The violence of the ethical encounter: listening to the suffering subject as a speaking body

How does the clinical encounter work? To tackle this question, the present study centers on the paradigmatic clinical encounter, namely, psychoanalysis, paradigmatic in that it is structured by the encounter itself. Our question thus becomes: how does the clinical encounter work, when its only modality is speech? By reading Jacques Lacan and Emmanuel Levinas together, we better identify how speech sets up as subjects those who address one another and how this subjectivation touches the suffering body specifically. In this framework, a definition of the encounter is put to work: The encounter of a sufferer and a listener, that is, the clinical encounter, is the opening of an inter-human space beyond suffering. This conception of the encounter permits a specifying of the violence it avoids—respecting the transcendence of the other irreducibly other—but also the violence that it mobilizes—through a presumption of subjectivity imposed upon the other, by which the subjectivation at work in the encounter is, by definition, a subjection to the other. This outlines, then, an ethics of the clinical encounter: a relationship of man to man commanded by one sensing body to another, i.e. a minimal and therefore radical ethics that is structured as a sensible ethics between speaking bodies.     

The analytic group: A multifaceted approach to the treatment of adolescents

During adolescence the peer group plays a major role in facilitating developmental processes, since it not only serves as a replacement for childhood love-objects and attachments, but offers the adolescent allies in the struggle to separate and become emancipated from parents. For those adolescents who, because of interpersonal and intrapsychic difficulties, have no peer group or have chosen an inappropriate peer group, providing a therapeutic group can make it possible for development to proceed. This paper presents not only a theoretical basis for the utilization of groups of peers in the treatment of adolescents, but also an elaboration on the dynamic processes which make possible improvement of ego-functioning and resolution of core conflicts related to the past, as well as to this particular developmental phase.     

A commentary on the symposium: The use of history in the social sciences curriculum

The use of history in the social science curriculum leads to a deepened understanding of the respective disciplines of anthropology, education, sociology, political science, psychology, and history of science. The use of history in the social sciences also leads to extradisciplinary interests in history, philosophy, and literature. Some highlights from a symposium and from the recent literature are discussed.     

The origin of language: A scientific approach to the study of man

The Enlightenment regarded language as one of the most significant achievements of man. Consequently inquiries into the origin and development of language play a central role in eighteenth-century moral philosophy. This new science of man consciously adopts the method of analysis and synthesis used in the natural sciences of the time. In moral philosophy, analysis corresponds to the search for the basic principles of human nature. Synthesis is identified with the attempt to interpret all artificial achievements of man (arts, sciences and institutions) as the effect of these principles and of man's physical and social environment - an attempt known as theoretical history. The type of explanation envisaged by theoretical historians is based on the principle of causality. It consists in a genetic reconstruction of the social phenomenon under investigation. Inquiries into the origin of language follow this pattern of explanation. They form part of theoretical history and thus represent a major aspect of the eighteenth-century scientific study of man.     

A patient's transference to the analyst's supervisor: effect of the setting on the analytic process

A case is presented in which the patient's transference to the analyst's supervisor became evident just prior to the switch from clinic to private patient status. The patient experienced the supervisor as a restraining father figure who protected her from acting on her erotic wishes toward the analyst. Analysis of this led to the recall of previously repressed memories of sexual wishes toward her brother, and the sense of protection from these wishes that she had gotten from the presence of her father. The literature on transference involving the supervisory constellation and the training setting is reviewed, and the concepts of split and institutional transference are examined. Factors inhibiting the analysis of patients' fantasies about the analyst's status as trainee, including the presence of the supervisor and the institute, are discussed.     

The interpretation of Libet's results on the timing of conscious events: a commentary

A commentary on articles by Klein, Pockett, and Trevena and Miller, in this issue, is given. Average shift in the point of subjective equality (PSE), calculated by Klein on Libet's data, and corresponding change in mean shift, calculated by Libet et al. (1983), may be "corrected," taking as a reference point the end of the minimum train duration. Values obtained, if significant, indicate a latency for conscious sensation of the skin stimulus of at least 230 ms. Pockett's main conclusions are favored, but her explanation of peripheral-lemniscal couplings is found to be unconvincing. Trevena and Miller's article unsuccessfully tries to rescue a dualist interactionist view. Libet's method of timing intentions is thoroughly criticized.     

