Should Analytic Patients Be “Created”? Reflections on Arnold Rothstein's Psychoanalytic Technique and the Creation of Analytic Patients

Abstract

The five points of Arnold Rothstein's interesting monograph are each discussed and critiqued in this article. In particular, Rothstein is commended for his commitment to expanding the availability of an intensive, psychoanalytic treatment for a broad spectrum of patients who may often be very difficult to engage. Rothstein also accounts for difficulties in engaging analytic patients from obstacles in the attitudes of analysts such as a latent lack of conviction about the efficacy of psychoanalysis and from overly restricted stereotypes about the spectrum of appropriate patients. He recommends a flexibility of technique and accommodation to the needs of patients with which this author agrees.

Others of Rothstein's observations and recommendations seem more problematic. Specifically, issue is taken with his suggestion that analysts attempt to provide a trial of psychoanalysis for all nonpsychotic patients and to begin on a less intensive basis only within the frame or interpreting prospective patients' objections as a resistance. This author also disagrees with Rothstein's interpretation that patients resist the offer of a psychoanalysis out of a self-defeating masochistic enactment that needs interpretation. Case examples are provided that belie this overly generalized interpretation. Additionally, this author critiques the metapsychological assumptions underlying this particular mode of interpreting a reluctance to begin psychoanalysis.

While commending Rothstein's therapeutic goals and recommended flexibility of technique, this author would also stress a fundamental concern about the patient's conscious and unconscious experience of the analyst's agenda. In other words, rather than working toward the analyst's goal of establishing a psychoanalytic situation, emphasis is placed instead on the basic right of patients to proceed in a manner that respects their sovereignty over how intensively they may choose to work. Therefore, in contradistinction to Rothstein's suggestions, it is recommended that the analyst's primary focus should be to provide an availability to work on the patient's conflicts and developmental needs with a respect for the timing of their emergence and expression within a treatment frame that invites but does not prematurely elicit and confront. By proceeding in this way a patient's salient dynamics will be allowed to emerge “organically” instead of being hastened prematurely in reaction to the analyst's insistence on the Tightness of a particular schedule or manner of proceeding. This author believes that with this approach more, rather than fewer, patients will be able to accept the recommendation of an intensive psychoanalytic treatment.     

Knowing,Influencing, and Healing: Paranormal Phenomena and Implications for Psychoanalysis and Psychotherapy

The serious consideration of paranormal phenomena, or psi, has not been scientifically respectable in modern intellectual discourse. A skeptical attitude persists despite robust evidence demonstrating the reality of nonlocal phenomena such as telepathy and the impact of mind from a distance. A major obstacle to the thoughtful consideration and integration of this evidence is the fact that paranormal phenomena do not fit within generally accepted models of how the universe works. Newer constructs and research findings in quantum physics, however, demonstrate the reality of nonlocal effects and help provide a conceptual framework that encompasses the research documenting psi. Paranormal phenomena have relevance for the fields of psychotherapy and psychoanalysis in the consideration of nonverbal communication and mutual influence between therapist and patient.     

Religious support and psychosocial well-being among a religious Jewish population

The three subscales of the Religious Support Scale assess perceived support from a person’s religious community, religious leaders, and God. This three-factor structure was replicated in the current study with a sample of 277 religious Jewish persons residing in Israel. Hierarchical canonical analysis showed that, even after controlling for general social support, Religious Leader and God Support were related to lower emotional distress, Religious Leader and Religious Community Support contributed to a higher level of life satisfaction, and Religious Community and God Support contributed to the prediction of perceived health. Findings are discussed in terms of religious support’s generalizability as a psychosocial resource for persons of various faiths.     

The role of individual differences in the accuracy of confidence judgments

Generally, self-assessment of accuracy in the cognitive domain produces overconfidence, whereas self-assessment of visual perceptual judgments results in underconfidence. Despite contrary empirical evidence, in models attempting to explain those phenomena, individual differences have often been disregarded. The authors report on 2 studies in which that shortcoming was addressed. In Experiment 1, participants (N= 520) completed a large number of cognitive-ability tests. Results indicated that individual differences provide a meaningful source of overconfidence and that a metacognitive trait might mediate that effect. In further analysis, there was only a relatively small correlation between test accuracy and confidence bias. In Experiment 2 (N = 107 participants), both perceptual and cognitive ability tests were included, along with measures of personality. Results again indicated the presence of a confidence factor that transcended the nature of the testing vehicle. Furthermore, a small relationship was found between that factor and some self-reported personality measures. Thus, personality traits and cognitive ability appeared to play only a small role in determining the accuracy of self-assessment. Collectively, the present results suggest that there are multiple causes of miscalibration, which current models of over- and underconfidence fail to encompass.     

