The Hospital Room as Uncanny: Psychoanalytic Observations and Recommendations for Pastors and Chaplains

This essay in applied psychoanalysis is written for the field of pastoral psychology, and it also has obvious affinities with the medical humanities. The author uses Freud’s (The uncanny. In J. Strachey (Ed. and Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 17, pp. 217–256). Vintage, London, 1919/2001) “The Uncanny” to question the concept of homelike hospital rooms. Instead of making patients feel more comfortable, the authors believes that these rooms could, in some cases, actually increase the anxiety of patients. The author uses Helena Michie’s personal story of her experience of touring a birthing suite to support this argument, as well as some poetry by Billy Collins. The author, however, does not stop with identifying a problem, as he also suggests that pastors and chaplains, when they provide care for their patients, should help them identify and use their own transitional and transformational objects. These objects, of course, will be highly idiosyncratic, and it is precisely this kind of attention—attention to the idiosyncrasies of individuals—that pastors and chaplains should be giving to those in their care. While there is a growing literature on D. W. Winnicott, who coined the term “transitional object,” and Christopher Bollas, who gave us the term “transformational object,” in medical and pastoral circles, the author suggests that attention to and the endorsement of the use of transitional and transformational objects should become a part of hospital policy, if only in chaplaincy handbooks, so as to recognize what many individuals are already doing.     

Methuselah and Company: A Case of Male Envy of Female Longevity

The Bible says that Methuselah, a direct descendent of Seth, the third born son of Adam and Eve, lived to the ripe old age of 969 years. On the assumption that this is a gross exaggeration, we asked ourselves why the writer (or writers) of the book of Genesis felt a need to exaggerate his age? On the basis of evidence that women live longer than men because they bear children and engage in maternal activities toward their offspring, we argue that the exaggerated ages of men in the Bible are a case of male envy of women because women have a longer life expectancy than men do. We suggest that this is an issue that is no less relevant to gender relations today. We propose that one way that men may deal with their envy of women is to assume the role of the “good-enough mother,” and that if this does not have the desired results, there is always humor.     

Comparison of measured and estimated cognitive ability in older adolescents with and without ADHD

Premorbid intellectual function estimation is a crucial part of patient evaluation following a traumatic brain injury (TBI), especially in individuals with ADHD who are at higher risk for TBI compared to their non-ADHD peers. This study investigates the value of using regression-based estimates of intelligence for concurrently predicting measured intelligence in a sample of older adolescents with and without a childhood history of ADHD. Correlations between measured and estimated intelligence are highly significant in the full sample and in the individual groups. Adding reading performance to the regression equation increases the accounted-for variance in both groups. Results indicate that regression equations based on demographic characteristics constitute a valid method for estimating premorbid functioning in adolescents with ADHD and that they can play an essential role in the assessment of individuals with ADHD who sustain TBI, especially when measures of word reading are used to augment demographic estimates.     

The discrimination of patient-generated and randomly generated MMPIs

A discriminant analysis was applied to 34 randomly generated and 34 patient-generated Minnesota Multiphasic Personality Inventory (MMPI) profiles. The discriminant was able to differentiate the two sets at greater than 97% accuracy. A cross validation based on derived unstandardized canonical discriminant functions was carried out on an additional 10 random and 10 patient MMPIs. It attained 95% accuracy. Eight experienced clinical psychologists attained less than 70% accuracy--six of the eight did no better than chance. The importance of including actuarial data in validity judgments was discussed.     

The effect of subliminal oedipal and competitive stimulation on dart throwing: another miss

Silverman and his associates have reported that subliminal presentation of oedipally relevant competitive stimuli can modify dart-throwing performance in male subjects. This study replicated their paradigm, but also examined the effects on performance of nonoedipal competitive stimuli. Our results failed to support Silverman's. Both types of subliminally presented competitive stimuli failed to have any systematic effect on dart-throwing performance.     

