Psychoanalytic patients in the U.S., CANADA,and Australia: I. DSM-III-R disorders,indications, previous treatment,medications, and length of treatment

To determine the demographics, DSM-III-R disorders diagnosed, indications used in recommending psychoanalysis, previous treatment histories, use of medication, and length of treatment in patients in psychoanalysis in the U.S., Canada, and Australia, a mail survey of practice was sent to every other active member of the American Psychoanalytic Association and every member of the Australian Psychoanalytical Society. This supplemented an earlier survey sent to all Ontario psychoanalysts. The response rates were 40.1 % (n = 342) for the U.S., 67.2% (n = 117) for Canada, and 73.9% (n = 51) for Australia. Respondents supplied data on 1,718 patients. The employment rate for patients increases as analysis progresses (p < .0001). The mean number of concurrent categories of disorders (Axis I, Axis II, and Disorders First Evident in Childhood) per patient at the start of treatment is 5.01 (SD = 3.66; median = 4; mode = 3). There are no statistically significant differences across countries. Mood, anxiety, sexual dysfunction, and personality disorders are most common. American Psychiatric Association / American Psychoanalytic Association peer review criteria for indicating psychoanalysis are followed for 86.5% of patients. Over 80% of patients in all three countries had undergone previous treatments prior to analysis. In the U.S., 18.2% of analysands are on concurrent psychoactive medication; in Australia, 9.6%. The mean length of analyses conducted in the U.S. is 5.7 years, in Australia 6.6, and in Canada 4.8. Psychoanalytic patients in all three countries have similar rates of DSM-III-R psychopathology, and many indications of chronicity.     

The relationship between STD locus of control and STD acquisition among adolescent girls

This longitudinal study examined adolescent girls' perception of control over sexually transmitted disease (STD) acquisition. Participants were asked questions regarding their perception of their STD locus of control (internal control; control by parents, partners, peers, and health care providers; and chance) at two waves of data collection. Of the 116 participants (mean age = 17 years), 82% were African-American and 18% were Caucasian. Responses to the measure of locus of control were significantly correlated across a 6-month interval. The responses regarding internal control, control by partner, and chance were not related to the acquisition of an STD in the next 6 months. Further, they were not influenced by an STD in the preceding 6 months. These results indicate that responses to a locus of control measure were stable over a 6-month period, and internal, partner, and chance locus of control perceptions seem to be neither determined by STD experience nor directly related to future STD acquisition. However, understanding an individual's locus of control may be helpful in providing appropriate counseling. Future research could examine how adolescent girls form their perceptions of control over STD acquisition.     

Between Wonder and Doubt: Psychoanalysis in the Goal-Free Zone

This paper examines the experiential dimensions of wonder and doubt as one way to articulate the creative and growth-promoting tensions between the medical/scientific model and the spiritual/mystical model. Both forms of experience, it is argued, function as necessary elements in a psychotherapy that integrates psychoanalysis and spiritual praxes. Fundamental differences between the medical/scientific model and the spiritual/mystical models are examined. The notion of the gap serves to illustrate these diametrically opposed, albeit compatible and necessary, points of view. The multifaceted layers of movement between Buddhism and psychoanalysis typify interacting dynamics between the two disciplines and provide a focal point for discussion. The paper then explores parallels between the Zen Buddhist notion of Satori as explicated in the writings of D. T. Suzuki and Wilfred Bion's notion of O. Theoretical aspects of the discussion provide a backdrop for exploring clinical experience regarding the relationship between acceptance and change, the clinical relevance of the Buddhist notions of gaining idea and basic goodness. The author also explores relationships between presence as actuality and ideal; knowing and not knowing; wonder and doubt. Clinical material supports the theoretical aspects of the discussion.     

Social neuroscience: understanding the pieces fosters understanding the whole and vice versa

Social science and neuroscience perspectives represent two ends of a continuum of levels of organization studied in psychology. Human behavior as a whole unfolds at social levels of organization, whereas much of the research in psychology has focused on cognitive and biological pieces of this whole. Recent evidence underscores the complementary nature of social, cognitive, and biological levels of analysis and how research integrating these levels can foster more comprehensive theories of the mechanisms underlying complex behavior and the mind. This research underscores the unity of psychology and the importance of retaining multilevel integrative research that spans molar and molecular levels of analysis.     

Encouraging research: make it collegial,enjoyable, and relevant

Researchers are too often trained under circumstances that discourage them from continuing research activities after they graduate. Three hypotheses are suggested that, if confirmed, would lead to a greater number of competent and enthusiastic researchers. (a) Arrange compatible peer groups. Allowing graduate students to form research teams to conduct dissertation studies would provide more social support than the individualistic environment traditionally required does. (b) Make the experience satisfying and enjoyable. Infuse a spirit of playfulness and puzzlement.