Zur Dynamik der Interaktion in der Supervision

The manifold functions of a supervisor in following the course of complex processes together with the trainee, are: ? to keep the goals of the supervision in view, ? to establish a teaching alliance and to support the wish and ambitions of the candidate to learn, ? to build a platform for the complex interactions with the trainee with regard to the dynamics of the training situation and keeping in mind the institutional influences, ? to lay down the setting for the work, ? to explore and to reflect how transference and counter-transference influence the interaction between patient and analyst as well as between trainee and supervisor, ? to examine these interactions together focussing continuously on the interaction between candidate and patient, and to encourage the candidate to do the same on his own, ? to continuously formulate hypotheses about the core conflict, the transference phenomena and resistance of the patient, ? to explore and reflect on the cooperative work.     

The compulsion to confess and the compulsion to judge in the analytic situation

In this paper the author shows that human beings have two quasi‐instinctual primitive tendencies – namely, the compulsion to confess and the compulsion to judge (to condemn or to absolve). These compulsions are originally unconscious and become conscious during the course of the analytic process. The compulsion to judge is a natural consequence of the compulsion to confess. These two tendencies are intensified by the analytic situation. The patient has a compulsion to confess to the analyst and to himself, and likewise the analyst has a compulsion to confess to himself and to the patient. The patient therefore has a compulsion to judge himself as good or bad and to judge the analyst as good or bad while, on the other hand, the analyst has a compulsion to judge himself as good or bad and to judge the patient as good or bad. The task of analysis is to make both patient and analyst conscious of their compulsions to confess and to judge (to condemn or to absolve). The compulsion to judge in the analyst, particularly if unconscious, may give rise to mistakes in diagnosis, technique, treatment, and the assessment of analysability. The requirement of analytic neutrality in the analyst constantly conflicts with his compulsion to judge. If we are profoundly involved in our patient's dramatic conflict, we are bound to pass a judgement (condemnation or absolution); however, when we judge, we are not neutral and therefore become incapable of intellectual consciousness of the patient's conflict. Conversely, if we do not judge, we are neutral, but are then relatively uninvolved in the patient's conflict and are hence virtually unable to achieve emotional consciousness. The author attempts to show that neutrality cannot and must not be a preconstituted attitude in the analyst, but can and must be a point of arrival following a profound, intensely felt existential experience based on an attitude of non‐condemnation and non‐absolution.     

吸烟利弊权衡对戒烟计划的预测作用：一个有调节的中介模型

考察吸烟利弊权衡对戒烟计划的预测,以及戒烟意愿的中介作用和未来取向的调节作用。对340名吸烟者进行问卷调查结果的统计分析发现：（1）吸烟利弊权衡显著正向预测戒烟计划;（2）戒烟意愿对吸烟利弊权衡和戒烟计划的关系起完全中介作用;（3）未来取向负向调节吸烟利弊权衡和戒烟计划的关系,但对吸烟利弊权衡和戒烟意愿关系的调节不显著。这些结果说明,吸烟者戒烟计划发展经历前决策和前行动阶段,且该过程受未来取向的调节。     

从认知逻辑视角看西方伦理学的发展

本文希望从认知伦理学的视角出发探讨伦理学的发展,以及人类对道德问题认知的过程与人类一般认知的逻辑之间的一致性。人类认知的逻辑是由概念到判断再到推论的过程,伦理学史由德性伦理学到规范伦理学再到话语伦理学、元伦理学和新德性伦理学的过程,实际上就是人类在道德认知上从概念伦理学到判断伦理学再到推论伦理学最后回归到概念伦理学的过程。     

Word use of outpatients with a personality disorder and concurrent or previous major depressive disorder

