Confidant Relations Among Taiwanese: Implications for Ethnic Chinese Health Care Treatment

The select individual(s) whom one trusts in sharing important personal matters is sometimes referred to as a confidant. The confidant relationship has received increasing attention in recent years as a major social factor contributing to individual health and wellness. Yet, little empirical data has been available to guide health researchers, policy-makers, and practitioners. In this study, 142 adult Taiwanese responded to a structured questionnaire. Participants comprised 105 females, 32 males, and five with sex unspecified (overall mean age?=?33.8, age range?=?18 to 74 years). They were asked whether they had a confidant, and if so, to describe various features of this relationship. Contrary to previous studies conducted in Europe and the Americas, our investigation found that Taiwanese men were equally likely as Taiwanese women to have a confidant (87.5 % of males and 89.5 % for females). Taiwanese women were significantly more likely to have a female rather than a male confidant, whereas males showed no such sex difference. A significantly higher percentage of confidants were non-family members rather than spouses or other immediate/extended family members. This finding is consistent with research on the relatively minor salience of emotional intimacy in Taiwanese marriages and the hierarchical structures of many Taiwanese families. The implications of our findings for enhancing Taiwanese and broader ethnic Chinese health treatment are discussed.     

Discussion: Toward a social‐constructivist view of the psychoanalytic situation

The three papers by Modell, Aron, and Greenberg are discussed in terms of their relationship to a new paradigm for understanding the psychoanalytic situation. The paradigm is called social‐construct‐ivist to capture both the idea of the analyst's participation and the idea of construction of meaning. It is argued that these theorists, as well as many of the authors they cite as part of a broad movement in the field, do not consistently meet the criteria for this paradigm, although they seem to be aiming for it. An important source of inconsistency and confusion derives from the confounding of the two axes: drive‐relational and positivist‐constructivist. Many relational theorists who hold fast to the idea that analysts can grasp the truth of both their own experience and that of the patient are no closer to the constructivist point of view than was Freud. The call by Aron and Greenberg for greater attention to the patient's resisted experience of the analyst's subjectivity is discussed in terms of its potential benefits and problems. The ritualized asymmetry of the psychoanalytic situation is said to have important functions, including prevention of excessive involvement and protection of the unobjectionable positive transference and of a degree of idealization. Modell's notion of paradox, which makes the therapeutic relationship seem “real”; and “unreal”; at the same time, is seen as a special instance of the always precarious social construction of reality. It is argued, moreover, that the social and individual aspects of experience are interdependent. Neither is reducible to the other, and both should be understood, like many other issues in the new paradigm, in terms of a dialectical interplay of figure and ground in experience.     

Response to Slavin: Considering the Evolutionary and Existential Contexts of Dialectical Constructivism

Within his evolutionary framework, Slavin elaborates eloquently on the dialectic of construction of meaning and anticipation of death. Also within that framework he highlights the emergence of the universal dialectic of self-interest and care for others, perhaps finding its most poignant expression in the relation of parents and children. I raise questions about Slavin's attribution of a “sense of loss” to humans who allegedly long for the experience of evolutionarily earlier species, particularly their sense of automatic connectedness and automatic ways of relating to the world free of the burdens of uncertain, self-conscious choice. A longing for earlier states in human development is easier to grasp than a longing for the experience of less advanced species from which humans evolved. Nevertheless, Slavin's views and my own are otherwise deeply compatible, particularly his sense of what emerges as the uniquely human challenge of intersubjective construction of meaning in the context of individual self-interest and in the face of death. Slavin is also emphatic that the pervasiveness of absolute belief systems that preempt awareness of ambiguity, the anxiety of freedom, and the dread of death, does not gainsay their defensive nature. I argue, in accord with Altman, Butler, and others, that denial of death may promote dissipation of communal sensibility and replacement of it in a capitalist world (and perhaps others as well) with destructive splitting and fetishistic, competitive pursuit of money and power.     

