Teenagers' attitudes about seeking help from telephone crisis services (hotlines)

The purpose of this study was to examine the attitudes toward the use of telephone crisis services (hotlines) among 519 adolescents in 9th through 12th grade mandatory health courses in six high schools in New York State. Few adolescents (2.1%) used hotlines and negative attitudes were stronger toward hotlines than they were toward other formal sources of help. The most common reasons for hotline nonuse related to feelings of self-reliance and shame. Objections to hotlines were strongest among students most in need of help by virtue of impaired functioning or feelings of hopelessness. The results underscore needed outreach efforts to youth.     

Stressors, quality of the child-caregiver relationship, and children's mental health problems after parental death: the mediating role of self-system beliefs

Investigated whether three self-system beliefs, fear of abandonment, coping efficacy, and self-esteem, mediated the relations of stressors and caregiver-child relationship quality with concurrent and prospective internalizing and externalizing problems in a sample of children who had experienced parental death in the previous 2.5 years. The cross-sectional sample consisted of 340 children ages 7-16 and their surviving parent/current caregiver; the longitudinal analyses employed a subset of this sample that consisted of 100 children and their parents/caregivers who were assessed at three time points. A multirater, multimethod measure of caregiver-child relationship quality and a multirater measure of children's mental health problems were used. The cross-sectional model supported a mediational relation for fear of abandonment, coping efficacy, and self-esteem. The three-wave longitudinal model showed that fear of abandonment at Time 2 mediated the relation between stressors at Time 1 and internalizing and externalizing problems at Time 3. Implications of these findings for understanding the development of mental health problems in parentally bereaved children and designing interventions for this at-risk group are discussed.     

Stressors, Quality of the Child–Caregiver Relationship, and Children's Mental Health Problems After Parental Death: The Mediating Role of Self-System Beliefs

Investigated whether three self-system beliefs, fear of abandonment, coping efficacy, and self-esteem, mediated the relations of stressors and caregiver–child relationship quality with concurrent and prospective internalizing and externalizing problems in a sample of children who had experienced parental death in the previous 2.5 years. The cross-sectional sample consisted of 340 children ages 7–16 and their surviving parent/current caregiver; the longitudinal analyses employed a subset of this sample that consisted of 100 children and their parents/caregivers who were assessed at three time points. A multirater, multimethod measure of caregiver–child relationship quality and a multirater measure of children's mental health problems were used. The cross-sectional model supported a mediational relation for fear of abandonment, coping efficacy, and self-esteem. The three-wave longitudinal model showed that fear of abandonment at Time 2 mediated the relation between stressors at Time 1 and internalizing and externalizing problems at Time 3. Implications of these findings for understanding the development of mental health problems in parentally bereaved children and designing interventions for this at-risk group are discussed.

Discussion: Toward a social‐constructivist view of the psychoanalytic situation

The three papers by Modell, Aron, and Greenberg are discussed in terms of their relationship to a new paradigm for understanding the psychoanalytic situation. The paradigm is called social‐construct‐ivist to capture both the idea of the analyst's participation and the idea of construction of meaning. It is argued that these theorists, as well as many of the authors they cite as part of a broad movement in the field, do not consistently meet the criteria for this paradigm, although they seem to be aiming for it. An important source of inconsistency and confusion derives from the confounding of the two axes: drive‐relational and positivist‐constructivist. Many relational theorists who hold fast to the idea that analysts can grasp the truth of both their own experience and that of the patient are no closer to the constructivist point of view than was Freud. The call by Aron and Greenberg for greater attention to the patient's resisted experience of the analyst's subjectivity is discussed in terms of its potential benefits and problems. The ritualized asymmetry of the psychoanalytic situation is said to have important functions, including prevention of excessive involvement and protection of the unobjectionable positive transference and of a degree of idealization. Modell's notion of paradox, which makes the therapeutic relationship seem “real”; and “unreal”; at the same time, is seen as a special instance of the always precarious social construction of reality. It is argued, moreover, that the social and individual aspects of experience are interdependent. Neither is reducible to the other, and both should be understood, like many other issues in the new paradigm, in terms of a dialectical interplay of figure and ground in experience.     

