Thinking with,and about,patients too scared to think: Can non‐interpretive maneuvers stimulate refl ective thought?

Patients incapable of higher-order (symbolic) thinking can often not tolerate evidence of the analyst's separate existence, particularly when that 'otherness' becomes evident in the process of the analyst's refl ecting upon and interpreting how the patient experiences or represents the analyst. The patient's intolerance of the analyst's efforts to think (refl ect upon and interpret) renders the usual psychoanalytic maneuvers employed to stimulate refl ective thought ineffective with such patients. Such patients have to learn to tolerate multiple perspectives before they can allow the analyst, or themselves, to think in the other's presence. The author presents two clinical vignettes that illustrate how the analyst's efforts to think about the patient were experienced by the patient as both intolerably distancing and as rejecting of an aspect of the patient's subjective reality. Working psychoanalytically with such patients requires the analyst to forgo the use of narrow interpretations that elucidate unconscious meanings and motives in favor of alternate technical maneuvers capable of facilitating the development of symbolic thinking and refl ective thought (insightfulness). These maneuvers include a demonstration of the analyst's willingness and ability to withstand (rather than 'interpret away') how he is being psychically represented by the patient, without becoming destroyed by, or lost within, the patient's characterization of him. Beside modeling a tolerance of alternate perspectives of one's self, other non-interpretive maneuvers that help facilitate the development of self-refl ective thought include: stimulating the patient's curiosity about the workings of his own mind by identifying incompletely understood behaviors or reactions worthy of greater psychological understanding, and insinuating doubt about the adequacy of the patient's explanations of such phenomena.     

Skimming the surface. Verbal overshadowing of analogical retrieval

It has become almost a maxim that "talking through" a problem is advantageous. Contrary to this wisdom, studies from numerous domains have demonstrated that describing one's thought processes or analyzing a judgment may, in some circumstances, actually impair performance. The two experiments reported here built upon prior work by examining the effect of verbalization on the retrieval of analogies. Participants read a series of 16 short stories. Later, they were presented with 8 test stories and indicated whether these stories were analogies of the stories they had read previously. Each test story shared the same deep structure with one prior story and only surface characteristics with another prior story. Half of the participants completed the test while thinking aloud, and half did not think aloud. In both experiments, participants who thought aloud were more likely to retrieve surface matches and less likely to retrieve true analogies than participants who did not verbalize their thoughts during the test.     

A comparison of thought suppression to an acceptance-based technique in the management of personal intrusive thoughts: a controlled evaluation

Research suggests that suppressing unwanted thoughts is not possible, leads to a subsequent increase in frequency of the suppressed thoughts, and results in higher levels of distress. Because thought suppression may have negative effects, an alternative, acceptance-based approach has been proposed. The current paper reports the outcomes of two studies. Study I examined the relationships between two naturally occurring strategies of thought management (thought suppression and acceptance), symptoms of psychopathology, and experiences with personally relevant intrusive thoughts. Results showed that those who naturally suppress personally relevant intrusive thoughts have more, are more distressed by, and have a greater "urge to do something" about the thoughts, while those who are naturally more accepting of their intrusive thoughts are less obsessional, have lower levels of depression, and are less anxious. Study II compared three groups (thought suppression, acceptance, and monitor-only groups) on the frequency and distress associated with experiencing personally relevant intrusive thoughts. Results revealed that those instructed to suppress their personal intrusive thoughts were unable to do so and experienced an increased level of distress after suppression, whereas those instructed to use an acceptance-based strategy experienced a decrease in discomfort level (but not thought frequency) after having used such a strategy. These data offer initial evidence that acceptance may be a useful alternative to the suppression of personally relevant intrusive thoughts.     

Psychological effects of thought acceleration

Six experiments found that manipulations that increase thought speed also yield positive affect. These experiments varied in both the methods used for accelerating thought (i.e., instructions to brainstorm freely, exposure to multiple ideas, encouragement to plagiarize others' ideas, performance of easy cognitive tasks, narration of a silent video in fast-forward, and experimentally controlled reading speed) and the contents of the thoughts that were induced (from thoughts about money-making schemes to thoughts of five-letter words). The results suggested that effects of thought speed on mood are partially rooted in the subjective experience of thought speed. The results also suggested that these effects can be attributed to the joy-enhancing effects of fast thinking (rather than only to the joy-killing effects of slow thinking). This work is inspired by observations of a link between "racing thoughts" and euphoria in cases of clinical mania, and potential implications of that observed link are discussed.     

