The Executive Manager and His or Her Organisation

Thoughts based on an inquiry and on experiences from my practice as a consultant, manager and company executive.     

A Research Inquiry into Some American Women's Sexual Concerns and Problems

Abstract

The New View of Women's Sexual Problems is supported by findings of the 1993-94 Ellison/Zilbergeld sexuality survey of 2,632 mostly white, college-educated women born 1905-1977 (Ellison, 2000; see questionnaire at www.womenssexualities.com). Sexual experiences of women with previous year sexual partners are reported. The most important sexual concerns or problems in the previous year of 1,637 women are categorized: 34% desire/frequency (low sexual desire, desire discrepancy); 28.5% physical responsiveness (female arousal, orgasm; male partners' erectile difficulties, ejaculatory control); 16% lovemaking (sexual technique); 7.5% finding a partner; < 5% sexual relationship, fertility, pregnancy, STDs/safe sex, the woman's body/health, non-monogamy, orientation; 547 others reported none. Exemplary quotes from respondents are included. Sex therapy for low sexual desire is addressed. Recommended solutions emphasize individual differences and the multidimensionality of sexuality.     

Patient and Family Descriptions of Ethical Concerns

Abstract

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants (N?=?196) described 219 unique ethical experiences that spanned many of the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting.     

Genetic Counselors' Judgments of Patient Concerns: Concordance and Consequences

The aims of this prospective study were to determine (a) the concordance between patient concerns and genetic counselors' judgments of these concerns, (b) the predictors of patient and counselor judgments, and (c) the relationship between concordance and patient outcomes. Patients' and counselors' views were sought before and after 131 routine genetic consultations. Before consultations, there was concordance about level of patient concern to within one point in 63% (82/131) of consultations and about type of patient concern in 60–84% of consultations. Lack of concordance in judging level and type of concern was associated with lower satisfaction with information and higher anxiety after the consultation. The biggest predictor of counselor judgment of concern was professional background: doctors judged patients to be more concerned than did nurses. Concordance of concern was predicted by counselors' experience in genetics: less experienced counselors overestimated patient concern. Future research needs to determine whether improving judgment of concern improves patient outcome.     

Sexual Assault: The Female Victim,Her Male Partner,and Their Relationship

Using the Crisis model of Fox and Scherl, treatment issues for the female sexual assault victim and her male partner are proposed.     

Treating the Sexual Concerns of Adult Incest Survivors and Their Partners

SUMMARY

Negative attitudes about sex and sexuality and many types of sexual dysfunction are common aftereffects of sexual child abuse and incest. The traumatic sexualization and the aversive sexual conditioning resulting from childhood abuse have long gone unrecognized, however. This article presents research findings regarding the impact of incest on sexual attitudes and functioning along with treatment recommendations.     

1例晚期肿瘤患者宁养服务浅谈

通过提供居家宁养护理指导和心理疏导的方法,为晚期癌症患者提供身、心、灵全方位的照顾,从而提高晚期癌症患者的生活质量。通过对1例晚期肿瘤患者进行症状控制、护理指导、心理疏导、灵性沟通,该晚期肿瘤患者及家属的自身照顾能力提高,晚期肿瘤患者在生命末期的生活质量有所提高,最终达到善终。身心灵的照顾在宁养服务中起重要作用,有利于患者生活质量的提高,但仍要根据患者的个体特点并掌握一定技巧。     

His and Her Perspectives: Gender Ideology, Work-to-Family Conflict, and Marital Satisfaction

This study examines the relationships between gender ideology, work-to-family conflict, and marital satisfaction. We hypothesize that gender ideology will moderate relationships between both the respondent’s work-to-family conflict and their spouse’s work-to-family conflict in predicting marital satisfaction, and that spouses’ gender ideologies will interact in predicting marital satisfaction. The hypotheses are addressed using data from a random sample of U.S. dual-earner couples (N?=?156) in a western state. The findings indicate that the more egalitarian women’s gender ideologies, the stronger the negative relationship between women’s marital satisfaction and women’s work-to-family conflict. The results also indicate that the dependence of men’s marital satisfaction on wives’ gender ideologies varies according to men’s own gender ideologies. Implications of the study are discussed.     

Her Body Speaks: The Experience of Dance Therapy for Women Survivors of Child Sexual Abuse

This qualitative, phenomenological study explores the experiences of dance therapy for 5 women who had been sexually abused as children. Using in‐depth, largely unstructured interviews, the women reflect on their dance therapy experiences and on their perceptions of the role of these experiences in their psychological healing. Analysis of these data revealed 6 common themes related to the women's sense of spontaneity, permission to play, struggle, freedom, intimate connection, and bodily reconnection. The implications of the findings are discussed in terms of the therapeutic nature of dance therapy and how this therapeutic modality facilitates change and healing in clients' lives.     

Her Mother Her Self: The Ethics of the Antigone Family Romance

This essay discusses the implications of Irigaray's readings of the Antigone in the construction of a feminist ethics. By focusing on the gaps and intersections between Lacanian psychoanalysis and Hegelian phenomenology as formulative of Irigaray's eventual call for an ethics of sexual difference, 1 emphasize the inevitability of rethinking the functions of historicity, femininity, and maternity in the formation of new models of intersubjectivity.     

Brief Report: The Sexual Harassment of Faculty Members by Students

We investigated sexual harassment by college students toward faculty members using modified versions of the Sexual Experiences Questionnaire (SEQ) developed by Fitzgerald and colleagues. The SEQ measures three major constructs of sexual harassment: gender harassment, sexual coercion (bribery), and unwanted sexual attention. The student version of the SEQ was completed by 359 college students (85% White); 102 faculty members (92% White) completed the faculty version. Although we did not ask about their social class, they are typically middle class. Female faculty reported experiencing significantly more unwanted sexual attention from students and were more bothered by it than male faculty. While the frequency of gender harassment did not differ significantly between male and female faculty, the latter were significantly more bothered by it than the former. Concerning students' responses to the SEQ, there were no significant gender differences. Sexual harassment as both a tool and a result of male dominance in society is discussed.     

