The search for evidence: Psychoanalytic practice and the male imaginary

In this paper, I will attempt to discuss the future of psychoanalytic practice in the wake of the National Institute of Health and Clinical Excellence’s (NICE) embrace of ‘evidence’-based practice. In 2005, NICE, whose task is to regulate the provision of health care across the National Health Service, adopted positivistic evidence-based protocols as the sole proof of the effectiveness of psychotherapy. Despite the success over the past 40?years of psychoanalytic and humanistic therapies in primary care and psychotherapy departments of psychiatric hospitals, NICE insists on restricting therapy, to those who can claim effectiveness as a result of using the data from client questionnaires commonly described as ‘outcome measures’ and it has gone on to promoting new modalities many of which have been imported from the States. As a consequence, most of the provision of psychotherapy in the public sector currently, whether as part of the National Health Service or the voluntary sector, has embraced evidence-based practice’ and many training organisations are promoting it, which will, in time, have an effect on private practice. I use some of the threads of the work of the feminist psychoanalyst Irigaray and others to understand this turn to positivistic science and how it can be understood as an instance of the retrenchment of the ‘male imaginary’ and a re-installation of the values of detachment and mastery. I query whether there are some problems within current theory, practice and institutionalisation which interfere with the emergence of a more progressive psychoanalytic practice.     

Belief in memories may be relinquished as often for adulthood as for childhood events,but for different reasons

ABSTRACT

The age distribution of nonbelieved memories (NBMs) reported by young and older adults typically reflects a large proportion of events dated to childhood. The present study aimed to further investigate the age of origin of NBMs by using instructions that include an NBM related to adulthood. Participants aged from 40 to 80 years were asked to describe an NBM, to explain why they had stopped believing their memory, and to rate its phenomenal characteristics. Participants also described and rated an age-matched believed memory (BM). The results revealed a similar proportion of nonbelieved events experienced in childhood and adulthood, thus calling into question the hypothesis that NBMs are mainly related to childhood events. We also found that NBMs might emerge for different reasons depending on the time of events. Additional analyses indicated that, overall, the influence of temporal distance on the ratings of phenomenal characteristics was similar for BMs and NBMs.     

Recalling semantic information about newly learned faces and voices

Several findings showed that semantic information is more likely to be retrieved from recognised faces than from recognised voices. Earlier experiments, which investigated the recall of biographical information following person recognition, used stimuli that were pre-experimentally familiar to the participants, such as famous people's voices and faces. We propose an alternative method to compare the participants’ ability to associate semantic information with faces and voices. The present experiments allowed a very strict control of frequency of exposure to pre-experimentally unfamiliar faces and voices and ensured the absence of identity clues in the spoken extracts. In Experiment 1 semantic information was retrieved from the presentation of a name. In Experiment 2 semantic and lexical information was retrieved from faces and/or voices. A memory advantage for faces over voices was again observed.     

When the Rule is Ruled Out: Exemplars and Rules in Decisions from Memory

What are the cognitive processes underlying people's decisions from memory? Previous research suggests that these processes can be best described by strategies that are based on abstract knowledge about the decision task (e.g., cue–criterion relations). However, recent results show that different cue presentation formats trigger the use of different decision strategies and that exemplar‐based strategies can account for memory‐based decisions as well. In three experiments, this effect was replicated, and mediation analyses identified the quality of the underlying knowledge representation as the critical variable that determines decision behavior. This supports the view that exemplar‐based reasoning is used as a backup system if cue abstraction is hindered. Copyright © 2012 John Wiley & Sons, Ltd.     

Ambulante Psychotherapie in Deutschland aus Sicht der Patienten

This study analyzed the provision of outpatient psychotherapy services in Germany in typical practice settings. In a representative survey (from June 2008 to September 2009) 1,212 subjects who received outpatient psychotherapy during the past 6 years were questioned about their experiences with outpatient psychotherapy via telephone interviews. Socio-economic data, reasons for seeking treatment, access paths, financial resources and psychosocial support data were collected. Therapeutic settings and modalities and concomitant medication treatment are described. The findings illustrate the problem of multiple psychiatric morbidity in the clinical practice and confirm the urgent need for patient access to professional psychotherapeutic services. Improving access to these services requires close cooperation between care providers.     

Newborn right-holding is related to depressive symptoms in bottle-feeding mothers but not in breastfeeding mothers

This study examines the relationships between infant holding preferences and maternal depression according to the newborn feeding mode. Links between depression and infant holding biases have been observed in mothers [Vauclair, J., Scola, C. (in press). Dépression, alexithymie et latéralisation dans la fa?on de porter un nouveau-né [Infant holding biases in relation to depression, alexithymia and laterality]. Annales Médico-psychologiques; Weatherill, R. P., Almerigi, J. B., Levendosky, A. A., Bogat, G. A., von Eye, A., & Harris, L. J. (2004). Is maternal depression related to side of infant holding? International Journal of Behavioral Development, 28, 421-427] but the fact that breastfeeding has never been studied in relation to these two factors is surprising as breastfeeding has some influence on depression (e.g., [Mezzacappa, E. S., Guethlein, W., Vaz, N., & Bagiella, E. (2000). A preliminary study of breast-feeding and maternal symptomatology. Annals of Behavioral Medicine, 22, 71-79]) and must also affect holding biases. Mothers who just gave birth (N=100) were tested few days after delivery. Measures of handedness, infant holding-side preferences, and level of depressive symptoms expressed by mothers (assessed with the CES-D scale) were collected via questionnaires. Asymmetries in emotional perception were assessed via a Chimeric Figure Task and a Dichotic Listening Task. Results showed that breastfeeding (1) reduced left-side bias for holding newborns and (2) was associated with lowest levels of depressive symptoms. Moreover, holding biases were related to maternal depression in bottle-feeding but not in breastfeeding mothers, namely that holding on the right-side while bottle-feeding was associated with higher levels of depressive symptoms. These results were not due to hemispheric specialization as auditory and visual asymmetries were similar between breastfeeding and bottle-feeding mothers. The discussion emphasizes the striking role of the early mother/child relationship's establishment on infant holding biases.     

Regular and problematic leisure-time Internet use in the community: results from a German population-based survey

In our study, we attempted to identify systematically the use of Internet applications in the German population in order to derive risk factors for problematic use. In a representative survey of the German population, we queried 1,401 women and 1,111 men between the ages of 14 and 94 years by specific questions and standardized questionnaires on depression, anxiety (HADS), and depersonalization (CDS-2). The majority of the German population (55%) used the Internet in their leisure time. Users were younger and had a higher socioeconomic status (education, employment, income). Leisure-time use included e-mail and information search, as well as shopping. Chatting, online communities, games and sex were domains of young, mostly male adults. Overall, 9.3% reported at least one negative consequence of Internet use, especially neglect of recreational activities and problems with family/partner, work or education, and health. Problematic use was associated with longer average daily online times, avoidance of negative emotions, preference for certain applications (gaming, gambling, online sex) and an increased rate of depersonalization. The extent of Internet use per se is not sufficient as an addiction criterion and other negative consequences; rather, specific adverse consequences need to be identified. If the Internet is used excessively to cope with negative affect states and alternative means of coping (e.g., social support, health-promoting behavior) are diminished, a vicious cycle may ensue with increasing stress and reliance on the reinforcing properties of certain online activities that may finally lead to addictive behavior.