On the counterfactual nature of envy: “It could have been me”

We examined whether counterfactual thinking influences the experience of envy. Counterfactual thinking refers to comparing the situation as it is to what it could have been, and these thought processes have been shown to lead to a variety of emotions. We predicted that for envy the counterfactual thought “it could have been me” would be important. In four studies we found a clear link between such counterfactual thoughts and the intensity of envy. Furthermore, Studies 3 and 4 revealed that a manipulation known to affect the extent of counterfactual thinking (the perception of being close to obtaining the desired outcome oneself), had an effect on the intensity of envy via counterfactual thoughts. This relationship between counterfactual thinking and the experience of envy allows for new predictions concerning situations under which envy is likely be more intense.     

Immediate source-monitoring, self-focused attention and the positive symptoms of schizophrenia

Previous research suggests that tendencies to misattribute one's own thoughts to an external source, as assessed by an immediate source-monitoring test, are associated with auditory verbal hallucinations (AVHs). However, recent research suggests that such tendencies are associated instead with symptoms of thought interference. The main aim of the present study was to examine whether such tendencies are differentially associated with different types of thought interference, with AVHs, or with both. It has also been suggested that external misattributions are especially likely to occur with emotionally salient material and if the individual's focus is on the self. These suggestions were also tested. The positive psychotic symptoms of 57 individuals with a diagnosis of schizophrenia were assessed and they then completed the Self-Focus Sentence Completion blank. Immediately after completing each sentence they were asked to indicate to what extent the sentence was their own. The number of sentences that were not rated as completely their own served as their externalisation score. Externalisation scores correlated significantly with the severity of three symptoms: voices commenting, delusions of being controlled, and thought insertion. In a logistic regression analysis, all three of these symptoms were significantly and independently related to externalisation. Externalisation was not associated with either a negative or a neutral self-focus. Thus tendencies to misattribute one's own thoughts to an external source are associated with AVHs and some, but not all, symptoms of thought interference. The importance for externalisation of self-focused attention and of the emotional salience of the elicited thoughts was not supported.     

Précis of The rational imagination: how people create alternatives to reality

The human imagination remains one of the last uncharted terrains of the mind. People often imagine how events might have turned out "if only" something had been different. The "fault lines" of reality, those aspects more readily changed, indicate that counterfactual thoughts are guided by the same principles as rational thoughts. In the past, rationality and imagination have been viewed as opposites. But research has shown that rational thought is more imaginative than cognitive scientists had supposed. In The Rational Imagination, I argue that imaginative thought is more rational than scientists have imagined. People exhibit remarkable similarities in the sorts of things they change in their mental representation of reality when they imagine how the facts could have turned out differently. For example, they tend to imagine alternatives to actions rather than inactions, events within their control rather than those beyond their control, and socially unacceptable events rather than acceptable ones. Their thoughts about how an event might have turned out differently lead them to judge that a strong causal relation exists between an antecedent event and the outcome, and their thoughts about how an event might have turned out the same lead them to judge that a weaker causal relation exists. In a simple temporal sequence, people tend to imagine alternatives to the most recent event. The central claim in the book is that counterfactual thoughts are organised along the same principles as rational thought. The idea that the counterfactual imagination is rational depends on three steps: (1) humans are capable of rational thought; (2) they make inferences by thinking about possibilities; and (3) their counterfactual thoughts rely on thinking about possibilities, just as rational thoughts do. The sorts of possibilities that people envisage explain the mutability of certain aspects of mental representations and the immutability of other aspects.     

Aspects of the unity of consciousness and everyday memory failures

We argue that analyzing everyday memory failures in terms of the "unity of consciousness" can elucidate the bases of such failures. A perfect unity amongst one's mental states is rare. In extreme cases the unity of consciousness can breakdown in dramatic fashion (e.g., in Dissociative Identity Disorder), but such breakdowns also occur in less dramatic ways that affect us in everyday life. For example, disruptions in the unity of consciousness can result in everyday memory failures, such as forgetting to put on a tie for an important formal meeting. After providing some philosophical background into the notions of "unity of consciousness" and "functionalism," we offer preliminary analyses of three examples of everyday memory failure. We then introduce and develop what we call the "unity model" of memory failure and show how it explains the examples. We also describe different ways that unity can break down which, in turn, can lead to memory failure and inappropriate behavior. We then show how slips of action and other kinds of cognitive failures (e.g., memory blocks) differ from everyday memory failures. Finally, we examine alternative models (e.g., Absentmindedness and Multimodal) arguing that the unity model is preferable, and then show how our model is consistent with some experimental results.     

