The Blank Screen of Cyberspace

Internet communication (cyberspace) media, which have entered our culture in various ways, present novel opportunities—and challenges—for analytic practice. The availability of new modes of interaction prompts reflection about the role of familiar structures for analytic work. We describe the most prominent interactional environments in the cyberspace world; factors affecting analytic work in cyberspace; and ways in which the cyberspace dimension of the outside world may affect even traditional analytic settings. For guidance, we invoke the familiar longstanding discussion of the role of the couch.     

Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern‐based qualitative analytic approaches

Thematic analysis methods, including the reflexive approach we have developed, are widely used in counselling and psychotherapy research, as are other approaches that seek to develop ‘patterns’ (themes, categories) across cases. Without a thorough grounding in the conceptual foundations of a wide variety of across‐case analytic approaches, and qualitative research more broadly—something rarely offered in counselling training—it can be difficult to understand how these differ, where they overlap, and which might be appropriate for a particular research project. Our aim in this paper is to support researchers in counselling and psychotherapy to select an appropriate across‐case approach for their research, and to justify their choice, by discussing conceptual and procedural differences and similarities between reflexive thematic analysis (TA) and four other across‐case approaches. Three of these are also widely used in counselling and psychotherapy research—qualitative content analysis, interpretative phenomenological analysis and grounded theory. The fourth—discourse analysis—is less widely used but importantly exemplifies the critical qualitative research tradition. We contextualise our comparative approach by highlighting the diversity within TA. TA is best thought of as a spectrum of methods—from types that prioritise coding accuracy and reliability to reflexive approaches like ours that emphasise the inescapable subjectivity of data interpretation. Although reflexive TA provides the point of comparison for our discussion of other across‐case approaches, our aim is not to promote reflexive TA as ‘best’. Rather, we encourage the knowing selection and use of analytic methods and methodologies in counselling and psychotherapy research.     

When Danny said no! Refusal of treatment by a patient of questionable competence

The patient we call Danny was a mildly mentally retarded male in his mid-thirties who adamantly refused kidney dialysis when it was offered as the only therapeutic option for his progressive kidney failure. It was uncertain how fully Danny understood the implications of his refusal. To complicate the case still further, several “advocates” emerged to speak on Danny's behalf — each with a somewhat different interpretation of the situation and different sets of value presuppositions and ethical principles to apply to the choice. We chronicle the development of this situation through a series of scenes; and in each scene we also attempt to clarify the ethical and medico-legal issues involved at that point. Danny was finally permitted to make this decision for himself — though more by default than by an agreement by all parties to honor his autonomy. Our hope is that this presentation will lead to further discussion and clarification of these important issues.     

Silicon in ‘pure gold’? Theoretical contributions and observations on teleanalysis by videoconference

Ideas about psychoanalysis via videoconference—videoconference teleanalysis (VT)—are presented with the general understanding that these settings produce a twofold split between various degrees of recognition/negativisation of the absence of the other, on one hand, and the expectation of physical co‐presence, on the other. This split has been put forward as dismantling the here, now, with me pre‐reflexive unity of the analytic experience. This article suggests that both members of the analytic dyad will seek to reappropriate the experience through a forced ego integration that interferes with accessing states of unintegration in the analytic treatment and produces subtle alterations to symbolisation work. The effort to overcome this condition is illustrated with clinical vignettes and therapists’ comments about feelings of inauthenticity and discontent when trying to sustain evenly‐suspended attention, as well as in the perception of a form of flattening of the alive nature of speech. However, this is not a constant for all VT, and mutual understanding can be an important mitigating feature. The focus of the discussion should be on the capacity of the analytic dyad to overcome such a split and not on a direct extrapolation of the perceptual limitations of VT to possible effects on transference / countertransference.     

Universal Ethical Principles in a Diverse Universe: A Commentary on Monshi and Zieglmayer's Case Study

Monshi and Zieglmayer's case study presents Sri Lankan participants as having views on the privacy of health information that differ radically from those commonly found in Western nations. This article explores 2 questions that their case study raises for the ethical review of research in international settings: First, are allegedly universal ethical principles—of the sort promulgated in the Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978)—useful in international settings?, and second, how should research oversight bodies address the challenges that arise in international behavioral and social science research?     