The Flawed Person of the Analyst: Commentary on Paper by Lauren Levine

The way that the current conception of mutual enactment is understood, any analysis, in order to be ultimately successful must first go badly for some period of time. Any analysis that goes too smoothly is subject to the suspicion that some very difficult interactional material is being mutually unaddressed. In this context I see that Dr. Lauren Levine enacted the role of her abandoned patient (concordant countertransference) and as well, for a time, indeed, figuratively abandoned her patient (complementary countertransference). The author's central contribution in this paper is an illustration of how drawing on difficult and painful dimensions in one's own personal analysis, the analyst has the advantage of being able to withstand highly toxic material in both the transference and the countertransference. Dr. Levine is fortunate in having had a personal analysis that helped her integrate highly shameful aspects of her self, though it must be recognized that this is not always the case in all training analyses.     

Response to Slavin: Considering the Evolutionary and Existential Contexts of Dialectical Constructivism

Within his evolutionary framework, Slavin elaborates eloquently on the dialectic of construction of meaning and anticipation of death. Also within that framework he highlights the emergence of the universal dialectic of self-interest and care for others, perhaps finding its most poignant expression in the relation of parents and children. I raise questions about Slavin's attribution of a “sense of loss” to humans who allegedly long for the experience of evolutionarily earlier species, particularly their sense of automatic connectedness and automatic ways of relating to the world free of the burdens of uncertain, self-conscious choice. A longing for earlier states in human development is easier to grasp than a longing for the experience of less advanced species from which humans evolved. Nevertheless, Slavin's views and my own are otherwise deeply compatible, particularly his sense of what emerges as the uniquely human challenge of intersubjective construction of meaning in the context of individual self-interest and in the face of death. Slavin is also emphatic that the pervasiveness of absolute belief systems that preempt awareness of ambiguity, the anxiety of freedom, and the dread of death, does not gainsay their defensive nature. I argue, in accord with Altman, Butler, and others, that denial of death may promote dissipation of communal sensibility and replacement of it in a capitalist world (and perhaps others as well) with destructive splitting and fetishistic, competitive pursuit of money and power.     

Response to Safran: The Development of Critical Psychoanalytic Sensibility

Jeremy D. Safran feels that my views regarding the relative merits of case studies and systematic empirical research are unnecessarily polarizing. I feel that, on the contrary, I'm offering bridges between my perspective and those of researchers on psychoanalytic process and outcome in two ways. One is through my own constructivist critique of traditional positivist case studies and theorizing based upon clinical experience. The second is through conceptualizing the place of systematic research within a constructivist paradigm. I am arguing that its place can be no different than that of case studies. Both generate possibilities for any particular analyst or analytic therapist to have in mind as he or she works with a particular patient at a particular moment. Safran locates the destructive effects of scientism with “biologically oriented researchers and cognitive therapists.” In my view, it might be convenient if the problem could be located exclusively with them, but the fact is that psychoanalytic researchers, as I demonstrate, are working largely within the same paradigm as their adversaries in the research world. That paradigm erroneously privileges systematic research as hypothesis-testing, whereas case studies are relegated to the status of anecdotal, hypothesis-generating work. I describe what I call “nonlinear constructivist learning” as the kind of “generalization” that case studies can yield and that is optimal for our field.     

Affective Predictors of Dissociation,III: Affect Balance

The relationship between dissociative tendencies and the balance of affective expression was investigated in a sample of 100 Australian psychology students. Dissociation was positively related to an imbalance of affect in favor of negative affects. Higher levels of dissociation were associated with more frequent experiences of negative affects but were unrelated to the expression of positive affects. The data are consistent with the view that trauma-related affects have a mediating role in the development of dissociative tendencies.     

Market and Customer Analysis for Sales Management

Abstract

The application of market and customer analysis to selling is discussed in this article. Four instruments were devised and used with three companies in order to improve the performance of their salespeople. While the needs of salespeople vary according to the company and the industry, these instruments can form the basis for organizing the activities of salespeople.