Countertransference and containment in a patient with a psychotic mother

The importance of countertransference reactions in the treatment of a borderline patient with a psychotic suicidal mother is discussed. In such a case containment can be seriously disrupted by the violence of the patient's projections into the therapist. Where a psychotic internal object has been brought for treatment it is particularly important that the therapist be able to identify not only with the sane and mad parts of the patient but with the destructiveness and cruelty of the patient and her primary object. The difficulties of tolerating these relentless projections of madness and despair are increased by the multiple and confusing aims of the patient's excessive use of projective identification. The invasive and hostile aspects of this are often heavily disguised beneath idealization of the self and object as well as of madness itself. For the patient, attempts to interpret the idealization are moreover felt as an assault on the lost loved object, and the therapy then unconsciously becomes a persecutory experience for the patient. The therapist can thus be drawn into feeling the full force of the anger and hatred towards the real disappointing object and the sense of hopelessness about the reparative task. Although such feelings need to be tolerated, eventually some distance from the often-unpleasant fluctuations in the countertransference must develop if a useful degree of containment is to be achieved.     

Autobiographical memory specificity in adults reporting repressed,recovered, or continuous memories of childhood sexual abuse

Some psychotherapists believe that adult survivors of childhood sexual abuse (CSA) are characterised by memory deficits for their childhood. Using the Autobiographical Memory Test (AMT), we asked nonabused control participants and participants who reported either continuous, recovered, or repressed memories of CSA to retrieve a specific personal memory in response to either positive or negative cue words from either childhood or adolescence/adulthood. The results indicated that participants who believed they harboured repressed memories of abuse tended to exhibit the greatest difficulty retrieving specific memories from their childhood. Neither posttraumatic stress disorder (PTSD) nor major depression was related to diminished memory specificity.     

The Disappearing (or Ghost) Mother Transference: In Search of the Available Mother Within

As analysts, we speak of maternal transference as if it were a unitary phenomenon. We are trained to expect intense, powerful transference reactions. Yet there is a group of female patients who have a specific type of transference that lacks intensity. These patients often present by not presenting. I term this phenomenon the disappearing (or ghost) mother transference. This transference is quiet and does not create much stress. Using a case example, I will define this particular type of object relationship and discuss an alternative technique in treating these patients. It is my premise that these women must discover for themselves, at their own time and in their own way, the caring, living, available mother in the analyst.     

Expect the Unexpected? Variations in Question Type Elicit Cues to Deception in Joint Interviewer Contexts

We examined the effect of (i) a second interviewer's demeanour and (ii) asking expected and unexpected questions on cues to deception. We predicted that liars compared with truth tellers would provide more detail to expected questions and less detail to unexpected questions, particularly when the second interviewer is supportive. Liars prepare answers for expected questions, and a supportive interviewer will encourage them to provide more detail. By definition, liars have not prepared answers for unexpected questions, and their answers to such questions will be less detailed. Participants (N = 168) appeared before two interviewers: The first asked all the questions, and the second remained silent. The second interviewer exhibited either a supportive or a neutral demeanour. As predicted, liars provided more detail to expected questions and less detail to unexpected questions, particularly when the second interviewer was supportive. In conclusion, a supportive second interviewer elicits cues to deceit. Copyright © 2013 John Wiley & Sons, Ltd.     

Target Detection,Identification, and Marksmanship During Battlefield Noise in a Synthetic Environment

This study was conducted to determine the impact of noise on target detection, identification, and marksmanship (TDI&M) and to examine the effectiveness of a monetary reward to improve performance. Twenty active duty male soldiers participated in a non-reward and reward trial, each comprising three time blocks of two alternating 20-minute sessions, one with 87-dBA battlefield noise and the other relatively quiet. Each session involved 15 minutes of TDI&M testing followed by 5 minutes of rest. Neither noise, time on task, nor reward caused any noteworthy changes in TDI&M performance, except for foe target engagement time (ET). It appears that subjects purposely increased ET over the duration of the task to improve their hit accuracy but did not succeed in doing so. The monetary incentive to improve performance was also ineffective, because the subjects applied a similar “best” effort during the no-reward trial prior to this manipulation.     

Epistemic closure under deductive inference: what is it and can we afford it?

