Social and Gendered Readings of Illness Narratives

This essay recognizes that the interactions that define medical care are problematic and that narrative is invoked to overcome these strains. Being grounded in science, medicine, too, might be influenced by a particular world-view that arose in the natural philosophy of the Scientific Revolution. If narrative responds to this sort of medicine, it may retain traces of this mindset. A feminist approach responds to this viewpoint and may used beneficially to analyze both the story of medicine and the stories within medicine. Tensions discussed from this perspective are those between sickness and health and those between patient and provider; also questioned are suitable form(s) of narrative and whose narratives are valued. Suggestions for broadening narrative to address these issues include letting the body speak for itself, overcoming the power differential in the patient/provider interaction and using standpoints to foster a more equal and just medical system.     

Suppression and hypothesis testing: does suppressing stereotypes during interactions help to avoid confirmation biases?

Recent work indicates that trying not to think in stereotypical terms increases the accessibility of stereotypical information, which paradoxically results in more stereotypical judgments. The present study translated the colour‐blindness ideology in general and stereotype suppression research in particular into an hypothesis testing setting. Participants who were asked to suppress their stereotypes when selecting a set of questions were indeed less guided by ambient stereotypes than control participants, thereby showing a reduction of the classical confirmation orientation in question preferences. Still, compared to control participants, suppressors also later reported more polarized impressions such that consistent targets were seen as more stereotypical and inconsistent ones as more counter‐stereotypical. Moreover, group evaluations were more stereotypical for suppressors than for controls indicating that suppression had led to stronger activation of the stereotypical representation. Results are discussed in light of the prevailing belief regarding the benefits of political correctness and colour‐blindness. Copyright © 2003 John Wiley & Sons, Ltd.     

Outcome evaluation in brief mother-infant psychotherapies: Report on 75 cases

The effects of brief mother–infant psychotherapies (maximum of 10 sessions) were examined in cases of functional and behavioral disturbances in children less than 30 months old. Seventy-five mother-infant dyads were assessed prior to treatment, at 1 week, and 6 months after therapy ended. The outcome measures were changes in the infant's symptoms, the behavioral interactions between mother and infant, and maternal representations. The effect of two forms of intervention—Psychodynamic Therapy and Interaction Guidance Therapy—were compared. Results indicated a significant symptom reduction; dyadic interactions became more harmonious (mothers became less intrusive and infants more cooperative). Maternal self-esteem grew significantly and negative affects decreased. Improvements lasted as least several months, with some positive improvement detected at the 6-month follow-up. No major difference in outcome was found between the effects of the two forms of intervention. Within the limitations of research in a clinical context, this study suggests that brief mother–infant psychotherapies are a cost-effective method of early intervention.     

Effects of Social Conditions on the Expression of Sex-role Stereotypes

In this study, 129 female and 83 male undergraduates were asked to make judgments about identical male and female law school applicants. Evaluations of the candidate employed two types of measures: (a) direct measures set up to assess judgments based upon objective criteria such as GPA and aptitude test scores, and (b) indirect measures designed to provide more opportunity for subjective factors and subtle ways for stereotyping to operate. It was hypothesized that increased social awareness of sex discrimination would reduce more blatant types of stereotyping expressed in the direct measures and force stereotyping into more subtle forms, measurable through the construction of the indirect indices. The results revealed no differences between male and female candidates on the direct measures. However, stereotyping appeared on indirect measures associated with personality characteristics and employment alternatives. The investigators concluded that prejudicial attitudes toward women continue to exist and are expressed in more subtle or „hidden” forms. Suggestions for developing means for measuring these attitudes as well as practical considerations for reducing discrimination in employment settings were presented.     