Towards a pluralist theory of singular thought

This paper investigates the question of how to correctly capture the scope of singular thinking. The first part of the paper identifies a scope problem for the dominant view of singular thought maintaining that, in order for a thinker to have a singular thought about an object o, the thinker has to bear a special epistemic relation to o. The scope problem has it is that this view cannot make sense of the singularity of our thoughts about objects to which we do not or cannot bear any special epistemic relation. The paper focuses on a specific instance of the scope problem by addressing the case of thoughts about the natural numbers. Various possible solutions to the scope problem within the dominant framework are assessed and rejected. The second part of the paper develops a new theory of singular thought which hinges on the contention that the constraints that need to be met in order to think singularly vary depending on the kind of object we are thinking about. This idea is developed in detail by discussing the difference between the somewhat standard case of thoughts about spatio-temporal medium-sized inanimate objects and the case of thoughts about the natural numbers. It is contended that this new Pluralist theory of singular thought can successfully solve the scope problem.     

Using session-by-session measurement to compare mechanisms of action for acceptance and commitment therapy and cognitive therapy

Debate continues about the extent to which postulated mechanisms of action of cognitive behavior therapies (CBT), including standard CBT (i.e., Beckian cognitive therapy [CT]) and acceptance and commitment therapy (ACT) are supported by mediational analyses. Moreover, the distinctiveness of CT and ACT has been called into question. One contributor to ongoing uncertainty in this arena is the lack of time-varying process data. In this study, 174 patients presenting to a university clinic with anxiety or depression who had been randomly assigned to receive either ACT or CT completed an assessment of theorized mediators and outcomes before each session. Hierarchical linear modeling of session-by-session data revealed that increased utilization of cognitive and affective change strategies relative to utilization of psychological acceptance strategies mediated outcome for CT, whereas for ACT the mediation effect was in the opposite direction. Decreases in self-reported dysfunctional thinking, cognitive "defusion" (the ability to see one's thoughts as mental events rather than necessarily as representations of reality), and willingness to engage in behavioral activity despite unpleasant thoughts or emotions were equivalent mediators across treatments. These results have potential implications for the theoretical arguments behind, and distinctiveness of, CT and ACT.     

Are "obsessive" beliefs specific to OCD?: a comparison across anxiety disorders

Cognitive models of obsessive-compulsive disorder (OCD) assign a central role to maladaptive beliefs about threat, uncertainty, importance and control of thoughts, responsibility, and perfection. Previous research has demonstrated that such beliefs relate to specific OCD symptoms in a theoretically meaningful way. The aim of the present study was to determine whether these beliefs are endorsed more strongly by OCD patients than by those with other anxiety disorders. Eighty-nine adult OCD patients, 72 anxious control (AC) patients, and 33 nonclinical control (NCC) participants completed a measure of obsessive beliefs as well as measures of depression and trait anxiety. Compared to NCCs and ACs, OCD patients more strongly endorsed beliefs related to threat estimation, tolerance of uncertainty, importance and control of thoughts, and perfectionism, but not inflated responsibility. Using revised, condensed subscales, OCD patients differed from ACs on beliefs about perfectionism and certainty and about importance and control of thoughts, but not on beliefs about threat estimation and inflated responsibility. When controlling for depression and trait anxiety, the OCD and AC group did not differ on most belief domains, except for a belief that it is possible and necessary to control one's thoughts. Results are discussed in light of evolving cognitive-behavioral theories that highlight appraisals of thought control and the use and effectiveness of varying thought control strategies.     

