The written summary in group psychotherapy revisited

This paper addresses the use of the weekly written summary with patients in group psychotherapy. In an effort to stimulate group process and effect cotherapist communication, the authors instituted this group recording in an ongoing psychodynamically oriented mixed adult group. While the utilization of this device did, in fact, stimulate the group process and became an important part of the group's life, the therapists additionally saw significant effects upon their working alliance. These included increased focused dialogue upon group dynamics, more purposeful planning for group interventions, and heightened awareness of the significance of interventions in the group.Ms. Bosman-Clark is formerly Clinical Instructor, Department of Psychiatry, Baylor College of Medicine.     

Errors in the quantification of uncertainty: A product of heuristics or minimal probability knowledge base?

The use of intuitive heuristics (e. g. representativeness and availability) has been put forward as an explanation for peoples' assignment of probabilities (Tversky and Kahneman, 1971). This phenomenon is seen as robust since experts as defined by education (professional psychologisis), despite advanced training in statistics and methodology, rely on the same heuristics as novices (lay people). Both experts and novices, as defined by education, were studied in a series of experiments and further classified as experts and novices according to their probability knowledge base, prior to receiving (or not) a brief (15-minute) training session. Immediately following training, subjects completed a probability test which consisted of ten Tversky and Kahneman (e. g. 1974) problems. The training significantly increased the number of problems correctly solved on the probability test and eliminated the expert/novice education classification. The results of a follow-up test 5 weeks after the experiment indicated that the training group maintained its superior performance. It is proposed that failure to use proper methods of probability assignment may not be due to intrinsic human inference biases or heuristics, but is a result of a minimal probability knowledge base.     

Is Pregnancy Necessary? Feminist Concerns About Ectogenesis

To what extent are women obliged to be child-bearers? If reproductive technology could offer some form of ectogenesis, would feminists regard it as a liberating reproductive option? Three lines of reproductive rights arguments currently used by feminists are applied to ectogenesis. Each fails to provide strong grounds for prohibiting it. Yet, there are several ways in which ectogenesis could contribute to women's oppression, in particular, if it were used to undermine abortion rights, reinforce traditional views of fertility, increase fetal rights in pregnancy, and perpetuate the unequal distribution of scarce medical resources. A re-thinking of women's relationship to pregnancy is needed in order to challenge ectogenetic research.     

Discrimination of facial expressions of emotion by depressed subjects

A frequent complaint of depressed people concerns their poor interpersonal relationships. Yet, although nonverbal cues are considered of primary importance in interpersonal communication, the major theories of depression focus little attention on nonverbal social perception. The present study investigated the ability of depressed, disturbed control, and normal American adults to make rapid discriminations of facial emotion. We predicted and found that depressed subjects were slower than normal subjects in facial emotion discrimination but were not slower in word category discrimination. These findings suggest that current theories of depression may need to address difficulties with nonverbal information processing. There were also no significant differences between depressed and disturbed control subjects, suggesting that the unique social-behavioral consequences of depression have yet to be identified.     

Adolescent suicide attempters presenting to a pediatric facility

This study profiles the characteristics of adolescent suicide attempters and the treatment they received in a pediatric emergency room (ER). A retrospective chart review of 4,072 adolescents seen in the ER at a children's hospital (CH) from July 1984 to June 1985 was undertaken. Twenty-seven adolescents who had deliberately injured themselves were identified. The average age was 14 years 7 months (range 11-19 years). Fifty-two percent of the patients were white and 78% were female. Ingestion was the most common method (78%), followed by attempted hanging (11%), and wrist laceration (7%). After evaluation by a pediatrician in the ER, 30% of the patients were treated and released, 11% were transferred directly to a psychiatric hospital, and 59% were admitted to the CH, with an average hospital stay of 1.88 days. Once hospitalized, consultations from psychiatry (81%), social service (50%), psychology (19%), and neurology (6%) were obtained. At the time of discharge from either the ER or CH, the patients had a variety of plans for ongoing care, with 52% being referred to outpatient counseling, 37% being transferred to a psychiatric hospital, and 11% having no documented plan for ongoing care. These results demonstrate that the evaluation of suicidal adolescents cared for in a pediatric facility may be episodic and suggest the need for a comprehensive program to approach the problem.     

