Nondirectiveness and genetic counseling

Nondirectiveness is the generally required and professed standard for genetic counseling. However, studies are lacking in the field of human genetics and in other disciplines which address either the theory or practice of this type of therapeutic procedure in the context of genetic counseling. Moreover, there is no indication the further development this concept has undergone in client-centered therapy has been acknowledged in human genetics. This could be due tot he historical development of genetic counseling, its inherent conflicts and often undefined goals, and the latent need of human geneticists to defend themselves against being accused of eugenic tendencies. Nondirectiveness and directiveness, however, can neither adequately describe what takes place in genetic counseling, nor can they — according to their original meaning — be used to define an ethical standard of genetic counseling. Starting with the writings by Carl Rogers (1942), an experiential approach is described, in which counseling is seen as a process of influence, which is wished by all the persons involved, during which activities are oriented toward the experience of the client, and which allows the counselor to communicate openly and directly with the client. The present study illustrates the use of the experiential approach in genetic counseling and shows that it can uphold the principle of ethics, which nondirectiveness demands and, at the same time, prevent the inevitable and unresolvable contradictions. This means that in their training genetic counselors must learn to recognize and constantly reflect on the influence they can and want to exert. In order to be able to use this influence in a responsible manner, genetic counselors must also learn to have a certain degree of flexibility so that they are able to check at any time how their client responds to this influence.     

Identität und die Ambivalenz gegenüber Fremdem

Zusammenfassung   Anhand der Erz?hlung Ein altes Blatt und des Films Easy Rider wird die Ambivalenz gegenüber Fremdem aufgezeigt: Liebe (Xenophilie) und Hass (Xenophobie) markieren die beiden Pole. Es geht dann um die Entwicklung eines psychoanalytischen Begriffs des allt?glich-lebensweltlichen Selbstseins, der diese Ambivalenz abbildet. Dazu wird das Konzept der Identit?t herangezogen. über Eriksons Verst?ndnis hinausgehend wird Identit?t nicht nur von ihrer Leistungsseite her gesehen, der Schaffung einer einigerma?en als geordnet und sinnhaft erfahrenen Welt (Positivit?t der Identit?t). Diese Leistung wird zugleich als Abwehr verstanden, wobei das Abgewehrte als der Identit?t ebenfalls zugeh?rig betrachtet wird (Negativit?t der Identit?t). Identit?t ist durch eine konflikthafte Dynamik von Selbsterhaltung und Selbstaufhebung gepr?gt. Im allt?glich-lebensweltlichen Kontext dominiert die Selbsterhaltungstendenz. In der Ambivalenz gegenüber Fremdem spiegelt sich die Dynamik von Selbsterhaltung (Ablehnung) und Selbstaufhebung (Anziehung). Genauer noch ist die Anziehung durch das Fremde als M?glichkeit zu verstehen, das Last- und Zwanghafte der Identit?tspositivit?t zu ver?ndern, d. h. ein Anderer werden zu k?nnen. Auf der Grundlage dieser überlegungen werden zwei Aspekte der Identit?t in der Postmoderne dargestellt: die Entwicklung einer adoleszent anmutenden Identit?tsstruktur und die Bedeutung der enormen Fülle von Fremdem, die die Globalisierung mit sich bringt. Ein Fallbeispiel zeigt, wie sich eine Angstsymptomatik als Ausdruck eines Identit?tswiderstands gegen die durchgreifende ?konomisierung der Arbeitsumgebung verstehen l?sst. Das klinische Material macht deutlich, dass die vorangehenden überlegungen auch für den klinischen Diskurs von Relevanz sind.

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Identity and ambivalence towards the stranger

Abstract   On the basis of the tale An Old Leaf and the movie Easy Rider, it will be shown that people have a deep-seated ambivalence towards what they recognize as extraneous to their own way of being. Xenophilia (attraction, love) and xenophobia (repulsion, hatred) are the two poles of the ambivalence. A psychoanalytic concept of being in one’s own everyday life-world in a way which comprehends the ambivalence of xenophilia and xenophobia is formulated. For this purpose the concept of personal identity is used. In contrast to Erikson identity is not restricted to its function of constituting an inner world for the subject, which is at least to a certain degree ordered and meaningful (positivity of identity). Rather, the positivity of identity is functioning defensively as well. What is fended off is not annihilated mentally, but it belongs to the subject’s identity (negativity of identity). Personal identity is thus conceptualized as a dynamic structure with two opposing forces, viz. identity-maintenance (mirrored in xenophobia), and identity-suspension (mirrored in xenophilia). In postmodernity the structure of identity resembles an adolescent one with the centre of identity shifting from the positivity of identity in the direction of its negativity. Due to processes of globalization there is a growing burden of influences on the subject’s identity that come from beyond the everyday life-world. Case material is presented that shows the clinical relevance of the ideas that have been developed. Severe symptoms of anxiety could be understood as an identity-maintaining resistance by opposing the transformation of the patient’s working conditions for the purpose of short-term economic goals only.

