Developmental changes of win-stay and loss-shift strategies in decision making

This study aims to clarify the developmental changes in real-life decision making when strategy is adjusted using both positive and negative feedback, that is, whether strategic adjustment evolves with age. A total of 84 participants divided into three age groups (children, adolescents, and adults) performed the standard version of the Iowa Gambling Task (IGT). Children and adolescents showed a strong bias in favor of disadvantageous choices whereas adults learned to decide advantageously during the course of the task. Interestingly, the results clearly demonstrate that children did not switch differently following gains and losses whereas adolescents and adults switched more often after a loss than after a gain, corresponding to the “loss-shift” and the “win-stay” strategies, respectively. The results also revealed that adults switched less often after losses compared to children and adolescents and, thus, used the loss-stay strategy more often than the 2 youngest groups. These new findings suggest that successful completion of the IGT by adults requires fine feedback monitoring and more frequent use of the win-stay and loss-stay strategic adjustments.     

Can research influence clinical practice?1

After briefly reviewing the unfavourable reception accorded empirical research by parts of the psychoanalytic community, as well as some of the benefits to clinical practice of analysts being involved in research activities, the author examines whether the findings of process and outcome research in psychotherapy and psychoanalysis can help identify the most appropriate forms of intervention for producing therapeutic change, given the specific condition of the patient and the relationship that the individual establishes with the analyst. He argues that research findings can influence clinical practice on various levels and in different areas, and goes on to examine a number of related issues: the specificity of therapeutic interventions versus the relevance of common curative factors; the dyadic conception of technique and ways of understanding the therapeutic action of the treatment alliance; and the strategic or heuristic conception in psychoanalytic therapy. Finally, the author presents clinical material with the aim of illustrating how the knowledge acquired through research can be applied to psychoanalytic treatment.     

Neutrality, interpretation, and therapeutic intent.

Neutrality is a central concept within the theory of psychoanalytic technique. We spell out the major controversies in which the concept has become embroiled, and provide a definition that we believe coincides with actual psychoanalytic practice. We discuss its merits and weaknesses, noting also the negative consequences of relying on older definitions. We relate neutrality to the interpretive process, indicating ways interpretation protects neutrality and is made more effective by it. We discuss the complex and controversial relation between neutrality and the analyst's therapeutic intent.     

Some observations on the psychoanalytic process

The author's aim is to delineate the psychoanalytic process and to distinguish it from the psychoanalytic situation, the transference neurosis, "insight," and psychoanalytic technique in general. Freud's 1913 views provide the basis for a concept of the psychoanalytic process centered on the recognition and interpretation of resistances and on the patient's reactions to the analyst's interventions. This clinically observable "unit" of the process is described and compared with Bernfeld's "facts of observation." The proposition is advanced that the process does not come to an end with the termination of analysis. It continues postanalytically in the form of the patient's more objective and more effective capacity for self-observation. The paper closes with a warning about the "pitfalls of perfectibilism" and with a plea for the elevation of the not-so-good analytic hour.     

The Anorectic Process in the Family: A Six-Stage Model as a Guide for Individual Therapy

This article presents a conceptual framework for individual treatment with chronic anorectic patients. In the first part of the article, the six-stage model for the anorectic process developed over the past years by M. Selvini-Palazzoli and her team is briefly explained. After presenting the model, we then discuss some related concepts, namely, "family game," "rule," and "strategy." Finally, the therapeutic technique in individual treatment is discussed. Two basic assumptions underlie this technique: first, the therapeutic relationship is instrumental, its main purpose being to improve the patient's personal relations outside therapy; second, the focus of the treatment is on the strategic incapacity of the patient who is caught up in and unable to cope with the "concealed family game."     

