Men,shame and antisocial behavior: A psychodynamic perspective

This paper discusses the psychosocial factors that contribute to male antisocial behavior. The role of shame and related affects is emphasized. Compensatory defenses associated with these affects are also described. Developmental concepts are reviewed in the light of recent research. Finally, some of the issues involved in doing psychotherapy with this population are discussed, with an emphasis on the value of group therapy.Parts of this paper were presented at the second annual conference onCulture, Race and Ethnicity in Group and Family Therapy which was sponsored by the Eastern Group Psychotherapy Society and New York University and was held in New York City, March 20–22, 1987.     

Terminations

Whether the person leaving the group is a group member or a group therapist, the basic dynamics of separation are the same, involving the separation process as well as mourning. Terminations evoke ambivalent feelings of both separation-pain and hope. Group members and the departing person experience a loss, which reminds them of other losses, and the departing person (group member or therapist) may also experience some guilt. Any termination will have an effect on the-group-as-a-whole, as well as on the individual members, and must be dealt with prior to the actual leaving, as well as after the termination.     

Acting out in group psychotherapy

Acting out is a common occurrence in group psychotherapy. After a brief review of relevant psychoanalytic and group psychotherapy literature, this paper presents various kinds of acting out by the individual group members and the handling of such acting out by the therapist, discusses acting out by the group as a whole, and gives a brief overview of acting out by the group therapist. Specific examples are given of acting out and ways of dealing with it.     

Out-of-Body experiences in the blind

The theoretical significance of out-of-body experiences in blind people is explored. In this context I report results of a survey of a small sample of blind adults. It is concluded that we have yet to locate a case of an out-of-body experience in the blind that has critical implications for the interpretation of the experience among the general population.Acknowledgement hereby is given to the efforts of Margaret Kerr, Coordinator of Field Services for the Royal Blind Society of New South Wales, Australia, in supervising the collection of data reported in this paper.     

Further validation of a measure of irrational belief

Malouff and Schutte (1986) developed a measure of irrational belief intended to be shorter and more content valid than other such measures and reported preliminary evidence of reliability and validity for the measure. The present two studies examined further the validity of the new measure. Study 1 produced evidence of construct validity in that a significant correlation was found between scores on the Malouff & Schutte measure and scores on a measure of hostility, which is a theoretically related construct. Study 2 produced evidence of construct validity in that scores on the Malouff & Schutte measure were found to be correlated with scores on two measures of theoretically related constructs: anxiety and irrational tendencies/beliefs. Study 2 also produced evidence of discriminant validity in that scores on the Malouff & Schutte measure were found to be significantly more highly correlated with scores on the more theoretically similar irrational tendencies/beliefs scale than with scores on the anxiety measure.     

Reductions in type a behavior,anxiety, anger,and physical illness as related to changes in irrational beliefs: Results of a demonstration project in industry

A series of stress management workshops was conducted in a Rational-Emotive Therapy (RET) format for an entire department in a large corporation (N=49). The population was rather general, i.e., nonstudent, nonclinical, and nonvolunteer. Measures were obtained before the program began and three to four months following completion on the dependent variables of Type A behavior, anxiety, anger, depression, assertiveness, and physical illness symptoms, and on the cognitive independent variables of irrational beliefs. Major changes were obtained on all dependent measures supporting previous work on the usefulness of an RET approach in reducing various types of distress. Further, these changes were shown to be strongly related to changes in irrational beliefs and changing such irrational beliefs was the major focus of the program. It is concluded, therefore, that a fundamental assumption of Rational-Emotive Therapy and theory is given additional empirical support.Paul J. Woods, Ph.D., co-editor of this Journal, is an associate fellow and an RET training supervisor of the Institute for Rational-Emotive Therapy     

The efficacy of rational-emotive group therapy in psychiatric inpatients

The impact of rational-emotive theory and therapy upon the practice of clinical psychology has been profound, and many purportedly objective experimental tests of its efficacy as a mode of treatment have been reported. Yet the great majority of these reports have failed to utilize actual clinical populations. This study evaluated rational-emotive group therapy with psychiatric inpatients. Results supported the claim that irrational beliefs are related to emotional disturbance. It was also shown that patients undergoing rational-emotive group therapy changed their self-reported irrational beliefs more than did a control group. Finally, there was a trend for the experimental subjects to be more likely to have been discharged from the hospital during the 90-day follow-up period than were control subjects. However, this study failed to demonstrate that change in irrational beliefs was related to improvement in psychiatric symptoms or rates of discharge from the hospital. Some of the difficulties in conducting treatment evaluation research in a psychiatric hospital setting are discussed with respect to these results.     

Physicians,battery, and the duty to give informed consent

This essay discusses the issue of informed consent as it relates not only to physician duty but also to patient duty. The author is particularly concerned with the possibility of battery charges against the physician unless a clear patient duty is articulated. In summary, the author concludes that we can prevent doctors from being forced to commit battery in a way which allows them to make reasonable choices for their patients without being open to the charge of having committed battery. At the same time, we would not allow doctors to abuse this privelege.     

Children with AIDS in the public schools: The ethical issues

The question of whether to allow children with AIDS to attend public school generates explosive emotions and has wide-reaching consequences. This paper focuses on the perspective of parents of well children who may be asked to attend school with children who have AIDS. These parents are poised at the heart of the dilemma: they are the ethical “bottom line,” and an argument that fails to satisfy them ought not to satisfy anyone. The conflicting commitments these parents face are first to the parentchild covenant which requires them to act in their child's best interests, and second, to the principles of beneficence and justice, which require them not to further burden a sick child with ostracism and isolation. Almost exact parallels exist between this issue and that of proxy consent by parents for children's participation in low-risk, non-therapeutic research. The lengthy and important debate between Paul Ramsey and Richard McCormick on this question is analyzed, concluding that McCormick's position in favor of thoughtful proxy consent is the more compelling. Returning to the question of allowing children with AIDS to attend school, the essay shows why the parallels are persuasive. On the ethical level, the apparent conflict of obligations is almost exactly the same; on the pragmatic level, the essay shows why sharing a classroom with a child who has AIDS is comparable to the “low-risk” category that the National Commission for the Protection of Human Subjects found acceptable in its 1978 guidelines. The essay concludes that parents of healthy childrenmay and ought to accept the presence of children with AIDS in the public school.