Breakdown in communication: On finding the child in the analysis of an adult

SUMMARY

In this paper a patient is described in whom communication with parts of herself and with her objects, internal and external, had broken down. I suggest that her way of communicating was achieved by projective identification, as described by Klein (1946) and Bion (1962). The only way she could deal with and communicate her own very “bothered” feelings was to “put them” into the analyst. In this way she “bothered” the maternal or analytic mind in such a way as to make the analyst experience feeling like a “bothered” child.

I have tried to show how the analyst holds or contains these feelings, and to show the gradual establishment in the patient of a different way of communicating with the analyst and with the more primitive parts of herself.     

Emotional Communication and the Unconscious in the Analytic Setting

ABSTRACT

One type of unconscious communication is conceptualized as a form of emotional communication, the channel of communication that conveys information about a person’s emotional state through the nonsymbolic expression of feelings and is experienced as feeling in the receiver. Some of the analyst’s feelings are attuned responses to the patient’s unconscious communications; others are disjunctive and related only to the analyst’s unconscious. Attuned feelings can be identified by their congruence—similarities, consistencies, and analogies—with the patient’s verbal material, which reveals the meaning that the analyst’s feeling has within the patient’s subjectivity. Attuned feelings also have a meaning within the analyst’s subjectivity. Two cases are discussed, one in which the analyst experiences the patient’s unconscious communication within the symbolism of one of her own childhood memories. The other illustrates the risk of confusing disjunctive feelings emanating from the analyst’s own unconscious with unconscious communication from the patient.     

Family-focused management: Treatment of choice for deviant and dependent families

Abstract

Helping professionals working with troubled families takes two approaches. One approach, noting that the identified patient's family's behavioral interactions have positive and negative effects on the patient and his symptoms, advocates involving family members in the treatment process. The other approach, noting that the identified patient alone has the power to resolve his problem, advocates treating the patient independently of the family. This latter approach, in effect, relieves family members of the painful feelings of responsibility. At first glance, these two approaches appear to be in conflict, and it is no wonder that professionals choose to remain with one or the other. Both points of view are valid, so that approaches need to be developed which incorporate both.     

Adolescent Decisional Autonomy Regarding Participation in an Emergency Department Youth Violence Interview

Much attention has been given to determining whether an adolescent patient has the capacity to consent to research. This study explores the factors that influence adolescents' decisions to participate in a research study about youth violence and to determine positive or negative feelings elicited by being a research subject. The majority of subjects perceived their decision to participate to be free of coercion, and few felt badly about having participated. However, adolescents who were alone in the room during the assent process were more likely to report that they chose freely to be a research subject. This study may influence the ways physicians communicate with adolescent patients around research assent within a clinical care environment.     

Physical activity,screen time and subjective well-being among children

Background/ObjectiveThe aim of the study was to explore the differences between physical activity and/or screen time levels on cognitive (Life satisfaction LS) and affective (Positive affect, PA and Negative affect NA) components of subjective well-being (SWB) in children.MethodThis cross-sectional study enrolled 1,540 children (1,040 boys, 8–12 years old). LS, PA, NA, physical activity and screen time were assessed with validated questionnaires.ResultsChildren who reported 3 days per week of physical activity or less had lower LS and PA than counterparts with ≥6 days of physical activity per week (p < .05). Participants who reported 2 hours per day or less of screen time had lower NA than counterparts with 4 hours per day or more of screen time (p < .05). Also, children who meet physical activity guidelines have higher LS and PA compared to inactive peers, even with high screen time. In contrast, excessive screen time was also related with NA independent of the level of physical activity.ConclusionsOur findings suggest that physical activity is related with positive feelings and LS, but does not eliminate the effect of screen time on negative feelings among Chilean children.     