The analytic surface and the theory of technique

This paper examines the concept of the analytic surface as a starting point for the interpretive process in relation to the theory of psychoanalytic technique. The history of the concept of the analytic surface within psychoanalysis is reviewed. Four different conceptualizations of analytic surfaces are described (M.M. Gill, P. Gray, A. Kris, E.A. Schwaber). The advantages of a "surface" approach are explored in relation to clinical work, the teaching of psychoanalytic technique, and opportunities for research. Some criticisms of the concept are explored.     

Structure and strategy in encoding simplified graphs

Tversky and Schiano (1989) found a systematic bias toward the 45 degrees line in memory for the slopes of identical lines when embedded in graphs, but not in maps, suggesting the use of a cognitive reference frame specifically for encoding meaningful graphs. The present experiments explore this issue further using the linear configurations alone as stimuli. Experiments 1 and 2 demonstrate that perception and immediate memory for the slope of a test line within orthogonal "axes" are predictable from purely structural considerations. In Experiments 3 and 4, subjects were instructed to use a diagonal-reference strategy in viewing the stimuli, which were described as "graphs" only in Experiment 3. Results for both studies showed the diagonal bias previously found only for graphs. This pattern provides converging evidence for the diagonal as a cognitive reference frame in encoding linear graphs, and demonstrates that even in highly simplified displays, strategic factors can produce encoding biases not predictable solely from stimulus structure alone.     

Unconscious determinants of career choice and burnout: theoretical model and counseling strategy

A psychodynamic‐existential perspective is proposed as a theoretical model that explains career burnout and serves as a basis for a counseling strategy. According to existential theory, the root of career burnout lies in people's need to find existential significance in their life and their sense that their work does not provide it. The reason that people choose a particular career is explained by psychoanalytic theory, which attributes it to significant childhood experiences, family dynamics, and familial vocational choices. Two detailed and 4 brief cases are presented to demonstrate the application of the psychoanalytic‐existential approach to career counseling that is sought as a result of burnout.     

Negativity and lies in analytic group therapy: an inquiry into Bion's ideas of K and -K

In this paper a kind of therapeutic failure in psychoanalytic group work, one that is common but frequently overlooked, is described. Essentially this failure is the result of patients who mislead the therapist by lying and by a negative process of thought that works against analytic aims of acquiring understanding and emotional truth. These processes and their effects, as they are manifested by an individual patient in a group and by the therapist, are described. Bion's later theory of K and -K offers a framework for the discussion of the group events.     

Negativity in psychotherapists' evaluations of clients and personal acquaintances

Forty-seven psychotherapists were studied to determine if they construed their clients more negatively than personal acquaintances. The sample included personal construct therapists, psychoanalytic candidates, and therapists from a community mental health center; they varied in terms of sex, age, years of experience, and clinical discipline. Subjects chose six personal acquaintances and six nonpsychotic individual-therapy clients who were then used as elements in a repertory grid. Constructs were elicited by comparing pairs of elements; all elements were rated on the constructs. Elements were also directly rated on several dimensions, including liking and similarity to self. Results indicated that therapists selectively focused on clients' negative characteristics and acquaintances' positive characteristics. Clients were liked less than acquaintances and were judged to be less like the self. The correlations between valuative variables tended to be higher in the construing of clients than in the construing of acquaintances, whereas expected improvement with therapy was not related to affective evaluation. There were no gender differences in these effects. Although there were no differences in degree of negative construal of clients among the therapist subgroups, the psychoanalytic candidates construed acquaintances less positively than did other therapists. The results suggest that deviancy may be a major dimension distinguishing therapists' construal of clients from their construal of acquaintances. This dimension may result from both therapeutic ideology and the fact that clients selectively present negative aspects of themselves in therapy, producing a bias in the information therapists receive. Possible negative implications for the therapeutic relationship are discussed.     

