From pilot fish to analyst: Finding a path between symbiotic and autistic defences

This paper presents the clinical case of a patient with autistic features. One of the main difficulties in his treatment was the particular rapid rhythm of his projections, introjections and re‐projections that constrained the analyst's capacity for reverie and hindered the use of effective projective identification processes. These alternating defensive constellations lead either to an expelling autistic barrier or to an engulfing symbiotic fusion. Their combination can be seen as the expression of a defence against an unintegrated and undifferentiated early experience of self that was in this way kept at bay to prevent it from invading his whole personality. Maintaining the symbiotic link, in which I kept included by staying partially fused to what was being projected and using my analytic function in a reduced way, helped to relate to what was in the patient's inside. Leaving this symbiotic link let my interpretations appear to ‘force’ their way through the autistic barrier. Yet as the process developed they allowed to show the patient how he ejected me and what was happening in his inside, behind his autistic barrier. So I found myself on the one hand accepting the symbiotic immobilization and on the other hand interpreting in a way that seemed forced to the patient, because it implied a breaking of the symbiotic position. The inordinate speed of projections and introjections could thus be interrupted, creating a space for awareness, reflection and transformation, and allowed the emergence of a connection between the patient's inside and outside. In the course of treatment I realized that this kind of dual defence system has been described by the late Argentinian analyst José Bleger. He assumes the existence of an early “agglutinated nucleus” that is held together by a psychic structure he calls the “glischro‐caric” position, in which projective identification cannot take place because there is no self/object differentiation. I have considered the rapid and fugitive use of projection and re‐introjection I met in my patient to be a manifestation of the dual defence system Bleger describes. Although he does not specifically mention this particular vicissitude of operative defences he does give hints about a rhythm in the patients’ projections and introjections.     

Relations Between the Development of Teaching and Theory of Mind in Early Childhood

The relations among children’s theory of mind (ToM), their understanding of the intentionality of teaching, and their own peer teaching strategies were tested. Seventy-five 3-, 4-, and 5-year-olds completed 11 ToM and understanding-of-teaching tasks. Subsequently, 30 of the children were randomly chosen to teach a peer how to play a board game, and their teaching strategies and levels of contingent teaching were recorded. There were developmental changes in the children’s understanding of teaching as an intentional activity. When teaching their peers, 3-year-olds used demonstration, whereas 4- and 5-year-olds added verbal explanations and began to adapt contingently to the learners’ changing knowledge level. Relations among ToM, understanding of teaching, and teaching level were found. The results suggest that the development of children’s teaching strategies and their contingency are closely tied to the development of ToM.     

Emotion Regulation Strategies in Cognitive Behavioral Therapy for Panic Disorder

Emotion regulation (ER) has been incorporated into many models of psychopathology, but it has not been examined directly in cognitive behavioral therapy (CBT) for panic disorder with agoraphobia (PD/A). In this study, a preliminary model of ER in CBT for PD/A is proposed based on existing theories, and several propositions of the model are tested. We hypothesized that increases in cognitive reappraisal would precede decreases in biased cognitions, decreases in expressive suppression would follow decreases in biased cognitions, and a reduction in symptom severity would follow decreases in expressive suppression. Twenty-nine patients who received CBT for PD/A completed weekly self-report measures of symptom severity, anxiety sensitivity, reappraisal and expressive suppression. In addition, patients were compared to a matched normal sample. Cross-lagged analyses partially supported the hypotheses. Reappraisal did not change until late stages of therapy and was generally not associated with treatment outcome. Suppression decreased significantly and exhibited a reciprocal relationship with biased cognitions. Symptom reduction followed decreases in suppression as hypothesized. However, patients did not differ in ER from matched controls at either pre- or posttreatment. Results suggest the important distinction between reappraisal and appraisal, and stress the role of session-by-session decreases in suppression as a predictor of symptom reduction.     

Examining the effects of stereotype threat on test-taking behaviors

This study examines the relationship between stereotype threat and individual test-taking behaviors. Previous research has examined the impact of stereotype threat on test scores, but little research has examined the impact of stereotype threat on the test-taking behaviors impacting those scores. Using a pre-post experimental design, stereotype threat was manipulated and test-taking behaviors (e.g., time spent per item, response changes) were measured while completing verbal ability items before and after the manipulation. The results indicated that stereotype threat minimally impacted time-related test-taking behaviors, but did impact behaviors related to response changes. Implications of the findings are discussed.     

Psychosoziale Versorgungsforschung

Health is of high value. Therefore, an effective and efficient care is a widely accepted societal objective. Correspondingly, health service research in general and for the psychosocial area in particular receives increasing attention from politics, health and pension insurance companies and professional organisations. These stakeholders promote health service research with considerable financial means. The various promotional programs are described and their implications are discussed. The relationship between content, purposes and methodology for the definition of research in health care is clarified. Finally, current research questions are exemplified by five key topics.     

The use of heuristics in intuitive mathematical judgment

Anecdotal evidence points to the use of beauty as an indication of truth in mathematical problem solving. In the two experiments of the present study, we examined the use of heuristics and tested the assumption that participants use symmetry as a cue for correctness in an arithmetic verification task. We manipulated the symmetry of sets of dot pattern addition equations. Speeded decisions about the correctness of these equations led to higher endorsements for both correct and incorrect equations when the addend and sum dot patterns were symmetrical. Therefore, this effect is not due to the fact that symmetry facilitates calculation or estimation. We found systematic evidence for the use of heuristics in solving mathematical tasks, and we discuss how these findings relate to a processing-fluency account of intuition in mathematical judgment.     

Measurement of equity sensitivity: a comparison of the Equity Sensitivity Instrument and Equity Preference Questionnaire

The psychometric properties of the Equity Sensitivity Instrument (Huseman, Hatfield, & Miles, 1985, 1987) and Equity Preference Questionnaire (Sauley & Bedeian, 2000) are compared. 173 undergraduate business majors completed several work attitude and personality measures. Results suggest that the Equity Preference Questionnaire may be a better measure of the equity sensitivity construct than the Equity Sensitivity Instrument which is typically used in research. Reliabilities for the scores on the Equity Sensitivity Instrument and Equity Preference Questionnaire were equivalent (coefficient alphas of .85 and .86, respectively); however, evidence for convergent and content validity was greater for the Equity Preference Questionnaire. Understanding individual differences in perceptions of equity and how best to measure these differences can affect workplace outcomes (e.g., turnover, employee engagement.     

Love Thyself Before Loving Others? A Qualitative and Quantitative Analysis of Gender Differences in Body Image and Romantic Love

The present study was designed to explore the intersection of body esteem, romantic love, and gender through qualitative and quantitative analyses. Male (n?=?107) and female (n?=?113) undergraduates completed the Body Esteem Scale (BES), four Romantic Love Experiences Scale (RLES) subscales, and two open-ended questions about the interrelation between body esteem and relationships. For both genders, significant correlations emerged between the BES and RLES, suggesting a link between body experience and romantic relationships. Regression analyses indicated that two individual RLES variables (i.e., trust and jealousy) predicted body esteem for women but not for men. Qualitative data coding revealed that, compared to men, women were more likely to disclose that body image influenced sexual relations and that relationships affected their self-confidence. These findings illustrate the interpersonal dimensions of body image and highlight the value of quantitative and qualitative methodologies.