Psychoanalytic supervision of the difficult patient

Control cases from the broad group of non-neurotic but potentially analyzable patients appear with increasing frequency. The intense, complex transferences they develop place great stress on the psychoanalytic relationship and evoke marked countertransference reactions in psychoanalytic candidates, which reverberate within the supervisory relationship. Through application of a case study method, common themes emerge in the candidate-supervisor dyad: idealization of the supervisor and of classical technique, identification with the patient, parallel process enactments, difficulty maintaining the analytic frame, and the importance of concurrent training analysis. Classical supervisory techniques must be adapted to the "difficult" (non-neurotic) control case. Complex countertransference issues must be carefully addressed while maintaining the teach/treat boundary.     

Group psychotherapy of the characterologically difficult patient

A broad range of characterologically difficult patients present for treatment in psychotherapy groups. Despite different clinical presentations, including features of the schizoid, borderline, and narcissistic personality disorders, these patients share a common developmental failing. Specifically, these individuals have failed to attain object constancy and the associated stable internalization of tolerably ambivalent representations of the self, and of the other, in relationship with one another. Splitting mechanisms predominate over integrative ones, as primitive defenses are utilized to deal with the individual's powerful needs and fears related to engagement and intimacy. These maladaptive interpersonal styles are clearly illuminated in group therapy, but often to the exclusion of the latent, intrapsychic derivatives of this behavior, with detrimental effects. This paper examines the group therapy of such patients from the perspective of object relations and self psychology theories, models that provide the essential link between the interpersonal and the intrapsychic worlds.     

Acquisition of expertise on a difficult perceptual-motor task by an amnesic patient

While numerous studies have reported learning of perceptual-motor skills by amnesic patients, few if any have documented the eventual acquisition of expertise on a given task. This paper recounts the learning of the computer game Tetris by a hippocampal amnesic, whose acquisition of the task in a formal evaluation was somewhat slower than that of a comparison group, but who after many hours of self-paced practice achieved expert-level play.     

Reconceptualizing difficult groups and difficult members

Group leaders can expect to encounter group and member behaviors and attitudes that are usually termed as difficult. This article presents a different perspective that focuses on how the group leader can better understand and make visible what the troubling behavior is communicating about unspoken or unconscious needs, fantasies and desires. Suggestions for more effective interventions are proposed.     

Issues in engaging high-risk adolescent mothers in supportive work

This paper focuses on the identification of the factors associated with the productive and unproductive use of supportive and therapeutic services by high-risk teen parents. Referral and treatment data were analyzed and discussed, as were two case studies. The importance of family support and family relationships to the use of services is highlighted in both the statistical and clinical data. Treatment implications are discussed.     

Why Skinner is difficult

Skinner's views are commonly misrepresented. One reason for this difficulty is that changes in the way that Skinner formulated his views occurred in a gradual evolution over time throughout Skinner's career, and the changes and their significance were not as conspicuously marked as they might have been. Among these changes were a movement from a two-term necessity to a three-term contingency; a movement from discriminative stimulus to setting as the first term in his three-term contingency; and a movement from determinism to random variation as a foundational principle in his selectionist behaviorism. When not seen in their historical development over time, a sample reading of Skinner's views may readily result in misleading or inaccurate interpretations, particularly in respect to his later work. Seen in historical context, however, the accounts that survived after the changes Skinner made are well integrated in a selectionist theory of behavior.     

Learning beyond the surface: engaging the cognitive,affective and spiritual dimensions within the curriculum

In Australia the separation of mind, body and spirit by secular society has had a significant influence on educational trends. An outcomes‐based approach to education, with an emphasis on cognitive learning, has meant that the affective and spiritual dimensions of students' lives have often been understated. Classroom programs in religious education have been affected by this educational climate where the pendulum has swung in favour of the achievement of cognitive learning outcomes. The cognitive dimension of learning is an integral part of the learning dynamic. However the roles of thinking, feeling and reflecting/intuiting are complementary within this process. Religious education is one curriculum area that can effectively address the interplay between the cognitive, affective and spiritual dimensions of learning. This paper outlines a model explored with pre‐service teachers at a publicly funded Catholic university. This model addresses the complementarity of the cognitive, affective and spiritual dimensions of learning. Examples of pre‐service teachers' work are drawn upon to demonstrate the interplay of these dimensions and to show how in practice this might be achieved within school curricula.     

Advantages of difficult tasks1

If people work on a hard task before proceeding to one of intermediate difficulty, success will be relevant (predictive of future success) while failure will be irrelevant (not predictive of future failure). However, if they work first on an easy task, success will be irrelevant (not predictive of future success) while failure will be relevant (predictive of future failure). Previous research thus suggests that experience with hard tasks should always lead to more favorable evaluations of one's performance and better future performance than experience with easy tasks. The present study tested these predictions by manipulating initial expectancy (high or low), perceived difficulty of a set of practice problems (practice problems easier, harder, or equal in difficulty to those on a subsequent test), and practice problem feedback (success or failure). As predicted, experience with hard practice problems was most beneficial, regardless of the level of the feedback which students received. This was more true for males than females and for students with high ability than students with low ability.