Reducing indices of unhappiness among individuals with profound multiple disabilities during therapeutic exercise routines.

A program was developed to reduce indices of unhappiness that accompanied therapeutic exercise routines among people with profound multiple disabilities. Indices of unhappiness were recorded, using an observation system that had been validated through previous research involving happiness-related variables, while support personnel conducted exercises with 3 participants. A multicomponent program was then implemented that involved presenting highly preferred stimuli before, during, and after each exercise session. Results indicated that the program was accompanied by reduced indices of unhappiness for each participant relative to the traditional method of conducting the exercises, although changes in the preferred stimuli used with 1 participant were required before consistent reductions occurred. Results are discussed regarding the importance of reducing unhappiness indices as a means of enhancing aspects of the daily quality of life for people with profound multiple disabilities. Areas for future research are also discussed, focusing on expanding the unhappiness-reduction procedures to other routine events that may occasion indices of unhappiness.     

Intersensory conflict between vision and touch: the response modality dominates when precise, attention-riveting judgments are required

In four experiments, reducing lenses were used to minify vision and generate intersensory size conflicts between vision and touch. Subjects made size judgments, using either visual matching or haptic matching. In visual matching, the subjects chose from a set of visible squares that progressively increased in size. In haptic matching, the subjects selected matches from an array of tangible wooden squares. In Experiment 1, it was found that neither sense dominated when subjects exposed to an intersensory discrepancy made their size estimates by using either visual matching or haptic matching. Size judgments were nearly indentical for conflict subjects making visual or haptic matches. Thus, matching modality did not matter in Experiment 1. In Experiment 2, it was found that subjects were influenced by the sight of their hands, which led to increases in the magnitude of their size judgments. Sight of the hands produced more accurate judgments, with subjects being better able to compensate for the illusory effects of the reducing lens. In two additional experiments, it was found that when more precise judgments were required and subjects had to generate their own size estimates, the response modality dominated. Thus, vision dominated in Experiment 3, where size judgments derived from viewing a metric ruler, whereas touch dominated in Experiment 4, where subjects made size estimates with a pincers posture of their hands. It is suggested that matching procedures are inadequate for assessing intersensory dominance relations. These results qualify the position (Hershberger & Misceo, 1996) that the modality of size estimates influences the resolution of intersensory conflicts. Only when required to self-generate more precise judgments did subjects rely on one sense, either vision or touch. Thus, task and attentional requirements influence dominance relations, and vision does not invariably prevail over touch.     

Authority,Psychotherapy and the Authority of the Therapist in the Religious Haredi Community

This article considers the meaning and significance of authority, and its relevance to the transference process, within the framework of psychotherapy in the orthodox Jewish (Haredi) community in Israel. In this community, deeply-rooted habits of obedience to the commandments of the Torah and the authority of the Rabbi are integral to maintaining an orthodox way of life. Clinical vignettes with Haredi patients are presented to illustrate the complexities that arise when both patient and therapist belong to the orthodox community, and highlight the authority-related issues that are central to the therapy. This combination of factors requires a sensitive and finely-tuned approach which will enable the therapist to maintain the treatment framework while still accommodating the orthodox way of life.     

Melancholic Response to War Destruction and the Emergence of a Group Assumption of Post-Ness

What psychological response does war and forced displacement evoke in victims? How do survivors of war communicate their experiences to their children? Finally, what culture does the psychological response to loss shape? Using data collected through interviews, psychological consultations, and children’s drawings from two sources—the ongoing Syrian civil war and the Bosnian war of 1992–1995, this paper suggests that the experience of the war generation becomes the organizing axis of their identity and that of their children. It seeks to demonstrate that survivor parents communicate their experience of loss through gesture, act, and object rather than through a coherent narrative. Whereas survivor children use metaphoric and metonymic readings of their parents’ everyday performance in order to construct meaning and form their identities as descendants of a given family. This paper argues that such an identity is characterized by ambivalence towards the self and towards others, melancholic longing for an idealized pre-war past, and the impossibility of letting it go.     

The Psychic Life of Fragments: Splitting from Ferenczi to Klein*

The present paper starts from the reflection that there is a curious “phenomenological gap” in psychoanalysis when it comes to processes of splitting and to describing the “life” of psychic fragments resulting from processes of splitting. In simpler terms, we are often in a position to lack a precise understanding of what is being split and how the splitting occurs. I argue that although Melanie Klein’s work is often engaged when talking of splitting (particularly through discussions on identification, projection and projective identification), there are some important phenomenological opacities in her construction. I show that by orchestrating a dialogue between Melanie Klein and Sándor Ferenczi, we arrive at a fuller and more substantive conception of psychic splitting and of the psychic life of fragments which are the result of splitting. This is even more meaningful because there are some unacknowledged genealogical connections between Ferenczian concepts and Kleinian concepts, which I here explore. While with Klein we remain in the domain of “good” and “bad” objects—polarised objects which are constantly split and projected—with Ferenczi we are able to also give an account of complicated forms of imitation producing psychic fragments and with a “dark” side of identification, which he calls “identification with the aggressor”. While attempting to take steps toward imagining a dialogue between Klein and Ferenczi, I note a certain silent “Ferenczian turn” in a late text by Melanie Klein, “On the Development of Mental Functioning”, written in 1958. In particular, I reflect on her reference to some “terrifying figures” of the psyche, which cannot be accounted for simply as the persecutory parts of the super-ego but are instead more adequately read as more enigmatic and more primitive psychic fragments, resulting from processes of splitting.     

Humility

This paper offers a nuanced discourse on the otherwise ignored topic of humility. It brings together scattered comments within psychoanalysis, secular lay-literature, sociocultural studies, and religious thought on humility. The paper also describes pathological variants of humility (excessive, deficient, false, and compartmentalized) and delineates five areas of clinical practice where humility plays an important role: (i) humility in selecting patients to treat, (ii) humility in daily conduct with patients, (iii) humility in the attitude of listening to clinical material, (iv) humility in the manner of intervening, and (v) humility in deciding upon the longevity of our professional careers.     

Somatic Countertransference as Evidence of Adhesive Identification in a Severely Traumatized Woman

This paper discusses the use of somatic countertransference as a means of learning about the patient, about projective and adhesive identification and about the object relating nature of the most traumatized and withdrawn part of the personality. It assumes an elemental knowledge of British Object Relations and uses clinical material to illustrate the hypotheses that somatic countertransference is an indicator of a very elemental communication occurring from the aspect of the psyche that is united in a body mind or mind body. The paper assumes that this body mind was object seeking at birth and perhaps before. Because these early aspects of the personality are non verbal and non conceptual, the analyst must rely not only on the verbal material in a session but on the emotional and sensual experiences within the transference and the countertransference. Such reliance requires a faith in one’s own intuition without a certainty that one is “right.” Because speaking of such early experience is difficult, often writers and analysts appear more certain than they are. This is a hazard of this type of analytic work. What I am writing about is conjecture or imagination or dream, but I am suggesting that such dream work is a valuable tool for analysis.     

Binocular Vision in the Total Situation

This paper investigates the concept of “total situation” which, even though introduced into psychoanalytic thinking via sister disciplines, such as sociology, the neurosciences, etc., has gradually acquired a relatively prominent position in current therapeutic practice. It is used as a metaphor for the envelopment of the unfolding transferential and related events in the analytic process. Irrespective of whether one focuses on the individual analytic condition or the group-analytic one, contemporary psychoanalytic perspectives include both the bi-personal unconscious interactions and the various levels of the total situation in their conceptualizations of the nature of the process. Such a complex approach in conceptualization can only be achieved through the so-called binocular vision of the analyst.