Processing homonymy and polysemy: effects of sentential context and time-course following unilateral brain damage

The present study investigated the abilities of left-hemisphere-damaged (LHD) non-fluent aphasic, right-hemisphere-damaged (RHD), and normal control individuals to access, in sentential biasing contexts, the multiple meanings of three types of ambiguous words, namely homonyms (e.g., "punch"), metonymies (e.g., "rabbit"), and metaphors (e.g., "star"). Furthermore, the predictions of the "suppression deficit" and "coarse semantic coding" hypotheses, which have been proposed to account for RH language function/dysfunction, were tested. Using an auditory semantic priming paradigm, ambiguous words were incorporated in dominant- or subordinate-biasing sentence-primes followed after a short (100 ms) or long (1,000 ms) interstimulus interval (ISI) by dominant-meaning-related, subordinate-meaning-related or unrelated target words. For all three types of ambiguous words, both the effects of context and ISI were obvious in the performance of normal control subjects, who showed multiple meaning activation at the short ISI, but eventually, at the long ISI, contextually appropriate meaning selection. Largely similar performance was exhibited by the LHD non-fluent aphasic patients as well. In contrast, RHD patients showed limited effects of context, and no effects of the time-course of processing. In addition, although homonymous and metonymous words showed similar patterns of activation (i.e., both meanings were activated at both ISIs), RHD patients had difficulties activating the subordinate meanings of metaphors, suggesting a selective problem with figurative meanings. Although the present findings do not provide strong support for either the "coarse semantic coding" or the "suppression deficit" hypotheses, they are viewed as being more consistent with the latter, according to which RH damage leads to deficits suppressing alternative meanings of ambiguous words that become incompatible with the context.     

Distress and recurrence of intrusive thoughts in younger and older adults

The current study incorporated a life span perspective into existing theories of intrusive thoughts to examine age-related differences in the difficulty controlling intrusive thoughts, the distress following intrusive thought recurrences, and the meanings assigned to these recurrences. Younger (N = 51) and older (N = 49) community adults were randomly assigned to suppress (i.e., keep out of mind) or monitor an intrusive thought. Participants rated their positive and negative affect throughout engagement with the intrusive thought, and they also rated the meanings they gave to recurrences of their everyday intrusive thoughts. The results demonstrated that older adults tended to perceive greater difficulty with controlling the intrusive thought than younger adults despite the fact that they did not differ in the actual recurrence of the intrusive thought. With regard to distress, older adults experienced steadier levels of positive affect than younger adults throughout engagement with the intrusive thought. However, older adults also reported greater residual negative affect after engaging with the intrusive thought than younger adults. Finally, older and younger adults appeared to assign meanings to recurrences of intrusive thoughts in line with age-relevant concerns. Specifically, older adults were prone to interpret the recurrence of intrusive thoughts as a sign of cognitive decline, but they were less likely than younger adults to see intrusive thoughts as a sign of moral failure. Together, these results highlight a range of potential risk and protective factors in older adults for experiencing emotion dysregulation after intrusive thoughts.     

Cognitive control of obsessional thoughts

A defining characteristic of obsessive-compulsive disorder (OCD) is unsuccessful suppression of unwanted thoughts. Recent evidence of individual differences in ability to control intrusive thoughts may inform our understanding of failures of cognitive control associated with OCD symptomatology. The current study investigated characteristics of cognitive style that are potentially associated with OCD symptoms and may influence response to unwanted thoughts, including perceived ability to control thoughts and tendency to ruminate. Undergraduate students (N = 166) completed self-report measures of OCD symptoms, perceived thought control, and ruminative thinking. They were then presented with a distressing target thought and completed a standard thought suppression paradigm. Correlational results indicated that, controlling for anxiety and depression, OCD symptoms were positively associated with rumination and inversely associated with perceived thought control ability. In addition, OCD symptoms were associated with higher levels of distress and greater spontaneous efforts to suppress the target thought during a baseline period, while perceived thought control ability predicted frequency of target thoughts during suppression. Finally, results of the experimental manipulation confirmed that participants instructed to suppress experienced more intrusions during the recovery period. Clinical implications and future directions are discussed.     

