Implicit relational knowing: Its role in development and psychoanalytic treatment

It is increasingly apparent that “something more” than interpretation is needed to bring about change in psychoanalytic treatment. Drawing on clinical and developmental observations, we propose that interactional processes from birth onward give rise to a form of procedural knowledge regarding how to do things with intimate others, knowledge we call implicit relational knowing. This knowing is distinct from conscious verbalizable knowledge and from the dynamic unconscious. The implicit relational knowing of patient and therapist intersect to create an intersubjective field that includes reasonably accurate sensings of each person's ways of being with others, sensings we call the “real relationship.” This intersubjective field becomes more complex and articulated with repeated patient–therapist encounters, giving rise to emergent new possibilities for more coherent and adaptive forms of interaction. During a transactional event that we term a “moment of meeting,” a new dyadic possibility crystallizes when the two persons achieve the dual goals of complementary fitted actions and joint intersubjective recognition in a new form. We argue that such moments of meeting shift the relational anticipations of each partner and allow for new forms of agency and shared experience to be expressed and elaborated. © 1998 Michigan Association for Infant Mental Health     

Bullying among siblings: The role of personality and relational variables

This study aimed to investigate: (1) the influence of gender, sibling age, and sibling gender on sibling bullying and victimization; (2) the links between personality characteristics, quality of the sibling relationship, and sibling bullying/victimization; (3) the association between sibling and school bullying/victimization, and the direct and indirect associations between personality variables and school bullying/victimization. The sample comprised 195 children (98 boys and 97 girls, aged 10–12 years). Instruments included: a self‐report questionnaire for bullying and victimization, the Big Five Questionnaire for Children and the Sibling Inventory of Behaviour. Results highlighted that the presence of an older brother is a risk factor for the emergence of sibling victimization. For both boys and girls, high levels of conflict in the dyad and low levels of empathy were significantly related to sibling bullying and sibling victimization. For males, energy was associated with sibling bullying and indirectly to school bullying; friendliness and high emotional instability were directly associated with school bullying. School victimization was directly associated with emotional instability for both males and females. Finally, both sibling bullying and sibling victimization were associated with bullying and victimization at school. The discussion highlights the role of a multi‐contextual approach to understand and prevent bullying.     

The role of relational information in contingent capture

On the contingent capture account, top-down attentional control settings restrict involuntary attentional capture to items that match the features of the search target. Attention capture is involuntary, but contingent on goals and intentions. The observation that only target-similar items can capture attention has usually been taken to show that the content of the attentional control settings consists of specific feature values. In contrast, the present study demonstrates that the top-down target template can include information about the relationship between the target and nontarget features (e.g., redder, darker, larger). Several spatial cuing experiments show that a singleton cue that is less similar to the target but that shares the same relational property that distinguishes targets from nontargets can capture attention to the same extent as cues that are similar to the target. Moreover, less similar cues can even capture attention more than cues that are identical to the target when they are relationally better than identical cues. The implications for current theories of attentional capture and attentional guidance are discussed.     

Thinking about the future early in life: The role of relational memory

The constructive episodic simulation hypothesis suggests that we imagine possible future events by flexibly recombining details of past experiences to produce novel scenarios. Here we tested this hypothesis by determining whether episodic future thinking is related to relational memory ability during the preschool years. Children (3- to 5-year-olds) were asked to remember a past event and imagine a possible future event using an adapted version of the recombination paradigm. Relational learning and inference were assessed using a task adapted from the neuroimaging literature. The results show that preschoolers were able to describe both past and possible future events; however, they produced more specific episodic details in relation to past events relative to future events. Episodic future thinking performance was correlated with performance on the relational inference task, consistent with the idea that the ability to flexibly recombine relational knowledge is critical in episodic future thinking.     

