Followup of psychoanalysis five to ten years after termination: III. The relation between the resolution of the transference and the patient-analyst match

As part of a long-term followup study of the outcome of psychoanalysis, we examined the relation between the extent of resolution of the transference at termination and the characteristics of the patient-analyst match. For twelve of the seventeen patients interviewed five to ten years after termination of psychoanalysis, the researchers found that the patient-analyst match played a role in the outcome of the analysis. Illustrations of the influence of the match in cases where the transference was resolved and those where it was not are presented.     

Is the match/mismatch model based on a statistical artefact?

In the match/mismatch model, recently formulated by Rachman and coworkers, it is stated that incorrectly predicted aversive experiences are generally followed by an immediate adjustment of the predictions concerning aversiveness of the next experience. This model can be considered to reflect a psychological process of the formation of expectations. In the present article it is argued that a simple H0 model, assuming that predictions are completely randomly generated by the subject, may account for the same effects. This H0 model is used in a stringent test of empirical data to determine if there are any effects of the discrepancy between prediction and experience on next prediction that exceed the effects explained by the H0 model. Although the H0 model produces effects very similar to the empirically observed effects, there is clear support for the hypothesized influence of the discrepancy between prediction and experience. Therefore, the model appears to reflect 'real' psychological processes and not chance findings.     

Types and correlates of blood/injury-related vasovagal syncope

This study investigated by interview, the initial syncopal episode of 103 blood/injury-related vasovagal fainters in order to examine two competing hypotheses concerning their origins. Graham (Circulation, 23, 901-906, 1961) postulated that the faint resulted when sympathetic nervous system (SNS) activity ceased on termination of a threat, leaving parasympathetic nervous system (PNS) activation unopposed. Engel [Fainting (2nd edn), 1962; Annals of Internal Medicine, 89, 901-906, 1978] proposed that when in the face of threat with SNS activation, escape is blocked, the PNS becomes activated as the conservation-withdrawal response, leading to syncope. We found cases clearly conforming to each of these formulations as well as some with characteristics of both, and some who fainted in response to blood or injury but with no perception of threat. The Graham and Engel types did not differ in terms of fear or avoidance of blood, injury, or medically-related situations nor did they differ in the frequency with which their parents reported blood/injury-related syncopal episodes. It is proposed that both may be activated by a common psychological mechanism involving cessation of a defensive posture. In contrast, the non-threat fainters showed significantly less medically-related avoidance and had a greater percentage (94%) of parents with positive faint histories.     

Alcohol and correspondence between self-report and physiological measures of anxiety

The present study was designed to determine the main effects of alcohol intoxication on self-report and physiological measures of anxiety. Second, we aimed to assess the role of the Marlowe-Crowne Social Desirability (MCSD) scale in predicting the relationship between self-report and physiological indices of anxiety irrespective of drink content. A final purpose of the study was to determine whether the MCSD could account for discrepancies in the effects of alcohol on the two anxiety response systems. Subjects were male social drinkers who received an 0.70 g/kg dose of alcohol or placebo. Results indicated that irrespective of drink content, subjects with high MCSD scores reported lower levels of anxiety than did subjects with low MCSD scores. This relationship was not evident for heart rate. These results for measures of anxiety were not influenced by drink content.     

The relationship between underpredicted pain and escape

Escape and avoidance that are disproportional to the danger of the pertinent stimulus are important clinical problems that are often related to inaccurate (catastrophic) expectations. One possible source of such expectations is a prior, underestimated aversive experience. In the present experiment the hypotheses that underestimated pain leads to escape and that it leads to avoidance were tested. In order to control for the effect of the intensity of the pain stimulus, a control group that received 20 pain stimuli of high intensity was formed. Subjects in the experimental condition received 17 pain stimuli of low intensity and 3 of (unexpectedly) high intensity (experimentally induced underprediction). Underprediction of the high intensity stimulus was significantly related to escape, but not to avoidance. The results suggest that the way in which avoidance was operationalized accounts for this. The strong support of the hypothesized relationship between underpredicted pain and escape is an important finding, however.     

Convergent and Discriminant Validity of FACES-III: Family Adaptability and Cohesion

Research on earlier versions of the Family Adaptability and Cohesion Evaluation Scales (FACES) has ostensibly shown that the scales lack discriminant and convergent validity (23). However, these studies have defined convergence as agreement between family members or as agreement between family members and family therapists. Such definitions confound real differences between respondents' perceptions of the family with the notion of convergent validity. In the current study, we take a different approach to construct validity. Multiple measures of family adaptability, cohesion, and talkativeness were administered to two family members (insiders) and two significant others (outsiders). The two insiders' responses were averaged together, as were the two outsiders' responses. Using confirmatory factor analysis, we demonstrated that family adaptability, cohesion, and talkativeness are distinct traits, and that the different sources of information about these traits, including FACES-III (24), have convergent validity.     

Further thoughts on second-order family therapy--this time it's personal

A series of articles has recently appeared in which implications of second-order cybernetics for the practice of family therapy have been discussed. In this article, we attempt to advance the discussion by addressing ideas that we think have not been adequately emphasized thus far. Specifically proposed are ideas about conditions that might facilitate the emergence of consciously pragmatic strategy informed by the kind of systemic wisdom that delicately balances natural systems without the benefit of human planning. It is argued that a shift in the personal habits of knowing and acting that typically organize individual human experience is required. After attempting to specify what this shift might involve, implications of these ideas for the practice of family therapy and for human action in general are discussed.     

Understanding how groups work: a study of homogeneous peer group failures

The study examines thirty-six homogeneous peer support groups that failed to positively benefit most of the participants. Outcomes were assessed pre and one-year post using measures of mental health, marital relationships, and motherhood role indices. Four central group process characteristics previously found to be common in successful peer support groups were used as a framework for developing a series of post hoc hypotheses. The groups were found to be low on cohesiveness defined behaviorally, saliency, cognitive structures for reframing common dilemmas, and limited in the range of therapeutic experiences.     

The two faces of alcohol myopia: attentional mediation of psychological stress

Two studies provided evidence that alcohol's relationship to psychological stress is indirect and is mediated by the allocation of attention. Study 1 found that, as the attentional demands of a distracting activity increased, so did alcohol's reduction of anxiety. Study 2 replicated this effect and found that a highly demanding activity could reduce anxiety even without alcohol. This study further implicated the role of attention in anxiety reduction by demonstrating a relationship between changes in anxiety and response latency to a secondary monitoring task. Finally, in both experiments, intoxicated subjects who did not perform any activity showed an increase in anxiety. From these data, we argue that alcohol affects psychological stress, to an important degree, through its ability, in conjunction with ongoing activity, to affect the amount of attention paid to stressful thoughts.