Affective quality of family relations and adolescent identity exploration

The purpose of this study was to examine the relationship between adolescent pubertal status, the affective quality of family relations, and the early adolescent's exploration of a sense of ego identity. Fifty-one intact families with adolescents in the seventh grade agreed to participate. Each family member completed a battery of questionnaires designed to assess familial adaptation to pubertal growth and identity exploration. The results reveal that the affective quality of parent-adolescent relationships and the pubertal status of the adolescent appear to influence the adolescent's exploration of ego identity. The need to establish the functional significance of familial adaptation to adolescent pubertal growth for identity development is discussed.     

Negativism and countertransference

The purpose of this work is to explore the phenomenon of negativism and the analyst's response to it during the course of analytic work with a patient in whom negativism is a central behavioral pattern. Melville's short story, "Bartleby the Scrivener," describing in telling detail the response of a sympathetic lawyer to profound and pervasive negativism in his legal scribe, is discussed as a literary analogy to the analyst-analysand dyad. Aspects of the concept of negativism within psychoanalysis are discussed. The potential usefulness of understanding certain unexpected countertransference responses to pervasive negativism is explored, as this is a relatively neglected area of psychoanalytic technique. A case is presented describing the analysis of a patient whose character, like Bartleby's, is a mixture of profound negativism along with schizoid, obsessional, and masochistic elements.     

Followup in psychoanalysis: clinical and research values

Psychoanalysis has never developed a tradition of systematic followup study to evaluate outcome and to improve technique and theory for a variety of reasons, partly theoretical, stemming from the conception of the unfolding transference neurosis and its analytic resolution as the precondition for cure, and partly historical, having to do with the happenstance of its development as a private practice-based discipline and training outside of the academic setting. Freud, however, was never bound by such strictures and published whatever post-treatment data he acquired on all his best-known case histories. But following Freud most analysts, with some notable exceptions, eschewed followup activity as unanalytic. It is this tradition that more recent studies like those of Pfeffer in New York and the Psychotherapy Research Project of The Menninger Foundation in Topeka have squarely challenged. Data are presented from the Menninger project dealing specifically with the impact of routine planned followup on issues of treatment termination and resolution and on the nature of the post-treatment period. The degree and kind of patient cooperation with the followup inquiry, the impact of followup on treatment termination and resolution (both impeding and facilitating), and the role of followup intervention in relation to return to formal post-treatment therapy (or consolidating against it), are all discussed.     

Emotional disturbance and the development of self-consciousness in adolescence

The development of self-consciousness and its relationship to emotional disturbance was examined in early and late adolescence. The Imaginary Audience Scale was administered to emotionally disturbed and nondisturbed adolescents. As predicted, results indicated that self-consciousness decreased with age in nondisturbed adolescents. For the emotionally disturbed adolescents, the development of self-consciousness in temporary situations did not follow consistent patterns, as indicated by interaction effects. A significant negative relationship was found between intelligence test scores and self-consciousness in the disturbed group. The findings support the premise that social-cognitive shifts found in early to late adolescence are disrupted in disturbed populations. The mediating role of social experience as a factor in cognitive and emotional development is discussed.     

Defining a family heritage and a new relationship identity: two central tasks in the making of a marriage

The roles of origin family environmental characteristics and couple consensus-building process within the development of marital relationships were examined prospectively in 16 premarital couples. Three important findings emerged. First, significant correlations were found between dimensions of origin family environment and the reported level of satisfaction within the couple's current relationship. Second, measures of the couple's ability to reach consensus concerning important interpersonal relationships appeared to be important mediators of the association between origin family environment and current relationship satisfaction. Third, important gender differences emerged that replicate and extend prior findings that portray women in the role of "relationship specialist" within their marriages. As a group, these findings were best explained by a developmental model of early marriage that envisions the young couple as facing two entwined tasks: to define both their family heritage and their new relationship identity. Overall, the importance of examining family-of-origin characteristics and consensus-building process as critical determinants of the fate of intimate relationships received strong support. The gender differences found in the literature reviewed, as well as the results of this study, have largely been overlooked by the theory and practice of family therapy. Efforts on both the research and theory construction fronts are needed to increase our understanding of the mechanisms whereby prior family experience is brought forward into current intimate relationships.