DANGEROUS LIAISONS: PSYCHOSIS AND VIOLENCE – WORKING IN A PSYCHIATRIC INTENSIVE CARE UNIT

This paper describes work with psychotic and violent patients which led to thoughts about the use of projective identification in violent enactments to communicate at physical rather than emotional levels. The excessive reliance on projective identification in these patients seems to reflect early problems in containment and to be associated with underlying fears of annihilation expressed in a dynamic oscillation between a dread of separateness and a dread of closeness. A violent enactment may attempt to resolve overwhelming anxieties about separateness by an attempt at fusion, which then may stir anxieties about engulfment. Alternatively, overwhelming anxieties about closeness may lead to violent attempts at separateness which then stir fears of fragmentation.

Moments of therapeutic contact with these patients seem to be achieved from a painful recognition of separateness but which simultaneously allows real closeness. For therapist and patient such moments seem to reflect the capacity to tolerate a third perspective, very difficult for patients whose fathers were often absent or ineffective. The therapeutic working through to achieve an integrated and separate identity is especially difficult for these patients because of problems of mourning separateness and of unravelling complex webs of projective identification which attempt to bind a fragile identity together against fears of fragmentation and death.     

Employee Gender, Gender Similarity, and Supervisor-Subordinate Cross-Evaluations

This article examines the relationship between employee gender and gender similarity on the one hand and supervisor-subordinate cross-evaluations and subordinate rewards on the other, using a sample of 651 employees from five midwestern organizations. Data were obtained through structured interviews, supervisor ratings of subordinates, and employee personnel records. Two-way analysis of variance results indicated that (a) evaluations of women are more positive than evaluations of men and (b) opposite-sex evaluations tend to be higher than same-sex evaluations, but (c) men subordinates receive more promotions, and same-sex subordinates more pay increases, than do women subordinates and opposite-sex subordinates respectively.     

Results of the healthy body healthy spirit trial.

Healthy Body Healthy Spirit was a multicomponent intervention to increase fruit and vegetable (F & V) consumption and physical activity (PA) delivered through Black churches. Sixteen churches were randomly assigned to 3 intervention conditions. At baseline, 1,056 individuals were recruited across the 16 churches, of which 906 (86%) were assessed at 1-year follow-up. Group 1 received standard educational materials, Group 2 received culturally targeted self-help nutrition and PA materials, and Group 3 received the same intervention as did Group 2 as well as 4 telephone counseling calls based on motivational interviewing (MI) delivered over the course of 1 year. At 1-year follow-up, Groups 2 and 3 showed significant changes in both F & V intake and PA. Changes were somewhat larger for F & V. For F & V, but not PA, there was a clear additive effect for the MI intervention.