Influence of Cognitive Factors on Sexual Assault Recovery: Descriptive Review and Methodological Concerns

This article aims to verify whether the empirical data presented in the literature on sexually assaulted victims support the hypothesis advanced by various aetiological models, which is that cognitions play an important role in the development and maintenance of Post-Traumatic Stress Disorder. The first objective is to present state-of-the-art results on sexually assaulted victims' post-traumatic cognitions and their link to post-assault symptomatology. The second objective is to analyse the various methodological facets of those studies. Finally, paths for future studies are traced and recommendations are made.     

The Unseen Spouse: Pitfalls and Possibilities for the Individual Therapist

Individual therapists often hear a great deal about our patients' spouses or partners, and naturally develop ideas and beliefs about that unseen other and about the causes of any relationship difficulties the patient reports. Not uncommonly, therapists can lose touch with the fact that their impressions of an unseen spouse are constructions that have emerged from the transference/countertransference field, based on only partial or limited information—not veridical truths. They can then talk with the patient about his or her partner or relationship issues in ways that can ultimately do both patient and spouse a significant disservice and perhaps distract from the patient's own issues and analytic goals. This paper discusses several factors that seem to contribute to the development of this problematic dynamic, including various qualities of the transference/countertransference field, and offers suggestions for avoiding or reducing it. Clinical material is used to illustrate key points.     

On the Patient's Becoming an Individual: The Importance of the Analyst's Personal Response to a Deprived Patient and Her Dreams

What patients mainly want—which Ferenczi noted as early as 1932 in his clinical diary and which Bion later expressed in his Cogitations (1992)—and what some patients need, is to experience how the analyst lives and processes the interpersonal events that lie at the origin of their affective and mental suffering. This is especially true with schizoid patients who were profoundly emotionally deprived in childhood. In this paper, the author investigates this crucial aspect of the intersubjective analytic relationship in his treatment of just such a patient, an extremely silent and inert young woman. Through a detailed examination of clinical material from various stages of her analysis, he explores how the analyst's unconscious emotional response serves as both a tool for comprehension and a key element of environmental facilitation—a “new beginning,” to use Balint's phrase—that may help the patient attain a level of development and emancipation that he or she has never experienced before.     

The First Man in Her Life: Father Emotional Responsiveness During Adolescence and College Women's Sexual Refusal Behaviors

Few empirical studies have examined how fathers influence daughters’ sexual interactions with male peers. We hypothesized that paternal emotional responsiveness would empower daughters to refuse unwanted sex. Female undergraduates (N = 144) and their fathers completed measures of paternal responsiveness during adolescence; daughters also reported their global self-worth, acceptance of male partner dominance, and sexual refusal behaviors. As expected, paternal responsiveness promoted daughters’ refusals of unwanted sex. Paternal responsiveness predicted daughters’ self-worth, partially explaining daughters’ increased sexual assertiveness. Perceived paternal responsiveness also negatively predicted daughters’ acceptance of male dominance. These results suggest that positive paternal relationships promote daughters’ sexual agency.     

Private Terrors Sexualized Aggression and a Psychoanalyst's Fear of Her Patient

This clinical paper explores the meanings and evolution of an analyst's reaction of fear in relation to her patient's sexualized aggression. From both an intrapsychic and an intersubjective perspective, the author analyzes the coconstruction of this transference—countertransference phenomenon. Case vignettes illustrate the author's attempts to address her patient's sexualized aggression while struggling to free herself from the feelings of intimidation and fearfulness stirred by his sadomasochistic fantasies and patterns of interaction. The analyst's unconscious identification with the patient's disowned femininity and narcissistic vulnerability is seen as central to this countertransference “stranglehold.” Release from the analyst's masochistic position comes through a shift in her own affective participation. The importance of the analyst's recognizing her own unconscious contributions to this sadomasochistic dynamic is emphasized and elaborated. Discussion also focuses on the relevance of gender to the issue of countertransference fear, as illustrated in this particular male patient—female analyst dyad.     

Couple Therapy for Depression Within a Naturalistic Setting in Finland: Factors Related to Change of the Patient and the Spouse

The study examined factors related to change in treatments for depression in couple therapy (CT; N = 29) and treatment-as-usual (TAU; N = 22). Treatments were adapted in accordance with the patient’s need. The patients’ depressive symptoms, general mental health and marital satisfaction were assessed at baseline and at 6 months post-baseline. The Hamilton Depression Rating Scale, the Beck Depression Inventory (BDI), the Symptom Check List-90, and the Dyadic Adjustment Scale (DAS) were used for the patients. The BDI and the DAS were used for the spouses. The couples in CT group assessed their subjective distress (SD) at every session by using the Outcome Rating Scale. The results showed that the spouses’ gender, the spouses’ depressive symptoms at baseline, and the number of therapy sessions were related to differing changes in the CT and TAU groups at the 6-month post-baseline assessment. The spouses in the CT group demonstrated a higher treatment response than those in the TAU group. In the CT group, the spouse’s benefit from the treatment was related to SD at the outset on the part of either the patient or the spouse or both. The change in the patient’s SD predicted the patient’s change in depressive symptoms, general mental health, and was associated with the patient’s change in marital satisfaction. The study emphasizes the importance of the spouse’s involvement in the treatment of depression, the provision of feedback on SD, and discussion of individual well-being and relational issues, in addition to the focus on depression.