Feeling states of people experiencing depression,anxiety, or comorbid depression and anxiety symptoms during a multi-day charity cycling ride: An ecological momentary assessment study

ObjectiveRegular exercise has substantial benefits for mental health. The way people feel during exercise impacts motivation. This study investigated whether experiencing depression, anxiety or comorbid depression and anxiety symptoms impacted feeling state responses throughout a charity cycling ride.DesignTo achieve this aim, we conducted an ecological momentary assessment study of feeling states (via Pleasant and Negative Affect Schedule items) across a multi-day cause-based cycling event.MethodMultivariate and univariate generalized linear mixed models was applied to test how affective and self-conscious emotional experiences changed across time and whether feeling state change differed between people experiencing depression, anxiety, or comorbid depression and anxiety symptoms.ResultsFor people experiencing depression symptoms, positive feelings decreased and negative feelings increased throughout the event. People experiencing anxiety symptoms had initially elevated negative feeling states that decreased across the event. For people experiencing comorbid depression and anxiety symptoms, changes in pride mirrored that of people experiencing only depression symptoms (decrease from initially high levels); whereas changes in guilt mirrored that of people experiencing only anxiety symptoms (initially high levels that decreased throughout event).ConclusionsThese findings demonstrate that depression and anxiety symptoms put people at risk for having negative affective and emotional experiences during exercise events and that these effects are further complicated when depression and anxiety symptoms co-occur. Exercise events and interventions must consider how to mitigate the potentially demotivating impacts that negative affective judgments can have on motivation for future exercise participation of people experiencing depression and/or anxiety symptoms.     

Love in the counter-transference: The uses of the therapist's excitement

SUMMARY

The psychoanalytic tradition has always had difficulty with the question of the therapist's sexual feelings toward the patient. This paper traces that difficulty: from Freud's original struggle to replace moralism with a psychoanalytic mode of understanding, to the more recent literature on countertransference which still seems particularly averse to the possibility of the therapist's sexual experience. By way of a discussion of a psychoanalytic psychotherapy, I argue for the sometimes central therapeutic role of the therapist's experiencing, and then containing, excitement.     

Typical-Atypical Interactions: One Patient’s Experience of Weight Bias in an Inpatient Eating Disorder Treatment Setting

Abstract

This article examines one patient’s experiences with weigh bias in an inpatient eating disorder treatment setting with a focus on interactions between the patient and her primary therapist. These therapeutic interactions had multiple unintended consequences, including bolstering feelings of denial, modeling of disordered behaviors, and disrupting the therapeutic alliance. Additional instances of weight bias with other treatment professionals, including an inpatient nutritionist and psychiatrist, are briefly discussed. The article ends with several brief recommendations for how clinicians can more skillfully approach issues of weight and size in the therapeutic alliance in order to resist size-related oppressions rather than reinforce them.     

GUIDED READING IN POETRY: COMBINING AESTHETIC APPRECIATION AND DEVELOPMENT OF ESSENTIAL SKILLS

Reading and sharing poetry fosters richness in languages and encourages understanding of ideas presented through a beautiful form of expression. Poetry takes the reader through expression of emotion and the ideas that these emotions inspire in the poet. Further, the poet stimulates the reader to explore his or her own feelings and ideas. Discussion of what a particular poem means to individual students provides opportunities to share ideas and feelings which the poem evokes.

The use of poetry invites students to read lines or particular phrases which are appealing to them or about which they have a question. Furthermore, teachers should be encouraged to combine the aesthetic dimensions of poetry with skills development. A poetry guide for encouraging basic language skills is presented herein.     

To Find a Voice

Abstract

This article will present a compilation of case studies that will document the art therapy process utilized to assist incarcerated women with histories of severe trauma in expressing their feelings in an appropriate manner. These case studies will show how art images produced within this therapeutic milieu enabled the women described to reconnect with disowned thoughts, feelings and fantasies in a safe way.     

Danger or Opportunity

SUMMARY

Countertransference is the sine qua non of all human relationships. The manner in which the couples therapist deals with countertransferential feelings can have a powerful impact as either a force for healing or a force for destruction. Based on the tenets of Integrity Therapy, this paper offers a philosophical and clinical examination of countertransference in couples therapy. Focusing on the areas of rigid adherence to therapeutic dogma, emotional expression at all costs, negative countertransference and projective identification, teaching unauthentic ways of interacting, and co-therapy issues, this paper explores the ways in which traditional dynamic, humanistic and emotionally centered couple therapies can both therapist and patient into a betrayed of self and of the couple relationship.     

