PAC)＞140pg/ml者占84.6%。CT及MRI阳性率高。术后病理肾上腺皮质腺瘤占85%,结节性增生占15%(其中原发性肾上腺增生占12.5%)。手术后血压及血钾均较前改善,非手术者口服安体舒通有效。原醛是可治性内分泌性高血压之一,建议高血压和/或低血钾者应常规检查RAA系统激素,并争取行影像学检查,以使原醛得到早期诊治,改善预后。     

Primary process in creative persons

The major hypothesis that quantity, quality, and control of primary process contents would be different in two groups of artists as a function of age and experience were tested by means of the Rorschach test. The Holt system of scoring was employed. A group of art students, mean age 21.7, and a group of renowned, mature artists, mean age 41.7, were compared. It was found that while quantity of primary process did not differ, the quality, density, defense demand, efficiency of defenses and controls, form level and REGO significantly differentiated experienced from inexperienced artists.     

Avicenna on the Primary Propositions

Avicenna introduces the primary propositions (or the primaries, for short) as the most fundamental principles of knowledge. (In this paper, we are not primarily concerned with the primary/first intelligibles as concepts/conceptions.) However, as far as we are aware, Avicenna’s primaries have not yet been independently studied. Nor do Avicenna scholars agree on how to characterize them in the language of contemporary philosophy. It is well-known that the primaries are indemonstrable; nonetheless, it is not clear what the genealogy of the primaries is (§2), how, epistemologically speaking, they can be distinguished from other principles (§3), what their phenomenology is (§4), what the cause of the assent to them is (§5), how to explain the relationship between the ‘innate [nature] of the intellect’ and the primaries (§6) and, finally, back to their indemonstrability, in what sense they are ‘indemonstrable’ (§7). We will try to fill this gap. As a corollary, we will explain why Gutas’s view [Gutas, Dimitri. 2012. ‘The empiricism of Avicenna’, Oriens, 40, 391–436], among others, according to which the primaries are analytic (in the Kantian sense) is not true in general (§8). More particularly, we will argue that some primary propositions can be categorized under Kantian synthetic a priori, consistent with Black’s and Ardeshir’s conjecture [Black, Deborah L. 2013. ‘Certitude, justification, and the principles of knowledge in Avicenna’s epistemology’, in Peter Adamson, Interpreting Avicenna: Critical Essays, New York: Cambridge University Press; Ardeshir, Mohammad. 2008. ‘Ibn Sīnā’s philosophy of mathematics’, in S. Rahman, T. Street, and H. Tahiri, The Unity of Science in the Arabic Tradition, New York: Springer]. We hope that this work opens up some space to study Avicenna’s philosophy of mathematics and logic in connection with his epistemology, philosophy of mind and metaphysics.     

Motivational Interviewing in Primary Care

Healthcare systems are in the process of reforming themselves to better meet the needs of people with, or at risk of developing, chronic diseases and long term conditions. One goal of these efforts is the coproduction of activated, informed, engaged and motivated patients and citizens. The clinical, public health and financial benefits of achieving such a goal may be dramatic. Motivational Interviewing (MI) is a proven and practical front-line approach which can help deliver this goal whilst also helping to deliver such policy objectives and intermediate outcomes as increased levels of patient centered care, participatory or shared decision making, evidence-based healthcare and improved clinician-patient relationships. Until now, MI has been passively diffusing through the system as a result of the innovation and early uptake by insightful individuals and organizations. If healthcare systems want to breakthrough to higher levels of performance, investment in the conscious and deliberate implementation of MI into front-line settings may prove helpful.     

An Overview of Primary Prevention

The historical antecedents of primary prevention are found in the methods of public health, counseling, and psychotherapy. Primary prevention is defined as being proactive and is aimed predominantly at high-risk groups not yet affected by the condition to be prevented. Its success is measured in a decline in the incidence of a condition that is compared with controls. Only through prevention can we reduce incidence, and it seems that it is the only feasible way to deal with the unbridgeable gap between the enormous number of individuals at risk for emotional disturbance and the limited availability of treatment resources.