‘Mr K’ – A successful case of analytic oriented therapy documented empirically: the role of the therapeutic relationship and reflexive self-awareness

A successful case of analytic treatment over the course of 250 sessions is described from different perspectives, including considerations from the two-year follow-up. The therapeutic alliance and the patient’s experiencing were evaluated. Pre-treatment diagnosis was validated via diagnostic interview. Symptoms and interpersonal problems were assessed at intervals. Data were analysed using two different time-series analyses. Aspects of agency with regard to mentalizing capacity were assessed with the Metacognitive Assessment Scale. We obtained the following main results: (1) Symptoms and interpersonal problems improved continuously until the end of treatment. Symptom severity fell to below the clinical cut-off. This successful outcome remained stable at the two-year follow-up. (2) The therapeutic relationship improved during the therapeutic process. (3) The patient’s capability for reflexive self-awareness, operationalized as experiencing, decreased. (4) The metacognitive mastery of the patient increased. The following conclusions were made after combining the empirical data with the clinical observations: (1) Mr K improved clinically in terms of symptoms, self-regulation and interpersonal problems as a result of his gaining affect control. (2) The patient’s experiencing does not capture a positive outcome in all cases. (3) Aspects of agency (i.e. metacognitive mastery) deserve further attention in psychoanalytic treatments.     

Retro- and prospection for mental time travel: Emergence of episodic remembering and mental rotation in 5- to 8-year old children

We investigate the common development of children’s ability to “look back in time” (retrospection, episodic remembering) and to “look into the future” (prospection). Experiment 1 with 59 children 5 to 8.5 years old showed mental rotation, as a measure of prospection, explaining specific variance of free recall, as a measure of episodic remembering (retrospection) when controlled for cued recall. Experiment 2 with 31 children from 5 to 6.5 years measured episodic remembering with recall of visually experienced events (seeing which picture was placed inside a box) when controlling for recall of indirectly conveyed events (being informed about the pictures placed inside the box by showing the pictures on a monitor). Quite unexpectedly rotators were markedly worse on indirect items than non-rotators. We speculate that with the ability to rotate children switch from knowledge retrieval to episodic remembering, which maintains success for experienced events but has detrimental effects for indirect information.     

Individual differences in attentional capability are linked to creative decision making

There is a link between visual attention and creativity concerning the generation of rare and flexible decisions/solutions. However, the relationship between individual differences in attentional capability and creative decision making has not yet been investigated in detail. The current study scrutinized this link in a sport‐specific divergent thinking task including videos of real game situations and compared performances between football players being divided into two different expertise levels (expert and amateur football players). We conducted a multiple linear regression analysis to assess whether attentional capability along the attentional focus’ meridians (horizontal, vertical, diagonal) and participants’ expertise level predict creative decision making. The attentional capability along the horizontal meridian of participants’ attentional focus and participants’ expertise level emerged as positive predictors. The findings provide evidence of a relationship between football players’ spatial distribution of attention that match the demands of their sport and an expertise advantage in sport‐specific creative decision making. Implications are not only important for sports, but also for all areas in which spatial attention is required in order to generate unusual solutions.     

The role of competition and knowledge in the Ellsberg task

Ambiguity avoidance denotes people's preference for gambling situations with known over unknown, or ambiguous, probability distributions. In four experiments we provide evidence for the interaction between competitiveness and knowledge in Ellsberg's task, in which people have a choice between a risky box (distribution of balls known) and an ambiguous box (distribution of balls not known). If the situation is perceived as competitive (the experimenter or an opponent is responsible for composing the boxes) people avoid ambiguity by betting on the box with the known probability distribution. If the task is perceived as cooperative (a partner or friend is composing the boxes) people are indifferent toward ambiguity or even ambiguity seeking. In addition, we find that people expect their winning odds to be less than even in the ambiguous box. Copyright © 2003 John Wiley & Sons, Ltd.     

