Why families are not like swamps,solar systems,or thermostats: Some limits of systems theory as applied to family therapy

Family systems theory presents an answer to the riddles of mental disorder and human functioning that stands in marked contrast to other prevailing views based on linearity and traditional science. At this stage of its development, the family systems view does not provide an internally coherent, predictive, or unifying theory about humans and their problems. Further, it tends to both undercontextualize and overcontextualize behavior, substitutes blaming the family for blaming the victim, reifies and anthropomorhizes the systems metaphor, dismisses such concepts as power and responsibility, and discourages research. As one theoretical and clinical perspective among many, however, it can be helpful and eye-opening.Based on a paper presented at the Forty-fifth Annual Conference of the American Association for Marriage and Family Therapy, Chicago, 1987.     

Tigers are something else: A case for family play

This paper is an attempt to bridge the two worlds of family therapy and filial play therapy, introducing the complementary idea of play in therapy. Family play therapy challenges the idea that play is only useful in the treatment of children. Clinical examples are given and uses of play are discussed, including evaluation, play as a therapeutic tool, and the development of themes. The authors believe that therapists who are willing to be playful offer their clients a new world of therapeutic experiences.     

Suicidal Ideation and Sexual Orientation in College Students: The Roles of Perceived Burdensomeness,Thwarted Belongingness,and Perceived Rejection Due to Sexual Orientation

A theoretical model in which perceived burdensomeness and thwarted belongingness were hypothesized to account for the association between sexual orientation and suicidal ideation among college students was tested. Among 198 college students (mean age 21.28 years), gay, lesbian, and bisexual students (n = 50) reported significantly higher levels of perceived burdensomeness and suicidal ideation than heterosexual students. The relationship between sexual orientation and suicidal ideation was partially accounted for by perceived burdensomeness, but not thwarted belongingness. This indirect effect was stronger at higher levels of perceived or anticipated rejection due to one’s sexual orientation. Implications for intervention and prevention science are discussed.     

Are There Gender‐Specific Risk Factors for Suicidal Activity among Patients with Schizophrenia and Depression?

Are there gender‐specific risk factors for suicidal activity among patients with schizophrenia and depression? A total of 74 schizophrenia patients (51 men, 23 women) and 77 unipolar nonpsychotic depressed patients (26 men, 51 women) from the Chicago Follow‐up Study were studied prospectively at 2 years posthospitalization and again at 7.5 years. Poor early posthospital global functioning is significantly associated with later suicidal activity only for men in both our schizophrenia and depressive samples. Early display of psychotic symptoms is associated with later suicidal activity among male schizophrenia patients. Early cognitive impairment is not significantly associated with later suicidal activity for any of the four groups of patients. The study results must be seen as exploratory and will hopefully spur future research on this important topic.     

Love in the counter-transference: The uses of the therapist's excitement

SUMMARY

The psychoanalytic tradition has always had difficulty with the question of the therapist's sexual feelings toward the patient. This paper traces that difficulty: from Freud's original struggle to replace moralism with a psychoanalytic mode of understanding, to the more recent literature on countertransference which still seems particularly averse to the possibility of the therapist's sexual experience. By way of a discussion of a psychoanalytic psychotherapy, I argue for the sometimes central therapeutic role of the therapist's experiencing, and then containing, excitement.     

Body Image Disturbance in Schizophrenia: A Study of Arms and Feet

This study investigated the significance of omitting arms/hands and legs/feet on the Draw-A-Person Test (DAP) in 128 hospitalized schizophrenic and 104 normally functioning adult males. The DAP was administered according to Machover's instructions, and the data were analyzed by chi-square tests. It was found that schizophrenics demonstrated significantly more omissions of arms/hands and legs/feet than the normals. These findings were interpreted to indicate body image disturbance in schizophrenia and were related to Schilder's and Federn's theories of the disorder emphasizing an impairment of ego boundaries.     

Some Developmental Aspects of Primary Process Manifestations in the Rorschach

A group of 27 male subjects were administered the Rorschach at ages 14 and 24. The protocols were scored for the main categories of the Holt Primary Process scoring system. A comparison of the two age groups indicates that at age 24 there is a decrease in the percentage of primary process responses and an increase in “adaptive regression.” Individual differences for all the primary process scoring categories remained highly consistent for the 10-year period spanned by the data. Adaptive regression was found to be significantly correlated with IQ, field independence (RFT), and Rorschach ratings of intellectualization at both ages. The results were viewed as suggesting that primary process manifestations on the Rorschach seem to be mediated by stable aspects of an individual's cognitive abilities and cognitive style.     

Body Image Alterations in Adults Due to Cerebrovascular Insufficiency

Changes in body image boundary were investigated in eighty-one patients with cerebrovascular insufficiency having varying degrees and sites of impairment. Barrier and Penetration scores were derived from the Rorschach according to the Fisher and Cleveland technique and were correlated with several indices of impairment and analyzed for changes over a two year period. Penetration scores were associated with three measures of intellectual ability. Barrier scores were correlated with verbal ability and vertebrobasilar angiogram. Barrier changed over time with a quadratic trend while Penetration did not change.