Beyond the International Relations framework: an essay in descriptive global ethics

Discussions of global ethics—about the types of ethical claim made on individuals and groups, not only states, by individuals and groups around the world—have had to move beyond the categories inherited in the International Relations discipline. Many important positions are not captured by a framework developed for discussion of inter-state relations. The blindspots seem to reflect an outmoded expectation that (i) giving low normative weight to national boundaries correlates strongly with (ii) giving more normative weight to people beyond one's national boundaries, and vice versa; in other words that these two dimensions in practice reduce to one. The paper develops an enriched categorisation. We need to recognise the separate importance of the two dimensions, and thus distinguish various types of ‘cosmopolitan’ position, including many varieties of libertarian position which give neither national boundaries nor pan-human obligations much (if any) importance.     

Epistemic Injustice and Resistance in the Chiapas Highlands: The Zapatista Case

Though Indigenous women in Mexico have traditionally exhibited some of the highest levels of maternal mortality in the country—a fact that some authors have argued was an important reason to explain the EZLN uprising in 1994—there is some evidence that the rate of maternal mortality has fallen in Zapatista communities in the Chiapas Highlands in the last two decades, and that other health indicators have improved. In this article, we offer an account of the modest success that Zapatista communities have achieved in improving their health levels. In particular, we argue that Zapatista women have implicitly used a form of feminist standpoint theory to diagnose the epistemic (and economic) injustice to which they have been traditionally subjected and to develop an epistemology of resistance that is manifested in actions such as becoming health promoters in their communities. We also argue that this epistemology of resistance is partially responsible for the improvement of health levels in their communities. Finally, on the basis of our discussion of the Zapatista case, we suggest that standpoint theory could play an important role in other healthcare settings involving oppressed minorities.     

Psychoanalytisch begründete Ans?tze in der forensischen Psychiatrie und Psychotherapie

After many years where manualized mainly behaviour treatments dominated in forensic settings, psychodynamic therapies are gaining acceptance and are performed and evaluated more and more in forensic hospitals and in prisons. This encompasses individual, couple, family and group therapies. Individual and group analysts are starting to perform these tasks again, mostly as workers in forensic settings but also as external therapists and supervisors. All staff members are important in creating a therapeutic community based on group analytic principles. They are therefore required to build up a therapeutic attitude supported by regular external case and team supervision. Delictogenic situations occur in everyday life as well as in professional settings and are analysed mainly in group therapies, considering situations of the past and the effect on other people. Modern manualized analytical concepts, such as transference-focussed psychotherapy (TFP) and mentalization-based therapy (MBT) depthen the quality of therapeutic work of all professionals in forensic settings. The multimorbid and sometimes dangerous patients require good ethical and professional attitudes. The psychoanalytic concepts of defence and resistance, transference and countertransference are essential parts of changing internalization and corrective emotional experience, important parts of useful forensic treatments.     

Answering the Ethical Question

Many philosophers have attempted to answer the ‘ethical question’: can the ethical value of an artwork ever contribute to its aesthetic value, and if so, how? In this paper, I consider a methodological question that arises out of this discussion: should attempts to address the ethical question use analytic tools found in contemporary philosophical literature, art criticism, or some combination of the two? I concur with arguments proposed elsewhere, which suggest that art criticism has an important role to play in addressing the ethical question. However, I argue that any fruitful attempt to answer the question must defend some particular way of understanding the ethical value of artworks, which suggests that we should address what I label the ‘art question’: what is the role and importance of art? This question, I suggest, is one with which philosophers can usefully engage. This division of labour offers a way forward in addressing this important issue.     

Affective Honesty and Compassion Come in Many Forms: Discussion of “Love (and Hate) With the Proper Stranger: Affective Honesty and Enactment,” By Holly Levenkron,L.I.C.S.W.

Holly Levenkron's work with her patient, Ali, beautifully illustrates one way that a creative analyst makes superb use of her own experience to communicate and negotiate with great affective honesty. Holly's analytic style emphasizes the effective use of a particular kind of self-disclosure and a way of thinking about intersubjectivity and enactment associated with the contemporary Relational movement. Yet, it may be Holly's personal willingness to allow the analytic relationship to profoundly destabilize and influence her that most engages Ali in their work.

