Anxiety Responses and Psychological Skill Use During the Time Leading up to Competition: Theory to Practice I

This study investigated temporal responses associated with competitive anxiety in athletes with facilitative and debilitative interpretations of their anxiety symptoms. Qualitative interviews assessed the intensity, frequency, and direction of cognitive and somatic symptoms experienced during a 7-day competitive cycle and the psychological strategies used to attain/maintain a positive psychological state. Analysis indicated three distinct temporal phases within the competitive cycle during which the intensity and frequency of cognitive and somatic symptoms increased. The facilitators utilized a refined repertoire of psychological skills to internally control and re-interpret the cognitive and somatic symptoms experienced. The debilitators did not possess this refined repertoire of psychological skills and relied on external strategies to stabilize the negative symptoms experienced. The findings emphasize the dynamic properties of the stress response and provide a framework for the structure, timing, and content of psychological skills interventions for use with performers who interpret anxiety symptoms as debilitative.     

Tanya and the Adaptive Dialectic of Romantic Passion and Secure Attachment

My analytic work with Tanya illustrated one unique, heightened, individual version of a pervasive human conflict: the way in which erotic passion can be experienced as inherently conflicting with other relational bonds and broader values. In virtually every culture throughout human history, we find expressions of this tension between passionate Eros and other forms of love.

My clinical approach entails an openness to multiple analytic perspectives, including Mitchell's posthumous views in Can Love Last. In addition, I make use of a sensibility informed by evolutionary biology as a vantage point for understanding the individual struggle of patients like Tanya, as well as illuminating some of the larger issues about Eros and attachment. I suggest that romantic aspects of Eros may have evolved as part of a complex psychological system designed to deal with specifically human existential vulnerabilities and anxieties, as well as a way of challenging the inherent human tendency to over-accommodate to the subjective world of the other.     

Review Essay: Constructivism with a Human Face

Irwin Hoffman's book Ritual and Spontaneity includes, but goes well beyond, his series of seminal papers—written over the past several decades—developing a psychoanalytic, constructivist perspective. A new, existential framework depicts what Hoffman calls the “psychobiological bedrock” at the core of the human process of constructing meaning—the lifelong effort to create a livable, subjective world in face of our ever present sense of loss, suffering, and, ultimately, mortality.

This review describes Hoffman's encompassing, existential perspective and discusses how, within this framework, he uses his dialectical sensibility to frame our understanding of both parenting and analysis as “semisacred” activities. The “dialectic of ritual and spontaneity”—the vital clash between disciplined adherence to the analytic frame and personally expressive deviations from it—represents the creative tension between the “magical” dimension of analytic authority and the healing influence of a genuinely expressive human relationship. Hoffman's perspective on the self-interested, “dark side” of the analytic relationship is compared with Winnicott's views on the vital, therapeutic role of “hate” and the paradoxical process by which the patient comes to “use” the analyst.

Unlike most postmodernist “constructivists,” Hoffman openly reveals his underlying belief in certain “transcultural, transhistorical universals”—his “psychobiological bedrock.” In acknowledging these “essentials” (assumptions about human nature) that in some form are integral, yet often hidden, elements of any system of thought, Hoffman saves his own dialectical constructivism from falling into dichotomous (constructivist vs. essentialist) thinking.     

Boundary Issues in Academia: Student Perceptions of Faculty—Student Boundary Crossings

Boundary crossings in academia are rarely addressed by university policy despite the risk of problematic or unethical faculty—student interactions. This study contributes to an understanding of undergraduate college student perceptions of appropriateness of faculty—student nonsexual interactions by investigating the influence of gender and ethnicity on student judgments of the appropriateness of numerous hypothetical interactions. Overall, students deemed the majority of interactions as inappropriate. Female students judged a number of interactions as more inappropriate than did male students, and with a few exceptions, Mexican American and Anglo American students were similar in their ratings of the appropriateness of faculty—student interactions. These findings suggest that universities need to be proactive in establishing guidelines concerning faculty-student boundary crossings.     

A Review of: “Groups: Applying the Functional Group Model,edited by Sharan L. Schwartzberg,Margot C. Howe, & Mary Alicia Barnes, 2008”

This paper describes the process of developing and implementing a new information system, POTENT, as part of a quality assurance exercise to improve occupational therapy documentation in the hospital record. Results of a Retrospective criteria audit are presented and are supportive of a more rigorous examination of POTENT's impact on documentation practices.     

Social Problem-Solving Skills in Children with Traumatic Brain Injury: Long-Term Outcomes and Prediction of Social Competence

The effects of childhood traumatic brain injury (TBI) on social problem-solving were examined in 35 children with severe TBI, 40 children with moderate TBI, and 46 children with orthopedic injuries (OI). The children were recruited prospectively following injuries that occurred between 6 and 12 years of age. They were followed longitudinally, and ranged from 9 to 18 years of age at the time of the current study, which occurred on average 4 years post injury. They were administered a semi-structured interview used in previous research on social problem-solving to assess the developmental level of their responses to hypothetical dilemmas involving social conflict. Children in the severe TBI group defined the social dilemmas and generated alternative strategies to solve those dilemmas at the same developmental level as did children in the OI group. However, they articulated lower-level strategies as the best way to solve the dilemmas and used lower-level reasoning to evaluate the effectiveness of the strategies. After controlling for group membership, race, socioeconomic status, IQ, and age, children's social problem-solving, and particularly the developmental level of their preferred strategies for resolving conflicts, predicted parents ratings of children's social skills, peer relationships, aggressive behavior, and academic performance. The findings indicate that children with severe TBI demonstrate selective, long-term deficits in their social problem-solving skills that may help to account for their poor social and academic outcomes.     

Fear response to dissociation challenge

Abstract

Participants (N = 101) scoring high or low on a new scale for assessing fear of dissociative sensations (Dissociation Sensitivity Index) underwent an audio/visual sensory challenge using a device called the D.A.V.I.D. Participants' report of subjective fear and level of dissociation were measured before and after completing the audio/visual sensory challenge. Consistent with prediction, participants scoring high on the DSI responded to the challenge with significantly greater increases in subjective fear and dissociative symptoms relative to those scoring low on the DSI. Contrary to prediction, the DSI performed poorer than the Anxiety Sensitivity Index in predicting participants' response to the audio/visual sensory challenge. Theoretical and clinical implications of the findings are discussed.