The analyst's space

The space the analyst creates in his consulting room gives expression to the most primitive elements in his personality. It does this despite, and even by means of, the professional conventions it incorporates. This phenomenon is first apparent in Freud's office where the space of the psychoanalytic situation originated. Here the room itself--filled with the antiquities he collected so passionately--met important narcissistic/symbiotic needs. In this sense it encodes a very early, unanalyzed level of relationship with his mother. It is suggested here that these phenomena, visible in Freud's office, are continuing elements of the analytic frame. Because of the character of the analyst and the structure of the relationship, the room becomes a mise-en-scène in which the narcissistic/symbiotic layers of both participants' characters are played out. Failing to recognize this may lead the analyst to treat seemingly regressive behavior as resistance and to intervene at developmental levels the patients has not achieved. Indeed, such "regressions" can only be understood as products of the situation itself. Phenomenologically, the analyst has become the corner in which he took refuge as a child; the corner to which the patient now comes for sanctuary. Because this connection is unconscious it cannot be called an alliance. Rather, it is a fortuitous interlocking that--like mother-child symbiosis--constitutes a matrix for new growth.     

DENTIST-IMPLEMENTED CONTINGENT ESCAPE FOR MANAGEMENT OF DISRUPTIVE CHILD BEHAVIOR

We evaluated the effectiveness of a dentist-implemented intervention in which brief escape from dental treatment was provided to manage disruptive child behavior during restorative dental treatment. Within a multiple baseline design across subjects, 4 children, aged 3 to 7 years, were provided temporary escape from dental treatment contingent upon brief periods of cooperative behavior. Disruptive behavior decreased when the appropriate escape contingency was used at least 80% of the time. The escape contingency required no more time than traditional management procedures (e.g., tell-show-do, reprimands and loud commands, restraint) to bring disruptive behavior under control. Independent ratings by two dentists provided social validation of the efficacy of the escape contingency.     

TESTING A HIERARCHICAL MODEL OF SELF-KNOWLEDGE

Abstract— A priming procedure (e g, Klein, Loftus Trafton, & Fuhrman, 1992) was used to lest a hierarchical model of self-knowledge. According lo this model, people simultaneously hold multiple representations of themselves that differ bath in their context specificity and in the type of knowledge of which they consist Specifically, context-independent self-knowledge is assumed to be represented abstractly without reference to any particular behaviors, whereas the representation of context-dependent self-knowledge includes knowledge of one's behavior in specific situations. Our results support a hierarchical model. Subjects accessed abstract knowledge when describing their context-independent personality characteristics, but accessed behavioral episodes when describing themselves in a specific context Possible implications of this research are discussed, as a the relation of a hierarchical model of self-knowledge to a mixed model of self-knowledge (e g, Klein & Loftus, 1993b).     

How Christian ethics became medical ethics: the case of Paul Ramsey.

Over the last century Christian ethics has moved from an attempt to Christianize the social order to a quandary over whether being Christian unduly biases how medical ethics is done. This movement can be viewed as the internal development of protestant liberalism to its logical conclusion, and Paul Ramsey can be taken as one of the last great representatives of that tradition. By reducing the Christian message to the 'ethical upshot' of neighbour love, Ramsey did not have the resources to show how Christian practice might make a difference for understanding or forming the practice of medicine. Instead, medicine became the practice that exemplified the moral commitments of Christian civilization, and the goal of the ethicist was to identify the values that were constitutive of medicine. Ramsey thus prepared the way for the Christian ethicist to become a medical ethicist with a difference, and the difference simply involved vague theological presumptions that do no serious intellectual work other than explaining, perhaps, the motivations of the ethicist.     

BEHAVIORAL ASSESSMENT AND TREATMENT OF CHRONIC FOOD REFUSAL IN HANDICAPPED CHILDREN

In this study, we examined the eating behavior of four handicapped children, none of whom exhibited self-feeding skills. All children had a history of food refusal and were nutritionally at risk; one child received all nourishment by way of a gastrostomy tube. Baseline data taken during mealtimes indicated that all children accepted very little food, expelled food frequently, and engaged in a number of disruptive behaviors. Treatments consisted of one or more of the following contingent events: social praise, access to preferred foods, brief periods of toy play, and forced feeding. Results of multiple-baseline and reversal designs showed marked behavioral improvement for each child and increases in the amount of food consumed. Further improvements were noted at follow-up, which ranged from 7 to 30 months posttreatment.