“You Must Remember This”

The question of a theory of analytic change is approached through a consideration of analytic impasse. Impasse is considered in relation to impasse in the analyst, linked to an impasse in some forms of mourning in the analyst. The analyst's impasse is considered in the light of character formation, the relation of analytic vocations to early attachment, and object ties in the analyst leading to problems with omnipotence. Impasse then is tied to various processes and defenses that shape and contribute to the analyst's countertransference. Analytic change is considered then in the context of theories of nonlinear development, models of speech practice, and mutative action. These ideas are explored through case material.     

Introduction to Judit Mészáros' “Progress and Persecution in the Psychoanalytic Heartland: Antisemitism,Communism, and the Fate of Hungarian Psychoanalysis”

In this introduction, a rationale is developed for why these accounts of the historical movements and catastrophes in psychoanalytic institutional histories are so important. I argue that we need to contextualize theory and practice in political and historical terms, seeing that historical forces shape institutions, the fates of individuals, and the evolution of theory and practice. In particular, I consider the impact of the events in Hungary over nearly 50 years as crucial elements in the eclipse of Ferenczi and his school. I argue that we need to rethink our too-narrow focus on comparative theory and imagine the role of history in the fate of ideas. The impact of fascism and of Stalinism on psychoanalytic work and practitioners is seen here as a necessary element in our understanding of where we are now and from what cultural and historical experiences we have emerged.     

Discussion: Putting our Heads Together; Mentalizing Systems

This discussion reviews the psychoanalytic and developmental psychological theories that utilize nonlinear dynamic systems theory to situate Sperry's paper in its theoretical and historical context. The power of such nonlinear models for clinical work and theories of mind is argued. The essay then argues that the shift in theory entails a shift in ways of clinical writing and that the clinical discussion in the paper does not always feel consonant with the theory. Moving to a model of nonlinearity, intersubjectivity, and uncertainty is likely to entail shifts in conceptualizing and conveying clinical material.     

Children's Mechanistic Reasoning

Reasoning about mechanisms is one of the hallmarks of disciplined inquiry in science and engineering, but comparatively little is known about its precursors and development. Children at grades 2 and 5 predicted and explained the motion of simple mechanical systems composed entirely of visible linkages (levers). Students' explanations of device behavior suggested four forms of knowledge: simple recognition of device components, noting of structural relations among components, construction of cause-effect rules derived by observation of regularities in device behavior, and identification of essential system components and interactions among components that accounted for cause–effect rules. Only a few children coordinated multiple essential components to constitute a mechanistic causal scheme. Mechanistic causal schemes, in turn, were associated with successful prediction of the output motion of a system. Device tracing via gesture and talk appeared to support this form of knowledge development, and hence may inform future instructional design.     

Living with Hereditary Haemorrhagic Telangiectasia: stigma,coping with unpredictable symptoms,and self-advocacy

Abstract

Objective: Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic condition causing frequent nose bleeds, skin lesions (telangiectasia) and arteriovenous malformations. Approximately, 50% of people experience life-threatening HHT symptoms including haemorrhages in the brain, lungs and liver. This study aimed to gain a qualitative understanding of the psychosocial impact of HHT over time. Design: Using a phenomenological framework, a rigorous narrative analysis was performed on 20 semi-structured interviews with individuals with HHT aged 20s–60s. Main outcome measures: Qualitative themes explaining life experiences prior to and following a clinical diagnosis of HHT. Results: Narratives highlighted four psychosocial themes: (i) the psychological impact of visible symptoms was significant and related to experiences of social stigma, (ii) individuals struggled to identify triggers of symptoms in order to reduce unpredictability, (iii) an illness identity was rejected by minimising HHT when talking about the present self, and by positive reframing as ‘lucky’ and (iv) self-advocacy was necessitated due to lack of expert coordinated care. Conclusion: HHT has a demanding impact on social, physical and psychological well-being. These findings have significant implications for health care, as narratives about interactions with health professionals often used the terms ‘frustrating’ and ‘not being heard’.     

Parents Will Be Parents: Conceptualizing and Measuring Nonoffending Parent and Other Caregiver Support Following Disclosure of Sexual Abuse

A gap exists in the literature with regard to the theoretical conceptualization of nonoffending parental and other caregiver (NOC) support of sexually abused children. Measures need to be developed that appropriately capture this construct. The purpose of this article is to present a qualitative study that asked 17 NOCs in different ways how they supported their sexually abused children after the disclosure of the sexual abuse. The multiple different types of support were coded and, using grounded theory, the structure of NOC support emerged from the data. The final structure of NOC support had 8 dimensions, including basic needs, safety and protection, decision making, active parenting, instrumental support, availability, sensitivity to child, and affirmation.