LISTENING AND SPEAKING PSYCHOANALYTICALLY ‐ WITHWHAT IN MIND?*

In this paper, the proposition is developed that multi‐model thinking with respect both to theories of mind and to theories of technique has always been implicitly present in psychoanalytic practice as a response to the demands of the clinical moment. But this has gone unnoticed and untheorised, in part because it is hidden in general considerations regarding tact, timing and (less discussed) variations in voice tone and also because our psychoanalytic practices, without our awareness but as adaptations to the clinical moment, do not always match our theories. The author offers reasons from the broad culture of psychoanalysis why this is so. He also offers a conceptualisation and a strategy for raising the implicit and untheorised to heightened levels of awareness; he does this by highlighting the place of patient characteristics as the underpinning of theory variation and the place of a vast array of clinical possibilities as the backdrop of analytic listening. Clinical examples are used throughout.     

Mindsets,rationality and emotion in Multi‐criteria Decision Analysis

This paper discusses the paradigm of multi‐criteria decision analysis (MCDA), and relates it to other disciplines. It concludes that MCDA needs a larger, not smaller, emphasis on values and subjectivity to increase rationality in decision‐making. The paper bases the argument on a conciliation of ethics, philosophy, neuro‐psychology and management paradigms. It observes that the MCDA ‘mindset’ relates to consequentialism, as opposed to virtue ethics and rule based ethics. Virtues and rules play an important role in practical decision‐making, however. Findings in neuro‐psychology show that reliable decision‐making requires emotions. Elicitation of emotions is therefore required in MCDA value trade‐off processes. This leads to a concept of emotional rationality, which defines rationality as a four‐dimensional concept that includes well‐founded values and breaks radically with common notions of rationality. Virtues do not easily lend themselves to value trade‐off, but questions of virtue usually creates strong social emotions, as opposed to the feebler global emotions that may arise in connection conventional trade‐off of end values. The conclusion is that MCDA should not be shy of subjectivity and emotion, but instead put more emphasis on it to increase rationality. A part of this challenge is how to deal with questions of virtue in decision‐making. Copyright © 2006 John Wiley & Sons, Ltd.     

Der gegenftand der pfychologie

Ohne Zusammenfassung     

On the misuse of group membership

Group membership is analyzed from the perspective of developmental theory. Maladaptive or nontransitional uses of the groups of everyday life, such as work and social groups as well as therapy groups, are discussed and illustrated with clinical examples. It is recommended that therapists pay attention to the nature and meaning of their patients' involvements in these sorts of groups, keeping in mind that the meanings of such affiliations are particularly influenced by developmental factors.     

The Contribution of Cognitive Resources and Leader Behavior to Organizational Performance1

A recently proposed cognitive resource theory of leadership effectiveness explicates the role of such cognitive variables as intellectual abilities, technical competence, and job-relevant knowledge (experience) in determining group performance. This paper reviews research showing that the leaders' intellectual abilities contribute to performance only when leaders are directive, do not experience stress, have supportive groups, and work on tasks which require intellectual effort.     

Linking empirically based theory and evaluation: The family bereavement program

Conclusion We have illustrated how our small theory (Lipsey, 1990) of bereavement guided the development and evaluation of a preventive intervention for bereaved children. Our small theory, based on prior empirical research, enabled us to identify family processes that appeared to mediate the effects of parental death on child mental health. Our intervention was designed to attempt to change these processes. The evaluation of our experimental trial of the intervention assessed changes on these processes as well as the more distal mental health outcomes. The experimental trial showed some-what encouraging results, in terms of the program's ability to modify the warmth of the parent–child relationship and to decrease symptomatology in the adolescent children. We also obtained further empirical support for our underlying theoretical model. Finally, implications for redesign of the program were derived from assessing the adequacy of the program components to change each of the mediators in the theoretical model.Support for this research was provided by NIMH grant P5OMH39246 which is gratefully acknowledged. David R. Pillow is now at Western Psychiatric Institute, Pittsburgh; Fred Rogosch is at the University of Rochester; Janette Beals is now at University of Colorado Health Sciences Center; Kim D. Reynolds is now at the University of Alabama, Birmingham; Carl Kallgren is now at the Pennsylvania State University, at Erie; and Rafael Ramirez is now at the University of Puerto Rico.     

Community mental health services for black and ethnic minorities

An investigation into the provision of community mental health services in one local authority Borough found that facilities for the rehabilitation and resettlement of the recovering mentally ill into the community were very limited and fell far short of ofJicial recommendations and that very little consideration was given to meeting the needs of black and ethnic minorities. An analysis of data porn service providers (Local Authority/Social Services/Health Authority), multidisciplinary teams, voluntary agencies and 120 black and ethnic minorities (users and non-users of mental health services) in the Borough suggested that black and ethnic minorities had little or no say in decisions about the provision of community mental health services to the extent that they feLt excluded. In many instances service providers had limited contact with black and ethnic minorities and some members of the multidisciplinary team had little to do with black people but yet influenced major decisions about the provision of services to meet their needs. The findings drew sharp attention to the diference between the views of service providers and those of service users in terms of the provision of community mental health services to meet the needs of black and ethnic minorities. Ninety six percent of those involved in the study were appalled over the apparent lack of emphasis placed on the provision of services to meet the needs of black and ethnic minorities and felt that nothing was being done to improve the inadequate service which was offered ly the voluntary sector.     

Heart rate during group flooding therapy for PTSD

The objective of this study was to assess, via heart rate, the arousal levels of participants in group trauma reexposure therapy for posttraumatic stress disorder, and so to better understand this common mode of treatment, particularly in regards to its presumed curative factor, extinction. Six Vietnam combat-related PTSD inpatients participated twice weekly in group trauma reexposure therapy during which their electrocardiograms were recorded. Heart rate was quantified continuously off-line. Heart rates of participantsnot directly engaged in imaginal reexposure to their personal combat traumas consistently exhibited mild linear declines from the beginnings to the ends of the approximately 2.5 hour sessions. Participants actively engaged in personal combat trauma reexposure exhibited higher whole-session heart rates. Most also exhibited more specific elevation extending over the later portions of therapy sessions during which intensive reexposure usually occurred. Surprisingly, no patients exhibitedfocal increases in heart rate concurrent with periods of most intensive traumatic incident review as judged from videotape. Administering imaginal reexposure in a group context does not preclude substantial physiological (sympathetic) arousal, as is preconditional for extinction. Under conditions in which the actively engaged reexposure patient is reliably identified, group trauma reexposure therapy may not provide an opportunity for “vicarious” flooding in nonengaged participants.