A perspective on the patterns of loss, lack, disappointment and shame encountered in the treatment of six women with severe and chronic anorexia nervosa

Abstract :  This paper explores how the aggressive fantasies and energies expressed in anorexic self-hatred can be recycled to become the basis of psychological growth and recovery. This shift is made possible by focusing on the telos of the analysand's psychological system as it expresses itself through her illness, and using Clark's idea that sanity is a form of recycled madness. It also draws on Jung's view of the unconscious as an active and purposive agent, and libido as a neutral psychic energy which can serve different purposes.
I discuss a number of clinical vignettes, focusing on the hard, ruthless, defiant and hateful aspects of (what might appear to be) 'monstrous' anorexic behaviour, and the kinds of countertransference reactions these behaviours can provoke. I also explore what these kinds of behaviours might represent in terms of multi-generational family dynamics, as well as mother-daughter dynamics.
At the core of the paper is the idea that the capacity to use aggression in clear ways, but within the limits of conscience, is essential for the protection of one's physical and psychological boundaries. Without the capacity to defend oneself, and the ability to decide quickly and clearly when it is right to risk hurting the other in order to do so, one cannot take any level of risk in life, or draw close to the other. I suggest that for recovery from anorexia to occur, the aggressive, self-hateful, destructive energies which are so central to the illness need to be recycled into these kinds of awarenesses and life-skills.     

Professional and ethical dilemmas experienced by counselling supervisors: The impact of organisational context

This paper examines the ethical and professional dilemmas faced by counselling supervisors working in a range of diverse organisational contexts. Questionnaires and interviews were used to explore supervisor experiences of working in counselling agencies, industry, education and health service settings. Ethical and professional dilemmas outlined by supervisors were examined in connection with their role within the organisation. It was found that both external and ‘in‐house’ supervisors were exposed to dilemmas focused around issues of responsibility, confidentiality, boundaries, professionalism, relationships, contracts and ethical practice. Supervisors were divided in their opinions about playing a more active, educative role within organisational systems. There was considerable support for the construction of more explicit relationships between supervisors and their employing organisation.     

Kurt Lewin

Kurt Lewin (1890–1947) is often called the father of social psychology, although this can be disputed. Lewin established a reputation in Germany for his work on affect and motivation when these topics were considered to be outside the scope of psychological research. He escaped the Nazis and started work in social psychology at the University of Iowa. In 1945, he established the Research Center for Group Dynamics at Massachusetts Institute of Technology, with faculty and students who formed modern experimental social psychology. He also established the Commission on Community Interrelationships and helped to found the T Group movement. Lewinian Field Theory stressed that behavior is a function of the person and the environment, or B = f (p, e).     

When educational supervision meets clinical supervision: what can we learn from the discrepancies?

The authors question the taken-for-granted notion of supervision. Their concerns arose out of an attempt to introduce 'clinical' supervision into academia as a way of addressing an increasing number of the ethical issues which confront lecturers. They recognise that knowledge can impact adversely on students and that lecturers at times find themselves compromised. They settled on supervision as an organisational space in the domain of power in which to address the distress they observed. However, through their different experiences of supervision, they soon found themselves talking past each other. When clinical supervision meets educational supervision, several anomalies are brought to the fore. The authors draw on Foucault's notion of discourse, and of knowledge as power, in order to foreground these and conclude by cautioning against an uncritical acceptance of supervision as an ethical practice. They believe there is a benefit in bringing together the two discourses of clinical and educational supervision for further discussion.     

Mexican‐Origin Parents’ Stress and Satisfaction: The Role of Emotional Support

Guided by a process model of parenting and the integrative model, this study examined sources of emotional support (i.e., partner, maternal, paternal) as related to stress and satisfaction resulting from the parenting role in a sample of Mexican‐origin young adult parents who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health) during Wave IV. Participants were male and female parents (26–35 years of age; 59% female; N = 737) who had children and a partner. Results from structural equation modeling revealed support from mothers as salient; high levels of maternal support were associated with high levels of parenting satisfaction. Tests of indirect effects suggested that parenting satisfaction played an intervening role in the link between maternal support and parenting stress. The pattern of results held across levels of linguistic acculturation but varied by gender. Understanding the mechanisms that predict parenting stress and satisfaction within the Mexican‐origin population may help in the identification of culturally sensitive intervention strategies.     

Attention-Deficit/Hyperactivity Disorder: A Neuropsychological Perspective Towards DSM-V

Neuropsychological methods and techniques have much to offer in the evaluation of the individual suspected as having Attention-Deficit/Hyperactivity Disorder (ADHD). After a review of the historical evolution of the ADHD concept, incidence and prevalence, and DSM-IV criteria for diagnosis, especially as regards omission related to gender differences, and other associated cultural, familial, socioenvironmental, and subject influences, this paper describes a number of dilemmas and obstacles encountered in clinical practice. Included are the confounds associated with the wide range of possible comorbidities, the insufficiency of current DSM-IV criteria, the emergence of subtype differentiation and its impact on diagnosis and treatment. The complex relationship between neuropsychological constructs and ADHD, and obstacles to valid assessment are also addressed. The complexities associated with a thorough ADHD evaluation are viewed within an impressive and expansive existing scientific framework and recommendations are made for future directions.     

Token mediated tool exchange between tufted capuchin monkeys (<Emphasis Type="Italic">Cebus apella</Emphasis>)

Three experiments were conducted to test whether a pair of tufted capuchin monkeys (Cebus apella) could generalize their ability to exchange tokens and tool objects with a human experimenter to similar exchanges with a conspecific partner. Monkeys were tested in side-by-side enclosures, one enclosure containing a tool-use apparatus and one or more token(s), and the other enclosure containing one or more tool object(s). The monkeys willingly transferred tokens and tools to a conspecific with little practice. Following a small amount of training, we also found that the monkeys would select situation-appropriate tokens to exchange for specific tools, but did not select appropriate tool objects in response to another monkey’s token transfers. Implications regarding role reversal are discussed.     

Significant other primes and behavior: motivation to respond to social cues moderates pursuit of prime-induced goals

Significant others can automatically activate a variety of goals, including goals that significant others have for an individual and the individual's personal goals that are associated with the significant others. Across three studies, this article shows that the effects of significant other primes (i.e., mother, roommate) on behavior depend on individual differences in both personal goals and responsiveness to social cues (i.e., self-monitoring, need to belong). Specifically, individuals who are motivated to respond to social cues assimilate to a goal that their primed significant other has for them, regardless of whether they personally hold the goal. Individuals not so motivated, on the other hand, assimilate to the goal only when it is one that they also personally hold. Implications of these findings for research on the prime-to-behavior relationship and interpersonal goal pursuit are discussed.