How Do Geneticists and Genetic Counselors Counsel Women from High-Risk Breast Cancer Families?

This qualitative study asked Australian Genetic Counselors and Clinical Geneticists working in cancer genetics to describe their practice when a woman attends a consultation about her family history and her risk of developing breast cancer. Twenty-nine out of 36 Clinical Geneticists/Genetic Counselors returned the questionnaire (82%). Participants identified the key goals of the consultation as (a) identifying the individual needs and concerns of the woman, (b) providing information on genes and chromosomes, (c) giving an individual risk assessment in the context of supportive interaction, and (d) discussing the pros and cons of genetic testing and putting a surveillance plan into place. Respondents emphasized the dual importance of counseling/support and information provision in this setting, suggesting that one could not be given without the other. Implications for clinical practice are discussed.     

Impulsive and premeditated subtypes of aggression in conduct disorder: differences in time estimation

Research aimed at identifying and studying subtypes of aggression have historically dichotomized aggressive subtypes, although specific nomenclature has varied; one approach has been to classify aggressive behavior as predominantly impulsive or predominantly premeditated. There are a number of behavioral and cognitive differences between those exhibiting these different forms of aggression. This study was designed to extend understanding of the impulsive/premeditated aggression dichotomy by comparing time estimation among adolescents exhibiting predominantly impulsive or predominantly premeditated forms of physical aggression who have a psychiatric diagnosis of conduct disorder (CD). Time estimation has previously been shown to be disrupted in impulsive and some aggressive individuals. Time estimation was compared between healthy Controls (n = 37) and two groups of adolescents with CD, those with histories of either predominantly impulsive (CD-Impulsive, n = 26) or predominantly premeditated (CD-Premeditated, n = 38) aggressive behaviors. Participants completed five computerized trials during which they estimated when 1 min had passed. Among aggressive adolescents with CD, the misperception of time was specific to those with histories of impulsive aggression, although time estimates improved with repeated testing and performance feedback. This study confirms the importance of considering the role and type of physical aggression when studying heterogeneous diagnostic groups like CD and supports the relevance of time estimation to certain subgroups of adolescents with CD.     

The social environments of early infancy in Japan and the United States

The social environments of early infancy in Japan and the United States were compared in terms of the context of caregiving and the quality of the month-infant interaction. Mothers of 17 Japanese infants and 17 infants in the United States were interviewed in their homes about the experiences that they provided for their 4-month-old infants, and mother-infant interactions were recorded on videotape. Levels of parents' education were similar in both countries. The context of the infant's development varied substantially with culture. Mothers in the United States provided a greater variety of experiences on the HOME and care of Japanese infants tended to be more exclusively provided by mothers whereas care of infants in the United States was shared by fathers and other caregivers to a greater extent. Examination of behaviour frequencies during mother-infant interaction indicated that mothers in Japan provided their infants with more vocal input and more physical play than mothers in the United States and Japanese mothers were more vocally responsive to their infants' vocalizations.     

Psychodynamic assessment of changes in children with autism under psychoanalytic treatment

In this article the authors report insights into autism developed through their extensive experience of psychoanalytic therapy with children with autism. The fi rst stages of body psychic development are seriously disrupted by this pathology, resulting in primitive anxieties of falling and of being liquefi ed. These anxieties are connected to the fragile development of body ego and of its related spatiotemporal organisation. The changes in children observed by the authors during the therapeutic process lead them to offer a psychodynamic assessment tool, which revolves principally around the development of body ego. After the initial state of 'severe autism', the authors describe three stages: the stage of 'recovery of the skin' (Bick); the established 'symbiotic phase', subdivided into 'vertical then horizontal splitting of the body ego'; and fi nally the stage of 'individuation'. First, the authors describe the principal psychoanalytic approaches to autism and refl ect on the links possible with nonpsychoanalytic work.     

Opening to the otherwise: The discipline of listening and the necessity of free‐association for psychoanalytic praxis

It is argued that only free‐association methodically opens the discourse of self‐consciousness (the representations available to reflective awareness) to the voicing of the repressed. The method is key to Freud's originality and the sine qua non of any genuinely psychoanalytic process. Clinical procedures which do not prioritize a steadfast and ongoing commitment to this method (instead emphasizing either interpretative formulations, as decisive acts that appear to fix and finalize the meaning of a particular lived experience, or the vicissitudes of transference‐countertransference in the immediate treatment situation) all too readily entrap the treatment, limiting its capacity to divulge the power of unconscious processes. Influenced by Laplanche, Freud's 1920 principles of lifefulness and deathfulness (the binding and unbinding of psychic energy in representations) facilitate an understanding of the unique significance of free‐associative discourse in opening the representational textuality of self‐consciousness to the voicing of that which is otherwise than representationality and reason. The ‘otherwise’ is intimated as the returning force of the repressed, as the ‘unfathomable navel’ of ‘thing‐presentations,’ experienced and expressed within the text of awareness, yet not translatable into the law and order of its logical and rhetorical reflections. Free‐associative discourse thus affects self‐consciousness in a way that is radically different from other creative procedures (‘psychosynthetic’ or integratively interpretive). In this respect, the status of free‐associative praxis as necessary for a genuinely psychoanalytic process is justified.     

Free-associating with the bodymind

Abstract

The history of attitudes toward Freud's adoption of free-associative discourse, as well as toward the significance of the clinical significance of the free-associative method, is critically reviewed. It is argued that, if one takes the re-inviting of repressed contents back into self-consciousness to be the defining process of psychoanalysis as a discipline (distinguishing it even from those psychotherapies that are based on psychoanalytic models of the mind), then free-associating is indeed the sine qua non of the psychoanalysis process. It is further suggested that whereas Freud's notion of libidinality radically subverts Cartesian dualism, our thinking about the significance of free-associative discourse has too frequently lapsed into the mistaken assumption that free-associating should only be about what “comes to mind.” In this context, a way of free-associating with the “bodymind” is described as an addendum to customary psychoanalytic practices. This augmented method remains faithful to Freud's practice of allowing the voice of sensuality to “join the conversation,” at the same time that its clinical implementation incorporates some of the wisdom concerning “breathwork” that comes from the yogic procedures for cultivating awareness.     

Preventing Contagion With Avian Influenza: Disease Salience,Attitudes Toward Foreigners,and Avoidance Beliefs1

Building on an evolutionary approach to out‐group avoidance, this study showed relations between perceived disease salience and beliefs in the efficacy of avoiding foreigners as protective measures in the context of a real‐life pandemic risk; i.e., avian influenza. People for whom avian influenza was salient and who held unfavorable attitudes toward foreigners were more likely to believe that avoiding contact with foreigners protects against infection. This finding suggests that individual differences in social attitudes moderate evolved mechanisms relating threat of disease to out‐group avoidance.