In a recent study, Rude, Gortner, and Pennebaker (2004) found word use to be related to depression and vulnerability to depression in the essays of college students. We sought to replicate and extend these findings in a clinical sample. Written essays of 304 psychiatric outpatients with a personality disorder and a mixed psychiatric profile on DSM-IV axis-I and 108 healthy controls were examined with word count software. Data on the tendency to be discrepant about the current self compared to a more ideal self were also gathered. We found that psychiatric outpatients in general used more words referring to the self and negative emotion words and fewer positive emotion words, compared to healthy controls. However, word-use proved unrelated to depression specifically. Actual-ideal self discrepancies were related to patient status and to current depression. Contrary to our hypothesis, these discrepancies did not correlate with the use of words referring to the self. We conclude that the negative content and self-focus of written essays and high levels of discrepancy reflect a negative thinking style that is common to a range of psychiatric disorders rather than being specific to depression.     

Resilience concepts and findings: implications for family therapy

Resilience is a term used to describe relative resistance to psychosocial risk experiences. There is abundant evidence that there is enormous variation in children's responses to such experiences but research to determine the processes underlying the variations needs to take account of several crucial methodological issues. The findings emphasize that multiple risk and protective factors are involved; that children vary in their vulnerability to psychosocial stress and adversity as a result of both genetic and environmental influences; that family-wide experiences tend to impinge on individual children in quite different ways; that the reduction of negative, and increase of positive, chain reactions influences the extent to which the effects of adversity persist over time; that new experiences which open up opportunities can provide beneficial 'turning- point' effects; that although positive experiences in themselves do not exert much of a protective effect, they can be helpful if they serve to neutralize some risk factors; and that the cognitive and affective processing of experiences is likely to influence whether or not resilience develops. The implications of these findings for family therapy are considered in terms of the need for therapists to look carefully at the ways in which different risk factors interact; to assess and take account of individual differences in susceptibility; to consider the extent to which risk factors impinge on the individual and, in that connection, to note the importance of patterns of social interaction outside as well as inside the family; to appreciate the role of both the peer group and individual characteristics in the development of negative and positive chain reactions; and to pay attention to the ways in which individuals process their experiences.     

论生态学的马克思主义的人道主义

生态学的马克思主义基于对人类命运的关照,立足人道主义,反对以单纯保护生态为目的的生态中心主义和企图转嫁生态矛盾的生态帝国主义;认为资本主义的生产、分配和消费方式是引发生态危机的根源;要想摆脱已经上升为人和自然之主要矛盾的生态危机,不仅需要建立“无增长的”经济模式,倡导“劳动闲暇一元论”和日常生活的“简朴主义”,根除虚假需求,克服异化消费,使生产过程分散化、民主化和管理科学化,变控制自然为解放自然,提倡技术为全人类服务,使生态学充满人道主义,而且需要根除资本主义生产的利润动机,杜绝独裁主义的政治和生产逻辑,反对技术法西斯主义,最终废除资本主义制度,建立非极权的、更易于生存的、以实现生态与社会和谐发展为目标的“稳态社会主义”。     

Joy in the Midst of Suffering: Clowning as Care of the Spirit in Palliative Care

SUMMARY

We find joy in the midst of suffering at Daw House, a palliative care unit. Stories, ranging from moments of gentle tenderness to wild hilarity, speak of profound joy and of the courage of those who participate. We articulate some of the why and how of caring clowning. Clown Doctors aim to affirm people as people with richly storied lives, to give permission for both laughter and tears, and to bring consolation to the spirit. The art of clowning means that we seek to elevate people, to sensitively tailor music, touch, and colour to the interests of those we encounter, to invite a sense of wonder and spontaneity and to work to transform situations through the imagination.     

The Sleeping Beauty and the Therapist’s Gaze: Commentary on Hours and Mayers’s Article on Finding a Path toward Re-Enchantment

In their article, Hours and Mayers make the case that in the imaginary world of fairy tales children have an opportunity to engage and symbolize and also to reflect on the experiences and motives of imaginary characters. This was the case with 8-year-old Barbara who responded to the fairy tales that were narrated to the group by joining in and beginning to share her ideas and reactions. In this commentary, it is argued that it was not just the experience of enchantment that enabled Barbara to begin to listen more attentively to the stories and to engage with her peers. It was also her experience of the narrator's gaze, the therapist who wanted to tell a story to her to make her feel enchanted by all the images and emotions stories can evoke to anyone who listens to them.     

Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Setting: Fifty children aged 8 to 15 years consecutively admitted to a children’s hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.     

Balancing fidelity and adaptation in the dissemination of empirically-supported treatments: The promise of transdiagnostic interventions

Assessing treatment fidelity is a core methodological consideration in the study of treatment outcome; it influences both the degree to which changes can be attributed to the intervention and the ability to replicate and disseminate the intervention. Efforts to increase access to evidence-based psychological treatments are receiving unprecedented support; but pressures exist to adapt treatments to service settings, running the risk of compromising fidelity. However, little evidence is available to inform the necessary conditions for the transportation of interventions to service provision settings, and the degree to which fidelity is even evaluated or emphasized in dissemination and implementation programs varies dramatically. Moreover, adaptation is associated with several benefits for dissemination efforts and may address relevant barriers to adoption. A particularly promising strategy for maximizing the benefits of both fidelity and adaptation is the use of transdiagnostic interventions. Such treatments allow for greater flexibility of the pacing and content of treatment, while still providing structure to facilitate testing and replication. Preliminary evidence supports the efficacy of this strategy, which may be particularly conducive to dissemination into service provision settings. At this time, further research is needed to evaluate the relationships among fidelity, adaptation, and outcome, and to determine the potential for transdiagnostic treatments to facilitate dissemination.     

Validation of a category system for arguments in conflict discourse

Theories of individuation predict systematic differences in argumentative behavior between adolescent girls and their mothers. In order to reveal the nature and functions of this kind of discourse, two studies were carried out on 110 mother-daughter pairs. The second study (n=80) replicated and extended the first study (n=30) on an independent sample. The mother-daughter pairs were asked to discuss a subject that had recently been at issue between them. To assess the argumentative behavior, a category system was developed that reflects the functional character of utterances in discourse. The aim of the research was to test the reliability and validity of the category system. Daughters are assumed to verbalize their own needs and preferences to increase the differences to the mother, and to weaken or reject the mother's arguments in an effort to resist control. Mothers, on the other hand, are supposed to exert control over the behavior of their daughters but do so within bounds of mutuality. This should lead to verbal initiatives and attempts to explain, support and modify their positions and arguments. The data showed high reliability of the categorization of arguments. The categories also differentiated between mothers and daughters. Daughters were more likely to try to weaken and reject (and accept) the mother's arguments and to state preferences while mothers tried to support and explain their positions and to retain control by initiating questions and arguments to which the daughters responded.     

“Bodyheartminding” (Xin 心): Reconceiving the Inner Self and the Outer World in the Language of Holographic Focus and Field

In this essay, inspired by the somatic turn in philosophy initiated by Richard Shusterman, I want to invoke the language of classical Confucian philosophy to think through the best efforts of William James and John Dewey to escape the mind-body and nature-nurture dualisms—that is, to offer an alternative vocabulary that might lend further clarity to the revolutionary insights of James and Dewey by appealing to the processual categories of Chinese cosmology. What I will try to do first is to refocus the pragmatist’s explanation of the relationship between mind and body through the lens of a process Confucian cosmology. And then, to make the case for James and Dewey, I will return to the radical, imagistic language they invoke to try and make the argument that this processual, holistic understanding of “vital bodyminding” is in fact what they were trying to say all along.     

