Ethnotherapeutic empathy (EthE)—Part I: Definition,theory, and process

This paper introduces the concept of ethnotherapeutic empathyin working with ethnoculturally different patients to increase the efficacy of therapy. This form of empathy is used instrumentally to get to know the patient's inner problematic images, anxieties, fears, depressive affect, suffering, hurt, disillusionment, rage, joy, and triumph. Clinical empathy with ethnic patients is instrumental in that it is purposive:it sets out to achieve what might be called patient-comprehending(that is, finding out the nature of the patient's problems) using this as guide to intervening—a form of creativity-in-action. Ethnotherapeutic empathy utilizes active ego processes, in contrast to the passive processes implied in artistic appreciation and surrender. This article presents the definitions of empathy, and associated intrapsychic and social factors, as well as physiological responses in empathie responding. The implications for clinical practice with patients of differing ethnocultural and racial groups are discussed. The article develops a foundation for understanding the therapeutic matrix of applied ethnotherapeutic empathy which is detailed in the second part of this article (Ethnotherapeutic Empathy [EthE]—Part II: Techniques of Vicarious experiencing Across Cultures).     

Violations of transitivity: Implications for a theory of contextual choice

Violations of strong stochastic transitivity in concurrent-chains choice were first reported by Navarick and Fantino. In a series of articles, Navarick and Fantino concluded that neither a unidimensional model capable of predicting exact choice probabilities nor a fixed-variable equivalence rule was possible for the concurrent-chains procedure. I show that when choice is modeled contextually (i.e., when preference for a schedule is affected by factors other than the schedule itself, e.g., aspects of the alternative schedule), a unidimensional, exact-choice probability model is possible that both predicts the intransitivities reported by Navarick and Fantino and provides a fixed-variable equivalence rule for the concurrent-chains procedure. The contextual model is an extension of the generalized matching law and violates a key assumption underlying traditional choice models—simple scalability—because of (a) schedule interdependence and (b) bias from procedural contingencies. Therefore, strong stochastic transitivity cannot be expected to hold. Contextual scalability is analyzed to reveal a hierarchy of context effects in choice. Navarick and Fantino's intransitivities can be satisfactorily explained by bias. If attribute sensitivity is context dependent, however, and if there are similarity structures among choice alternatives, the contextual model is shown to be able to predict violations of ordinal preference. Therefore, it may be possible to formulate a deterministic, general psychophysical model of choice as a behavioral alternative to probabilistic, multidimensional choice theories.     

Three forms of stress in Cambodian adolescent refugees

Sixty-nine Cambodian adolescents and young adults were interviewed to determine their experience as children surviving the Pol Pot regime (1975–1979);their first-year experience of resettlement in this country; and their experience of stressful events during the past year. Current DSM-III-R diagnostic status was also determined. A strong relationship between earlier war trauma, resettlement strain, and symptoms of posttraumatic stress disorder (PTSD) was found. In contrast, the strongest relationship with depressive symptoms was found for recent stressful events. These results are discussed in light of current findings from stress and PTSD research.Dr. Clarke is Assistant Professor of Psychiatry in the Division of Child Psychiatry, Oregon Health Sciences University, Portland, Oregon. Dr. Sack is Director of the Division of Child Psychiatry and Principal Investigator of the Khmer Adolescent Project. Brian Goff is a Research Assistant.This project was supported by the National Institutes of Mental Health [NIMH] grant #5-RO1-MH42927-02, Dr. William H. Sack, M.D., Principal Investigator.     

Grading the ‘cultural literacy’ project

The essay examines the argument advanced by E.D. Hirsch, Jr., for instituting ‘cultural literacy’ as a fundamental priority of schools. A number of confusions and equivocations in Hirsch's reasoning are identified, and the propensity of his project to indoctrinate is exposed. Among the features of Hirsch's argument shown to be troubling are his shifting construal of ‘language’, his inconsistency about the requirements of cultural literacy, and his uncritical relation to traditional images of the American past and present. The upshot is to raise the question why Hirsch's project has elicited wide support and praise.     

Visual and tactile memory for 2-D patterns: Effects of changes in size and left-right orientation

Visual identification of 3-D objects depends on representations that are invariant across changes in size and left-right orientation. We examined whether this finding reflects the unique demands of processing 3-D objects, or whether it generalizes to 2-D patterns and to the tactile modality. Our findings suggest that object representation for identification is influenced greatly by the processing demands of stimulus materials (e.g., 2-D vs. 3-D objects) and stimulus modality (touch vs. vision). Identification of 2-D patterns in vision is adversely affected by left-right orientation changes, but not size changes. Identification of the same patterns in touch is adversely affected by both changes. Together, the results suggest that the unique processing demands of stimulus materials and modality shape the representation of objects in memory.     

Traumatic Stress Personality Disorder (TrSPD): Intertheoretical Therapy for the PTSD/PD Dissociogenic Organization

This article discusses a new personality disorder entity, traumatic stress personality disorder, conceptualized as a composite organization with transactional properties that mutually structure post-traumatic stress disorder (PTSD) and personality disorders (PDs). The transactional/synergistic view of PTSD/PD comorbidity derives in part from scientific findings that PTSD's enduring biological effects are discernible in the personality of individuals 30 to 50 years or more after the overwhelming event, and from psychodynamic formulations on the development and structuring of personality defenses. An intertheoretical therapy model is also presented, and consists of multiple therapies actively integrated to meet the patient's complex post-trauma needs. This article argues for the development of theoretical, investigatory, and therapeutic measures to address PTSD/PD configurations in traumatized victims. Basically, the position espoused is that PTSD/PD should be measured as one rather than two entities, with neither component being considered as a confounding but integral factor in measurement. The eight components of traumatic stress personality disorder are discussed, along with a case study to demonstrate the model's clinical applications. The integration of cognitive, behavioral, psychodynamic, and existential treatment approaches is geared to assist the victim to developmental progress to survivor status, and then beyond this level of integration to thriver a person whose adaptational learning in therapy created a vital psychological immune system that consistently protects against dissociative regression in response to the daily stresses of life. Transference, countertransference, therapists' self-care and self-monitoring are seen as integral to the treatment of traumatic stress personality disorders.