Bearing the unbearable: ancestral transmission through dreams and moving metaphors in the analtyic field

Abstract: This paper explores how untold and unresolved intergenerational trauma may be transmitted through unconscious channels of communication, manifesting in the dreams of descendants. Unwitting carriers for that which was too horrific for their ancestors to bear, descendants may enter analysis through an unconscious need to uncover past secrets, piece together ancestral histories before the keys to comprehending their terrible inheritance die with their forebears. They seek the relational containment of the analytic relationship to provide psychological conditions to bear the unbearable, know the unknowable, speak the unspeakable and redeem the unredeemable. In the case of ‘Rachael’, initial dreams gave rise to what Hobson (1984) called ‘moving metaphors of self’ in the analytic field. Dream imagery, projective and introjective processes in the transference‐countertransference dynamics gradually revealed an unknown ancestral history. I clarify the back and forth process from dream to waking dream thoughts to moving metaphors and differentiate the moving metaphor from a living symbol. I argue that the containment of the analytic relationship nested within the security of the analytic space is a necessary precondition for such healing processes to occur.     

中医药学将走向何方

由于中医缺乏形态学,中医没有成熟的科学实验,中医的诊断很难标准化、客观化,理论逻辑的致命弱点,理论体系难以重构,所以中医药学在很长一段时间内将保留下来之后,随着中医药学的理论体系的缺陷无法克服,原有的中医药体系必然解体,其中有部分内容融入现代医学。中医药学的归宿就是逐渐融入现代医学。     

Affektive Interaktion zwischen Patienten und Therapeuten

Zusammenfassung Eine positive therapeutische Beziehung wird therapieschulenübergreifend als wichtige Voraussetzung für den Therapieerfolg angesehen. Meist wird jedoch in Studien lediglich die schriftliche Patienteneinschätzung erfasst. Nonverbale Aspekte der Interaktion zwischen Patienten und Therapeuten werden kaum untersucht. Aus einer Studie zur Vorhersage des Erfolgs stationärer Fokaltherapie werden affektive Interaktionsprozesse im Erstinterview exemplarisch zwischen einer erfolgreichen und einer nicht erfolgreichen Behandlung mit mikroanalytischen Verfahren (facial action coding system, FACS) verglichen. In der nicht erfolgreichen Therapie waren die mimischen Affektäußerungen reziprok; Therapeutin und Patientin zeigten ähnliche vorherrschende (sog. Leit-)Affekte. Erfolgreicher waren die Behandlungen, wenn die Therapeuten komplementäre Affektmuster zeigten. Implikationen für Behandlungstechnik, Supervision und Weiterbildung werden diskutiert.     

A formal framework for modelling the developmental course of competence and performance in the distance,speed, and time domain

The developmental course in the distance–speed–time domain is still a matter of debate. Traditional stage models are contested by theories of continuous development and adaptive thinking. In the present work, we introduce a formal framework for modelling the developmental course in this domain, grounding on Competence-based Knowledge Space Theory. This framework, as a more general case, widely includes assumptions and facets of previous models and covers empirical findings collected based on different experimental paradigms. By a distinction of latent competences and observable performance, model validation is not bound to a certain experimental paradigm and no one-to-one correspondence between competences and tasks is required. Therefore, the framework has the potential to bridge the gap between stage models and models of continuous development. The approach also precisely defines misconceptions, for example overgeneralization, and empirically investigates their occurrence. In the present work, we established a prototypical model for the development of understanding the distance–speed–time system. We extended this model with definitions based on different perspectives of overgeneralization. The assumptions of the model and its extensions were examined on the basis of the results of two empirical investigations using six judgment task types. The results yielded a reasonably good fit of model and data. No evidence was found for the occurrence of overgeneralization in this domain. The theoretical model and empirical results are discussed with respect to their relationship to other developmental models and theories.     

专科医生应注重整体性和系统思维训练——由一例甲亢患者门诊长期误诊引发的哲学思考

临床医学专科的发展对促进医学科学的进步起到了重要的推动作用,尽管它可能缺乏整体性、系统性临床思维,但在可预见的将来,它仍是综合性医院医疗实践的主旋律,医学界应对此有较为清醒的认识。本文从哲学的角度分析了造成误诊的原因,然后指出防止或减少误诊的途径是培养科学的临床思维,并提出了在临床过程中培养整体思维和系统性科学思维的一些方法。     

Analysis of the elements of attention: A neuropsychological approach

A model for conceptualizing the components or elements of attention is presented. The model substitutes for the diffuse and global concept of attention a group of four processes and links them to a putative system of cerebral structures. Data in support of the model are presented; they are derived from neuropsychological test scores obtained from two samples, the first consisting of 203 adult neuropsychiatric patients and normal control subjects, and the second, an epidemiologically-based sample of 435 elementary school children. Principal components analyses of test scores from these two populations yielded similar results: a set of independent elements of attention that are assayed by different tests. This work presents a heuristic for clinical research in which the measurement of attention is essential.     

我国人体器官移植的社会支持系统研究

供体来源不足严重制约了我国器官移植事业的发展。有鉴于此,建立一个非技术的人体器官移植的社会支持系统对促进我国器官移植事业的发展将具有重要意义。通过对该系统各组成部分如法律法规系统、组织管理系统、宣传教育系统、补偿系统的研究,旨在对我国器官移植事业的发展有所裨益。     

巴西医疗保障体系

从巴西医疗保障体系的建立、资金筹集和使用等方面介绍巴西医疗保障体系,重点关注巴西全民统一医疗制度。鉴于巴西与我国在卫生系统绩效和医疗保障制度改革中所面临的相似挑战,试图通过对巴西医疗保障体系比较详细地介绍及与我国进行简单的对比,总结成功经验、吸取教训为我国建立全民覆盖的医疗保障体系提供借鉴和参考。     

抑郁症的流行病学研究与预防——读《中国人群死亡及其危险因素流行水平、趋势和分布》有感

根据《中国人群死亡及其危险因素流行水平、趋势和发布》的报告和相关研究表明,全世界约有1亿人患有抑郁症,且数量有增无减,抑郁症将成为本世纪一种相当流行的病症.由于抑郁症是一种患病率高,严重危害人类身心健康,具有高自杀风险的精神疾病,更需要我们采取措施积极预防.目前采用的主要预防方法有:积极的心理健康教育、处理好家庭与社会的关系、社会支持、心理调适和体育锻炼等.     

香港医疗制度与改革

香港的医疗制度由一个"二元医疗体系"组成,在体制模式、融资制度及服务规管三方面的安排都有其独特之处,为香港七百多万人提供了一个全民医疗安全网,能够达到公平、有效、可及性高及质素佳的要求。但是这个医疗系统也存在不少问题和隐忧,需要有效的改革,包括管治、管理、服务安排和融资模式改革等。