Recent developments in the technical approaches of English-language psychoanalytic schools

This paper summarizes developments in the major approaches to psychoanalytic technique derived from the ego psychology, Kleinian, British independent, self psychology, intersubjectivist, and interpersonal schools over the past fifty years. The author proposes that two major contemporary currents may be differentiated from each other, namely, the psychoanalytic "mainstream"--derived from contemporary Kleinian, contemporary Freudian, and British independent sources, and the "intersubjectivist-interpersonal-self psychology" current. In significant contrast to these two major currents within the English-language psychoanalytic approaches, the French psychoanalytic school has evolved a unique third approach to analytic technique. The author proposes that these three currents constitute the dominant trends regarding technique in contemporary psychoanalytic practice. The paper concludes with a brief outline of the characteristics of each of these technical approaches.     

On the Psychoanalytic Treatment of the Depressive Personality

In order to discuss the depressive personality we have first to distinguish between this clinical entity and other types of depressive psychopathology that might also be chronic. The character traits and psychodynamics of the depressive personality confirm that there is a special group of patients, who belong to a depressive disorder continuum. The particular technical problems that depressive personality present are: (1) the inability to enjoy anything and the consequences of this on the therapist's experience and interventions, and (2) the negative therapeutic reaction which threatens the analytic process and the therapist's competence. If we combine transference/extratransference interpretations with an "empathetic understanding" approach to systematic confrontation and interpretation, we can therefore justify the need for a slightly modified psychoanalytic technique in the treatment of the depressive personality.     

Eye Movements in Strategic Choice

In risky and other multiattribute choices, the process of choosing is well described by random walk or drift diffusion models in which evidence is accumulated over time to threshold. In strategic choices, level‐k and cognitive hierarchy models have been offered as accounts of the choice process, in which people simulate the choice processes of their opponents or partners. We recorded the eye movements in 2 × 2 symmetric games including dominance‐solvable games like prisoner's dilemma and asymmetric coordination games like stag hunt and hawk–dove. The evidence was most consistent with the accumulation of payoff differences over time: we found longer duration choices with more fixations when payoffs differences were more finely balanced, an emerging bias to gaze more at the payoffs for the action ultimately chosen, and that a simple count of transitions between payoffs—whether or not the comparison is strategically informative—was strongly associated with the final choice. The accumulator models do account for these strategic choice process measures, but the level‐k and cognitive hierarchy models do not. © 2015 The Authors. Journal of Behavioral Decision Making published by John Wiley & Sons Ltd.     

How wide is the widening scope of psychoanalysis and how solid is its structural model? Some concerns and observations

The author advances the thesis that in the past 35 years there has been a relatively silent but nonetheless significant movement within the mainstream of American psychoanalysis toward a more "modest" position. This movement has been stimulated from different sources, sometimes with diverse goals and different programs. One determinant was the reaction to the post-World War II euphoria in regard to psychoanalysis and its possible therapeutic powers. Another element has been the ongoing consolidation of our knowledge and understanding of the ego-psychological, structural-model approach to analytic theory and technique, an approach which emphasizes both intrapsychic conflict and compromise formations. A consequence of this more modest position has been a greater appreciation of the limitations of psychoanalysis as well as the significance of those limitations. This more realistic appraisal of psychoanalysis may not have encouraged the widening scope of the indications for analysis, but the enhanced understanding of its limitations offers the promise of more effective psychoanalytic work in areas that have not been considered ideal for the so-called "traditional" analysis. It is suggested that more sophisticated approaches in the analysis of resistance and character, of "conflict" (in distinction to "diagnoses"), together with a more applicable understanding of the psychoanalytic process, can all contribute to a deepening, if not necessarily widening, of our psychoanalytic endeavors.     

Freud and hypnosis: Report of post-rejection use

The development of hypnosis as a therapeutic and experimental method was significantly influenced by Sigmund Freud's announced rejection of the technique late in the nineteenth century; however, a Hungarian-born hypnotist, Franz Polgar, related in his little-known autobiography that he served as Freud's assistant for six months in 1924. Possible factors related to this seeming paradox are discussed, including the evidence that many of Freud's psychoanalytic colleagues were then actively interested in hypnosis and the negative value associated with the modality had been lifted during the time when Polgar reported that Freud himself was utilizing the method. This is a historically important account of the interface between two prominent therapeutic techniques.     

