Patterns of psychotherapy development: A mixed-method analysis using assimilation indices

Understanding how assimilation develops is essential in promoting personal change. By attending to signs or indices of assimilation in the speech of clients, therapists can use this process to assess how the therapy is developing and to tailor intervention. The system of assimilation indices was developed to use assimilation to understand the process of change. This system signals five sub-processes of assimilation: external distress, pain, noticing, decentring, and action. This study consisted of a longitudinal mixed-method analysis, following a multiple cases embedded design. The system of assimilation indices was applied to the recordings of nine psychotherapies and contrasted with both the outcome of the therapy and the perspectives of the therapists and clients about their therapy process. The results show that the system of indices is useful in understanding multiple pathways for assimilation. The system of indices is seen as a useful tool for understanding assimilation and as having clinical value in anticipating challenges to the success of the therapy. This study also shows how the indices are sensitive to the nuances in the change process observed in clinical settings.     

Contacting a 19 month‐old mute autistic girl: A clinical narrative

Conveying that psychoanalysis offers rich opportunities for the very early treatment of autistic spectrum disorders, this clinical communication unfolds the clinical process of a 19 month‐old ‘shell‐type’ encapsulated mute autistic girl. It details how, in a four‐weekly‐sessions schedule, infant Lila evolved within two years from being emotionally out‐of‐contact to the affective aliveness of oedipal involvement. Following Frances Tustin's emphasis on the analyst's ‘quality of attention’ and Justin Call's advice that in baby–mother interaction the infant is the initiator and the mother is the follower, it is described how the analyst must, amid excruciating non‐response, even‐mindedly sustain her attention in order to meet the child half‐way at those infrequent points where flickers of initiative on her side are adumbrated. This helps attain evanescent ‘moments of contact’ which coalesce later into ‘moments of sharing’, eventually leading to acknowledgment of the analyst's humanness and a receptiveness for to‐and‐fro communication. Thus the ‘primal dialogue’ (Spitz) is reawakened and, by experiencing herself in the mirror of the analyst, the child's sense of I‐ness is reinstated. As evinced by the literature, the mainstream stance rests on systematic early interpretation of the transference, which has in our view strongly deterred progress in the psychoanalytic treatment of autistic spectrum disorders.     

Values and Antisocial Behavior Among Spanish Adolescents

A number of studies have indicated that delinquent adolescents have characteristic value systems. However, most of these studies have adopted a “known-groups” design—that is, they have compared institutionalized delinquents and non-institutionalized adolescents, assuming those adolescents to be non-delinquent. Designs of this type do not distinguish effectively between the statistical effects of delinquency and of institutionalization. In this study, the authors investigated relationships between values and self-reported antisocial behavior in three adolescent groups: 435 school-attending boys, 529 school-attending girls, and 95 delinquent boys in juvenile rehabilitation centers or prisons. The results indicate that antisocial behavior is associated with hedonistic values and a lack of interest in conventional values and social values. These relationships cannot be explained by the institutionalization effects.     

Intervenciones familiares en el tratamiento de los pacientes con esquizofrenia: aproximaciones recientes

Resumen

Después de mencionar los postulados básicos que subyacen a los modelos tradicionales de terapia familiar a los que se han planteado serias críticas, se revisan nuevos modelos que superan estas limitaciones. Estos nuevos modelos de intervención familiar comparten dos características principales: considerar a los familiares aliados naturales del proceso de rehabilitación del paciente y basarse en el empleo de estrategias terapéuticas claramente operacionalizadas. Se describen brevemente cuatro de estas estrategias y se revisa la evidencia que apoya su eficacia: la terapia familiar orientada a la crisis de Goldstein, el paquete de intervenciones psicosociales desarrollado por Leff y cols., la terapia familiar conductual de Falloom y el programa de psicoeducación familiar de Anderson y cols. Su eficacia es analizada en términos de la disminución observada en las tasas de recaídas y en la consecución de otros beneficios para el paciente y la familia. Se señalan un conjunto de principios generales que deben presidir las intervenciones con estas familias. Por último, se hace una reflexión acerca de algunas deficiencias que estudios futuros han de subsanar para poder alcanzar unas conclusiones más sólidas sobre la eficacia de estos nuevos procedimientos terapéuticos.     

