Commentary: “A Fundamental Polarity in Psychoanalysis: Implications for Personality Development,Psychopathology, and the Therapeutic Process” by Sidney J. Blatt

A commentary on Dr. Sidney J. Blatt's article, “A Fundamental Polarity in Psychoanalysis: Implications for Personality Development, Psycho-pathology, and the Therapeutic Process” is presented by articulating Dr. Blatt's significant contribution to psychoanalysis, developmental and attachment theory, and therapeutic process research. According to Blatt's theory, normal maturation involves a complex reciprocal transaction between two developmental lines throughout the life cycle: (a) the establishment of stable, enduring, mutually satisfying interpersonal relationships and (b) the achievement of a differentiated, stable, and cohesive identity. He has applied this theory to understand both normal and pathological psychological phenomena, the latter resulting from disruptions in these developmental lines, resulting in an overemphasis on relational (anaclitic) or self-definitional (introjective) issues. Further, Dr. Blatt has evaluated his theoretical model through empirical study and demonstrated that relationally oriented and self-definitionally oriented persons have differential responses to psychotherapy. Finally, areas of question and potential for future research are outlined. Specifically, it is argued that although anaclitic and introjective configurations are easy to discuss as distinct types, relevant evidence from attachment theory raises the issue of whether these types may be better conceptualized as dimensions, with different configurations located within two-dimensional space. Further, findings of a group evidencing mixed anaclitic and introjective features raise additional questions about how these configurations relate to one another, and evidence from the attachment literature is used to shed light on this issue.     

Attachment Theory,Psychoanalysis, Personality Development,and Psychopathology

Blatt and Levy place attachment theory and research in a broad theoretical matrix by considering the relationship of attachment patterns to personality development and to different types of psychopathology in adults. Thus Blatt and Levy construct conceptual bridges between the two configurations of personality development and psychopathology that Blatt and colleagues have developed over the past quarter century (e.g., Behrends and Blatt, 1985; Blatt, 1974, 1995; Blatt and Behrends, 1987; Blatt and Blass, 1990, 1996; Blatt and Shichman, 1983) and attachment theory and research. Blatt and Levy identify a polarity that is central to attachment theory and research, the polarity of attachment and separation, and they note that this polarity has also been central in much of classic psychoanalytic theory (e.g., Freud, 1930; Loewald, 1962). This polarity is expressed in attachment theory and research in the differences between avoidant and anxious-preoccupied insecure attachment patterns as well in the distinction between two types of disorganized attachment, helpless-withdrawn and negative intrusive, identified by Lyons-Ruth (1999, 2001).

This polarity of attachment and separation, or relatedness and self-definition is also fundamental to personality development that occurs in the hierarchical dialectic transaction of two basic developmental lines—interpersonal relatedness and self-definition (Blatt and Blass, 1990, 1996). This polarity is also inherent in the conception of two fundamental configurations of psychopathology—anaclitic psychopathology, the dependent (or infantile) and hysterical personality disorders—that are preoccupied with issues of interpersonal relatedness, and introjective psychopathology, the paranoid, obsessive-compulsive and depressive personality disorders, in which issues of self-definition and self-worth are dominant (Blatt, 1974, 1995; Blatt and Shichman, 1983). Thus, the identification of this fundamental polarity provides the basis for establishing links between attachment patterns, personality development, and adult psychopathology. Blatt and Levy also attempt to integrate psychoanalytic concepts of the representational world (e.g., Sandler and Rosenblatt, 1965)—the development of concepts of self and significant others—with the internal working models (IWMs) of attachment relationships. This integration enabled Blatt and Levy to bring a fuller developmental perspective to the IWMs of attachment theory and to note that, based on differences in the content and structural organization of the IWMs or mental representation of self and significant others, several developmental levels can be identified in both avoidant and anxious preoccupied attachment. These developmental levels within each attachment style also identifies less and more adaptive forms of both types of insecure attachment. Thus, the integration of the psychoanalytic concepts of mental representation with concepts of the IWM of attachment theory and research enables Blatt and Levy to create a fuller developmental perspective in the study of insecure attachment patterns.     

Psychoanalytic Training: The “Faculty System”

The primary and ideal version of the task faced by training institutes is simple: to help aspiring candidates become competent. Candidates receive assistance in developing their knowledge and skills as practitioners. But to look at training more closely is to see a far more complex set of demands and expectations. Indeed, training as it is actually conducted in most institutes can easily seem inconsistent, contradictory, and, at times, self-defeating. Moreover, in the golden age of psychoanalysis, training was considerably more haphazard and casual than it has become, but our efforts to become more systematic and thoughtful about training coincide with a general decline in our level of originality. Why has training, the development of competence, seemingly so clear and simple a task, become so complex and confusing?     

P = f (Conscientiousness × Ability): Examining the Facets of Conscientiousness

We posited that the form of the joint effects of motivation and ability in traditional performance models are interactive because motivation triggers the use of energy resources required to deploy ability at work. Moreover, we posited that achievement might best represent motivation compared to five other facets of Conscientiousness or global Conscientiousness. In two samples of customer service representatives, achievement interacted with general mental ability (GMA) in predicting task performance, whereas global Conscientiousness and the other five facets did not. This suggests that researchers examining the motivational aspects of Conscientiousness might uncover a more consistent pattern of results for task performance if they focus on the achievement facet. Furthermore, managers might see the highest levels of task performance in certain contexts when hiring individuals based on both achievement and GMA.     