Two Systems of Self-Regulation and the Differential Application of Psychoanalytic Technique

Out of our work over the years on child development, clinical technique, and sadomasochism, we have begun to formulate a model of development that describes two possible ways of responding to feelings of helplessness in the face of the challenges of internal and external experience. Any psychoanalytic model has implications for how we think about technique and can be tested on the basis of its utility in generating technical ideas and enhancing our therapeutic repertoire. At this juncture in the history of our field, it is crucial for us to demonstrate that psychoanalytic techniques are effective in helping people enter treatment, change, and finish in a way that consolidates their gains. In this paper we explore the utility of our two-systems model for expanding the discourse about psychoanalytic technique.     

Developments in cognitive neuroscience: II. Implications for theories of transference

An integration of psychoanalytic theory with contemporary developments in cognitive neuroscience offers a useful perspective on long-standing controversies about the nature of transference, and a better understanding of the precise mechanisms by which transferential processes occur. Contemporary psychoanalytic views of transference are reviewed, and the many processes that constitute transference are described. Two issues that have emerged in different guises for several decades-the role of the analyst in eliciting transference, and the nature of "real" and "transferential" components of the therapeutic relationship-are reconsidered in the light of concepts such as connectionist networks. Although a useful analytic stance is one that allows the patient's enduring dynamics to dominate the analytic field, it is suggested, anonymity is neither a cognitive possibility nor the driving force behind most transference reactions, and the distinction between "real" and "transferential" perceptions is one of therapeutic interest, not of mechanism. Certain features of the analytic situation make some dynamics more likely than others to enter the treatment relationship, notably those related to authority, intimacy and attachment, and sexuality. Transference reactions are best understood as constructed from a combination of the patient's enduring dispositions to react in particular ways under particular conditions; features of the analytic situation and of the analyst; and interactions between patient and analyst. These reactions do not unfold ineluctably from the patient's mind in the consulting room, nor are they cognitive constructions of the patient-analyst dyad or co-constructions of relatively equal partners exerting their influence on the analytic field.     

The centrality of the psychoanalytic setting and the changing aims of treatment. A perspective from a theory of object relations

The psychoanalytic setting, which includes the bond between analysand and analyst, is the foundation of psychoanalytic treatment. This object tie, although in the here and now, and "real", is demarcated from ordinary life and can be thought of as existing within a different level of reality. The psychoanalytic setting is subject to symbolic transformations that enable non-specific developmental conflicts to be worked through. I have described this transformation as the "dependent/containing transference," which I have compared and contrasted to the highly variegated and specific "iconic" transference (transference neurosis). This view of the psychoanalytic setting leads the analyst to pay special attention to problems of entrustment and safety and to the communicative process that regulates the closeness and distance between the two participants.     

The infant and the infinite: On psychoanalytic faith – Bion,Meltzer and Kierkegaard

This paper discusses the meaning of psychoanalytic faith as a useful developmental concept, which applies to the therapeutic process in the consulting room as to other intimate educational experiences. Faith is a concept which has been little considered in relation to psychoanalysis, partly owing to semantic confusion with ‘the Faith’ as in religious or psychoanalytic dogma, and partly owing to the difficulty of defining or describing what it is, outside accepted jargon. Yet, faith is traditionally the gateway to experiencing the unknown – a psychoanalytic goal-demanding negative capability. It is suggested that philosophy and poetry, where the concept is more familiar, can provide psychoanalytic parallels for this particular type of learning from experience. The viewpoints of Bion, Meltzer and Kierkegaard are taken as contributing to a picture of how, in the psychoanalytic session, there may be a developmental encounter between the infant (patient) and the infinite (the transference process, rather than the analyst as a person).