On Digital Consciousness and Psychic Death

This paper describes states of consciousness in some disturbed or traumatized patients in which time is not experienced as being linked to future or past. The patient's experience in this state is “digital” rather than continuous, making it difficult for him to have an inner sense of continual “aliveness” and to link analytic sessions together. In extreme cases, his world may be experienced as a succession of moments interrupted by little blanks or psychic deaths. The experiential, developmental, and neurobiological aspects of these states are explored with an emphasis on implications for psychoanalytic treatment.     

Discussion of Katherine Oram's Case

This case is a wonderful example of the impressive transformations that can be achieved in a psychoanalytic encounter between a gifted clinician and a gifted patient. It is discussed from the point of view of the development of evocative object constancy and of the sadomasochistic relationships that ensue when there are deficits in object constancy and attachment. For many patients with these issues, to be with anyone means being in pain and to be without pain means being alone. This is illustrated with examples in both the transference and the countertransference.     

The Family Story Technique and Intrafamily Analysis

The Family Story Technique (FST) was devised because of its promising versatility in the assessment among family members of affect, interactional patterns, and outlook on the future. The FST makes use of ten selected TAT cards and a modification of Fine's scoring system. Reliability of scoring in terms of per cent agreement between two scorers was found to range from 67% to 100% for usable categories. Potential usefulness of the FST in family diagnosis and family patterning of interactions is illustrated by a case presentation of family FST scores.     

A Method for the Evaluation of Affective Associations to Figure Drawings

Usual scoring systems for figure drawing techniques are based on structural and content aspects of the drawing, and ignore the affectively toned associations that occur when an observer first sees a drawing. A system for measuring two components of judgment, (a) emission of affective associations (b) evaluation of affective associations, has been developed. This method was applied with some success in studying individuals who had represented in their drawings an image that corresponded to their actual physical appearance. The research so far suggests that the evaluation component of judgment may contribute more to discrimination than the emission component.     

A Direct Study of Halo Effect

Five individuals were evaluated on a 7-point scale from strongly dislike (1) to strongly like (7). A week later the same people were rated on 16 relatively distinct traits, such as carefulness, sense of humor, fairness, and sociability. For three of the rated individuals, there were no extreme ratings on the general impression (liking) scale by raters, and the correlations between those scores and mean trait ratings were .26, .32, and .36. For the other two, there were sharp and extreme ratings on the general liking scale, and correlations between those scores and mean trait ratings were .60 and .76. This method provides a more appropriate and more meaningful index of halo effect than other methods because it is based more directly on Thorndike's (1920) original concept.     

Mental Health and Adverse Childhood Experiences

The theoretical basis of occupational therapy interventions was investigated in two mental health facilities in the Midwestern United States. Using retrospective cohort and grounded theory designs, 121 medical records were reviewed and five occupational therapy practitioners were interviewed. Theoretical reasoning was not explicitly documented, but according to analysis, the behavioral/cognitive-behavioral model, client-centered models, and the model of human occupation were the most frequently used theories to guide interventions. Lack of documentation of theory use has significant implications for the value accorded to occupational therapy skills in health care. A larger study is recommended to increase external generalizability of the findings.     

Developing Roles and Skills in Community-Living Adults With Severe and Persistent Mental Illness

People with severe and persistent mental illness often experience a disruption in the development of social roles, and the skills within these roles. Role Development, a set of guidelines for practice, is an intervention to develop roles and skills. The purpose of this study was to continue to examine the efficacy of this intervention. Ten people attending two community mental health programs participated in evaluation and treatment based on Role Development. Quantitative pretest and posttest measures were used. Qualitative components were incorporated to get a sense of the experience involved in developing roles and skills. Quantitative results indicated statistical significance (p < .05) in the development of roles and skills. Qualitative data revealed multiple trends experienced by the participants. This study contributes to the evidenced-based knowledge regarding development of roles and skills for persons living with severe and persistent mental illness.     

Group training in communication skills for couples: A preliminary report

Abstract

This article reports on the initial development and evaluation of a group skill-training program for couples. The program, entitled the Communication Skills Workshop (CSW), aims at improving communication and problem-solving skills within the context of relationships. The orientation of the CSW is preventive and educational in that it (a) serves couples prior to the onset of serious relationship discord, and (b) focuses on the learning of general communication skills and problem-solving strategies rather than the amelioration of specific relationship conflicts.