Callous-Unemotional Traits in Individuals Receiving Accommodations in University

Research with antisocial individuals suggests that callous-unemotional (CU) traits, a dimension of psychopathy, consistently predict severe antisocial behaviours and correlate with deficits in recognizing negative emotions, especially fearful facial expressions. However, the generalizability of these findings to non-antisocial populations remains uncertain and largely unexplored. This small, exploratory study aimed to extend this research by measuring CU traits and facial emotion recognition in university students with Attention-Deficit Hyperactivity Disorder (ADHD), learning disabilities, other psychiatric disorders, and comparison participants with physical/sensory disabilities. As the clinical groups can exhibit deficits in emotion recognition, this study sought to shed light on the candidacy of CU traits as a factor in emotion recognition. Results suggested that individuals in the diagnostic groups possess similar levels of CU traits to the comparison group and that the relationship between CU traits and emotion recognition deficits previously seen in antisocial populations is not present in this sample. Contrary to the hypothesis, those in the diagnostic groups displayed similar levels of accuracy on an emotion recognition task as the comparison group. Recommendations are made for future research to use more specific and representative diagnostic populations to further assess the relationships between CU traits and emotion recognition in non-antisocial populations.     

The Importance of Teleology to Boyle's Natural Philosophy

Boyle prefaced his Disquisition about the Final Causes of Natural Things with the claim that there are three dangerous consequences for failing to engage in the pursuit of final causes. Boyle was sincere in this claim, for there is a systematic line of reasoning in his texts that incorporates all three consequences and establishes conceptual connections between his science, his theology, and his value theory. I argue in this paper that Boyle's teleological outlook led him to believe that the natural philosopher is morally obligated to continue his investigations of nature on the grounds that a deeper understanding of the teleological order necessarily motivates divine worship. Moreover, Boyle saw a conceptual connection between a teleological study of nature and revealed theology, a connection that reveals that a study of teleological nature can lead to the highest form of happiness. I conclude with a summary, and some remarks about the sincerity and weaknesses of Boyle's reasoning.     

The Discrimination of Patient-Generated and Randomly Generated MMPIs

A discriminant analysis was applied to 34 randomly generated and 34 patient-generated Minnesota Multiphasic Personality inventory (MMPI) profiles. The discriminant was able to differentiate the two sets at greater than 97% accuracy. A cross validation based on derived unstandardized canonical discriminant functions was carried out on an additional 10 random and l0 patient MMPIs, It attained 95% accuracy. Eight experienced clinical psychologists attained tess than 70% accuracy–six of the eight did no better than chance. The importance of including actuarial data in validity judgments was discussed.     

The Paranoia of Everyday Life: Some Personal,Psychological, and Pastoral Thoughts

Freud, early in his writings, makes the argument that paranoia results from the repression of distressing memories, paralleling hysteria and obsessional neurosis. The difference, however, is that paranoia makes use of a special psychic mechanism—projection—whereas hysteria makes use of conversion into somatic innervations and obsessional neurosis makes use of substitution or displacement. Drawing on recent research in paranoia, which suggests that feelings of paranoia are quite common among non-clinical populations, perhaps even as common as feelings of anxiety and depression in non-clinical populations, I suggest that paranoia “in everyday life”—that is, paranoia among non-clinical or so-called “normal” populations—results from the suppression (rather than the repression) of distressing thoughts (rather than memories). The mechanism of projection is still at work, but because paranoia in everyday life results from suppression rather than repression, it is much less severe but also much more common. I have followed the logic of Freud’s writings and I have used the method of introspection to come to this conclusion. I argue that pastors and other such persons would do well in knowing something about paranoia so that (1) they can deal more compassionately with those struggling with paranoia and so that (2) they can deal more compassionately with themselves, since it is likely, I believe, that many pastors often struggle with feelings of paranoia. I note several strategies for coping with paranoia as I deal with religious and psychological aspects of paranoia.