The Influence of Background Music on the Visitor Museum Experience: A Case Study of the Laiho Memorial Museum,Taiwan

ABSTRACT

The uses and functions of music within the museum environment are of both practical and theoretical interest. This article investigates the impact of background music on the museum visitor experience using information collected from 20 in-depth interviews with visitors to the Laiho Memorial Museum in Taiwan. Each participant heard either a piece of light music or a historical recording of a 1930s song while visiting Laiho's personal study exhibited in the museum. These two types of background music have comparable information loads, although they fit the exhibit to different degrees. Qualitative analysis of interview data indicates that background music played in museums has both emotional and cognitive influences on the visitor experience. This study showed that light music evoked warm and relaxed feelings in participants, whereas a 1930s song evoked feelings of nostalgia and curiosity to learn more about the song. The results are discussed in terms of the diverse needs, behaviors, and attitudes of museum visitors.     

Acute exercise effects on worry,state anxiety,and feelings of energy and fatigue among young women with probable Generalized Anxiety Disorder: A pilot study

BackgroundLittle is known about the acute effects of exercise among individuals with clinical or subclinical Generalized Anxiety Disorder (GAD).PurposeThus, this study examined worry, state anxiety, and feelings of energy and fatigue responses to acute aerobic exercise and quiet rest, and explored potential moderators of response among young adult women with worry scores indicative of GAD.MethodsSeventeen young women with Penn State Worry Questionnaire scores ≥45 (60 ± 8) completed 30-min treadmill running at 65%–85% heart rate reserve (%HRR) and 30-min seated quiet rest in counterbalanced order. Outcomes included worry, state anxiety, and feelings of energy and fatigue. Two condition X two time repeated measures ANOVA examined differences across condition and time. Hedges’ d effect sizes (95%CI) were calculated to quantify and compare the magnitude of change. Independent-samples t-tests explored potential moderators of outcome response.ResultsTotal exercise time was 35.8 ± 3.4min with a mean 30.3 ± 0.16 in-zone minutes (65%-85%HRR); participants exercised at ∼72.9 ± 0.03 %HRR (range 66%–79%). Compared with quiet rest, acute exercise significantly improved worry engagement, state anxiety, and feelings of energy and fatigue (all p ≤ 0.031). Moderate-to-large (d = 0.44 to 1.69) reductions in state anxiety and feelings of fatigue and improvements in feelings of energy were found. Exercise-induced reductions in worry engagement were significantly larger among non-high trait anxious participants. Compared to normal sleepers, quiet rest significantly increased feelings of fatigue among poor sleepers.ConclusionFindings provide support for the positive effects of acute aerobic exercise on worry, state anxiety, and feelings of energy and fatigue among young women with worry indicative of GAD.     

Strengthening Voices

SUMMARY

As a therapist I have chosen to work with adolescent girls whose voices are among the weakest in our society. They have been sexually, physically and/or emotionally abused as children. Many have seen their mothers beaten by their boyfriends or husbands. Many have body-perfection obsessions such as anorexia and bulimia. Almost all of them have run away from home, hung out downtown, stolen property, relied on drugs and alcohol, and purposefully hurt themselves to take away their feelings. Many have resorted to selling their bodies on the streets or within their peer groups. They all operate from a self-belief of worthlessness, a belief that has gender socialization and abuse at its core. It is at this core that the therapeutic relationship must begin. This article describes a therapy relationship with a 14-year-old girl. This work with adolescent girls is described as being guided by three main principles, that of relationship, justice and soul work.     

WORLDLY AND UNWORLDLY FEELINGS,FABRICATION AND LETTING GO

ABSTRACT

This paper proposes a framework for understanding vedanā and emotion in relation to each other, and both of them in relation to awakening. The vedanā (or feeling tone) that arises in mental experience will be shown to be central to emotion. Western views of emotion will be examined alongside some of the Buddha’s teachings on vedanā. The paper will show mental vedanā, and human emotion in the context of the two psychological orientations of ‘fabrication’ and ‘letting go’, which are then correlated with the Buddha’s notions of ‘worldly’ and ‘unworldly’ feelings. The paper proposes that such contextualisation is useful towards the development of a clear intellectual understanding of the nature of feelings, while (more importantly) it could support practitioners in a process of meditative inquiry and transformation.     

Respect and the Confucian concept of Li (ritual propriety)

ABSTRACT

This paper specifically deals with the relation between respect and li禮in the Confucian context. Li has both negative and positive sources. On the positive level, ritual propriety enables one to express internal moral and religious feelings, especially respect, reverence and humility. Furthermore, this work investigates into the relevant feelings and acts of respect and ritual propriety, as well as meaningful critiques of ritual, in an attempt to clarify the genuine expression of ritual propriety that helps to actualize human inner moral and religious approaches.     

