Navigating Critical Theory and Postmodernism: Social Justice and Therapist Power in Family Therapy

The family therapy field encourages commitment to diversity and social justice, but offers varying ideas about how to attentively consider these issues. Critical informed models advocate activism, whereas postmodern informed models encourage multiple perspectives. It is often not clear how activism and an emphasis on multiple perspectives connect, engendering the sense that critical and postmodern practices may be disparate. To understand how therapists negotiate these perspectives in practice, this qualitative grounded theory analysis drew on interviews with 11 therapists, each known for their work from both critical and postmodern perspectives. We found that these therapists generally engage in a set of shared constructionist practices while also demonstrating two distinct forms of activism: activism through countering and activism through collaborating. Ultimately, decisions made about how to navigate critical and postmodern influences were connected to how therapists viewed ethics and the ways they were comfortable using their therapeutic power. The findings illustrate practice strategies through which therapists apply each approach.     

Commentary on Federica Melandri’s “Milk and Tears”

ABSTRACT

Dr. Melandri’s use of the 2001 Revised Diagnostic Profile to assess 5-year-old Leo brought forth different emphases than Anna Freud’s original Diagnostic Profile (1965). Dr. Melandri’s explicit sharing of how she reacted to and felt in Leo’s presence is far more explicit. Another difference is how fluently Dr. Melandri integrates metapsychology with diverse clinical theories to describe Leo’s development. Had the original Diagnostic Profile been used, there would have been greater emphasis on libidinal phase development, such as orality, anality, phallic, and oedipal development, not to mention dynamic and structural achievements. This essay asks: “what’s at stake?” regarding these different emphases. The author concludes with a few remarks in general about the 2001 Revised Profile, including comments about the fate of Freud’s and Anna Freud’s radical vision.     

Psychologists' Experiences with the Better Access Initiative: A Pilot Study

The Australian Government's Better Access initiative was introduced in late 2006 to increase treatment rates for people with mental disorders. It provides for reimbursement of psychologists' services through Medicare. The current pilot study examines the experiences of psychologists with this initiative. A random sample of 204 of 4,235 psychologists in private practice was approached and 73 psychologists (36%) were interviewed. The current study suggests that psychologists have had positive experiences with Better Access. They have appreciated the greater security of income and greater variety of work afforded by the initiative, and they have observed flow‐on benefits in terms of increased access and reduced stigma for their clients. Additional research is required to corroborate these findings with a larger sample of psychologists, but the current findings provide indicative evidence that Better Access is assisting psychologists to meet a previously unmet community need for mental health care.     

Converted patients and clinic patients as control cases: a comparison with implications for psychoanalytic training

All twenty-eight respondents to a recent poll of the thirty institutes affiliated with the American Psychoanalytic Association reported that they now accept cases converted from psychotherapy to psychoanalysis as control cases. This study was designed to compare converted cases to clinic cases systematically with respect to patient characteristics, treatment, and the educational experience of the treating candidate. The study followed twenty-four candidates entering analytic training between 1992 and 1995, who treated thirty-four clinic cases and forty-three converted cases between February 1993 and July 2000. Clinic and converted patients were comparable with regard to demographics, prior treatment histories, structural diagnoses, and Axis I diagnoses. In addition, the two groups of cases were indistinguishable with respect to the rate at which candidates received credit toward graduation requirements. Candidates treating converted cases earned approximately dollars 7,600 per patient per year, compared to candidates treating clinic cases, who earned nothing. Eighty-four percent of converted patients diagnosed with a mood disorder by the treating candidate were on medication, in contrast to only 20% of clinic patients with the same diagnosis. Similar differences were seen in the case of anxiety disorders. Given the prevalence of affective and anxiety disorders in control cases and the availability of a variety of medications and psychotherapies with documented efficacy in treating these disorders, candidates should be trained to discuss treatment options with patients who present with Axis I disorders.     

