Psychic development and the group analytic situation

Psychic development can be viewed as the emergence and establishment of coherency which is an aspect of organization. This paper discusses the concept of coherency and reviews some early developmental processes in the mother/infant interaction that establish coherency. The development of the matrix of the analytic group is viewed as the establishment and development of group coherency. Finally, the link between the development of individual coherency and group coherency is outlined.Dr. Malcolm Pines is a Consultant Psychotherapist at Tavistock Clinic, founder member of the Institute of Group Analysis (London), member of the British Psychoanalytical Society, and Past President of the International Association of Group Psychotherapy.     

Peer review: Selecting the best science

The major challenge facing today’s biomedical researchers is the increasing competition for available funds. The competitive review process, through which the National Institutes of Health (NIH) awards grants, is built upon review by a committee of expert scientists. The NIH is firmly committed to ensuring that its peer review system is fair and objective. Wendy Baldwin, Ph.D., is Deputy Director for Extramural Research, National Institutes of Health. This paper is based on a presentation at a workshop, “Advances in Peer Review Research”, American Association for the Advancement of Science Meeting, Baltimore, MD, February 9, 1996.     

Delirium and isolated angiitis of the central nervous system: a case report and review

Central nervous system (CNS) vasculitis is a rare entity, especially when it occurs in isolation; it is seen more commonly as part of a multisystem vasculitis. Common presenting symptoms include persistent headache, encephalopathy, and multifocal signs. We discuss the case of a 68-year-old female who presented twice in 1 month with confusion and choreaform movements. Extensive workup was negative for a connective tissue disease or other conditions in the differential, including neurosarcoidosis, Creutzfeldt-Jakob disease, and neurosyphilis. The only significant findings were elevated erythrocyte sedimentation rate, inflammatory signs in the CNS, and diffuse slowing of the electroencephalogram. A presumptive diagnosis of isolated angiitis of the central nervous system (IACNS) was made and the patient was successfully treated with steroids. She recovered fully with no residual symptoms. The diagnosis of IACNS is often difficult given there are no definitive laboratory investigations or pathognomonic presentation. However, a series of signs, symptoms, and laboratory findings have been proposed that are helpful in making the diagnosis. To our knowledge, IACNS presenting primarily with delirium has not been previously reported in the literature. The diagnosis of IACNS is purely speculative for this case, as the gold standard for diagnosis, a leptomeningeal cortical biopsy, was not performed.     

Peer review and innovation

Two important aspects of the relationship between peer review and innovation includes the acceptance of articles for publication in journals and the assessment of applications for grants for the funding of research work. While there are well-known examples of the rejection by journals of first choice of many papers that have radically changed the way we think about the world outside ourselves, such papers do get published eventually, however tortuous the process required. With grant applications the situation differs in that the refusal of a grant necessarily curtails the possible research that may be attempted. Here there are many reasons for conservatism and reservation as to the ability of a grant allocation process based on peer review to deliver truly innovative investigations. Other methods are needed; although such methods need not be applied across the board, they should constitute the methods whereby some 10–20% of the grant monies are assigned. The nomination of prizes for specific accomplishments is one way of achieving innovation although this presumes that investigators or institution already have available the money necessary to effect the innovations; otherwise it is a question of the selection and funding of particular individuals or institutions and requiring them to solve particular problems that are set in the broadest of terms.     

The analytic situation as a dynamic field. 1969

This paper discusses the consequences of the importance that recent ³ papers assign to the countertransference. When the latter acquires a theoretical and technical value equal to that of the transference, the analytic situation is configured as a dynamic bi‐personal field, and the phenomena occurring in it need to be formulated in bi‐personal terms. First, the field of the analytic situation is described, in its spatial, temporal and functional structure, and its triangular character (the present–absent third party in the bi‐personal field) is underlined. Then, the ambiguity of this field is emphasized, with special weight given to its bodily aspect (the bodily experiences of the analyst and the patient being particularly revealing of the unconscious situation in the field). The different dynamic structures or lines of orientation of the field are examined: the analytic contract, the configuration of the manifest material, the unconscious configuration – the unconscious bi‐personal phantasy manifesting itself in an interpretable point of urgency – that produces the structure of the field and its modifications. The authors describe the characteristics of this unconscious couple phantasy: its mobility and lack of definition, the importance of the phenomena of projective and introjective identification in its structuring. The authors go on to study the functioning of this field, which oscillates between mobilisation and stagnation, integration and splitting. Special reference is made to the concept of the split off unconscious ‘bastion’ as an extremely important technical problem. The analyst’s work is described as allowing oneself to be partially involved in the transference–countertransference micro‐neurosis or micro‐psychosis, and interpretation as a means of simultaneous recovery of parts of the analyst and the patient involved in the field. Finally, the authors describe the bi‐personal aspect of the act of insight that we experience in the analytic process.     

On antithetic and metathetic words in the analytic situation

Freud's view of primal words emphasized their origins in the vocal acquisition of language and their similarity to primary process behavior in young children. Our English vernacular is rich in word play of reversals and antitheses, some words being truly ancient, others originating in the subversions of slang and in the child's penchant for mirror imaging and other primary process play. In the regression of analytic work the uttered word can combine with dream imagery and behavioral enactment to convey the antitheses abounding in the oral, anal, and early phallic concerns of the individuating child acquiring language.     

Peer attachment and self-esteem: A meta-analytic review

Peer attachment might provide individuals with opportunities to build their sense of self-worth. The purpose of this paper was to meta-analytically review literature on peer attachment and self-esteem. A total of 22 articles reporting 24 studies documenting correlations between peer attachment and self-esteem in adolescents and emerging adults were included in this meta-analysis. Of these studies, most examined links between global peer attachment and self-esteem, while few studies reported any associations between specific dimensions of peer attachment (i.e., trust, communication, and alienation) and self-esteem. Results showed significant correlations between peer attachment and self-esteem, consistently found both in studies focused on global attachment as well as in studies including specific attachment dimensions. Furthermore, since a significant heterogeneity was found across the studies, the effects of various categorical and continuous moderators related to characteristics of the study samples and designs were tested. Implications of these findings for future research are discussed.     

Empathy, counteridentification, countertransference: a review, with some personal perspectives on the "analytic instrument"

To understand the affect-laden psychological processes of patients in a fully informed way, analysts must be able to tolerate a regression in which their unconscious or primary-process modes of functioning are given full sway. With the aid of impressions acquired in this way, cognitive functions in the analytic task are provided with a kind of authenticity not otherwise achievable. There are potential problems that can interfere with the analyst's functioning in the desired manner, and an awareness of these problems is essential. Basic issues of theory and technique that are involved are considered herein.     

Peer review for journals: Evidence on quality control, fairness, and innovation

This paper reviews the published empirical evidence concerning journal peer review consisting of 68 papers, all but three published since 1975. Peer review improves quality, but its use to screen papers has met with limited success. Current procedures to assure quality and fairness seem to discourage scientific advancement, especially important innovations, because findings that conflict with current beliefs are often judged to have defects. Editors can use procedures to encourage the publication of papers with innovative findings such as invited papers, early-acceptance procedures, author nominations of reviewers, structured rating sheets, open peer review, results-blind review, and, in particular, electronic publication. Some journals are currently using these procedures. The basic principle behind the proposals is to change the decision from whether to publish a paper to how to publish it. The author, a professor of marketing at the Wharton School since 1968, was a founder editor of the Journal of Forecasting and the International Journal of Forecasting. This paper is based on a presentation at a workshop, “Advances in Peer Review Research”, American Association for the Advancement of Science Meeting, Baltimore, MD, February 9, 1996.