The idea that knowledge can be extended by inference from what is known seems highly plausible. Yet, as shown by familiar preface paradox and lottery-type cases, the possibility of aggregating uncertainty casts doubt on its tenability. We show that these considerations go much further than previously recognized and significantly restrict the kinds of closure ordinary theories of knowledge can endorse. Meeting the challenge of uncertainty aggregation requires either the restriction of knowledge-extending inferences to single premises, or eliminating epistemic uncertainty in known premises. The first strategy, while effective, retains little of the original idea—conclusions even of modus ponens inferences from known premises are not always known. We then look at the second strategy, inspecting the most elaborate and promising attempt to secure the epistemic role of basic inferences, namely Timothy Williamson’s safety theory of knowledge. We argue that while it indeed has the merit of allowing basic inferences such as modus ponens to extend knowledge, Williamson’s theory faces formidable difficulties. These difficulties, moreover, arise from the very feature responsible for its virtue- the infallibilism of knowledge.     

A pilot evaluation of the efficacy of a couple-tailored print intervention on colorectal cancer screening practices among non-adherent couples

The objective of this study was to evaluate the efficacy of a couple-tailored print (CTP) intervention on colorectal cancer screening (CRCS), CRCS intentions, and on knowledge and attitudes among couples in which neither partner is on schedule with regard to CRCS. A total of 168 married couples with both members non-adherent with CRCS were randomly assigned to receive either a CTP pamphlet accompanied by a generic print (GP) pamphlet or a GP pamphlet only. Couples completed measures of CRCS, intentions, relational perspective on CRCS, discussions about CRCS, spouse support for CRCS, spouse influence strategies, CRC knowledge, perceived CRC risk, and CRCS benefits and barriers. Results indicated there was no significant benefit of CTP vs. GP on CRCS, but there was a significant increase in CRCS intentions in CTP compared with GP. There was also a significant increase in relationship perspective on CRCS, a significant increase in husbands’ support of their wives’ CRCS, and a significant increase in CRCS benefits in CTP. In summary, CTP did not increase CRCS practices but increased intentions and perceived benefits of CRCS as well as improving couples’ ability to view CRCS as having benefit for the marital relationship.     

SURVIVORS OF THE HOLOCAUST AND THEIR CHILDREN

Despite the importance given in their narratives to the birth of their children and grandchildren, in most of the interviews I conducted with Holocaust survivors they do not discuss their children or family life in detail. Rather, for many of them, discussion is generally connected to how or what they have explained to their children about their experiences during the war. Survivors’ preoccupation with this issue could be understood as a response to the context in which they find themselves, in which a particular social discourse about survivors has developed. This discourse arguably engendered particular responses from survivors: it is a question that survivors expect to be asked, and it is seen as part of their prescribed role. Based on over 50 narrative interviews with survivors of the Holocaust, this article explores how survivors reflect and understand their parenting. It examines to what extent their behaviour has been influenced by their experiences during the war, or in reaction to a particular social discourse. Whilst literature on the second generation has been predominantly based on the responses of the children of survivors, this article provides important evidence of how survivors reflect on and understand their parenting.     

Rosalia H.: with Freud in a prelude to psychoanalysis

Abstract

The case of Fräulein Rosalia H. is discussed quite briefly by Freud in one of his contributions to Studies on hysteria. This case of ‘retention hysteria’ was included in another much longer case study, and it is designed to illustrate how a ‘mnemic symbol’, which operates to condense a group of memories, may be formed during the course of an analysis. A new symptom thus appears which may throw more light on the circumstances which gave rise to the presenting symptom. Despite the richness of this case, Freud does not refer to it again in his writing and there has been very little discussion of it in psychoanalytic commentaries. This paper explores how the case serves as a transition point from pre-psychoanalytic conceptions of symptomatology and clinical practice, and how it can be read as a prelude to psychoanalysis proper.     

The Catholic Church,moral doctrine,and HIV prevention in Recife,Brazil: Negotiating the contradictions between religious belief and the realities of everyday life

Religious beliefs have had a key role in shaping local responses to HIV and AIDS. As the world's largest Catholic country, Brazil is no exception. Yet little research has been conducted to document how religious doctrine is enacted in practice among its lay leaders and followers. In this article, we present ethnographic research from Recife, Brazil, conducted to understand the way in which religious doctrines are interpreted at a local level. Contextualised within the sociology of contemporary Brazilian Catholicism, we draw on interviews with clergy members, lay leaders, and parishioners to discuss how the Catholic Church's vision of sexuality translates into everyday lives of its followers. We explore the disjuncture between the Catholic ideals of fidelity and delaying sex until marriage with the everyday reality of the Church's followers, highlighting the role that gender plays in defining sexual roles and expectations. We conclude by posing questions for future research and HIV prevention strategies considering the formal institutional response of the Brazilian Catholic Church to AIDS on the one hand, and the social and cultural contexts in which Catholics live their daily lives on the other.