Day treatment of patients with personality disorders: experiences from a Norwegian treatment research network

This study sought to investigate the following research questions: Are time-limited day treatment programs for patients with personality disorder (PD) effective outside resourceful university settings, and what are the overall treatment results when the program is implemented on a larger scale? Do all categories and subtypes of PDs respond favorably to such treatment? How intensive should such day treatment programs be? All patients (n = 1,244) were consecutively admitted to eight different treatment programs in the Norwegian Network of Psychotherapeutic Day Hospitals from 1993 to 2000. Altogether, 1,010 patients were diagnosed with PD. Avoidant, borderline, not otherwise specified (NOS), and paranoid PD were the most common conditions. SCID-II and MINI were used as diagnostic instruments. Outcome measures included GAF Global Assessment of Functioning, (GAF; American Psychiatric Association, 1994), SCL-90R, CIP, Quality of Life, work functioning and parasuicidal behavior, measured at admittance, discharge and 1-year follow up. The attrition rate was 24%. The number of dropouts did not improve over time. As a group, completers with PD improved significantly on all outcome variables from admittance to discharge and improvement was maintained or increased at follow up. Treatment results were best for borderline PD, cluster C patients, PD NOS and No PD, and poorer for cluster A patients. Units with a high treatment dosage did not experience better outcomes than those with a low treatment dosage (10 hours per week). Results from the University unit were not better than those from units at local hospitals or mental health centers.     

Trait correlates of relational aggression in a nonclinical sample: DSM-IV personality disorders and psychopathy

The implications of adult relational aggression in adults for personality pathology are poorly understood. We investigated the association between relational aggression and features of DSM-IV personality disorders and psychopathy in a sample of undergraduates (N = 220). In contrast to the childhood literature, we found no significant difference in relational aggression between men and women. Unlike overt aggression, which correlated about equally highly with features of all three personality disorder clusters, relational aggression correlated significantly more highly with features of Cluster B than Clusters A or C. In addition, even after controlling for overt aggression, relational aggression correlated significantly with features of psychopathy, although only with Factor 2 traits. With the exception of sadistic personality disorder features, gender did not moderate the relationship between relational aggression and personality pathology. Further research on the psycho-pathological implications of relational aggression in more severely affected samples is warranted.     

The role of categorical information in processing relational attributes

In two experiments, the effect of knowledge about relevant common taxonomic categories on judgments of relative magnitude was investigated. In Experiment 1, subjects judged the relative size of objects that belonged to the categoriesbuilding andanimal. The symbolic distance effect was smaller for between-category pairs (e.g.,horse-cabin) whose members could be classified more quickly into the two categories. This result strongly suggests that subjects used category membership to determine relative size on at least some portion of the trials. In Experiment 2, a similar attenuation of symbolic distance was obtained when subjects judged the relative height of furniture and vehicles. A simple explanation of the reduced symbolic distance effect for between-category pairs is that subjects occasionally fail to categorize the items into different categories and have to compute relative magnitude from the magnitudes of the two items. Fits to the data using the bootstrap technique suggest that more involved assumptions are required.     

The role of relational reasoning in children's addition concepts

The study addresses the relational reasoning of different‐aged children and how addition reasoning is related to problem‐solving skills within addition and to reasoning skills outside addition. Ninety‐two 5‐ to 8‐year‐olds were asked to solve a series of conceptually related and unrelated addition problems, and the speed and accuracy of all self‐reported strategies were used to monitor their addition performance. Children were also given a series of general relational reasoning tasks to assess their ability to solve problems based on thematic, causal and visual relations. The results revealed that, while children were able to reason about commutativity relations, recognition of relations based on additive composition was rare. Furthermore, children's ability to reason about addition concepts increased with age and problem‐solving proficiency. Reasoning about addition concepts was related to performance on the thematic, causal and visual reasoning tasks for older children but not for younger children. Overall, the findings suggest that while children's early knowledge of addition relations is domain specific, as children develop in their broader reasoning abilities these developments enhance their addition reasoning.     

