Use of the analyst as a fetish.

In some cases a gratifying transference fantasy is the subject of progressive analytic work, while in other cases the same type of fantasy eludes investigation, and its enactment causes treatment to become an unproductive endless task. One cause for the latter difficulty can be that the patient uses his or her analyst as a fetish, permitting the distinction between reality and fantasy to remain inconclusive, so that relinquishment of magical expectations does not take place. The particular form of thinking involved in use of the analyst as a fetish is described. The role of illusion, its various clinical manifestations, the countertransference reactions they can evoke, and the technical problems posed are discussed. Special attention is given to the crucial issue of termination. By considering extreme instances in which use of the analyst as a fetish predominates, the author hopes to call attention to a phenomenon that appears to some degree in many, if not all, analyses.     

Human evaluative conditioning: acquisition trials, presentation schedule, evaluative style and contingency awareness.

Two different processes may be operative in human Pavlovian conditioning: signal learning and evaluative learning. Whereas most studies on evaluative conditioning focused on a mere demonstration of the phenomenon or on a theoretical analysis of the underlying processes, some basic parameters of evaluative learning are still unexplored. Hence, using the standard neutral picture--(dis)liked picture pairing paradigm (Baeyens, Eelen & Van den Bergh, 1990), in this study the effect of two parameters of evaluative conditioning was assessed on a between-subjects base, namely the Number of Acquisition Trials (2/5/10/20) and the Presentation Schedule of the stimulus pairs (blockwise or random). Additionally, the study included an exploratory analysis of the potential effects of the Evaluative Style of subjects (Feelers vs Thinkers, operationalized in terms of speed of emitting evaluations). Finally, the relationship between contingency awareness and evaluative learning was reassessed. Neutral-liked conditioning was found to be quadratically related to the number of acquisition trials (increase in effect up to 10 trials, decrease from 10 to 20 trials), whereas neutral-disliked conditioning linearly increased with increasing numbers of trials. Randomized vs blockwise presentation schedules of the stimulus pairs did differentially affect the overall pattern of conditioning, but in a way which was both unexpected and difficult to account for theoretically. Both the Evaluative Style of subjects and contingency awareness were demonstrated to be generally orthogonal to conditioned shifts in CS valence. Based on these findings, some practical suggestions are provided for the application of evaluating conditioning based therapeutical interventions to affective-behavioral disorders which are centred around inappropriate (dis)likes.     

A case of premenstrual distress: bisexual determinants of a woman's fantasy of damage to her genital.

Case material is used to illustrate specific clinical application of the concept of primary femininity. Some contemporary contributions to the psychoanalytic theory of female psychosexual development are presented as complementary with, rather than contradictory to, more familiar, longstanding formulations that emphasize phallic strivings in women. In the clinical example reported, a fantasy of genital damage underlay a woman's premenstrual distress. Aspirations and concerns related to both aspects of her fundamental bisexuality participated in symptom formation and had to be investigated in order to achieve symptom relief. As the analytic work unfolded, it could be seen that the patient's awareness of her feminine aims served to keep her masculine aims out of awareness, and vice versa.     

In search of how people change. Applications to addictive behaviors.

How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key trans-theoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages--pre-contemplation, contemplation, preparation, action, and maintenance--and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a trans-theoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.     

Reaction time to threat stimuli in panic disorder and social phobia

Two studies assessed response time among clinically anxious subjects and normal controls when presented with threat, positive and neutral stimuli under perceptual (lexical decision) and semantic (category decision) task conditions. In Study 1, panic disorder subjects' (n = 14) performance was compared to that of matched normal controls (n = 14) while in Study 2 social phobic subjects (n = 24) were compared to matched normal controls (n = 24). Relative to matched normal controls, panic disorder subjects but not social phobics tended to show greater slowing in performance on the more cognitively complex (category) task. A second finding, consistent across both studies was that, compared to the normal control groups, both panic and social phobic groups showed significantly slowed responses to threat words in both the perceptual and semantic tasks. Such findings are directly counter to the predictions of a mood congruence hypothesis. This apparent contradiction is resolved by a review of the literature which indicates that mood-related facilitation effects are obtained only in tasks which tap awareness of threat information rather than speed of response. It is suggested that while anxiety may produce enhanced awareness of threat, it may inhibit responsiveness to it. The results of these studies are seen as consistent with ethological theories of inhibited motoric responses under certain threat conditions. Furthermore, the findings suggest that caution is indicated in interpreting slowed reaction time to threat stimuli in tasks such as the Stroop color naming task as purely the result of attentional processes.