Positive affect and learning: exploring the “Eureka Effect” in dogs

Animals may experience positive affective states in response to their own achievements. We investigated emotional responses to problem-solving in dogs, separating these from reactions to rewards per se using a yoked control design. We also questioned whether the intensity of reaction would vary with reward type. We examined the response (behavior and heart rate) of dogs as they learned to gain access to different rewards: (1) food (2) human contact, and (3) dog contact. Twelve beagles were assigned to matched pairs, and each dog served as both an experimental and a control animal during different stages of the experiment. We trained all dogs to perform distinct operant tasks and exposed them to additional devices to which they were not trained. Later, dogs were tested in a new context. When acting as an experimental dog, access to the reward was granted immediately upon completion of trained operant tasks. When acting as a control, access to the reward was independent of the dog’s actions and was instead granted after a delay equal to their matched partner’s latency to complete their task. Thus, differences between the two situations could be attributed to experimental dogs having the opportunity to learn to control access to the reward. Experimental dogs showed signs of excitement (e.g., increased tail wagging and activity) in response to their achievements, whereas controls showed signs of frustration (e.g., chewing of the operant device) in response to the unpredictability of the situation. The intensity of emotional response in experimental dogs was influenced by the reward type, i.e., greatest response to food and least to another dog. Our results suggest that dogs react emotionally to problem-solving opportunities and that tail wagging may be a useful indicator of positive affective states in dogs.     

Attachment style and subjective motivations for sex

The relation of attachment style to subjective motivations for sex was investigated in an Internet survey of 1999 respondents. The relations of attachment anxiety and avoidance to overall sexual motivation and to the specific motives for emotional closeness, reassurance, self-esteem enhancement, stress reduction, partner manipulation, protection from partner's negative affect and behavior, power exertion, physical pleasure, nurturing one's partner, and procreation were explored. As predicted, attachment anxiety was positively related to overall sexual motivation and to all specific motives for sex, with the exception of physical pleasure. Avoidance was negatively related to emotional closeness and reassurance as goals of sex and positively related to manipulative use of sex but minimally related to most other motives. Sexual passion was positively related to attachment anxiety and negatively related to avoidance, and anxiety was related to the maintenance of passion over time, whereas avoidance was related to loss of passion over time.     

Loneliness then and now: Reflections on social and emotional alienation in everyday life

Loneliness, social isolation, and emotional alienation have become an all-too-common way of life to millions of North Americans; to those who succumb to it and become immobilized, to those who are in the midst of their life's race and do not want to admit it, and to many of those who seek psychological intervention for problems which are seemingly unrelated to loneliness. Being so fundamental to human experience, loneliness merits a closer look and examination of its effects on daily living and its relation to time and space. The present paper describes the various facets of loneliness and looks at man's search for refuge from its devastating pain—a search that is as old as the history of man, and which transcends geographical, cultural, and religious boundaries.     

Aging: I don’t want to be a cyborg!

Examination is made of a range of cyborg solutions to bodily problems due to damage, but here with particular reference to aging. Both technological and animal implants, transplants and prosthetic devices are phenomenologically analyzed. The resultant trade-off phenomena are compared to popular culture technofantasies and desires and finally to human attitudes toward mortality and contingency. The parallelism of resistance to contingent existence and to becoming a cyborg is noted.     

Polling and public policy

This commentary distinguishes five reasons why one might want to conduct a survey concerning people's beliefs about death and the permissibility of harvesting organs: (1) simply to learn what people know and want; (2) to determine if current law and practice conform to the wishes of the population; (3) to determine the level of popular support for or opposition to policy changes; (4) to ascertain the causes and effects of popular beliefs and attitudes; and (5) to provide guidance in determining which law and practices are ethical. The commentary expresses qualms about how well surveys in general can perform with respect to the fifth objective, and it provides specific reasons to doubt whether this survey is informative from the perspective of a moral philosopher concerned with the nature of death and the contours of a permissible system of organ procurement.     

NGO-government partnerships

In an effort to streamline service and generate efficiency, governments have looked increasingly to non-government organizations (usually not-for-profit charities) to deliver service to the public. This new way of subcontracting is often referred to as partnership and has created interesting challenges for both government and non-government sectors. These range from threats to the autonomy of NGOs to the downloading of deficits to the private sector. The field of immigration and settlement provides a particularly interesting example of study.