Some thoughts about thought disturbance in adolescence

One of the principal aims of adolescence is the development of the capacity to think for oneself. The authors explore the difficulties caused by disturbances of thinking in borderline adolescents, pointing out the role that the analyst can take in promoting better functioning of their patients' mental processes. Two cases are explored, one through a supervision and the other through direct clinical experience. Both illustrate the efforts of the analyst to carry out 'management in the area of thinking' with those borderline patients who have not received help from their parents to think, and still need to be shown how mentation takes place. The authors propose some changes in technique in order to implement this improvement, including sharing with the patient the way in which the analyst thinks about him. Thinking itself can be an important integrating factor for these patients.

Une des tâches principales de l'adolescence est de développer la capacité à penser par soi-même. Les auteurs explorent les difficultés occasionnées par des troubles de la pensée chez des adolescents borderline et soulignent le rôle que peut jouer l'analyste pour favoriser un meilleur fonctionnement des processus psychiques chez ces patients. Deux cas sont étudiés dans cet article ; dans l'un, le matériel est extrait de séances de supervision, dans l'autre, il est tiré directement de la situation thérapeutique. Ces cas mettent en évidence les efforts de l'analyste pour aider le patient à mieux fonder ses processus de pensée ; dans les états limites, le patient bien souvent n'a jamais pu bénéficier de l'aide de ses parents dans ce domaine et devra encore apprendre comment mettre en ?uvre l'idéation. Les auteurs proposent quelques modifications techniques afin de faciliter l'activité mentale chez ce type de patient, visant notamment à lui faire part de la manière dont son analyste pense à lui. La pensée en elle-même peut être un facteur important qui favorise l'intégration psychique chez ces patients.

Uno degli scopi principali dell'adolescenza e' lo sviluppo della capacita' di pensare per se stessi. Le autrici esplorano le difficolta' causate dai disturbi del pensiero in adolescenti borderline, sottolineando il ruolo che l'analista puo' avere nel promuovere un miglior funzionamento dei processi mentali dei loro pazienti. Vengono riportati due casi, uno attraverso l'esperienza di supervisione e l'altro attraverso l'esperienza diretta del lavoro clinico. In entrambi i casi viene illustrato lo sforzo dell'analista di portare avanti il 'management nell'area del pensare' con quei pazienti bordeline che non sono stati aiutati dai loro genitori a pensare, e che ancora hanno bisogno di capire come prende luogo il processo del pensare. Le autrici propongono dei cambiamenti nella tecnica per poter implementare tale miglioramento, compreso il condividere con il paziente il modo in cui l'analista pensa a lui. Il pensare puo' essere di per se' un importante fattore di integrazione per questi pazienti.

Eines der Hauptziele der Adoleszenz ist die Entwicklung der Fähigkeit, für sich selber zu denken. Die Autorinnen betrachten die Schwierigkeiten, die durch Denkstörungen bei Borderline- Jugendlichen verursacht werden, und stellen die Rolle heraus, die Analytiker einnehmen können, um ein besseres Funktionieren der mentalen Prozesse ihrer Patienten zu fördern. Es werden zwei Fälle betrachtet, einer durch Supervision und der andere durch direkte klinische Erfahrung. Beide illustrieren die Bemühungen der Analytikerin, 'Management im Bereich des Denkens' auszuführen mit diesen Borderline-Patienten, die von ihren Eltern keine Unterstützung zu denken erlangt hatten, und denen noch gezeigt werden muss, wie Denkprozesse stattfinden. Die Autorinnen schlagen einige Veränderungen in der Technik vor, um diese Verbesserung zu implementieren, einschliesslich dem, dass man dem Patienten mitteilt, wie die Analytikerin über ihn denkt. Denken selbst kann ein wichtiger integrierender Faktor für diese Patienten sein.     

日本安乐死立法之考察与研究

日本成文法律目前尚无关于安乐死的明确规定,但是一些典型的判例已经对安乐死合法的条件做出了界定。日本社会和民众绝大多数能够接受消极安乐死,但是强烈反对积极安乐死。积极安乐死属于日本刑法上的杀人罪行为,但是量刑较轻。     

Some thoughts on the diffusion of psychoanalysis: the group dimension, ethics and the sense of identity

In this paper the author questions some of the ways in which psychoanalysis is passed on to the wider public, one of which is sometimes evocative of the sales promotion of a consumer product in contemporary society. This methodology does not give sufficiently deep prior thought to the eventual consequences of side effects. The detailed exposition of clinical cases, for example, raises sensitive ethical issues, even when anonymity is preserved. Although it is true that making information about Freud's theories more widely available may indeed encourage people to think about training as psychoanalysts, it is noticeable that this process is sometimes considered to be a form of training in itself. Some participants feel that acquiring a psychoanalytical vocabulary and reading clinical reports form a sufficient basis for practising thereafter as psychotherapists, both in institutional contexts and in private practice. The absence of group work on the part of the organizers might explain why closer study is not made of the methodologies of transmission and the different levels that it involves. This is sometimes due to the absence of a common object, formed within and by the group, and to the emergence of manic defences in the group.     

Some introductory thoughts

Education must be a central part of the building of Europe: because access to knowledge can overcome the dangers of exclusion, but also because education offers the key to citizenship and thereby to the future of Europe.     

Some thoughts about a scientist-practitioner approach to assessment training in counselling psychology

Training effective scientist-practitioners has long been an issue of concern in counselling psychology. In a recent paper, Friedlander (1992) developed a useful prototype to foster science-practice integration in a counselling seminar. Drawing on Friedlander's prototype, the question of “how to foster science-practice integration in assessment” is considered. Some assessment reading lists and class exercises designed to illustrate such integration are proposed. These teaching materials are presented: (a) in hopes that they might prove useful for some assessment instruction purposes; and (6) in hopes that they might stimulate further thinking about how to best foster science-practice integration in counselling psychology assessment courses.     

Beliefs about obsessional thoughts

Recent cognitive-behavioral formulations of obsessive-compulsive disorder postulate that intrusive or obsessional thoughts are subject to appraisal. Extreme beliefs about the occurrence and meaning of intrusive thoughts direct appraisal, thus causing marked distress and subjective responsibility which may lead to neutralizing activity. A brief self-report belief inventory was developed from a 92-item pool to assess extreme beliefs concerning intrusive thoughts and responsibility, the control of such thoughts and their possible consequences, and the appropriateness of guilt and neutralizing behavior as a response. The inventory was developed sequentially on two nonclinical samples (N=125, N=265) to distinguish between neutralizing and nonneutralizing subjects. Initial psychometric data for the final instrument were obtained for two further nonclinical samples (N=61, N=50) along with a sample of OCD patients and a matched control group. The instrument showed satisfactory reliability and evidence of criterion, convergent, discriminant, and factorial validity. Finally, data from a heterogeneous outpatient medical sample (N=299) was used to test the relationship among obsessive-compulsive symptoms, mood state, and beliefs. The implications of these results for contemporary models of obsessive-compulsive disorder are discussed.     

Some thoughts on empathy and countertransference

Two aspects of countertransference-namely, the countertransference reaction and empathic understanding-must be distinguished. The term countertransference should be reserved exclusively for the conscious reactions of the analyst emerging from the preconscious by virtue of the patient's current transferences; the term empathy should be used to denote a perspective whereby the analyst employs current countertransference reactions for an understanding of the patient's inner life.