An imaginary analytic scenario is described with an analyst, Dr. X, who like Holly is destabilized by Ali but whose thinking about intersubjectivity and enactment emphasizes an empathic immersion in Ali's experience of the analytic relationship. In contrast to Holly, Dr. X focuses primarily on grasping and interpreting the adaptive strivings that animate Ali's differently organized subjective world.

The underlying capacity to acknowledge and use the analyst's own version of the patient's issues may also characterize analyses such as that of the hypothetical Dr. X—in style that are more explicitly “interpretive” (less confrontative) than Holly's work. These two contrasting approaches highlight the wide range of ways to think about intersubjectivity, enactment, and affective honesty in the analytic process.     

Therapeutic Misconceptions: When the Voices of Caring and Research Are Misconstrued as the Voice of Curing

Research on doctor-patient communication has characterized such interactions as being asymmetrical. The present article tries to shift emphasis away from the different orientations individuals bring to the communicative setting and attempts to highlight the different orientations ("voices") within a given individual. We draw on an in-depth analysis of discourse between a 2 l-year-old man who can be ascribed the roles of both patient and potential research subject and an interviewer who acts in both the role of medical staff and researcher. Focusing our analysis on a limited number of linguistic forms (pronouns and demonstratives), it is argued that the use of the same form for different referents signals a conflation of two voices—the voice of health care ("caring") and the voice of "research." Furthermore, we argue that the voice of research is most likely to be interpreted by the patient/research subject within the framework of curing. As such, the present article promotes a shift in emphasis from different institutional—and as such often assumed to be preexisting—orientations between the communicating parties to differing orientations within the individual that cannot help but be misconstrued in terms of the curing voice. Our conclusion focuses on the ethical and discourse analytic implications of analyzing voices in a discussion.     

Narrative as a hermeneutical relationship to the unconscious

In this article, what seems to have been two central tenets in contemporary psychoanalytic narrative theory are challenged. The one—propounded by Roy Schafer—is that the goal of psychoanalytic work is to furnish the analysand with an alternative narrative. The other—propounded by Donald Spence—is that any story will do, if only it is coherent, consistent, persuasive and encompasses the known “facts”. Basing his critique of the mentioned standpoints on an intersubjective understanding of psychoanalytic work and a concept of interpreting inspired by the existential hermeneutics of Martin Heidegger, the author discusses the nature of the analytic dialogue and the role of transference together with the ethical basis of truth in the analytic project. Finally, it is indicated that there is a limit to analytic working-through, where the analysand's narrative activity must come to a halt and room be left for a resolve, where the analysand may undergo a fundamental transformation.     

Making Choices: Ethical Decisions in a Global Context

The changing milieu of research—increasingly global, interdisciplinary and collaborative—prompts greater emphasis on cultural context and upon partnership with international scholars and diverse community groups. Ethics training, however, tends to ignore the cross-cultural challenges of making ethical choices. This paper confronts those challenges by presenting a new curricular model developed by an international team. It examines ethics across a very broad range of situations, using case studies and employing the perspectives of social science, humanities and the sciences. The course has been developed and taught in a highly collaborative way, involving researchers and students at Zhejiang University, the Indian Institute of Technology, Bombay and Brown University. The article presents the curricular modules of the course, learning outcomes, an assessment framework developed for the project, and a discussion of evaluation findings.     

Ethical Presence in the Psychoanalytic Encounter and the Role of Apology<Superscript>*</Superscript>

This paper discusses aspects of ethical presence in psychoanalysis, and the possible use of apology in the therapeutic process. The author roughly delineates two periods in the history of psychoanalysis regarding the ethical dimension—the early classical period which is influenced by Freud’s ethics of honesty, which gradually evolves towards the more recent intersubjectively-influenced period, necessitating the assimilation of an ethics of relationships. It is suggested that explicit theorizing of the ethical dimension into psychoanalysis offers added value to its effectiveness, and a framework is presented for combining relational, intersubjectively informed ethical dialogue, with contributions of classical technique, enriching the therapeutic potential of psychoanalytic work.     

Was Wittgenstein an Analytic Philosopher?