A funny thing happened on the way to the journal: a commentary on Foucault's ethics and Stuart Murray's "Care of the self"

Stuart Murray's 'Care and the self: biotechnology, reproduction, and the good life' utilizes Foucault's "care of the self" to examine health domains in its title. The present author discusses three important articulations of concern with the Foucauldian concepts of care of the self that are absent in the work of Murray and others: first, the voluntarism and individualism inherent in ideas about care of the self; second, the absence of the interactional and relational; and, third, the perpetuation of the interpretation of Foucault's concept of governmentality, 'the conduct of conduct', as primarily coercive.     

Individual characteristics related to prison violence: A critical review of the literature

At the end of 2010, prisons in the United States incarcerated over 1,605,127 inmates, yielding an imprisonment rate of 497 per 100,000 residents (Guerino, Harrison, & Sabol, 2011). Approximately 15.6% of correctional officers have been the victim of an inmate assault (Duhart, 2001) and 21% of inmates reported being victims of violence in prison (Wolff, Blitz, Shi, Siegel, & Bachman, 2007). However, which inmates are more likely to perpetuate these violent acts while incarcerated? The present paper critically reviews the empirical literature on the relation between individual characteristics of inmates and prison violence. Variables are divided into three general categories: demographic, criminal history, and psychological variables. From over 500 studies, a representative sample of 20 studies from 1990 to 2011 was reviewed based on specified inclusion criteria, such as adult males incarcerated in English-speaking countries. Although there are some discrepant findings, a general conclusion can be reached regarding most variables. These characteristics are compiled into a prototype of an inmate at “high” risk and an inmate at “low” risk for prison violence. Methodological limitations of the research are presented, as well as suggestions for future research directions.     

The findings of the Dartmouth Atlas Project: a challenge to clinical and ethical excellence in end-of-life care

The Dartmouth Institute for Health Policy and Clinical Practice Atlas Project found "staggering variations" in the quality and quantity of end-of-life care provided to Medicare patients with severe chronic illness across the United States. Particularly concerning is the finding that more care is provided to patients who live in "high-supply" areas, irrespective of the effectiveness of care, and that more care often equaled inappropriate care that increased patients' suffering at the end of life. Patients in "lower supply" areas typically received better, more appropriate levels of care and reported higher levels of satisfaction with the care they received.     

The patient's progress from this world to that which is to come: commentary on the Consensus Statement of the Working Group on Roman Catholic Approaches to Determining Critical Care.

The author comments on the consensus statement from the point of view of an ethics consultant in Germany. Since many hospitals in Germany are under considerable competitive pressure, mission statements are becoming more and more important in order to draw a distinction between the different hospital types and to convey the meaning of the corporate identity both internally and externally. The Consensus Statement, which provides basic orientation without going into too much detail, can be a helpful initial document. However, it does not deal with two specific problem areas which are examined more closely in the commentary: the application of risk-of-death algorithims in ICUs and the question of church membership of the caregivers to enable a proper preparation for death. The commentary also reveals certain difficulties in the discussion taking place in Anglo-Saxon countries and Continental Europe.     

A contribution to the understanding of the role of the superego in dreams: Further development of an approach to dreams in analytic group psychotherapy

Seven dreams from patients in three different groups are presented to illustrate the author's ego-psychological approach to dreams in group under varying conditions as well as to emphasize particular concepts regarding the role of the superego in the dream. This paper demonstrates how the author addresses group process, individual functioning and the dream simultaneously within the context of an ongoing therapeutic process. The first section of the paper points out that theoretical contributions towards an understanding of the dream, since its original position of importance, have been almost nonexistent. The author believes the significance of the superego throughout the analytic process as well as in theory has been underestimated.Dr. Edwards is an Associate Supervisor and Faculty Member at the Postgraduate Center for Mental Health in the Group Department. She is also a Training and Supervising Analyst at the National Institute for the Psychotherapies, a Training Analyst at the Institutes of Religion and Health and the Blanton-Peale Graduate Institute, and a Lecturer and Guest Faculty at the New York University Postgraduate Medical School.