Paranoia and narcissism in psychoanalytic theory. Contributions of self psychology to the theory and therapy of the paranoid disorders

Many factors go into a choice of a therapeutic focus: the patient's psychopathology; the therapist's training, countertransference reactions, and ideological beliefs; and, importantly, a decision about what seems most amenable to treatment and change. As a theory, self psychology describes one aspect of the paranoid process; as such, it is an incomplete theory that complements rather than invalidates more classical theories. As a technique, however, it suggests a style and focus conducive to working with paranoid patients, one that is markedly supportive, nonconfrontational, yet also interpretive. In this context, it must be remembered how difficult it is to treat paranoid patients psychotherapeutically, much less to keep them in treatment. The strategies discussed above do not wholly replace other dynamic approaches (e.g., counterprojective techniques), nor are they universally applicable. Some patients may be more amenable than others. However, the techniques provide a very supportive framework that may help the therapist to be more available to and in contact with the paranoid patient. More broadly, this paper's application of self psychology to the theory and therapy of the paranoid disorders further illustrates the practical utility of this approach. Attention to the narcissistic developmental line, interpersonal selfobject relationships, intrapsychic conflicts and deficits, and empathic immersion in the patients's world are important adjuncts to the psychotherapy of paranoid patients. Rather than an either/or dichotomy, the principle of overdetermination suggests a both/and relationship between self psychology and traditional theory, such that the self psychological approach complements rather than contradicts the classical psychoanalytic theory. The vicissitudes of the self simply add another perspective or vantage point from which to understand and respond to the patient, one which has perhaps more applicability for preoedipally disordered patients.     

Coping strategies and diastolic blood pressure

An organizational field study involving 95 civil service employees examined the ways these individuals coped with the stressful events of their daily living. Lazarus' cognitive-phenomenological analysis of psychological stress provided the theoretical framework. Subjects indicated on Lazarus' Ways of Coping Checklist those coping thoughts and actions used in the specific encounter described as stressful. As hypothesized, individuals experiencing higher diastolic blood pressure were more likely to cope using strategies characterized by wishful thinking, avoidance, and minimization of threat than were individuals exhibiting lower blood pressure. Implications from both an individual and organizational perspective are discussed.     

Subtypes of limbic system dysfunction evoking homicide in limbic (?) Psychotic trigger reaction and temporal lobe epilepsy--evolutionary constraints

Within an evolutionary context two subtypes of limbic system dysfunctioning are compared: (1) the previously proposed limbic psychotic trigger reaction, in which nondrive motivated homicide is triggered by a specific individualized external stimulus, which evokes a brief-lasting active reliving of past (moderately) stressful, frequently repeated ("kindled"?) situations. The brief-lasting out-of-character homicidal episode with flat affect is typically associated with first-time formed or unformed hallucinations of various modalities and with overactivation of the autonomic nervous system. There is no (noticeable) loss of consciousness, enabling the patient's full recall (at times with suicidal attempts) (Pontius, 1981, 1984, 1987). (2) A rare case of homicide during a fugue state with echopraxia in temporal lobe epilepsy is discussed.     

Hypnotic susceptibility and its relationship to outcome in the behavioral treatment of asthma: some preliminary data

12 subjects from an experiment on relaxation therapy for asthma were given the Harvard Group Scale of Hypnotic Susceptibility, Form A. Full scale hypnotic susceptibility scores were positively correlated, at a borderline significance, with improvement in the methacholine challenge test, a measure of asthma severity. Performance on the amnesia item of the Harvard Group Scale was correlated with improvement in self-reported symptoms of asthma.     

Blocking Effects in Two-Choice Discrimination Tasks in Rhesus Monkeys Macaca Mulatta

The Psychological Record - The present experiments investigated blocking effects in rhesus monkeys (Macaca mulatta) in a discrimination learning paradigm using a single stimulus modality. Two...     

Examination of apparent extent as an explanation of the Poggendorff effect

The explanation of apparent misalignment in the Poggendorff figure, based on underestimation of the intertransversal distance, was investigated in two experiments. In Experiment 1, subjects judged the intertransversal distance in the traditional Poggendorff figure and two of its variants. The size of the acute angle and the intertransversal distance were manipulated. Half of the subjects made the judgments with the method used by Wilson and Pressey (1976) and the other half made their judgments with the method used by Greist-Bousquet and Schiffman (1981). The results indicated that perceived intertransversal distance was greater with the former method. In Experiment 2, subjects adjusted the transversals to apparent collinearity in the same displays as were used in Experiment 1. The collinearity judgments were transformed to allow comparison with the results of Experiment 1. Comparison of the collinearity judgments with the distance judgments indicated that they did not follow similar trends. For each Poggendorff variant, proportional distance judgments increased as the size of the acute angle increased, and decreased as the intertransversal distance increased. Collinearity judgments did not vary as a function of intertransversal distance. As the size of the acute angle increased, collinearity judgments increased for two of the Poggendorff variants but decreased for the third. It was concluded that the findings did not support the explanation of apparent misalignment based on underestimation of the intertransversal distance.     

Counseling: A conversion experience

In this article, the experience of conversion, which is usually delegated to the realm of spiritual studies, is applied to the counseling experience. It is posited that a person who goes through a successful counseling process will experience a turning around, will cease leading life in a dysfunctional way, and will move forward in a manner by which the person experiences life in a new perspective. This new perspective brings the person wholeness and balance.     

Carl Rogers and Martin Luther—A “reformation” in the helping professions

The 16th century schism in Christian thought leading to the Reformation has an interesting analogy in Carl Rogers' attempt to reform the helping professions. An exploration of this analogy clarifies much of the theoretical tension in the contemporary arena of pastoral counseling.     

Changes in the incidence of nocturnal bruxism in college students: 1966-1989

The frequency of self-reported nocturnal bruxism in three large samples of college undergraduates was compared as a means of assessing change in the incidence of this disorder since 1966. We found the incidence of nocturnal bruxism had increased from 5.1% to 20.5% in college students over the period covered by these studies.