Looking a Hundred Years Back: Remarks on the Concept of "Wishing" in Psychoanalysis

While the concepts of "wish" and "wish fulfillment" have indeed remained central since the start of classical psychoanalysis, they are only weakly anchored both in theory and practice. It has become common today for psychoanalysts to use the term "to wish" in the sense of "to want" or "to intend." As a first step, it will be emphasized that "wish" should not be constructed along the lines of "intention." An examination of the relationship of "wish" to "wish fulfillment" is then followed by an evaluation of its practical significance for psychoanalysis and for our understanding of mental life in a general sense. Turning to an example dream sequence, we will arrive at the psychoanalytic core of the issue: the assumption of hidden, non-obvious, non-recognizable wish fulfillment scenarios. At this point in the discussion, a method of access will be sketched out - the dramaturgical approach - that, although it makes use of the idea of free association, does so in a manner that diverges from Freud's original recommendation.     

Ethical and Professional Challenges of Genetic Counseling – the Case of Austria

Genetic counseling is gaining in importance with the increasing application of genetic testing for diagnosis and clinical treatment. Genetic counseling often raises ethical and professional challenges and prior research has categorized them into 16 domains. The purpose of this study was to analyze the situation in Austria on the basis of these challenges and discuss it in the national and international context. While in some countries there is a special profession for genetic counseling, in Austria it is provided by medical geneticists or other physicians in the context of their specialization. Psychosocial professionals might be consulted or brought in if necessary. Results from 95 survey respondents (including physicians and psychosocial professionals) revealed a greater interest in the topic of genetic counseling by medical specialists other than medical geneticists. The most frequently encountered challenges among physicians were informed consent, organizational constraints, withholding information, and attaining/maintaining proficiency. The psychosocial professionals experienced maintaining proficiency and organizational constraints as the prevalent challenges. Additional findings and practice implications are presented.     

Unanswered Prayers: Religiosity and the God-Serving Bias

Two self-report experiments examined how religiosity affects attributions made for a target person’s death. Online adults (Study 1, N = 427) and undergraduate students (Study 2, N = 326) read about Chris who had a heart attack, used religious or health behaviors, and lived or died. Participants made attributions to Chris and God (both studies), and reported their emotions (Study 2). Participants made more attributions to Chris when he lived than when he died, but only when he used health behaviors. The highly religious made more attributions to God, but not when Chris used religious behaviors and died (the God-serving bias); they reported the most positive emotions when Chris lived after using religious behaviors (the Hallelujah effect). Directions for future research in terms of implicit religious beliefs and normative evaluations of religion are discussed.     

INSIGHTFULNESS AND LATER INFANT ATTACHMENT IN CLINICALLY DEPRESSED AND NONCLINICAL MOTHERS

The aim of this pilot study was to investigate the relationship between maternal insightfulness and sensitivity and subsequent infant attachment security and disorganization in clinically depressed and nonclinical mother–infant groups. Nineteen depressed mothers with infants ages 3 to 11 months participated in this study. Twenty nonclinical mother–infant dyads were matched to the clinical sample according to infant sex and age. Maternal depression was assessed using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994), insightfulness using the Insightfulness Assessment (IA), and sensitivity using the Maternal Sensitivity Scales (M.D.S. Ainsworth, 1969). IA classifications and subscales were considered separately. Later infant attachment was assessed by the Strange Situation Procedure (M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978). Depressed mothers tended to have less securely attached children than did nonclinical mothers. Within the clinical sample, the insightfulness categories correlated slightly moderately with attachment security, but were not related to attachment disorganization. Within the nonclinical sample, the IA categories were slightly moderately associated with attachment security and with disorganization. On IA subscales, relationship patterns differed in clinically depressed and nonclinical mother–infant dyads. These findings provide the first evidence of the predictive power of the IA categorization and subscales on subsequent infant attachment. They also may allow the development of different foci of intervention for enhancing insightful caregiving.     

Fantasized recipient-donor relationships following lung transplantations: a qualitative case analysis based on patient narratives

The present study examines the relationships between lung transplant recipients and their unknown, deceased donors. Out of 20 semi-structured interviews, eight narratives, by three female and three male recipients respectively, were identified in which the figure of the donor played a role. These narratives were examined using JAKOB, a qualitative research tool that analyses relational configurations and diagnoses psychodynamic conflicts. Analysis revealed a broad range of varying themes and relationships with equally varying wish and fear themes. All the narrators dealt either explicitly or implicitly with whether and how they are connected to their donors. In five narratives, specific personality traits were attributed to the figure of the donor; in four narratives, latent feelings of guilt concerning the donor's death were expressed. Indeed, the figure of the donor was not always perceived as an independent person, separate from the narrator's self: in two cases, the donor appears as part of the recipient's self, while in another case, the donor is presented as a transitional object for the recipient. The findings of the narrative analysis are discussed within a theoretical model of psychical organ integration.     

Implementation and Development of Federally-Funded Systems of Care Over Time

This study describes development in federally funded systems of care. Data for this study were collected using the System of Care Assessment that rated grantees' enactment of system of care principles in the infrastructure and service delivery domains. Data were collected by trained raters who conducted several site visits over the funding period. This study described system development over time across 61 sites and tested whether gains were statistically significant. Latent profile analysis was used to explore whether sites could be meaningfully grouped based on their baseline service delivery domain scores. Differences across groups were tested in terms of community, system, and client characteristics. Differential growth across groups was also examined. Overall, systems of care developed over time in both the infrastructure and service delivery domains. Although infrastructure scores were generally lower than service delivery scores, greater gains were seen for the infrastructure domain. Three groups of sites were identified that could be distinguished in terms of degree of development overall, and for specific system of care principles. The groups of sites differed in terms of community factors, system features, and client characteristics. In addition, repeated measures analyses found differential growth in system development over time across groups.     

Integration of hand and finger location in external spatial coordinates for tactile localization

Tactile stimulus location is automatically transformed from somatotopic into external spatial coordinates, rendering information about the location of touch in three-dimensional space. This process is referred to as tactile remapping. Whereas remapping seems to occur automatically for the hands and feet, the fingers may constitute an exception in that some studies have implied purely somatotopic coding of touch to the fingers. When participants judge the order of two tactile stimuli, they often err when the stimulated body parts (usually the two hands) are crossed, presumably because somatotopic and external coordinates are in conflict in crossed postures. Using this task, we investigated, first, whether the fingers are unlike other limbs with regard to spatial coding, by testing whether crossing effects, indicative of external coding, were observable when stimulating two fingers, either on the same or on different hands. Second, we investigated the interaction of hand and finger posture in tactile localization of finger stimuli. Crossing effects emerged when fingers and hands were crossed, suggesting external coding for all body parts. Crossing effects were larger when both hand and finger were located in the hemifield opposite to their body side, and smaller when only hand or finger lay in the opposite hemifield. We suggest that tactile location is estimated by integrating the external location of all relevant body parts, here of a finger and its belonging hand, and that such integrative coding may represent a general principle for body part processing as well as for tool use.