Perceiving subjectivity in bodily movement: The case of dancers

This paper is about one of the puzzles of bodily self-consciousness: can an experience be both and at the same time an experience of one′s physicality and of one′s subjectivity? We will answer this question positively by determining a form of experience where the body′s physicality is experienced in a non-reifying manner. We will consider a form of experience of oneself as bodily which is different from both “prenoetic embodiment” and “pre-reflective bodily consciousness” and rather corresponds to a form of reflective access to subjectivity at the bodily level. In particular, we argue that subjectivity is bodily expressed, thereby allowing the experience of the body′s subjectivity directly during perceptual experiences of the body. We use an interweaving of phenomenological explorations and ethnographical methods which allows validating this proposal by considering the experience of body experts (dancers).     

Children with Autistic Spectrum Disorders: Individual Differences,Affect, Interaction,and Outcomes

In this article, we have drawn upon the attachment motivational system (Bowlby, 1988; Lichtenberg, 1989; Shane, Shane, and Gales, 1997) as a guide to providing “positive new experience” as the cornerstone of therapeutic progress. We see positive new experience as paramount, over and above insight and/or interpretation because insight and interpretation are so varied among different theories. The common denominator that is effective in therapy, then, must be something beyond insight and interpretation. We call that therapeutic factor the positive new experience and will draw from attachment theory to understand its components. In addition, using the attachment motivation system and trauma research, we elaborate on why certain types of negative experiences in psychotherapy and psychoanalysis should be avoided. We address, in particular, harmful repetitions of traumatic relational patterns or traumatic events in the transference, overemphasis on “the empathic stance,” and the search for motivation in patients' behaviors where such a search may be based on the false assumption that all behavior is motivated. This latter category addresses aspects of behaving that may not be motivated; that is, they just “are,” and as such, the search for and attribution of meaning in such instances may lead to failed understanding and insight and to faulty correctives. We have illustrated with clinical examples both positive new experience and three types of negative experiences to be avoided in treatment.     

Hypnotic experience and the autism spectrum disorder. A phenomenological investigation

In recent decades, the focus in autism research progressively expanded. It presently offers extensive material on sensorimotor disturbances as well as on perceptive-cognitive preferences of people with autism. The present article proposes not only a critical interpretation of the common theoretical framework in autism research but also focuses on certain experiences common to some people with autism and which can be appropriately understood by phenomenology. What I will call “hypnotic experiences” in autism are moments in which some individuals withdraw into intense sensorial and perceptive experiences. Following their examples, I use the term “hypnosis” primarily to describe a trance state in which the individuals become highly alert to and awake for an experience of a totally new kind. Through a close analysis of autobiographical writings from people with autism I defend the idea that the particularity of hypnotic experiences in autism consists in a certain qualitative shift within experience itself: what changes, in the hypnotic moments, is the way a person with autism relates to his/her own bodily experiences. If this qualitative shift is indeed difficult to account for within a reifying and intellectualist research perspective, phenomenology offers a large conceptual framework for understanding it. Phenomenology, and precisely, phenomenological psychopathology, will thus emerge as a major device in accounting for such “hypnotic experiences”. The argument mainly draws on the twofold structure of experience which is traditionally used in phenomenological research: it claims that in hypnotic experience people with autism are inclined to focus on non-reified “sensings”, “perceivings” and “movings”, and thus leave aside the object itself and any intentional reification of it. Finally, I will claim that this restriction to mere non-reified sensings might lead to a completely new conception of self and world. In the hypnotic experiences of autism, neither the subject nor the object come to a full-blown and independent existence. A thorough phenomenological analysis of hypnotic experience in autism therefore also has to face the question of a corresponding ontology of these experiences.     

Listening to Somatosensory States in Psychoanalysis: Body,Trauma, and Poetry

ABSTRACT

The author starts from the apparently outdated James-Lange theory of emotion to rediscover elements of modernity for contemporary psychoanalysis: from James’ bodily-sensory dimension to Damasio’s “feeling of what happens,” to Bucci’s attention to the patient’s visceral narrative in session. William James stated that bodily sensations are the first elements on the path toward consciousness. Damasio emphasizes that “Consciousness is rooted in the representation of the body”. Bucci presents a framework for identifying linkages between bodily and symbolic states and to observe the various degrees of patients’ “visceral speech” in session. These parallels support a sensibility to listen to language as the voice of the body: the relationship between the patient’s narrative and the bodily-sensory dimension can be grasped through the patient’s “imagery” which may reference earlier somatic experience. Particular emphasis is given to the story-telling of trauma.     