Frequency and Psychosocial Correlates of Eating Disorder Symptomatology in Male Figure Skaters

Using a cross-sectional, mixed-method design, this study examined the frequency and psychosocial correlates of eating disorder (ED) symptomatology among male figure skaters (n = 29; M_age = 18.45 years) and explored their perspectives on skating-related weight pressures. One participant (3.7%) scored within range of a clinical ED. Body mass index, sport-related weight pressures, and sport-related body dissatisfaction explained 30% of variance in ED symptomatology; only weight pressures were significant. Although most endorsed the positive influences of skating, a perceived body–performance link was their most frequent weight pressure. Coping with sport-related weight pressures should be addressed in applied sport psychology and ED prevention.     

Thinking Developmentally in Child and Adult Psychoanalysis

Psychoanalysis in theory and clinical practice is a developmental domain. Psychoanalysts think about their patients from a developmental point of view. The analytic relationship promotes development in both analyst and patient. Two concepts central to this author’s developmental point of view are epigenetics—as used in biology and philosophy—and that of the analyst as “developmental object.” Optimally, the analyst as developmental object facilitates what Rita Tähkä terms the “developmental illusion,” which intersubjectively transforms psychic structures, enabling alternatives to the repetition compulsion. Two vignettes with adult patients illustrate how empathic intimacy in psychoanalysis with an emphasis on latency and toddler phases as reconstructed in adult analysis presaged psychic growth. Transference as a vehicle for a developmental history taking is also considered.     

Resilience of the Childhood Origins of Dutch Mothers’ Gender Role Attitudes

Based on qualitative analysis of 39 in depth interviews with Dutch mothers, this paper firstly explores if differences in primary socialization are relevant to an understanding of Dutch mothers’ current diverse (personal) gender role attitudes. Secondly, it addresses the interplay of a mother’s own gender role attitude and those of her partner and peers. The findings reveal that Dutch mothers’ current diverse gender role attitudes have origins in the transmission of different mental and verbal parental, especially maternal, symbols. Egalitarian mothers often recall a strong mother-figure, the verbal persuasion of economic independence and/or particular non-traditional upbringing matters that appealed to their logic of being financially independent. The memories of traditional/adaptive mothers rather stand out for the resignation of unpaid tasks by their own mothers, and the absence of parental encouragement to consider their professional life. The findings further indicate that in childhood originated aspects of mother’s personal gender role attitude continue to shape the character of mother’s behavior and new social relationships.     

Trajectories of Happiness 5 Years Following Medical Discharge for Traumatic Disability: Differences Between Insider and Outsider Perspectives

We studied the predictive impact of proxy “outsider” reports, injury type, and functional independence on trajectories of happiness over the first 5 years following medical treatment for a traumatic spinal cord injury, brain injury, severe burns or inter-articular fractures (total N = 1,271). It was anticipated that lower functional independence and outsider status would predict lower happiness trajectories, with injury type having little effect over time. A measure of functional impairment and the life satisfaction index containing the items that assessed happiness were administered 12, 24, 48, and 60 months post-discharge. Trajectory modeling revealed that lower functional independence significantly predicted lower happiness, regardless of injury type. Outsider reports predicted significantly higher happiness scores than the insiders reported themselves. These differences persisted across time and injury type. Additional analyses found that insider/outsider status accounted for one percent of the variance in happiness scores and functional independence accounted for twenty percent of the variance. Moreover, for all injury groups, there was no evidence for changes in happiness trajectories over time. Outsider accounts differ significantly from insider estimations of variables of positive adjustment accounts but explain little variation in the reports of happiness overall and still have practical and clinical value as secondary sources of information about positive emotional experiences, particularly when reports from the “insider” are not possible.     

The conflict of harmony: Intergroup contact,commonality and political solidarity between minority groups

Recent work on social change has complicated the picture regarding the influence of intergroup contact with majority groups on minority group members' perceptions of inequality and willingness to engage in social action. The present research investigated the ability of a commonality-focused message to inspire political solidarity between minority groups, as well as the potential moderating role of intergroup contact with a majority group on the efficacy of this message for political solidarity. Across two experiments, as hypothesized, political solidarity from one minority group to another was highest within a commonality condition, relative to group-boundaries salient and control conditions, which was explained by increases in commonality perceptions. As expected, however, these effects were moderated by majority group contact, such that those with high levels of contact with majority group were less likely to show the commonality-to-political solidarity relation. Implications for intergroup contact and more broadly social change are discussed.