The interpersonal alliance as the principle of psychoanalytic therapy]

The classical opinion encountered in psychoanalytic psychotherapy is that the main curative agent is language, i.e. the information proffered by the analysand and the interpretations of the analyst. Over and against this view the author draws attention to the non-verbal structures in the twosome relationship between analysand and therapist. Essential elements of this working alliance, he suggests, operate via non-verbal behaviour. Hence this behaviour needs to be systematically observed and evaluated. His conclusion is that it requires the consideration of non-verbalized fantasies and affects for the therapeutic relationship to develop into a "good relationship".     

The wish to be soothed as a resistance.

As the analyst makes the correct interpretations of resistance in the opening phase of an analysis, the patient begins to feel understood, often for the first time. This feeling allays anxiety and depressive affects, and the patient comes to experience the analyst as a soother. These initial exchanges may lay the foundation for a positive transference which acts as a buffer against turbulent transferences. In some patients this positive transference develops rapidly, often with prompt symptom remission. In others--children as well as adults--the analyst must persistently interpret defensive regressions before a stable, positive transference can emerge. In either case, in order to avoid the analysis of conflict, some patients become resistant to the analysis of the wish to be soothed. Many of these patients have had a childhood filled with traumatic parental stimulation or rejection. Two clinical accounts illustrate these contentions.     

Validity and clinical scale comparisons between the MMPI and MMPI-2 with psychiatric inpatients.

This study was designed to investigate the comparability of the original MMPI (1950) and the MMPI-2 (1989) with a psychiatric patient population. 34 male and 3 female patients, shortly after admission to one of two acute psychiatry units, completed the old and revised versions of the MMPI. Paired t tests indicated but scant differences for raw scores, while many more differences were found among T scores for validity, clinical, and supplemental scales. Analyses, however, showed all scales on the two forms to be highly correlated. Analysis of the high-point and two-point codes across the two administrations also showed relative stability, although the proportion of Scales 2 (Depression) and 8 (Schizophrenia) decreased, while those for Scales 6 (Paranoia) and 7 (Psychasthenia) increased markedly in the MMPI-2 protocols. Examination of each version's discriminability among mood- and thought-disordered subsamples suggested that the MMPI provides slightly better delineation between diagnostic classes. Discriminant function analyses showed that there were essentially no differences between the two forms in the accurate classification of clinical and nonclinical groups. The findings reported here provide support for the MMPI-2; despite modification, the newer form retains the advantages of the original MMPI. Differences found here may be unique to psychiatric patients and their patterns of MMPI/MMPI-2 equivalence and may not generalize to other special populations.     

Reliability and validity of the Cognitive Slippage Scale in two populations.

Analyses of responses from a clinical sample of 120 patients (primarily schizophrenics) and from 158 college students to the Cognitive Slippage Scale, a scale designed by Miers and Raulin to identify speech deficits and confused thinking in schizophrenic and schizotypal personality disorders showed high internal reliability; Cronbach's coefficients alpha were .89 and .86 in the clinical and college student samples, respectively. The mean scale scores significantly differentiated the two samples. Also, change scores over 4 wk. showed adequate stability for both samples. Item analysis indicated Items 11, 20, 21, and 28 may not reliably discriminate between schizophrenic and college student samples. Over-all, these preliminary results are consistent with the reliability and validity of the scale.     

Demoralization and living alone: outcome from an urban community study.

The purpose of the present study was to investigate differences in demoralization between those who live in single-person households and those who live in households with others in a random sample of 8,634 urban adults. Responses to the 26-item Psychiatric Epidemiologic Research Interview did not substantiate that adults who live alone are more likely to be demoralized than those who live with others, until age and gender are considered. Men who live alone scored higher on demoralization than men who live with others, yet women who live with others scored higher on demoralization than those who live alone. An interaction for living arrangement and age group on demoralization was also observed.     

The evolution of Freud's theory about dreaming.

Freud revised his theory of dreams significantly. First, he discovered the role of the id in dreaming. He hypothesized that the function of dreaming is to gratify an infantile sexual wish, in accordance with the pleasure principle, and thereby to preserve sleep. However, he learned later that anxiety generated by recent events plays a greater role in stimulating dream formation than he had thought and that some dreams actually generate anxiety. These clinical observations caused him, in large part, to revise his theories of dreaming, of anxiety, and of the mental apparatus.     

Psychological compensation: a theoretical framework.

The 2 main objectives of this article are to review a variety of literatures in which the concept of compensation is used and to integrate the results of this review into a general framework of compensation. The review focuses on 4 domains of psychological inquiry: compensation for sensory handicaps, cognitive deficits, interpersonal losses, and brain injury. In the proposed framework, underlying dimensions and 4 basic steps in the progression of compensatory behavior are distinguished. The latter include origins, mechanisms, forms, and consequences. Finally, we describe ways in which researchers in particular domains can benefit from the global, process-oriented framework we propose. For most of the areas of compensation research reviewed, investigators can profit from a consideration of a broader selection of dimensions, additional steps in the process, alternative outcomes, and both objective and subjective assessment procedures.     

Modulatory role of serotonin in neural information processing: implications for human psychopathology.

Investigation of the role of 5-hydroxytryptophan (5-HT), which functions as a modulator in the central nervous system, across behavioral contexts suggests that a general principle of transmitter function may be derived that is independent of specific behaviors and specific neural loci. A functional principle of 5-HT action in neural information processing in the central nervous system is proposed. Extremes deviations in 5-HT activity result in biases in information processing that may have direct effects on behavior. Such biases may predispose to pathological conditions such as violent suicide and aggression.