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überarbeitete Fassung eines Vortrags, gehalten anl?sslich der DPG-Jahrestagung „Psychoanalyse in Zeiten der Globalisierung. Struktur und Identit?t im Wandel“, 22.–25. 5. 2008 in München     

Monitor yourself! Deficient error-related brain activity predicts real-life self-control failures

Despite their immense relevance, the neurocognitive mechanisms underlying real-life self-control failures (SCFs) are insufficiently understood. Whereas previous studies have shown that SCFs were associated with decreased activity in the right inferior frontal gyrus (rIFG; a region involved in cognitive control), here we consider the possibility that the reduced implementation of cognitive control in individuals with low self-control may be due to impaired performance monitoring. Following a brain-as-predictor approach, we combined experience sampling of daily SCFs with functional magnetic resonance imaging (fMRI) in a Stroop task. In our sample of 118 participants, proneness to SCF was reliably predicted by low error-related activation of a performance-monitoring network (comprising anterior mid-cingulate cortex, presupplementary motor area, and anterior insula), low posterror rIFG activation, and reduced posterror slowing. Remarkably, these neural and behavioral measures predicted variability in SCFs beyond what was predicted by self-reported trait self-control. These results suggest that real-life SCFs may result from deficient performance monitoring, leading to reduced recruitment of cognitive control after responses that conflict with superordinate goals.     

The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: a systematic review

Clinical supervision is a central part of psychotherapist training but the empirical support for specific supervision theories or features is unclear. The aims of this study were to systematically review the empirical research literature regarding the effects of clinical supervision on therapists’ competences and clinical outcomes within Cognitive Behavior Therapy (CBT). A comprehensive database search resulted in 4103 identified publications. Of these, 133 were scrutinized and in the end 5 studies were included in the review for data synthesis. The five studies were heterogeneous in scope and quality and only one provided firm empirical support for the positive effects of clinical supervision on therapists’ competence. The remaining four studies suffered from methodological weaknesses, but provided some preliminary support that clinical supervision may be beneficiary for novice therapists. No study could show benefits from supervision for patients. The research literature suggests that clinical supervision may have some potential effects on novice therapists’ competence compared to no supervision but the effects on clinical outcomes are still unclear. While bug-in-the-eye live supervision may be more effective than standard delayed supervision, the effects of specific supervision models or features are also unclear. There is a continued need for high-quality empirical studies on the effects of clinical supervision in psychotherapy.     

How Category Selection Impacts Inference Reliability: Inheritance Inference From an Ecological Perspective

This article presents results from a simulation-based study of inheritance inference, that is, inference from the typicality of a property among a “base” class to its typicality among a subclass of the class. The study aims to ascertain which kinds of inheritance inferences are reliable, with attention to the dependence of their reliability upon the type of environment in which inferences are made. For example, the study addresses whether inheritance inference is reliable in the case of “exceptional subclasses” (i.e., subclasses that are known to be atypical in some respect) and attends to variations in reliability that result from variations in the entropy level of the environment. A further goal of the study is to show that the reliability of inheritance inference depends crucially on which sorts of base classes are used in making inferences. One approach to inheritance inference treats the extension of any atomic predicate as a suitable base class. A second approach identifies suitable base classes with the cells of a partition (of a preselected size k) of the domain of objects that satisfies the condition of maximizing the similarity of objects that are assigned to the same class. In addition to permitting more inferences, our study shows that the second approach results in inheritance inferences that are far more reliable, particularly in the case of exceptional subclasses.     

How differences in perceptions of own and team performance impact trust and job satisfaction in virtual teams

Employees frequently engage in social comparison processes and tend to perceive their own performance as superior compared to that of their peers. We expect this to be particularly salient in virtual teams where employees receive few cues upon which the comparison with other members of their team can be based. With reliance on social comparison and social exchange theory, we propose that such “perceived overperformance” has negative effects on job satisfaction, which is mediated by trust in the team. We confirm this with a sample of field-service employees (n = 753) using structural equation modeling with bootstrapping. We corroborated our findings in focus groups, which suggest the need for performance indicators that are easily communicated to and comprehended by employees to maintain trust and satisfaction.