Engaging the consumer: The science and art of the value creation process

Regulatory engagement theory [Higgins, E. T. (2006). Value from hedonic experience and engagement. Psychological Review, 113, 439–460.] proposes that value is a motivational force of attraction to or repulsion from something, and that strength of engagement contributes to value intensity independent of hedonic and other sources of value direction. This paper reviews different sources of engagement strength, including dealing with challenges by opposing interfering forces and overcoming personal resistance, preparing for something that is likely to happen, and using “fit” or “proper” means of goal pursuit. We present evidence that each of these sources of engagement strength can intensify the value of something, and we show how stronger engagement can not only make something positive more positive but also make something negative more negative. We also discuss how these effects of stronger engagement on the value of something else are independent of actors' own personal experiences during goal pursuit. We then broaden regulatory engagement theory by describing the nature of these personal experiences from different sources of engagement strength—distinct positive experiences (e.g., feeling “pleasure” vs. feeling “right”) and distinct negative experiences (e.g., feeling “tension” vs. feeling “defiance”)—and consider the science and art of combining them with engagement strength for maximal persuasion and influence.     

Evidence-Based Therapist Responsivity to Disruptive Clinical Process

Although a historically prominent model of evidence-based practice (EBP) privileges the faithful delivery of single empirically supported treatment (EST) packages, psychotherapy research demonstrates that therapist adherence to an EST is often unrelated to patient outcome. Additionally, perseverative adherence when facing disruptive clinical process can relate to worse outcomes. In contrast, unmanipulated within-case variability in adherence, or the natural incorporation of theoretically “off-brand” interventions into an EST, can associate with more improvement. Further supporting the value of therapist flexibility, treatments that intentionally integrate theory-informed departures (away from the foundational EST) vis-à-vis specific disruptive clinical processes can outperform the standard EST without such departures. Thus, responsively adjusting treatments, such as cognitive-behavioral therapy (CBT), to patients’ contextualized pathology, characteristics, and momentary interactions with the provider may represent a more empirically well-supported form of EBP. Consistent with these ideas, we present an overview of context-responsive psychotherapy integration (CRPI), an approach to EBP in an if-then key. CRPI frames common factors as typical and potentially disruptive clinical “if” situations that therapists will encounter and to which they “then” need to be responsive beyond strict adherence to any EST. Notably, such departures can be temporary, thereby supporting vs. replacing the primary EST interventions. To illustrate CRPI’s application to practice, we focus on one example of patient resistance to CBT as a contextual process marker and motivational interviewing as a theory- and evidence-informed departure response. We also discuss clinical, cultural, empirical, and training considerations from the CRPI perspective.     

Seeking the Pathos of God in a Secular Age: Theological Reflections on Mystical Experience in the Twentieth Century

Our current context is a “moving” and unstable one. We are facing not only a time of change, but what Pope Benedict XVI terms “an epochal change.” The impact of this transformation upon religion is unmistakable. In this article I reflect on one aspect of this impact: the one that affects and transforms the experience of God, also called mystical experience. I explore the concept of experience, trying to give a more precise idea of what we understand by mystical experience. I then reflect on the importance of mystical biographies and narratives to theology, including the particular characteristics that emerge when this narrative is about the mystical experiences of twentieth‐century people of faith. I present the specific “case” of Dorothy Day as an exemplification of mystical experience. I conclude with several reflections about how human beings find the way towards God in our secular.     

Brief Acceptance and Commitment Therapy and Exposure for Panic Disorder: A Pilot Study

Cognitive and biobehavioral coping skills are central to psychosocial therapies and are taught to facilitate and improve exposure therapy. While traditional coping skills are aimed at controlling maladaptive thoughts or dysregulations in physiology, newer approaches that explore acceptance, defusion, and values-based direction have been gaining interest. Acceptance and Commitment Therapy (ACT) involves creating an open, nonjudgmental stance toward whatever thoughts, feelings, and bodily sensations arise in a given moment, experiencing them for what they are, and moving toward them while inner experiences such as anxiety are present. This approach can be seen as consistent with exposure therapies and may be utilized to organize and facilitate engagement in exposure exercises. This study examines the feasibility and efficacy for combining a brief ACT protocol with traditional exposure therapy. Eleven patients with panic disorder with or without agoraphobia received 4 sessions of ACT followed by 6 sessions of exposure therapy, with data collected on a weekly basis. Acquisition of ACT skills and their application during exposure was monitored using a novel “think-aloud” technology. Treatment was associated with clinically significant improvements in panic symptom severity, willingness to allow inner experiences to occur, and reductions in avoidant behavior. Although preliminary, results suggest that our brief training in ACT only (as assessed prior to exposure exercises) and in combination with exposure therapy was acceptable to patients and offered benefits on the order of large effect sizes. Clinical and research implications are discussed.     