Intrusive images and intrusive thoughts as different phenomena: Two experimental studies

According to the dual representation theory of PTSD, intrusive trauma images and intrusive verbal thoughts are produced by separate memory systems. In a previous article it was shown that after watching an aversive film, participants in non-movement conditions reported more intrusive images than participants in a free-to-move control condition (Hagenaars, Van Minnen, Holmes, Brewin, & Hoogduin, 2008). The present study investigates whether the experimental conditions of the Hagenaars et al. study had a different effect on intrusive thoughts than on intrusive images. Experiment 2 further investigated the image–thoughts distinction by manipulating stimulus valence (trauma film versus neutral film) and assessing the subsequent development of intrusive images and thoughts. In addition, both experiments studied the impact of peri-traumatic emotions on subsequent intrusive images and thoughts frequency across conditions. Results showed that experimental manipulations (non-movement and trauma film) caused higher levels of intrusive images relative to control conditions (free movement and neutral film) but they did not affect intrusive thoughts. Peri-traumatic anxiety and horror were associated with subsequent higher levels of intrusive images, but not intrusive thoughts. Correlations were inconclusive for anger and sadness. The results suggest intrusive images and thoughts can be manipulated independently and as such can be considered different phenomena.     

The Return of the Dissociated: Discussion

Psychoanalysis and politics intersect variously. Some psychoanalytic writings have critiqued society, whereas others have applied socially critical insights about class and race to illuminate transference—countertransference enactments and other clinical matters. The hegemonic politics of psychoanalysis, less intentional but equally influential, define maturity and mental health by idealizing of some psychological and behavioral traits and some clinical stances (especially authoritarianism), and by demonizing of certain categories of persons (notably nonheterosexuals and people of color), certain types of practice (e.g., social work), and certain sorts of ideas (e.g., that clinical and theoretical practices are political practices, too). One way to redress these problems is to reclaim the marginal—homosexuality and queerness, affect's presence in politics, and the political in the psychical (in which instance, the concept of multiple self-states may be useful). Any such effort requires recognizing and articulating one's own subject-position, that is, one's own class, race, gender, or sexual location.     

The Mystery of Hysteria and the Crossroads of Power: Commentary on Paper by Sam Gerson

“Hysteria and Humiliation,” it is argued, performs a small miracle, weaving inner and outer perspectives on a seemingly mysterious condition into a clinically useful formulation. Its bold new thinking is shown to clear up many conceptual problems about the state of mind and sufferings that a diagnosis of “hysteria” usually designates. This paper, it is suggested, also puts paid to the classical denigration of women implicit in the very category of hysteria itself, thus advancing the psychoanalysis of power.     

Adapted digital music players for individuals with severe impairments

Portable music production devices, such as radios, cassette players, and MP3 players, have characteristics that make them less than ideal for teaching the cause‐and‐effect relationships that would enable children and adults with severe impairments to control them independently and appropriately. Even when adapted for control with adaptive switches, the relationship between switch closure and on–off operation results in contingency characteristics that can inhibit learning. Some solutions to these problems are described, and for those individuals who can learn with complex contingencies, some promising products are reviewed. Copyright © 2011 John Wiley & Sons, Ltd.     

Shared suffering can mitigate aversively‐generated aggression:

Although considerable research indicates that aversive conditions (such as uncomfortably high temperatures) often evoke aggressive inclinations, there is also evidence that people are attracted to those who share their discomfort. In a 2 × 2 design, female participants in either a hot or comfortable room worked with a nearby partner exposed to the same temperature but whose reactions to the temperature were either the same as, or different from, their feelings about the temperature. The women in a fifth condition had a partner situated in a room with a comfortable temperature . Consistent with Schachter's [1959] social–emotional comparison theory, the highest level of aggression was displayed by the participants in the hot room working with a partner whose emotional reactions were different from their own, whereas their counterparts, also exposed to the high temperature but whose partner's feelings were similar to their own, exhibited the least aggression over all the trials. Aggr. Behav. 32:80–87, 2006. © 2005 Wiley‐Liss, Inc.     

THE PROBLEM OF ASSESSING EXECUTIVE FUNCTIONS

The capacities for formulating goals, planning, and carrying out plans effectively - the executive functions - are essential for independent, creative, and socially constructive behavior. Although they tend to be vulnerable to brain impairment, they are often overlooked in neuropsychological and neurological examinations. Reasons why there are few formalized examination procedures for evaluating executive functions are suggested. Prefrontal contributions and the importance of other brain areas (e.g., subcortical, right hemisphere) to executive functions are discussed. Assessment techniques are presented for evaluating four categories of executive capacities: (1) goal formulation, (2) planning, (3) carrying out goal-directed plans, and (4) effective performance. The Tinkertoy Test®, which can provide information about these capacities, is described in some detail. Need for further exploration in this area is emphasized.