Response to Safran: The Development of Critical Psychoanalytic Sensibility

Jeremy D. Safran feels that my views regarding the relative merits of case studies and systematic empirical research are unnecessarily polarizing. I feel that, on the contrary, I'm offering bridges between my perspective and those of researchers on psychoanalytic process and outcome in two ways. One is through my own constructivist critique of traditional positivist case studies and theorizing based upon clinical experience. The second is through conceptualizing the place of systematic research within a constructivist paradigm. I am arguing that its place can be no different than that of case studies. Both generate possibilities for any particular analyst or analytic therapist to have in mind as he or she works with a particular patient at a particular moment. Safran locates the destructive effects of scientism with “biologically oriented researchers and cognitive therapists.” In my view, it might be convenient if the problem could be located exclusively with them, but the fact is that psychoanalytic researchers, as I demonstrate, are working largely within the same paradigm as their adversaries in the research world. That paradigm erroneously privileges systematic research as hypothesis-testing, whereas case studies are relegated to the status of anecdotal, hypothesis-generating work. I describe what I call “nonlinear constructivist learning” as the kind of “generalization” that case studies can yield and that is optimal for our field.     

Cracking the Code: Using Personal Narratives in Research

The use of personal narratives in research across the field of psychology has dramatically increased in recent years. In studies spanning a wide range of topics, personal event narratives have provided especially valuable insights into the processes and products of cognitive development. This article offers a guide for researchers who might use personal narratives in research currently or in the future. Issues and best practices surrounding collecting, transcribing, and coding personal narratives are presented. Practical challenges, commonly used methods, and recommended guidelines are described. Illustrations of different types of personal narrative coding systems are offered. The article also highlights benefits of and resources for conducting personal narrative research.     

The experience of chronic illness: Issues of loss and adjustment

Abstract

The impact of a long-term illness creates a pervasive dilemma for individuals in regard to maintaining both emotional and social well-being. Dealing with the medical ramifications of illness may be only one small part of the challenge. Too often, a number of personal losses are encountered in addition to functional limitations. Chronic illness may affect an individual's sense of self-worth, relationships with family and friends, and future goals and plans. The acceptance of these losses and adaptation to the illness are shaped in part by the meaning the individual ascribes to the event. It is further influenced by societal reactions and interactions with others. Unfortunately, persons with chronic illness often find themselves alone in their struggle to adapt. The purpose of this article is to discuss the issues relevant to such persons and to identify ways in which counseling can facilitate this difficult process.     

Small subitizing range in people with Williams syndrome

Recent evidence suggests that the rapid apprehension of small numbers of objects—often called subitizing—engages a system which allows representation of up to 4 objects but is distinct from other aspects of numerical processing. We examined subitizing by studying people with Williams syndrome (WS), a genetic deficit characterized by severe visuospatial impairments, and normally developing children (4–6.5 years old). In Experiment 1, participants first explicitly counted displays of 1 to 8 squares that appeared for 5 s and reported “how many”. They then reported “how many” for the same displays shown for 250 ms, a duration too brief to allow explicit counting, but sufficient for subitizing. All groups were highly accurate up to 8 objects when they explicitly counted. With the brief duration, people with WS showed almost perfect accuracy up to a limit of 3 objects, comparable to 4-year-olds but fewer than either 5- or 6.5-year-old children. In Experiment 2, participants were asked to report “how many” for displays that were presented for an unlimited duration, as rapidly as possible while remaining accurate. Individuals with WS responded as rapidly as 6.5-year-olds, and more rapidly than 4-year-olds. However, their accuracy was as in Experiment 1, comparable to 4-year-olds and lower than older children. These results are consistent with previous findings, indicating that people with WS can simultaneously represent multiple objects, but that they have a smaller capacity than older children, on par with 4-year-olds. This pattern is discussed in the context of normal and abnormal development of visuospatial skills, in particular those linked to the representation of numerosity.