Intuiting the Process of Another: Symbolic,Rational Transformations of Experience

In experiential personal construct psychotherapy (Leitner, 1988) the establishment of a ROLE relationship between the therapist and client is of primary importance. This is done through -approaching the process that is the other. In this article the meaning of “approaching the process” is examined in terms of S. K. hanger's concept of nondiscursive, or presentational, symbolism. Patterns of behavior in relationships are seen as symbolic transformations of experience. Observing and experiencing these patterns of behavior are mays therapists can intuit the process of the other and enhance the creation of a ROLE relationship.     

Phenomenology of Bodily Integrity in Disfiguring Breast Cancer

In this paper, I explore the meaning of bodily integrity in disfiguring breast cancer. Bodily integrity is a normative principle precisely because it does not simply refer to actual physical or functional intactness. It rather indicates what should be regarded and respected as inviolable in vulnerable and damageable bodies. I will argue that this normative inviolability or wholeness can be based upon a person's embodied experience of wholeness. This phenomenological stance differs from the liberal view that identifies respect for integrity with respect for autonomy (resulting in an invalidation of bodily integrity's proper normative meaning), as well as from the view that bodily integrity is based upon ideologies of wholeness (which runs the risk of being disadvantageous to women). I propose that bodily integrity involves a process of identification between the experience of one's body as “Leib” and the experience of one's body as “Körper.” If identification fails or is not possible, one's integrity is threatened. This idea of bodily integrity can support breast cancer patients and survivors in making decisions about possible corrective interventions. To implement this idea in oncology care, empirical‐phenomenological research needs to establish how breast cancer patients express their embodied self‐experiences.     

The sensory nature of reward in instrumental behavior

Improvement in the sensory state, or “better-being,” achieved either through obtaining desirable sensations or through escaping undesirable sensations, is considered the essential value which maintains the instrumental behavior. This value may vary depending on such factors as the intensity of the stimulus producing sensations, the effects of its previous occurrence, and the changes in the internal and external environment. Methods of evaluation of sensory “better-being” by means of measuring instrumental, autonomic and EEG responses are discussed.     

A preliminary examination of the role of psychotherapist fidelity on outcomes of cognitive processing therapy during an RCT for military sexual trauma-related PTSD

While cognitive processing therapy (CPT) is an effective evidence-based treatment for many veterans with military-related post-traumatic stress disorder (PTSD), not all veterans experience therapeutic benefit. To account for the discrepancy in outcomes, researchers have investigated patient- and research design-related factors; however, therapist factors (e.g. fidelity) have received less attention. The present study is a preliminary examination of the effect of psychotherapists’ fidelity during CPT on clinical outcomes during a randomized clinical trial (RCT) for military sexual trauma-related PTSD. PTSD symptoms, trauma-related negative cognitions (NCs), and depression symptoms were assessed for 72 participants at baseline, and 1-week, 2-month, 4-month, and 6-month posttreatment. Of the four CPT therapists, two were found to have significantly poorer (i.e. “below average”) treatment fidelity scores compared to the other two therapists who had “good” treatment fidelity scores. To examine possible therapist effects on outcomes, hierarchical linear modeling was utilized with therapist fidelity entered as a Level 2 predictor. Participants treated by a therapist with “good” treatment fidelity experienced significantly greater reductions in PTSD symptoms, NCs, and depression symptoms than patients treated by a therapist with “below average” treatment fidelity. Our preliminary findings highlight the importance of monitoring, maintaining, and reporting fidelity in psychotherapy treatment RCTs.     

重要还是笨重?——概念表征对重量具身效应的影响

本研究考察在"重量-重要性"和"重量-灵活性"两种情境下重量具身效应的表现,进而探讨概念表征对具身效应所产生的影响。实验结果表明,在"重量-重要性"情境下,被试认为重鼠标的价格显著大于轻鼠标的价格,并且更容易将重鼠标与高价值货币,轻鼠标与低价值货币建立联系,表现为经典的"重量-重要性"具身效应;而在"重量-灵活性"情境下,被试认为重鼠标的价格显著小于轻鼠标的价格,并且鼠标重量与高低价值货币之间的联系并没有明显倾向性,重量具身效应出现明显变化。研究结果表明,重量具身效应受概念表征的显著影响,该效应的表现不仅取决于对客体重量的经验,更取决于主体如何对重量感进行认知表征。。     