An Empirical Comparison of Commitment Scales

In a previous review of the literature, Morrow (1983) identified a redundancy or overlap among the various measures of commitment. The present study employed a factor analytic design to examine the intercorrelations among various job, organizational, and value commitment scales. In addition, possible consequences of the various scales were analyzed. Results from 216 police officers identified a general factor as well as unique components. The commitment scales were able to explain between 20% and 40% of the variance of several self-report measures. Explanations and implications of the results were discussed.     

Extending sequence-class membership with matching to sample

Three normal adults were first trained to point sequentially to each member of several pairs of visual stimuli. This baseline training established one class of stimuli to which subjects responded first, and another class of stimuli to which they responded second. Then, in a matching-to-sample procedure, baseline-sequence stimuli served as samples and new visual stimuli served as comparisons. Subjects were trained to choose one group of new comparisons when the sample was a "first" stimulus from the sequence baseline, and to choose the other new comparison stimuli when the sample was a "second" from the sequence baseline. When the new stimuli were then presented as pairs in the posttest, two subjects pointed to them in sequences predictable on the basis of the stimulus-class membership established during matching to sample. The failure of one subject to demonstrate sequential transfer was shown to be a consequence of the failure of the matching-to-sample procedure to establish stimulus classes. The production of sequences that were not directly trained suggested an empirical approach to the analysis of simple grammatical behavior.     

Competing tasks as an index of intelligence

Most studies involving competing (or dual) tasks have been concerned with the investigation of models of attention and have stressed the importance of task characteristics in determining competing-task performance. The relatively few studies which have looked at individual differences in competing-task performance suggest that measures of this performance could reflect operations which are central to cognitive functioning. This paper examines two key questions which stem from this research: is there a separate ability involved in competing-task performance? Is competing-task performance more indicative of general intellectual functioning?A battery composed of both single and competing tasks was presented to 91 Ss. Two sets of scores, ‘primary’ and ‘secondary’, were obtained from the competing tasks. The results indicate that ‘single’ and ‘primary’ scores are basically measuring the same thing but that ‘secondary’ scores measure what is perhaps a time-sharing factor. There is also some evidence that primary and secondary scores are more indicative of the general factor, as measured by this battery, than their single counterparts.     

Decision Pattern Analysis as a General Framework for Studying Individual Differences in Decision Making

This paper investigated decision pattern analysis (DPA) as a general and standard framework for studying individuals' consistent decision making behavior within and between contexts. DPA classifies decisions on the basis of judgement accuracy and the goal orientation of the decided‐upon action. Over repeated decisions, patterns of individuals' decision behavior are described by five variables: competence, optimality, recklessness, hesitancy and decisiveness. A fictitious medical decision making test and three standard cognitive ability tests (extended with confidence ratings and a ‘submit answer for marking’ decision) were used to investigate the psychometric properties of these DPA variables. Internal consistency of the decision patterns ranged from good to excellent. Convergent validity was assessed via cognitive abilities, metacognitive confidence and a control criterion imposed on confidence that determines the decision to be made: the point of sufficient certainty. Personality variables were included to assess discriminant validity. As hypothesised, cognitive abilities showed positive correlations with competence and optimality. High confidence, low points of sufficient certainty and a greater discrepancy between them were associated with higher decisiveness and recklessness, and lower hesitancy. Personality measures showed mixed and generally weak correlations with the DPA variables. These convergent and discriminant results also held after controlling for all variables in regression. The results provide preliminary psychometric support for DPA as a general framework of behavioral decision making. DPA has the potential to be exploited in many contexts for uses that, to date, have been unachievable in a psychometrically valid manner. Copyright © 2015 John Wiley & Sons, Ltd.     

The Multidimensionality of Motivation for Jewish Religious Behavior: Content, Structure, and Relationship to Religious Identity

The present study examined the content and structure of self–reported motivation for Jewish religious behavior. Initial items were generated from comprehensive and detailed responses to a semi–structured interview and an open–ended questionnaire. Principal component factor analysis with orthogonal rotation was carried out on the responses of a sample of 323 research participants to two parallel sets of the 111 items produced by the above process. The factor structures for each of these sets of items were highly similar to each other and consisted of the following five reliable factors: belief in a divine order, ethnic identity, social activity, family activity, and upbringing. These factors appear to reflect the way religious behavior can contribute to the satisfaction of a number of general human motives. Persons with different religious identities were found to attribute their performance of religious ritual to different motives, providing a partial explanation for the apparent anomaly of the performance of religious ritual by persons who identify themselves as secular.