Abstract: This article first surveys the established views on Wittgenstein's relation to analytic philosophy. Next it distinguishes among different ways of defining analytic philosophy—topical, doctrinal, methodological, stylistic, historical, and the idea that it is a family‐resemblance concept. It argues that while certain stylistic features are important, the historical and the family‐resemblance conceptions are the most auspicious, especially in combination. The answer to the title question is given in section 3. Contrary to currently popular “irrationalist” interpretations, Wittgenstein was an analytic philosopher in all phases of his career, albeit an exceedingly exotic one whose style transcends the limits of academic philosophy in general. On the historical understanding he qualifies because he was influenced by and in turn influenced mainly analytic philosophers. On the family‐resemblance conception he qualifies both because he developed and employed logico‐linguistic analysis and because he initiated the linguistic turn and the distinction between philosophy and science that characterizes one important strand in analytic philosophy.     

The Asian Disease Problem and the Ethical Implications Of Prospect Theory

We discuss the bearing of Daniel Kahneman and Amos Tversky's Prospect Theory on some central issues in ethics. It has been argued that the theory provides a better explanation of our intuitive responses to some important ethical decision cases—like some famous cases put by Philippa Foot and others—than traditional and widely acknowledged ethical principles do. In this way, Prospect Theory contributes to the new wave of skepticism, emanating from the social sciences, about the role of intuitive judgments in ethical theory and philosophy more generally. We focus on Kahneman and Tversky's famous Asian Disease Problem. We show that the case fails to support Prospect Theory over traditional ethical theory as an explanation of the most common intuitive responses to the case, and, moreover, fails as an account of the most common intuitive responses to Foot's famous trolley case and related cases. We maintain that careful critical attention to all these cases shows that Prospect Theory has not made a successful incursion into ethics, whatever it may have established about non‐ethical decision‐making.     

The roots of empathy and aggression in analysis

Empathy and interpretation have complementary roles in analysis. Empathy diminishes psychological arousal, ego-defences, and promotes the therapeutic relationship. Interpretation, when adopted in the service of character analysis and the uncovering of unconscious conflict, represents one element of a larger set of interventions termed analytic aggression, whose primary goal is to promote insight. Psychoanalysis has been increasingly influenced by derivative theories that promote the therapeutic relationship. Clinical observations suggest that the application of analytic aggression has diminished and that many modern treatments may have become overly skewed towards empathic approaches. This paper explores ethical humanism, Jamesian typology, and feminine psychology, as factors that have contributed to the diminished emphasis on analytic aggression in practice. Eastern myth and Buddhist psychology are used to explicate the core features of narcissistic mental structuring and to support the continued importance of analytic aggression in its treatment. Case material is examined to elucidate the benefits and limits of analytic aggression.     

Ethics and the Social Dimension of Research Activities

This study identifies some of the ethical issues that arise in the everyday practice of researching in collecting interactional data. A form of conceptualizing ethics in research is proposed as awareness of the social dimension of research practices and their transformative nature. The collection of ethnographic data—including interviewing, observing, audiovisual recording, and other methods—is achieved by means of social interactions that necessarily imply issues of face, relevance, appropriateness, politeness, and identity, to name a few. Research activities have an impact on both the setting and the participants in the study, in fact, they become part of the setting studied. At times, participants may be using the research activity for their own ends. It is important for researchers to be aware of and responsible for the impact they have on the setting under study. Some ethical problems encountered conducting actual research activities are discussed as an illustration: issues related to negotiation of consent in semipublic settings and to the protection of informants’ anonymity. The actual resolution of these problems is presented as research findings from the everyday practice of doing research. Systematic reflection on the social and interactional dimension of how ethical decisions are taken during actual research activities could make legislation on the protection of research participants and ethical guidelines more realistic and useful.     

The Effects of Salesperson Compensation on Perceptions of Salesperson Honesty1

A reputation for honesty and trustworthiness is important to success in sales. In this article, we report 2 experiments examining the effects on perceived salesperson honesty of information about how the salesperson is compensated (commissions vs. straight salary). In both experiments, commissioned salesmen were perceived as less honest than were noncommissioned salesmen, but compensation method had no effect on the perceived honesty of saleswomen. The discussion of these findings focuses on their implications for sales management.