Romantic involvement and depressive symptoms in early and late adolescence: The role of a preoccupied relational style

Two studies examined the association between depressive symptoms and romantic involvement in adolescence and tested the hypothesis that romantic involvement is associated more strongly with symptoms among adolescents who have a more preoccupied style of relating, compared to adolescents who have a less preoccupied style of relating. Study 1 (N = 96 early adolescent females) examined concurrent associations and Study 2 (N = 80 late adolescent males and females) examined longitudinal associations. In both age groups, romantic involvement was associated with greater depressive symptoms and this was most true among adolescents with a preoccupied style of relating. Implications for models of depression and adolescent romantic functioning are discussed.     

Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment

This paper is concerned with the psychopathological processes that account for the persistence of severe eating disorders. Two separate but interrelated lines of argument are developed. One is that the leading evidence-based theory of the maintenance of eating disorders, the cognitive behavioural theory of bulimia nervosa, should be extended in its focus to embrace four additional maintaining mechanisms. Specifically, we propose that in certain patients one or more of four additional maintaining processes interact with the core eating disorder maintaining mechanisms and that when this occurs it is an obstacle to change. The additional maintaining processes concern the influence of clinical perfectionism, core low self-esteem, mood intolerance and interpersonal difficulties. The second line of argument is that in the case of eating disorders shared, but distinctive, clinical features tend to be maintained by similar psychopathological processes. Accordingly, we suggest that common mechanisms are involved in the persistence of bulimia nervosa, anorexia nervosa and the atypical eating disorders. Together, these two lines of argument lead us to propose a new transdiagnostic theory of the maintenance of the full range of eating disorders, a theory which embraces a broader range of maintaining mechanisms than the current theory concerning bulimia nervosa. In the final sections of the paper we describe a transdiagnostic treatment derived from the new theory, and we consider in principle the broader relevance of transdiagnostic theories of maintenance.     

Integration of weight and distance information in young children: The role of relational complexity

Young children's integration of weight and distance information was examined using a new methodology that combines a single-armed apparatus with functional measurement. Weight and distance values were varied factorially across the item set. Children estimated how far the beam would tilt when different numbers of weights were placed at different distances from the pivot. There was a developmental progression from non-systematic responding (3-year-olds) to responding based on a single variable, usually weight (4-year-olds) to responding based on integration of weight and distance (5-, 6- and 7-year-olds). Individual analyses revealed additive and multiplicative integration rules in children aged from 5 years. Weight–distance strategy complexity increased with age and was associated with better performance on independent measures of relational processing, especially the more complex items. Thus weight–distance integration involves processing of complex relational information. The findings enhance the explanatory power of Relational Complexity theory as a domain-general approach to cognitive development.     

The use of the self in group leadership: a relational perspective

This article, written from a relational perspective, describes a shift that is taking place in the thinking of many psychodynamically oriented psychotherapists regarding the practice of therapy and the implications it has for group therapists. The shift, from one-person to two-person and multi-person theory, has particular importance for group leaders since it recommends making the subjective involvement of the therapist in the interactional field of the group much more a part of the treatment process. Theory and research on the use of countertransference, non-interpretive interventions, humor, and spontaneity by the leader are reviewed and vignettes are presented to illustrate the application of these ideas. Guidelines regarding the application of such ideas in group therapy are also discussed.     

Need-adapted treatment of schizophrenic processes: The essential role of family-centered therapy meetings

Need-adapted treatment is a psychotherapeutically oriented approach to psychoses that has been planned and is implemented individually in each case, combining different activities so that they meet the needs of each patient as well as the people making up her or his personal interactional network (usually the family). A systemic initial intervention, carried out as a conjoint session of the patient, the family members, and a team of 3–4 staff members is an essential part of this approach. The name therapy meeting was given to these sessions because of their notable therapeutic significance. Therapy meetings are often continued during the later phases of treatment to follow up the course of treatment and to reassess the therapeutic plans.