The transference neurosis in Freud's writings

This paper reviews the evolution of the concept of transference neurosis in Freud's writings. It suggests that the language in which the concept of the transference neurosis is originally expressed by Freud includes an idea of the analyst as aggressively pursuing the analytic cure by waging a solitary battle against the patient's disease. With the representation of the death drive and the larger role accorded to sadism as its external manifestation in Freud's revised drive theory of 1920, the patient becomes the ally; resistance, in the sense of the conservative forces, not disease, in the sense of libidinal conflict, becomes the enemy. It is thus difficult to speak of a transference neurosis in the circumscribed way Freud originally meant it, and he ceased to use the term after 1926 rather than redefine it to fit his broader perspective. In this broader perspective, relative resolution of conflict replaced radical liberation of the patient from disease. That Freud did not redefine the term does not imply that he discarded it, or that we necessarily should. This paper suggests that Freud implied a functional distinction between transference as transforming agent and transference neurosis as result of that transformation. That distinction defines psychoanalytic cure in terms of the understanding of a symbolic transformation which is, through the transference neurosis, reexperienced as part of the psychoanalytic process.     

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.     

Reducing adverse reaction to stress in the workplace. Psychology's expanding role

This section draws attention to occupational stress and suggests ways in which psychologists can apply their knowledge of research methods and treatment to this issue. In this article, the past and present role of psychologists in occupational stress is examined and ways in which psychologists might play a more central role are proposed. Although industrial/organizational and health psychology are most obviously applicable to the study of workplace wellness, more focused attention and wider application of knowledge from other subspecialities are also examined. The need for increased attention to work and family; race, class, and gender; and training and public policy issues are also discussed.     

Lessons from the aftermath of Flight 232. Practical considerations for the mental health profession's response to air disasters

The fiery crash of a DC-10 at Sioux City, Iowa, on July 19, 1989, caused a crisis of major proportions, with attendant mental health needs. Various articles have described the need for psychological response teams in such crises. The present article provides practical guidelines for the preparation of a mental health disaster plan and for the coordination of a mental health team responding to a major air disaster. Such disasters can occur in any part of the country at any time. It is hoped that the suggestions in the present article will help teams that respond to future air disasters provide more rapid, effective, and efficient delivery of services to the survivors and their families, and the families of those who are killed.     

Maudsley Obsessional-Compulsive Inventory: obsessions and compulsions in a nonclinical sample

Obsessive-compulsive disorder is increasingly being studied in nonclinical samples. The self-report instruments used to select these samples, however, have not been validated with a diagnostic interview. This study thus investigated the predictive validity of the Maudsley Obsessional-Compulsive Inventory (MOCI) using the Anxiety Disorders Interview Schedule (ADIS), a semi-structured interview created according to DSM-III guidelines. Four sections of the ADIS--generalized anxiety disorder, simple phobia, social phobia and obsessive-compulsive disorder--were administered to 11 individuals who scored in the top 2% and 11 individuals who scored in the normal range of the MOCI 6-7 months prior to the interview. High nonclinical MOCI scorers reported more frequent and severe obsessions and compulsions as well as greater disturbance by these symptoms. In addition, the high MOCI group experienced more general worry and interference from worry, and more frequent and severe physiological symptoms when they worry. However, the two groups did not differ in terms of simple and social phobia symptoms. High MOCI scorers thus did not report a broad range of anxiety symptoms or fears, but specific obsessions and compulsions. These results provide further support for the validity of the MOCI in nonclinical samples over a 6-7 month interval.     

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.     

A comparison of cognitive function in community-dwelling and institutionalized old people of normal intelligence

Two carefully matched groups of normal old people living in institutions or in the community were administered a neuropsychological cognitive test battery. In general, the institutionalized group performed worse than the community group. Discriminant function analysis identified a subgroup of high-functioning institutionalized subjects whose performance more closely resembled that of the community group than the remainder of the institutionalized group. Differences between the various groups were not due to differences in IQ, age, health, or other controlled variables. The critical tests that differentiated the groups were sensitive to impaired function in frontal and medial-temporal lobe brain regions. The results suggest a complex interaction involving effects of age and environmental factors on brain function and cognition.     

A historical perspective on recent studies of social learning about foods by Norway rats

Early naturalists explained field observations of social influences on animal learning in terms of spoken language, deliberate tuition of one animal by another, or intentional imitation. During the first half of the present century, experimental psychologists analyzed instances of social learning by animals in laboratory tasks as special cases of operant or classical conditioning. Neither of these traditional approaches provided much insight into the complex processes that often support animal social learning. By combining ethological focus on social learning as it occurs in natural habitat with analytical techniques developed in the psychological laboratory, contemporary researchers have made considerable progress in describing the many ways in which social interactions influence behavioural development in animals. The author's investigations of social influences on food selection by Norway rats provide one example of such an ethopsychological approach to the study of animal social learning.     

Peer-group association and adolescent tobacco use

Mosbach & Leventhal (1988) examined the relation of cigarette smoking to peer-group identification in rural Wisconsin adolescents. They found that among dirts (problem-prone youth), regulars (average youth), hot-shots (good social or academic performers), and jocks (athletes), youth most likely to smoke were dirts and hot-shots. We performed a replication with a Southern California cohort and also for use of smokeless tobacco. We hypothesized that jocks would be the main users of smokeless tobacco. We identified the same groups and an additional one, skaters (skateboarders or surfers). As Mosbach & Leventhal found, cigarettes were used most by dirts. Contrary to their results, but consistent with other research, we found that hot-shots were least likely to smoke. Contrary to our prediction, we found that skaters and dirts were more likely to use smokeless tobacco than were jocks. Our data show that both tobacco forms are used by problem-prone youth.