Die Effekte psychoanalytisch orientierter und verhaltenstherapeutischer Langzeittherapien

This prospective study compares 31 patients in behavior long-term-therapy (with an average of 63 sessions) with 31 patients in psychoanalytically-oriented long-term-therapy (with an average of 185 sessions) in a naturalistic design. All patients passed a diagnostic interview (SKID) by an external interviewer. Only patients with depression and anxiety problems (Axis I of DSM III – R) were included in the study. Symptoms (SCL-90-R), interpersonal problems (IIP-D) and goals (GAS) were examined at the beginning, after 1 year, after 2.5 and 3.5 years. We found that the characteristics of patients, who choose – or were referred to – psychoanalytically oriented or behaviour long term therapy were different, even when their diagnosis were comparable, in a number of characteristics, such as education, access to psychotherapy (recommended by professionals versus patients introduce themselves), the taking of psychotropic medication, and the strain of symptoms. The results demonstrate how research comparing therapies using parallelized samples do not meet reality in every case: Even if psychoanalists and behavior therapists do treat equal disorders, – and they each do that very successfully, as we could prove – the patients differ in many ways. Effect sizes and clinically significant results about changes of the symptomatic and of interpersonal problems are presented that prove the efficacy of the treatments.     

Is Homeopathy a Science?—Continuity and Clash of Concepts of Science within Holistic Medicine

The question of whether homeopathy is a science is currently discussed almost exclusively against the background of the modern concept of natural science. This approach, however, fails to notice that homeopathy—in terms of history of science—rests on different roots that can essentially be traced back to two most influential traditions of science: on the one hand, principles and notions of Aristotelism which determined 2,000 years of Western history of science and, on the other hand, the modern concept of natural science that has been dominating the history of medicine for less than 200 years. While Aristotle’s “science of the living” still included ontologic and teleologic dimensions for the sake of comprehending nature in a uniform way, the interest of modern natural science was reduced to functional and causal explanations of all phenomena for the purpose of commanding nature. In order to prevent further ecological catastrophes as well as to regain lost dimensions of our lives, the one-sidedness and theory-loadedness of our modern natural–scientific view of life should henceforth be counterbalanced by lifeworld–practical Aristotelic categories. In this way, the ground would be ready to conceive the scientific character of homeopathy—in a broader, Aristotelian sense.     

Grasping the diagonal: controlling attention to illusory stimuli for action and perception

Since the pioneering work of [Aglioti, S., DeSouza, J. F., & Goodale, M. A. (1995). Size-contrast illusions deceive the eye but not the hand. Current Biology, 5(6), 679-685] visual illusions have been used to provide evidence for the functional division of labour within the visual system-one system for conscious perception and the other system for unconscious guidance of action. However, these studies were criticised for attentional mismatch between action and perception conditions and for the fact that grip size is not determined by the size of an object but also by surrounding obstacles. Stoettinger and Perner [Stoettinger, E., & Perner, J., (2006). Dissociating size representations for action and for conscious judgment: Grasping visual illusions without apparent obstacles. Consciousness and Cognition, 15, 269-284] used the diagonal illusion controlling for the influence of surrounding features on grip size and bimanual grasping to rule out attentional mismatch. Unfortunately, the latter objective was not fully achieved. In the present study, attentional mismatch was avoided by using only the dominant hand for action and for indicating perceived size. Results support the division of labour: Grip aperture follows actual size independent of illusory effects, while finger-thumb span indications of perceived length are clearly influenced by the illusion.     

Disseminating evidence-based treatments for PTSD in organizational settings: A high priority focus area

Dissemination of evidence-based treatments for PTSD has become an important focus of activity in the aftermath of recent terrorist attacks (e.g., London underground and U.S. 9/11 attacks), natural disasters (e.g., Indian Ocean tsunami and Hurricane Katrina), and wars (e.g., in Iraq and Afghanistan). This has become a high priority need for all mental health training and service delivery organizations. Researchers and educators have begun to examine clinician and client perceptions and preferences regarding PTSD treatment processes, and health care systems are organizing more comprehensive efforts at training and system change. As this evolution of services moves forward, effective dissemination should be a major focus of health policy research for the next decade or more.This review critically evaluates the PTSD-related research and emerging theory related to four major sets of variables that affect dissemination: (1) Practitioner factors, (2) Training methods, (3) The practice innovation(s) being disseminated; and (4) Organization or system factors. We evaluate findings from recent studies in light of emerging models of dissemination, and in the final section of the paper, we consider five broad topics with particular implications for dissemination of PTSD-specific treatments. They are: (1) The content of dissemination (i.e., which treatment protocols or intervention methods should be prioritized); (2) Strict adherence versus flexibility in the use of treatment manuals and the role of fidelity assessment; (3) The need for collaboration with user audiences; (4) The potential role of web-based technologies in increasing the effectiveness and efficiency of dissemination; and (5) Development of dissemination infrastructures within organizations.