The non-symbolic level of psychical reality

Freud introduced the concept of psychical reality as a consequence of abandoning the theory of seduction, and although this meant a turning point in his theoretical thinking he never defined the concept concisely and systematically. Thus it is possible to delineate at least two meanings of psychical reality that run through Freud´s writings as well as the writings of contemporary analysts. On the one hand psychical reality encompasses the whole field of subjective experiences. On the other, it is understood more narrowly as a transformation of experiences in the unconscious.

Substituting the idea of different meanings ascribed to Freud´s concept this article proposes to differentiate between levels in the psyche with the main focus on the unconscious level of the dream and of phantasy and the real unconscious. Starting from the most superficial level of subjective reality the text moves to that of fantasy formation illustrated by primarily Freud´s text on `A child is being beaten´. Adding Laplanche´s translational model the article ends up at the deepest level represented by the late Lacan and his concept of the real Unconscious.

The paper concludes that the term real points to something exceeding symbolization and the imaginary—thus escaping comprehension—and yet is absolutely indispensable to the organization of unconscious processes.     

Building Capacity Among Laity: A Faith-Based Health Ministry Initiative

A systematic review of topic-specific faith-based health programs determined that health outcomes can be improved though faith-based health interventions. A university research team, in partnership with the Kansas United Methodist Church and a United Methodist philanthropy, facilitated planning and development of a statewide initiative to increase the capacity of laity-led health ministry teams. The purpose of this paper is to describe the processes utilized to design and implement an initiative to increase capacity for laity-led comprehensive health ministry among Kansas United Methodist Church congregations and to share the key elements of the initiative.     

Spiritist Hospital Chaplaincy in Brazil: 5 Years of Documented Experience

Spiritist Hospital Chaplaincy in Brazil has been growing significantly in recent years, with the implementation of new services through the work of Spiritist Medical Associations (SMAs) in different regions of the country. This article describes the importance of historical interconnections from the advent of spiritism in the world and its introduction in Brazil to the emergence of Spiritist Hospital Chaplaincy in our country and presents the documented experience over 5 years of spiritist chaplain care, in the period from 2012 to 2016, guided by the SMA of Piracicaba at the Unimed Hospital of Piracicaba (São Paulo). We documented 41,914 visits to 13,983 inpatients and an analysis of these records allowed us to reflect on the importance of this service and confirm its expansion and acceptance by different contemporary religious beliefs.     

Comparing Live and Video Observation to Assess Early Parent-child Interactions in the Home

Observation is the ‘gold standard’ for assessing parent-child behavior, however few studies have compared coding live, in real time, versus coding from videotapes in terms of their achievable levels of coder reliability within the field of parent programme research. This is important for practitioners and researchers for whom decisions might be influenced by time and financial constraints, but where outcomes may have real practical and clinical implications. Trained coders in the Dyadic Parent-Child Interaction Coding System Revised, coded 40 half-hour videotapes of 33 parent-toddler dyads interacting in the home on 29 items of dyadic behaviour. Four theorised composite variables were constructed. Videotaped data were compared to data drawn from the same interactions previously coded ‘live’ in the home. Correlations indicated significant agreement between the two modes at the item by item level (p?<?.001). Wilcoxon Rank tests revealed significant differences (p?<?.001) between the two modes. Eight items exceeded a ±30% change in median score suggesting clinically relevant differences. Although both methods achieved acceptable levels of inter-rater reliability, video coding achieved higher levels of agreement. Subtle differences exist between the two modes. Whilst neither mode proved superior it is suggested that they should not be used interchangeably.     

Genetic Counseling for Early-onset Familial Alzheimer Disease in Large Aboriginal Kindred from a Remote Community in British Columbia: Unique Challenges and Possible Solutions

A novel, pathogenic presenilin 1 (PS1) mutation has recently been identified in a large Aboriginal kindred living in dispersed communities throughout British Columbia, Canada. Disseminating genetic information and ensuring that appropriate genetic counseling services are provided to all concerned relatives have posed several unique challenges. These challenges include knowledge exchange and continuity of care in a geographically remote and culturally distinct community. To our knowledge, this is the first time a specific genetic counseling approach has been needed for early-onset familial Alzheimer disease (EOFAD) in a North American Aboriginal community.     

When sex is more than just sex: attachment orientations, sexual experience, and relationship quality

The authors explored the contribution of individual differences in attachment orientations to the experience of sexual intercourse and its association with relationship quality. In Study 1, 500 participants completed self-report scales of attachment orientations and sexual experience. The findings indicated that whereas attachment anxiety was associated with an ambivalent construal of sexual experience, attachment avoidance was associated with more aversive sexual feelings and cognitions. In Study 2, 41 couples reported on their attachment orientations and provided daily diary measures of sexual experiences and relationship interactions for a period of 42 days. Results showed that attachment anxiety amplified the effects of positive and negative sexual experiences on relationship interactions. In contrast, attachment avoidance inhibited the positive relational effect of having sex and the detrimental relational effects of negative sexual interactions. The authors discuss the possibility that attachment orientations are associated with different sex-related strategies and goals within romantic relationships.     

The relationship context of human behavior and development

The influence of social relationships on human development and behavior is receiving increased attention from psychologists, who are central contributors to the rapidly developing multidisciplinary field of relationship science. In this article, the authors selectively review some of the significant strides that have been made toward understanding the effects of relationships on development and behavior and the processes by which relationships exert their influence on these, with the purpose of highlighting important questions that remain to be answered, controversial issues that need to be resolved, and potentially profitable paths for future inquiry. The authors' thesis is that important advances in psychological knowledge will be achieved from concerted investigation of the relationship context in which most important human behaviors are developed and displayed.     

An ethics perspective on transcranial magnetic stimulation (TMS) and human neuromodulation

This paper concerns the ethics of human neuromodulation using transcranial magnetic stimulation (TMS). We examine the challenges of modulating the brain with TMS through the research ethics lens and in clinical medicine for treating frank pathology, primarily in psychiatric diseases. We also consider contemporary issues raised in the neuroethics literature about managing unexpected findings, and relate these to TMS and to other frontier neurotechnology that is becoming openly available in the public domain. We argue that safety and informed consent are of paramount importance for TMS, but that personal values and sociocultural factors must also be considered when examining the promise of this technology and applications that ought to be highlighted for extra precautions.     

Young children make scale errors when playing with dolls

Prior research (DeLoache, Uttal & Rosengren, 2004) has documented that 18- to 30-month-olds occasionally make scale errors: they attempt to fit their bodies into or onto miniature objects (e.g. a chair) that are far too small for them. The current study explores whether scale errors are limited to actions that directly involve the child's body. We investigated whether children would also make scale errors with a doll and objects that were much too small for the doll (e.g. a chair, a bed). Many participants did try to fit the doll into or onto the miniature objects. Thus, the previously documented phenomenon of scale errors extends to situations in which the relevant size difference is between two objects. This finding supports the view that scale errors occur when visual information about object size fails to influence the decision to act on an object. The results are discussed in terms of the use of visual information for the planning and control of actions.