Thinking with,and about,patients too scared to think: Can non‐interpretive maneuvers stimulate refl ective thought?

Patients incapable of higher-order (symbolic) thinking can often not tolerate evidence of the analyst's separate existence, particularly when that 'otherness' becomes evident in the process of the analyst's refl ecting upon and interpreting how the patient experiences or represents the analyst. The patient's intolerance of the analyst's efforts to think (refl ect upon and interpret) renders the usual psychoanalytic maneuvers employed to stimulate refl ective thought ineffective with such patients. Such patients have to learn to tolerate multiple perspectives before they can allow the analyst, or themselves, to think in the other's presence. The author presents two clinical vignettes that illustrate how the analyst's efforts to think about the patient were experienced by the patient as both intolerably distancing and as rejecting of an aspect of the patient's subjective reality. Working psychoanalytically with such patients requires the analyst to forgo the use of narrow interpretations that elucidate unconscious meanings and motives in favor of alternate technical maneuvers capable of facilitating the development of symbolic thinking and refl ective thought (insightfulness). These maneuvers include a demonstration of the analyst's willingness and ability to withstand (rather than 'interpret away') how he is being psychically represented by the patient, without becoming destroyed by, or lost within, the patient's characterization of him. Beside modeling a tolerance of alternate perspectives of one's self, other non-interpretive maneuvers that help facilitate the development of self-refl ective thought include: stimulating the patient's curiosity about the workings of his own mind by identifying incompletely understood behaviors or reactions worthy of greater psychological understanding, and insinuating doubt about the adequacy of the patient's explanations of such phenomena.     

CONNECTIONS BETWEEN LOWER BACK PAIN, INTERVENTIONS, AND ABSENCE FROM WORK: A TIME-BASED META-ANALYSIS

We conducted qualitative and quantitative reviews of the medical literature to develop an understanding of the linkages between nonspecific lower back pain (LBP) and employee absenteeism, and the efficacy of lower back pain interventions (LBPI) in reducing absenteeism. First, we offered a general time-based framework to clarify the causal flows between LBP and absence. Second, we inspected LBPIs designed to ameliorate LBP, which should, in turn, lead to reduced absence-taking. Third, we conducted a meta-analysis of 45 effect sizes involving 12,214 people, to examine the relationships between both LBP and LBPIs and absenteeism. Consistent with a presumption in the medical literature, we found support for the idea that chronic LBP has a positive overall relationship with absence-taking. The relationship was stronger for absence frequency measures than time lost measures. In addition, we found that increasing aggregation time (i.e., increases in the periods over which absence is observed) enhances the size of the chronic LBP-absence connection. Further, evidence showed that LBPIs were effective overall in reducing absenteeism. Finally, when there was a temporal mismatch between the form of LBP (acute vs. chronic) and the absenteeism aggregation period in LBPI studies, effect sizes were significantly smaller. We concluded with a discussion of these results, methodological limitations, and suggestions for future research that blends medical with organizational approaches to the etiology of absence.     

Words as Weapons—When Do They Wound? Investigations of Harmful Speech

The following investigations juxtapose jurisprudence and communication literatures to examine under what conditions racist speech is perceived as harmful. Specifically, one theory of legal liability, the tort of intentional infliction of emotional distress, and one intergroup approach, social identity theory, guided three empirical studies investigating verbally disturbing communication targeted at Asian Americans. The studies examined how the attribution of harm was influenced by variables such as group membership, message severity, message explicitness and the medium ofpresentation. One finding in particular, an interaction between group membership and message explicitness (direct vs. indirect), emerged across the three studies. Results revealed that as “objective” evaluators of deprecating speech, out-group members attributed the direct messages of racism to be more harmful than in-group members did, but, conversely, in-group members evaluated the indirect messages of racism to be more harmful than the out-group members did. Theoretical explanations for this finding and its resulting legal implications are discussed.     

SMOKING AND SELF-CONCEPT IN YOUNG ADULTS: AN IDIOGRAPHIC METHOD OF MEASUREMENT

An idiographic repertory grid method of measuring self-concept was used in a nomothetic design to study the relation between smoking behavior and four components of self-concept: real self, ideal self, social self, and ideal social self. Personal constructs were elicited from 32 smoker and 32 nonsmoker male and female college students. Differences between smokers and nonsmokers on all four components of self-concept supported the criterion-related validity of the measures. Implications were discussed for the assessment method and clinical practice.     

THE IMPACT OF MOTIVATION,EMPOWERMENT, AND SKILL‐ENHANCING PRACTICES ON AGGREGATE VOLUNTARY TURNOVER: THE MEDIATING EFFECT OF COLLECTIVE AFFECTIVE COMMITMENT

This study advances research on macro human resource management by examining collective commitment as a mediator of motivation, empowerment, and skill‐enhancing practices and aggregate voluntary turnover. Findings from 20 top HR managers and 1,748 employees in 93 different job groups suggest collective affective commitment independently mediates the negative relationships between motivation and empowerment‐enhancing practices and aggregate voluntary turnover. Human resource practices functioning to enhance the knowledge, skills, and abilities of the workforce are positively associated with voluntary turnover but are not mediated by collective affective commitment. Functionally, this paper resolves the divergent thinking of 4 streams of research regarding HR practices, collective commitment and aggregate turnover. The implications for macro‐HRM theory and practice are discussed.     

MOTIVATION TO LEARN AND COURSE OUTCOMES: THE IMPACT OF DELIVERY MODE, LEARNING GOAL ORIENTATION, AND PERCEIVED BARRIERS AND ENABLERS

This naturally occurring quasi-experiment examined how learning goal orientation (LGO), delivery mode (classroom vs. blended learning), and the perception of barriers and enablers related to motivation to learn and course outcomes. Study participants were 600 students enrolled in either classroom or blended learning courses. As hypothesized, learners in the blended learning condition, high in LGO, and who perceived environmental features as enablers rather than barriers had significantly higher motivation to learn. Motivation to learn, in turn, was significantly related to course outcomes (satisfaction, metacognition, and grades). The mediation hypotheses received partial support. Finally, exploratory analyses revealed 3 significant interactions between delivery mode, LGO, and perceived barriers and enablers on motivation to learn and course satisfaction.     

Some Thoughts I Can't Help Thinking

Specific reactions to the Heppner and Anderson, Keeney and Morris, and Gelso articles are offered. Also, some general thoughts on counseling research are provided.