Performance in Autobiographical Memory of Older Adults with Depression Symptoms

The aim of this study was to compare the performance in the Autobiographical Memory Test in older adults with high scores on depression symptoms (HDS) compared with a matched group with low scores on depression symptoms (LDS) according to the clinical cut‐off of the Centre for Epidemiological Studies Depression Scale. Participants were asked to generate specific autobiographical memories in response to a series of positive and negative cue words. Latencies of responses for each item were also scored. LDS participants showed a higher proportion of specific memories than HDS participants. Latencies of responses to positive and negative cues were greater for HDS than LDS. Specific autobiographical memory was positively associated with Life Satisfaction. Cognitive emotional changes in the function of memory with age are suggested as a possible explanation for the findings. Copyright © 2012 John Wiley & Sons, Ltd.     

Multicriteria Classification with Unknown Categories: A Clustering–Sorting Approach and an Application to Conflict Management

This work proposes an approach to cluster and sort a set of alternatives considering multi‐criteria categories with a partial order structure. It can be considered a heuristic approach because it does not attempt to derive an optimal partial order among all conceivable clusters of alternatives. Rather than this, it intends to be a simple approach that is transparent to the Decision Maker (DM) whose assistance is sought to help shaping the results. The approach proposed arises from the conjugation of traditional Clustering analysis and Multi‐criteria sorting tools. At the outset, the number of categories and their characteristics is unknown. First, we need to detect only the clusters themselves on the basis of a similarity measure independent of the preferences of the DM. Next, we detect potential partial order relations that might exist between them, according to the subjective preferences of the DM. Such preferences are elicited only after the DM has examined the clusters detected and deemed that these categories made sense. The new approach performs very well in a real‐world problem of management of intragroup conflicts and conflict handling strategies. Copyright © 2012 John Wiley & Sons, Ltd.     

RECRIMINATION IN THE ANALYTIC SITUATION: A HYPOTHESIS ABOUT ITS INFLUENCE ON PSYCHOANALYTICAL GROUPS

This paper deals with certain distortions in communication generated by mutual recrimination that is the result of disturbances in the ideal agencies of both parties. Although the ideal ego, superego and ego ideal participate equally in reproach, it is the latter which is the most decisive. In clinical experience, recrimination may easily colour the analytic dialogue. In such cases, interpretation loses its sense of clarification and another type of dialogue replaces it. There, words are used to take possession of the other, for its autonomy is a threat to the static character of the pathology of mourning. The problem of recrimination has also tainted the development of psychoanalysis, to the point of disrupting the process of discovery itself. This paper deals with repercussions in the psychoanalytic movement and also in the elements that constitute its structure. Finally, different variations and disturbances in the psychoanalytic ideal are considered, as well as the involvement of the psychoanalytic institution in preserving or transforming the ideal. Here the importance of institutions and institutional ideals is emphasised. Finally, we suggest that ideals either encourage or hinder the working through of individual and collective mourning.     

Learning Psychoanalysis: A Classification Based on Students' Learning Trajectories

This study was undertaken in an effort to sharpen selection procedures and improve faculty response to the learning needs of students. Eschewing a traditional anticipatory approach in determining suitability for training, the authors undertook a retrospective study to investigate the learning trajectories of candidates. A learning trajectory is defined as the particular way individuals learn, or fail to learn, as they advance through an Institute's training program. The database of this study grew out of the authors' experience with students in classrooms, in supervision, and from discussions about them in Progression, Selection, and The Evaluation of Learning committees. Realizing the reductionism of categorizing a highly complex and diverse group of individuals, the authors, nonetheless, found that candidates tended to group into five rather distinct categories. This paper discusses in detail the characteristics of these five categories and suggests ways in which this grouping may help in both selection and in planning more effective training for candidates. The authors are fully aware that this study has impressionistic qualities and warrants more rigorous research methods, but hope that it will arouse interest in other psychoanalytic centers and stimulate studies to corroborate, refine, or reject the conclusions reached by this group.