Therapist memory and reverie: implications for the clinical setting

In this work, the author considers reveries to be ‘dream-like-memories’. In the course of a session they appear as proto-memory – the therapist’s early traumatic object relations that are recorded in the unconscious at an almost bodily level (a type of unthought known) and which are resurrected between therapist and patient when a similar traumatic subject arises between them. The therapist’s reveries are recollections in the form of dream-like allusions to his past experience. A clinical vignette from the psychotherapy of a child whose father suffered from PTSD (following a wartime experience in Afghanistan and Iraq) is discussed. Dissociative dynamics were repeated in the therapeutic relationship, in the form of an obsessive game intending to preserve the state in which there was no need to remember what had been unconsciously transmitted to the child: his father’s wartime experience. The projection of the primary elements which had been silenced evoked in the therapist allusions to his unconscious identification with his ancestor’s post-traumatic experiences. These allusions helped in overcoming the dissociated state. The role of memory in child psychotherapists’ receptivity of trauma is revisited.     

A Family Therapist for Life: Observations and Options

“Life” is used here in the chronological sense of years spent as a family therapist and in the existential sense of experiencing “life” in terms of satisfaction, meaning, and vitality in one’s living. In the 1950s, there were few guidelines for professionals recognizing the need for working therapeutically with families. Becoming and being a family therapist are discussed, along with lifetime learning about family and tolerance for ambiguity in understanding family and marital relationships and dynamics; flexibility in implementing therapeutic interventions; functioning in ways that fit with one’s personality, beliefs, and principles; working where one functions best; and what works at what stage for the family therapist and relating these to establishing and maintaining “life” in one’s living.     

Fearlessness and courage in paratroopers undergoing training

105 recruits to the Parachute Regiment were studied during parachute training. From information given regarding their expectancies and experiences of jumping, three profiles were identified. These were labelled “Courageous”, “Fearless” and “Over-confident”. Two-thirds of the sample belonged to the first category and less than 10% to the last. A number of bodily reactions were frequently associated with anxiety during parachute jumping. These reactions were similar to those reported by veteran soldiers and airmen during combat. They differ from reactions reported by patients suffering from ‘clinical anxiety’, and it is suggested that this contrast might reflect differences in preparation for “fight” or “flight”.     

Perchance to Sleep: Minding the Unworded Body in Psychoanalysis

In contemporary relational psychoanalysis, influenced by developmental/attachment theories, infant research, and neurobiology, the effectiveness and transformational potential of “the talking cure” can be thought of as, at times, located in areas of nonverbal engagement. It has become increasingly evident that human experience is born in the body and structured in body-based memory that informs us of what we “know in our gut” and contributes to our relating as embodied beings—experiences that as psychoanalysts we cannot or need not necessarily translate directly into declarative discourse. A detailed case presentation from work with a patient suffering from a severe sleep disorder and other forms of bodily dysregulation will be offered to illustrate and explore the affectively meaningful engagement between patient and analyst of somatically encoded, presymbolic memory within the context of a symbolically rich, verbal treatment relationship.     

Wish,Need, Drive: Motive in the Light of Dynamic Systems Theory and Edelman's Selectionist Theory

Almost all psychoanalytic theorizing posits some basic and presumably built-in motivational thrusts. The goal of this paper is to present an alternative way of thinking about the beginnings of motivation. I go into some detail about recent contributions from two areas of research: dynamic systems theory as applied by Esther Thelen to infantile motor development and Gerald Edelman's (1992) theory of “Neural Darwinism.” What emerges are two interlocking hypotheses: The first is that what we infer as drives or other versions of “basic” motivations are already a late development of motivational organizations that started out from a collection of rather primitive biases. The second hypothesis, based on dynamic systems thinking or complexity theory, is that a great many developmental features that appear to be driven by a built-in genetic program or design, are, in fact, the spontaneously emergent, and therefore the never completely predictable, resultant of the interplay of embedded, embodied, and environmental elements. It is also hypothesized that, just as motivational systems lead to the emergence of new capacities and functions, so too do new capacities beget new motivational derivatives in an ever-more complex developmental spiral. Early experience plays an enormously important and highly individual role in the creation of conative patterns that eventually crystalize into what we, as observers and theoreticians, begin to categorize into systems of motivation. Depending on the observer and his or her frame of reference, certain motivational systems are held to be superordinate to others; these then are held up as basic motives. As psychoanalysts we currently find ourselves in a situation of competing organizational systems vying for prominence. The multiplicity of such systems speaks to our uncertainty and the need for further study to clarify the many questions that this line of thinking evokes. The second section of this paper explores the relations among need, wish, impulse, and defense as varieties of motivational systems that have already crystalized out of the early beginnings of motivation.