Group treatment of the hyperventilation syndrome

Hyperventilation (hv) is increasingly recognized as being significant in a number of psychological and medical conditions. The core of treatment for hv is breathing retraining, usually on an individual basis. This article describes a group therapy for breathing retraining for patients with hv-induced panic reactions. An analysis of group process suggests that such treatment is helpful in ways impossible for individual retraining and that further exploration of this modality is warranted.     

Emergent themes and roles in short-term loss groups

Clinical observations regarding themes and roles that are characteristic of short-term, psychoanalytically oriented therapy groups for loss patients are presented. They reflect aspects of both the therapy and the patients. Themes refer to the content of a recurrent conflict in the group. They include trust, survivor guilt, mortality, and termination. Roles refer to a set of patient behaviors that represent a shared conflict. They include the apparition, monk, professor, professional nurturer, emotional conductor, and cruise director. Challenges that the themes and roles present to the therapist and clinical guidelines for addressing them are offered. Awareness of characteristic themes and roles and possible therapist responses are regarded as important parts of the preparation and training of therapists who plan to conduct short-term loss groups.     

Rethinking levels of abstraction in family systems theories.

This article is an attempt to improve the way we conceptualize "levels" in family systems. The first section reframes thinking about levels by identifying an array of different ways of thinking about levels. The next section suggests a parsimonious frame-work for thinking about levels of abstraction in systemic processes. The proposed framework integrates several earlier ways of conceptualizing levels, and helps eliminate some of the confusion, inconsistencies, fragmentation, and limitations of some earlier models. The new framework has three categories that are called Levels I, II, and III. The most abstract level (III) includes phenomena such as family paradigms and values. The intermediate level includes processes such as second-order change, regime, and "meta" processes such as metacommunication and meta-rules. The least abstract level refers to specific processes such as transformation processes and rules. The article concludes with an attempt to demonstrate the usefulness of the proposed framework by showing how it can be used to eliminate a number of conceptual problems in earlier models, improve conceptual clarity, help generate new theoretical insights, and help deal with several controversies in the field.     

Potential Perils of the Demonstration-Consultation Interview in Family Therapy: A Case Study of Contextual Confusion

This article focuses on a specific aspect of consultation in contemporary family therapy, namely, problems that arise in the context of a consultation that simultaneously serves as a demonstration of a particular model of therapy. The demonstration-consultation interview is used widely in family therapy, but has received little attention in the literature. We use a case example of the apparent persistent deterioration in the clinical state of a patient following such a family interview with a visiting expert, and examine the possible contribution to the patient's deterioration that the demonstration-consultation context creates for the various participants. We offer provisional guidelines to minimize the risk of negative effects of the demonstration-consultation interview, pending empirical research into this phenomenon.     

Sleep physiology and psychological aspects of the fibrositis (fibromyalgia) syndrome

Fibrositis (fibromyalgia) patients were compared with normal controls in terms of electrophysiology (EEG), self-report indicants of awakening, quality of sleep, behaviourally signalled awakenings, and Symptom Check List 90R (SCL-90R) scores. The results differentiated fibrositis patients from normal controls in terms of SCL-90R scores, with fibrositis patients showing significantly more psychopathology. Fibrositis patients had more alpha EEG sleep and less REM and Stage 1 sleep. They were better able to recall their behaviourally signalled awakenings the following morning and reported qualitatively less satisfying sleep than the normal controls. The alpha EEG sleep anomaly may reflect a vigilant arousal state during nocturnal sleep and result in the daytime experience of unrefreshing sleep, psychologic distress, that re-enforces the perpetuation of the sleep-related symptoms.     

The Predictors of Post-Sterilization Regret in Married Women1

We interviewed a sample of 317 married women prior to a tubal sterilization (195) or a husband's vasectomy (122) and then reinterviewed them yearly for 5 years. Using these women's responses to six questions about their feelings and desires following sterilization, we fitted a latent-variable model of post-sterilization regret to the data by means of a linear structural equation analysis. The results confirmed our view that post-sterilization regret was not a simple psychological state but rather was a complex process with different, causally linked manifestations. This process began with a renewed interest in having a baby, proceeded to the development of negative feeling about the three decisions that lead to sterilization, and concluded with a desire to reverse the surgery. This sequence was affected by the negative, post-sterilization effects of the sterilization and by the Occurrence of divorce. Next, we identified the pre-sterilization predictors of six regret variables from our model by means of a series of linear regression analyses. The major pre-sterilization predictors of the regret process included being relatively young, ambivalence about future childbearing, negative attitudes toward sterilization, dominance of the decision making by the woman's husband, and conflict with her husband during decision making. Finally, we divided the sample into quintiles on the basis of their scores on a Pre-Sterilization Predictor Scale and assessed the performance of our predictor variables as indicators of risk of regret by determining the level of negative feelings toward sterilization in each quintile. The results confirm the discriminatory power of our predictors. The overall findings indicate a number of psychological and marital issues, the exploration of which might help counselors provide anticipatory and preventative services to couples seeking sterilization.     

After-contraction phenomenon: influences on performance and learning

Three experiments investigated the influence of an after-contraction phenomenon on the performance and learning of a dynamic force-production task. The after-contraction effect refers to an involuntary potentiation (induced by a sustained precontraction) that is thought to summate with voluntary motor commands to bias subsequent responding. The precontraction involved a brief (20 s) static contraction. The subsequent influence of the precontraction on a dynamic force-production task was assessed. Experiments 1 and 2 were aimed at demonstrating the direct impact of the precontraction intensity on the magnitude and decay of the after-contraction effect. The results indicated that as the intensity of the precontraction increased, the magnitude of the induced bias increased. In Experiment 3, the indirect influence on subsequent retention of varying the precontraction intensity during acquisition was investigated. The results indicated that the performance of subjects experiencing varying precontraction intensities during acquisition was inferior to that of subjects experiencing a constant precontraction intensity, but the performance of the varied precontraction intensities group was superior on the test of retention. It is noted that the paradoxical reversal from acquisition to retention is similar to that found in contextual interference experiments and may arise from similar mechanisms.     

Classifying by dimensions and reading: a comparison of the auditory and visual modalities

Children have difficulty learning to read alphabetic writing systems, in part, because they have difficulty segmenting spoken language into phonemes. Young children also have difficulty attending to the individual dimensions of visual objects. Thus, children's early difficulty in reading may be one sign of a general inability to selectively attend to the parts of any perceptual wholes. To explore this notion, children in kindergarten through fourth grade (Experiments 1, 3, and 4) and adults (Experiment 2) classified triads of spoken syllables and triads of visual objects. Classifying speech by common parts was positively related to reading and spelling ability (Experiments 1 and 4), but usually not to classifying visual stimuli by common parts under free classification instructions (Experiments 1 through 3). However, classification was more consistent across the visual and auditory modalities when the children were told to classify based on a shared constituent (Experiment 4). Regardless of instructions, performance on the visual tasks did not usually relate to reading and spelling skill. The ability to attend selectively to phonemes seems to be a "special" skill--one which may require specific experiences with language, such as those involved in learning to read an alphabetic writing system.