Psychiatric Symptom Impairment in Children with Autism Spectrum Disorders

The general aim of this study was to examine the relation of psychiatric symptom-induced impairment with other common parameters of mental health in children with autism spectrum disorder (ASD). Prevalence rates are used to illustrate the implications of different criteria for caseness. Parents/teachers completed DSM-IV-referenced rating scales for 6–12 year old children with ASD (N?=?115), the majority of whom were boys (86 %). Most children were rated by parents (81 %) or teachers (86 %) as being socially or academically impaired by symptoms of at least one psychiatric disorder. The most common impairing conditions (parent/teacher) were attention-deficit/hyperactivity disorder (67 %/71 %), oppositional defiant disorder (35 %/33 %), and anxiety disorder (47 %/34 %), and the combined rates based on either informant were generally much higher. Agreement between symptom cutoff and impairment cutoff was acceptable for most disorders. A larger percentage of youth were impaired by psychiatric symptoms than met symptom cutoff criteria, and the discrepancy between impairment cutoff and clinical cutoff (impairment cutoff plus symptom cutoff) was even greater. Impairment was moderately to highly correlated with both number and severity of symptoms. Parents’ and teachers’ ratings indicated little agreement as to whether a child was impaired. Findings for youth with ASD were similar to non ASD child psychiatry outpatient referrals, but clearly different in several ways from comparable studies of community-based samples.     

Disaster Impact Across Cultural Groups: Comparison of Whites, African Americans, and Latinos

The current study extends knowledge regarding the differential impact of natural disasters among White, African American, and Latino survivors of Hurricane Ike through its use of a large, regional sample recruited via representative sampling procedures to examine the associations between cultural identification and disaster impact, including loss, damage, and negative mental health outcomes. Consistent with previous research, results indicated disparities between cultural groups with regard to disaster exposure. Additionally, type of disaster impact was differentially associated with PTSD and depression status dependent on cultural group. Specifically, the extent of personal disaster exposure, property damage, and loss of services made significant contributions to PTSD status among White survivors. African-Americans were more likely than White and Latino Ike survivors to endorse post-disaster PTSD and depression and endorsement of depression was predicted by severity of property damage. With respect to Latino respondents, only the extent of personal disaster exposure significantly contributed to both PTSD and depression status. Implications of the current findings are discussed with regard to future disaster preparedness and response efforts and the implementation and evaluation of community-based disaster resources.     

Adapting Motivation,Control, and Compensation Research to A New Environment

The authors discuss the need to adapt research in three substantively related but paradigmatically diverse research domains (salesperson motivation, control systems, and compensation) in light of the evolving selling environment. A key objective is to suggest the desirability of integrating these literatures, which, ultimately, all seek to inform management regarding how salespeople and sales organizations can be encouraged to become more productive. The authors maintain that specification of the right goals and metrics constitutes a fundamental common denominator across the three literatures.     

Cognitive control and consistency in compliance

Abstract

The purpose of this prospective study was two-fold. First, three modes of compliance assessment were used to examine whether renal dialysis patients comply consistently across medical regimens (fluid, potassium, phosphorous, protein) and whether compliance is consistent across mode of assessment (patient self assessment, medical staff ratings, physiological data). Second. a cognitive model predicting fluid compliance was tested to see if it would generalize to predict dietary compliance and medication taking. Patients' self-control perceptions of compliance, staff assessments of compliance, and physiological data were collected prospectively for 85 end-stage renal disease (ESRD) patients. Results indicated substantial consistency across medical regimen depending on the mode of assessment; staff assessment showed the most consistency, followed by patients' self-assessments and lastly by physiological data. Despite this consistency across medical regimens, the cognitive-control model only predicted fluid compliance; the model failed to explain dietary and medication compliance. Reasons and implications for these results are discussed.     

The dimensional structure of benefit finding in multiple sclerosis and relations with positive and negative adjustment: A longitudinal study

Benefit finding is a meaning making construct that has been shown to be related to adjustment in people with MS and their carers. This study investigated the dimensions, stability and potency of benefit finding in predicting adjustment over a 12 month interval using a newly developed Benefit Finding in Multiple Sclerosis Scale (BFiMSS). Usable data from 388 persons with MS and 232 carers was obtained from questionnaires completed at Time 1 and 12 months later (Time 2). Factor analysis of the BFiMSS revealed seven psychometrically sound factors: Compassion/Empathy, Spiritual Growth, Mindfulness, Family Relations Growth, Lifestyle Gains, Personal Growth, New Opportunities. BFiMSS total and factors showed satisfactory internal and retest reliability coefficients, and convergent, criterion and external validity. Results of regression analyses indicated that the Time 1 BFiMSS factors accounted for significant amounts of variance in each of the Time 2 adjustment outcomes (positive states of mind, positive affect, anxiety, depression) after controlling for Time 1 adjustment, and relevant demographic and illness variables. Findings delineate the dimensional structure of benefit finding in MS, the differential links between benefit finding dimensions and adjustment and the temporal unfolding of benefit finding in chronic illness.     

Gender differences in type a behavior and hostility within an organizational setting

Abstract

Recent investigations suggest that the hostility component of the Type A behavior patter (TABP) is a greater detriment to health than the overall pattern. Some researchers suggest that certain Type A characteristics (e.g., job-involvement) are actually adaptive. This study compared the relative relationship of the TABP and hostility to career-related achievement and psychosocial adjustment among 223 service-delivery employees. Male and female participants completed the Jenkins Activity Survey and the MMPI Hostility Scale as part of a cardiovascular disease risk factor screening. The TABP was positively associated with managerial status for both men and women. However, the TABP was positively related to psychosocial adjustment variables among men only. Hostility was significantly related to undesirable outcomes including lower job status, life dissatisfaction, and unfavorable perceptions of the workplace for both men and women. Discussion addresses organizational factors which might perpetuate hostility and the TABP, as well as gender differences in the experience of these constructs.