Notes on the Tenacity of Therapeutic Presuppositions in Process Research: Examining the Artfulness of Blamings in Family Therapy

In their recent contribution to the Journal of Family Therapy , Frosh et al . apply discourse analytic methods to the study of 'process' in family therapy. While we welcome this contribution, we suggest that the authors' reading of the data has been affected by a number of fundamental presuppositions, which have led them to neglect the skilful rhetorical work taking place in the session. In this paper, we have undertaken an alternative analysis of the data, examining its rhetorical features and suspending judgement on the efficacy of the therapeutic project and on the truth status of statements made by participants in the session. While acknowledging that our microanalytic method has some shortcomings, we contend that attention to the situated and strategic nature of 'therapy talk' has exposed the primacy of notions of responsibility and blame in family work, and has shown how these issues are artfully negotiated by therapist and family in the cut and thrust of the therapeutic interview.     

The Patient Self-Determination Act and Advance Directives: Snapshots of Activities in a Tertiary Health Care Center

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.     

The Sublime and the Other

What is the philosophical significance of the “sublime”, and does this concept still have any relevance to contemporary life? In this essay, I argue that the experience of the sublime is exceptionally important, insofar as it presents us with a general model for the experience of otherness, the encounter with transcendence itself, which might reasonably be viewed as impossible. As Rudolf Otto suggested, the experience of the sublime is closely related to the experience of the sacred; and even in Burke and Kant, the sublime is to be grasped as both an aesthetic and a religious experience which finally opens the individual to that which is greater than herself. Thus, the sublime has become a major theme in postmodern theory, precisely because it gives us access to the sacred and that which is wholly “other.”     

Biasing the pacemaker in the behavioral theory of timing

In the behavioral theory of timing, pacemaker rate is determined by overall rate of reinforcement. A two-alternative free-operant psychophysical procedure was employed to investigate whether pacemaker period was also sensitive to the differential rate of reinforcement. Responding on a left key during the first 25 s and on a right key during the second 25 s of a 50-s trial was reinforced at variable intervals, and variable-interval schedule values during the two halves of the trials were varied systematically. Responding on the right key during the first 25 s and on the left key during the second 25 s was not reinforced. Estimates of pacemaker period were derived from fits of a function predicted by the behavioral theory of timing to right-key response proportions in consecutive 5-s bins of the 50-s trial. Estimates of pacemaker period were shortest when the differential reinforcer rate most strongly favored right-key responses, and were longest when the differential reinforcer rate most strongly favored left-key responses. The results were consistent with the conclusion that pacemaker rate is influenced by relative reinforcer rate.     

Group therapists and AIDS groups: An exploration of traumatic stress reactions

As the AIDS epidemic continues unabated, there is growing clinical evidence that the catastrophic nature of this disease is creating a second category of trauma casualties. They are the health care practitioners who witness the narratives of those who are living with and dying from AIDS. This article examines how multiple AIDS-related deaths of group members exert a traumatizing effect on group therapists, creating vicarious traumatization. Vignettes are presented that illustrate reactions associated with traumatic stress, including death images, survivors' guilt, psychic numbing, suspicion of counterfeit nurturance, and struggle for meaning. Possible therapeutic interventions for group therapists coping with multiple deaths are also explored.The author wishes to acknowledge the endeavors of the volunteer group therapists and the Clinical Group Services staff of the Gay Men's Health Crisis of New York City, who provide group therapy to over 900 clients a week. This article is written in admiration of their extraordinary effort and dedication.     

DECONSTRUCTING THE MYTH OF THE NONAGGRESSIVE WOMAN

One of the most pervasive and undisputed gender stereotypes is that men are more aggressive than women. However, this stereotype has, until recently, led researchers to conclude that women are nonaggressive and, therefore, to ignore the topic of female aggression as a distinct phenomenon. The basis of the myth, factors supporting its maintenance, and theories of female aggression are examined. A feminist reinterpretation of aggression that views women's and men's aggressive behavior within social structural arrangements that create and sustain differential power relations is presented.