The internal world of the juvenile sex offender

This paper explores the consequences of the therapist's two successive pregnancies on a female patient. The second pregnancy was felt to be particularly difficult and disturbing. One of the central reasons was that after the patient's birth, the mother had a disabled child, followed by a stillbirth and soon after that the father left to marry another woman. Using Freud's concept of deferred action I will argue that my second pregnancy revised these earlier traumatic experiences.

The patient seemed to have incorporated and identified with a damaged maternal object that at the time of the original trauma was left husbandless, depressed and suffering from panic attacks. Although the therapist's healthy pregnancies seemed to reassure temporarily, it was difficult for the patient to hold onto a view of a helpful and productive therapist, one separate from this damaged internal mother. This was particularly so during and after the second pregnancy, where there was a marked absence of an idea of a third object, a father or a husband, who could help the patient deal with this pregnancy, her only escape was to retreat and act out.

The acting out was in part identification with a fleeing father and in part a defence against the absence of such a third object, so that it was used as a way of avoiding claustrophobic feelings of being trapped with the damaged mother. Her feelings of triumph then produced much guilt, and impeded reparation.

Another important issue that two successive pregnancies bring, are feelings of guilt in the therapist for exposing the patient to two major disruptions. In this patient's case it exacerbated the internal reality of a damaged maternal figure.     

Detriangulation of Absent Fathers in Single-Parent Black Families: Techniques of Imagery

The projection of the mother's unresolved feelings about an absent father onto one or more of her children-often the eldest son expected to assume the role of parental child-is an obstacle frequently encountered in therapy with single-parent Black families. Acknowledgment and resolution of these feelings by the mother is an important step toward reestablishing generational boundaries and improving communication between mother and children. It is suggested that the empty chair procedure and the use of family photographs are two interventions that can be used within the context of structural and/or transgenerational family therapies to help the mother separate her feelings about the absent father from her feelings about her children. Models for the use of both approaches and the potential benefits of each is presented. The successful outcome of either technique may depend, however, on variables in the family's history and the stage of therapy during which the techniques are introduced.     

Validation française du School Burnout Inventory

IntroductionFirst studied in adults, the concept of burnout was recently extended to adolescents in order to evaluate the impact of school requirements on their health.ObjectiveThis study aim at assessing construct validity, reliability and concurrent validity of a French version of the School Burnout Inventory (Salmela-Aro, Kiuru, Leskinen, & Nurmi, 2009) that characterize school burnout by exhaustion linked to school demands, cynicism toward school and feelings of inadequacy as a student.MethodThree hundred and eighty-seven adolescents have filled the translated questionnaire and a confirmatory factor analysis was performed on the data.ResultsThe analysis confirmed the tridimensional structure of the scale and mainly show satisfactory psychometric qualities.ConclusionThis measurement scale should provide clinicians with a rapid and simple assessment of school burnout in adolescents. Researchers could also benefit from it in order to extend theoretical knowledge about this trouble.     

Survey of School Psychologists' Attitudes,Feelings, and Exposure to Gay and Lesbian Parents and Their Children

Abstract

School psychologists' attitudes and feelings toward gay and lesbian parents were surveyed in relation to their training and exposure, and professional services offered to gay and lesbian parents and their children. The relationship between attitudes, feelings, training, exposure, and demographic characteristics was explored as well. A stratified random sample of 500 school psychologists who were members of NASP was surveyed using a 30-item questionnaire. Out of the 500 surveys sent, 267 school psychologists (53.4%) returned them. Overall, school psychologists have positive attitudes and feelings toward gay and/or lesbian parents. More specifically, school psychologists who were female, homosexual/bisexual, or living in the Western region of the United States had significantly more positive attitudes and feelings toward gay and/or lesbian parents. Although few school psychologists (30%) received any formalized training, those who had some training indicated more positive attitudes. The majority of school psychologists (89.4%) reported having personal associations with homosexual individuals. More exposure to homosexual individuals by a school psychologist indicated more positive attitudes as well as feelings. Implications of the findings and future research directions are discussed.