A procedural theory of therapeutic action: Commentary on the symposium,Interventions that effect change in psychotherapy

Operating largely outside of awareness, the procedural mode of processing has been neglected in psychotherapy and psychoanalysis, and yet it is critical to our understanding of therapeutic action. This group has made an outstanding contribution to a procedural theory of therapeutic action, integrating some of the most important current concepts in infant research, cognitive psychology, systems theories, and adult psychoanalysis. The procedural mode of “implicit relational knowing” is placed within the context of a moment-by-moment, mutual regulation model of co-constructed exchanges. Nonlinear dynamic systems theory has greatly influenced their theory of change. The centerpiece is Louis Sander's concept of the “moment of meeting.” Although the concept of intersubjectivity is central in all the papers, the multiple uses of the term suggests that a careful re-examination of the definitions of intersubjectivity is sorely needed. We must now integrate the work of this group with other current procedural theories of therapeutic action. © 1998 Michigan Association for Infant Mental Health     

"Till destruction sicken": the catastrophe of mind in Macbeth

The author examines the tragedy of Macbeth from the vertex of its portrait of the effects of the hero's abandonment to the "blindest fury of destructiveness" (Freud, 1930, p. 121), using aspects of psychoanalytic thought to illuminate the theme. She affirms that Macbeth's immediate transformation in phantasy from loyal subject to future assassin threatens to flood his psyche with the uncontainable energy of destruction and thus to produce a psychic catastrophe. The remainder of the play is then examined as a representation of Macbeth's attempts to defend himself from that catastrophe: the only objects whose existence he can tolerate are those that cannot challenge his possession of the crown, which leads him to attempt to destroy all opposition. Since this is impossible, his alternative is to denude his mind of its perception of the reality in which the actions of others will inevitably produce future transformations which he is unable to control. The play's last soliloquy anticipates the final state, the repose of emptiness; it portrays a mind, emptied of emotion, looking at a world which it has denuded of meaning.     

Vocal congruence in mother-infant play

Turn-taking is the fundamental temporal structure of adult dialogue. This structure defines two types of joint silence: intrapersonal pause (silence bounded by the vocalizations of a single speaker) and switching pause (silence bounded by the vocalizations of different speakers). Switching pauses mark the boundaries of the turn exchange. In adult conversation the mean durations of both types of pause are characteristically matched between partners. This matching, termed vocal congruence, occurs developmentally earlier in the case of switching pauses. We hypothesized and confirmed that mothers and infants match switching pauses but not intrapersonal pauses at 4 months, even though the infants' vocalizations are prelinguistic. Second, since there are known affective correlates of vocal congruence in adult conversation, we hypothesized a similar affective correlate for mother-infant vocal congruence. We found, for the intrapersonal pause only, that the degree of matching within a dyad correlated with infant affective engagement. We conclude, from switching pause congruence, that a turntaking dialogic structure is being regulated in the mother-infant pair at 4 months in the same way as seen in adult conversation. Thus, both the temporal structure of adult dialogue and its affective correlate are prelinguistic.Supported in part by NIMH grant No. 41675.     

Normative and psychometric data on the body image assessment--revised

After falling into disfavor in the early 1990s, the construct of body image, as measured by body-size estimation (BSE) techniques, has been the focus of increasing interest in the eating disorder literature because of recent theoretical, empirical, and methodological advances. However, no published BSE measure to date has been shown to be psychometrically sound, well normed, inexpensive, and straightforward. This article provides normative and psychometric data for an adapted silhouette BSE measure. Comprehensive normative data are presented on college women's cognitively and affectively based body-size estimates, as well as their desired body size and related discrepancy indexes (cognitive vs. desired, affective vs. desired, affective vs. cognitive). Preliminary data indicate that indexes from the new measure are moderately reliable over time, consistent with their theoretical link to fluctuations in body-related attitudes. Data also support the convergent validity of the measures. Affectively based BSE, alone or as part of a discrepancy measure with desired body size, was most strongly related to measures of eating pathology, body focus, body dissatisfaction, and depressed affect.     

Diversity: A Problem in Common

The more we live in densely populated environments in which we regularly encounter people of different ethnic origins, classes, sexual orientations, and gender identities, the more we tend to feel that we have a sophisticated relation to diversity. Being exposed to diversity and embracing it, however, are different things. The latter depends on a level of self-acceptance and self-understanding that can also develop in a less overtly diverse environment. Further, celebrating diversity is not the same as experiencing the essential oneness of humanity, including oneness with people whose political views we do not share. C. G. Jung's theory of psychological types offers a deep approach to embracing diversity, since the eight types of consciousness that Jung felt created differences between people also occur within each of us. Learning to identify each of the types within ourselves can be a step toward accepting both the psychological diversity around us and the inevitable limitations in being comfortable with the differences that all of us share.     

On the Origins of Disorganized Attachment and Internal Working Models: Paper II. An Empirical Microanalysis of 4-Month Mother–Infant Interaction

A microanalysis of 4-month mother–infant face-to-face communication predicted 12-month infant disorganized (vs. secure) attachment outcomes in an urban community sample. We documented a dyadic systems view of the roles of both partners; the roles of both self- and interactive contingency; and the importance of attention, orientation, and touch, as well as facial and vocal affect, in the co-construction of attachment disorganization. The analysis of different communication modalities identified striking intrapersonal and interpersonal intermodal discordance or conflict, in the context of intensely distressed infants, as the central feature of future disorganized dyads at 4 months. Lowered maternal contingent coordination, and failures of maternal affective correspondence, constituted maternal emotional withdrawal from distressed infants. This maternal withdrawal compromises infant interactive agency and emotional coherence. We characterize of the nature of emerging internal working models of future disorganized infants as follows: Future disorganized infants represent states of not being sensed and known by their mothers, particularly in moments of distress; they represent confusion about both their own and their mothers' basic emotional organization, and about their mothers' response to their distress. This internal working model sets a trajectory in development which may disturb the fundamental integration of the person. The remarkable specificity of our findings has the potential to lead to more finely focused clinical interventions.     

Weakness of will, reasonability, and compulsion

Experimental philosophers have recently begun to investigate the folk conception of weakness of will (e.g., Mele in Philos Stud 150:391–404, 2010; May and Holton in Philos Stud 157:341–360, 2012; Beebe forthcoming; Sousa and Mauro forthcoming). Their work has focused primarily on the ways in which akrasia (i.e., acting contrary to one’s better judgment), unreasonable violations of resolutions, and variations in the moral valence of actions modulate folk attributions of weakness of will. A key finding that has emerged from this research is that—contrary to the predominant view in the history of philosophy—ordinary participants do not think of weakness of will solely in terms of akrasia but see resolution violations and moral evaluations as playing equally important roles. The present article extends this line of research by reporting the results of four experiments that investigate (i) the interplay between hastily revising one’s resolutions and the degree of reasonableness of the actions one had resolved to undertake, (ii) whether ordinary participants are willing to ascribe weakness of will to agents whose actions stem from compulsion or addiction, and (iii) the respects in which akratic action, resolution violations, and the seriousness of an addiction impact attributions of weakness of will to agents acting in accord with their addictions.