A Review of: “Fairburn,C. G. (2008). Cognitive Behavior Therapy and Eating Disorders.”

Successful reports of behavioral treatment of encopresis describe interventions as unpleasant as the disorder: hospitalization, laxatives, prompted toileting, aversive consequences. The focus on soiling rather than on the constant constipation that precedes encopresis, on the reduction of soiling rather than on the acquisition of effective toilet use. Five normal chronically constipated children (four of whom were encopretic) were treated at home with combinations of: preparatory instructions, rewards for clean pants, reward for appropriate toileting (bowel movement in toilet). Once soiling was eliminated and appropriate bowel movements occured regularly, all families were taught to fade treatment contingencies. To determine the contribution of the toileting reward to treatment effectiveness, this reward was added to the other two treatment components in a multiple baseline across four cases; it provided a significant ingredient in short-term success. A fifth child achieved short-term success with only the instructions and the clean pants reward. Long-term results (11-20 months) revealed that the fifth child, who never received the toileting reward, was the only one who relapsed.     

Utility of verbal-nonverbal correspondence-training techniques in outpatient pediatric settings

Verbal-nonverbal correspondence training is a behavioral approach recommended in the development of adaptive behaviors and the reduction of problem behaviors. This paper summarizes research findings involving 4 verbal-nonverbal correspondence-training techniques and then illustrates the potential utility of these techniques in general pediatric settings. Particular emphasis is placed on strategies pediatricians could employ to teach patients how to use these techniques effectively to decrease problem behaviors at home (e.g., ADHD, refusing to take the prescribed medication, eating problems) among children seen in outpatient pediatric settings.     

Id analysis and technical approaches

The author argues that the technical advances stemming from Freud's (1923) introduction of the structural theory permit a more naturalistic and specific approach to analyzing unconscious conflict, thus facilitating id analysis. The earlier topographical technique underestimated the role of suggestion; often, it entailed interference with patients' capacity for self-observation, as well as with the exploration of their own drive derivatives. In order to illustrate the type of id material obtainable with a contemporary ego psychology approach, the author presents clinical vignettes and commentaries. It is recognized that clarifications, defense interpretations, and Gray's close-process interventions may need to be adapted to different cultural milieus.     

大渐弥留的混沌之态：评《生死有时》一书

在人类命运共同体遭受一场前所未有的大疫威胁之际,上海教育出版社及时地推出了《生死有时》一书。尽管其副标题发问的要点是“美国医院如何型塑死亡”,但这个问题的尖锐性指向几乎是所有的重症医学实践。大疫将人之死的个体性纳入到一个疾病全球化的视野,《生死有时》并没有讨论重大公共卫生危机导致的世界性灾难,然而也能让我们联想到一个存在主义意义的危机问题。那就是大渐弥留的混沌之态。在此书中,涉及生命末端期的混沌问题包括：尊严死何以可能？旨在尊重患者主体性的生前预嘱是否可行？针对重症患者的医疗措施应该何时从常规治疗过渡到临终关怀？