Know yourself and you shall know the other... to a certain extent: multiple paths of influence of self-reflection on mindreading

Social and neurocognitive research suggests that thinking about one's own thinking and thinking about the thinking of others-termed 'mindreading', 'metacognition', 'social cognition' or 'mentalizing' are not identical activities. The ability though to think about thinking in the first person is nevertheless related to the ability to think about other's thoughts in the third person. Unclear is how these phenomena influence one another. In this review, we explore how self-reflection and autobiographical memory influence the capacity to think about the thoughts and emotions of others. We review studies suggesting that the more individuals are able to reflect on and retrieve episodes from their life narratives, the more they are likely to grasp others' thoughts and emotions. We discuss evidence supporting this possibility including studies of the neurocognitive bases of empathy and self-awareness and how different aspects of self-reflection may impact on mindreading. We also draw from clinical reports how improved self-reflection may result in a more nuanced mindreading, namely persons suffering from schizophrenia and narcissistic personality disorder. We finally discuss the implications for research and practice and consider whether there are conditions in which the reverse is true, where self-reflection might impair mindreading or in which mindreading may facilitate self-reflection.     

超越弗雷格的“第三域”神话

<正>如达米特所指出的:"弗雷格关于思想及其构成涵义的看法是神话式的。这些恒久不变的实体居住在‘第三域’(the third realm),后者既不同于物理世界,也不同于任何经验主体的内心世界……。     

The management of innovation: Recasting the role of creativity

Abstract

This article examines difficulties arising from the deep-rooted assumption that the innovation process exists as a phenomenon incorporating two distinct and identifiable stages of creative discovery and subsequent implementation. An alternative perspective is proposed in which innovation is represented as the process whereby individuals enact new social procedures; creativity is the associated process in which the meanings of the enactments are discovered and labelled. Innovation treated in this manner occurs as the streams of human activities and ideas mutually interact. The starting, ending, and bounding of an innovation project are all parts of a unitary process of meaning-creation within social contexts. “Creative” thoughts and actions interact throughout the process. (“Creativity through the finishing line”; “implementation first and last”). Not least, such an interpretive model avoids the difficulties that have been encountered in attempts to treat innovation as a series of objective stages. It furthermore provides a coherent theoretical status for creativity as the meaning-creating processes within all personal discovery and learning activities.     

Cognitions related to anxiety: a pilot study of treatment

In general, where anxiety appears to have a specific external focus, such as the situations which are avoided by phobic patients, treatment involving systematic exposure to those situations seems to be effective. This is less appropriate, or even impossible, where anxiety is not dependent on any external circumstance, but is described by the patient as occurring at any time or place, either chronically over long periods, or acutely in the form of ‘panic attacks’. These patients with ‘generalised’ anxiety often describe internal cues for anxiety either in the form of thoughts (e.g. worry over a current problem) or somatic (e.g. chest sensations interpreted as possible heart disease). Beck et al. (1974) has suggested that on interview, all patients diagnosed as suffering from diffuse or generalised anxiety can report specific ideas or other cognitive cues which are associated with anxiety. These usually concern possible traumatic events, such as illness and death, or social rejection. Clearly Beck has in mind the possibility that these cognitions have the effect of inducing anxiety, although even if the validity of the subjective reports were to be accepted, the problem remains of whether the relationship between mood state and cognitions is causal and if so, in which direction it operates. Obviously a causal relationship may also operate in both directions simultaneously, to form a ‘vicious circle’ in which each exacerbates the other. To establish whether there is a sense in which particular cognitions contribute causally to anxious mood, it would be necessary to find a method of manipulating the type or frequency of cognitions thought to be operating in this way.

One obvious possibility is that of ‘thought-stopping’: that is, patients could be taught to identify thoughts which are associated with anxiety and stop them in the usual way (Wolpe, 1973, p. 211) e.g. by' shouting stop, and substituting an alternative thought. The present study was planned as a pilot experiment to determine (i) if appropriate anxiety related cognitions could be elicited from a series of patients with generalised anxiety, (ii) if the reported frequency of such thoughts could be modified by a thought-stopping technique, and (iii) if any changes in thought frequency were associated with improvements in mood.

Clearly there are many ‘non-specific’ features involved in thought-stopping which could also have therapeutic effects on mood. For this reason it was necessary to include an alternative procedure, not directed at reducing thought frequency, but having the same degree of plausibility to patients, and preferably to therapists. The control procedure chosen for this purpose was modelled on desensitisation, in which patients were encouraged to allow the supposedly anxiety-provoking thoughts into their mind and tolerate them, rather than attempt to stop them. In summary, the study employed a relaxation training phase as a base-line, followed by a cross-over design in which the two treatment phases of thought-stopping and ‘cognitive desensitisation’ were given to each patient, in balanced order.