Exploring Confluence

Healthy coupling, defined as coupling which supports the growth of the personhood of both partners, is explored herin. Healthy coupling is viewed as being based on a rhythm of confluence (formation of a "We" from the "I" and the "Thou") and difluence (clear differentiation of an "I" and a "Thou" from the "We"). Criteria for the recognition of natural, flexible confluence and difluence are contrasted with those of an unnatural, rigid pattern.     

The Ghost Triangle as an Obstacle to Intimacy

SUMMARY

This paper addresses some of the issues associated with a ghost triangle that threatened intimate bonding between a couple. A widower's unresolved mourning had led to an impasse in the relationship. Because only one partner sought therapy, intervention was limited to assessing options for detriangulation as requisite to the viability of the relationship, followed by individual and group support to develop relationship closure. Additional treatment goals included creating self-awareness about past and present problematic relationship patterns and strengthening self-care and mutual support.     

Emotionally Focused Couple Therapy

Abstract

Working with couples who are both survivors of emotional abuse and are currently in an emotionally abusive relationship can be particularly challenging for the clinician. This article focuses on Emotionally Focused Couple Therapy as a recommended practice approach for clients who are caught in emotionally abusive patterns with one another. The article reviews relevant literature on this approach and illustrates the specific interventions applied lo an emotionally abusive couple.     

The Moderating Effects of Mindfulness on Psychological Distress and Emotional Eating Behaviour

Current evidence and theory suggests that emotional eating resulting from attempts to manage psychological distress, such as anxiety, depression, and stress, is considered to be a major contributor to obesity. Mindfulness has been shown to be related to disordered eating behaviours. Employing a non‐clinical sample of 42 males and 115 females, the present study investigated the contribution of mindfulness as a potential moderator between psychological distress and engagement in emotional eating, while controlling for the effects of gender and general nutrition knowledge. Consistent with predictions, psychological distress was positively associated with engagement in emotional eating, while mindfulness was found to share an inverse relationship. Moreover, after controlling for gender and general nutrition knowledge, the interaction between psychological distress and mindfulness was found to significantly predict the tendency to engage in emotional eating over and above the individual effects of these variables. The findings from the current study add to the current literature supporting the use of mindfulness‐based interventions for treatment of emotional eating practices in individuals experiencing anxiety, stress, and lower levels of depression.     

Couple Therapy Research and the Practice of Couple Therapy: Can We Talk?

As has been true in every other realm of psychotherapy, couple therapy research generally has had very little impact on the day-to-day practice of couple therapists. To a significant degree, this unfortunate disconnection may be attributable to an overemphasis by researchers in the field on treatment packages and therapeutic methods/techniques. Insufficient attention has been paid to other important sources of influence on treatment outcomes, especially the couple therapist herself/himself. It is argued that effective couple therapy requires a good "fit" between the person of the therapist and her primary theoretical orientation, and that couple therapists may be more influenced by research that addresses process aspects of the therapeutic approaches to which they have their primary theoretical allegiances.     

Is Viewing Ostracism on Television Distressing?

ABSTRACT

Being ostracized can be a painful and distressing experience and can lead to subsequent aggression by the victim. However, it is unknown whether watching someone else be ostracized either in real life or on television is similarly distressing. The purpose of the current study was to examine what type of distress (if any) is induced after viewing ostracism on television. The study consisted of 50 participants, half who viewed a movie clip containing ostracism and half who viewed a control clip. Physiological and self-report data revealed that viewing ostracism was distressing to participants. In particular, participants who viewed the ostracism clip reported a lower sense of belonging, self esteem, and mood, and a greater increase in heart rate and skin conductivity than those who viewed the control clip.     

Health Risk Behaviors and Their Relationships to Health Care Utilization Among Veterans Receiving Primary Medical Care

This paper reports the findings of a behavioral health risk screening form and examines the interrelationships among behavioral risk factors and health care utilization. Participants were 1,000 veterans who completed a brief self-report questionnaire assessing affective distress and behavioral health risk factors while they waited to see their primary care provider. Participants reported a mean level of affective distress in the mild range on a scale of 0 to 20 (M = 6.4, SD = 4.95), and 22.4% reported moderate or high levels of affective distress. Fifty percent of the sample denied alcohol use; 5% of the men and none of the women reported a pattern of use that met established criteria for at-risk drinking. Twenty-six percent of the sample reported current tobacco use, 45% acknowledged concerns about diet and/or weight, and 54% reported concern about pain. These factors were largely significantly intercorrelated and several were related to indices of health care utilization. It was concluded that veterans receiving health care in primary care settings report significant levels of affective distress and other health risk behaviors and that the presence of these factors is associated with increased use of the health care system. These data encourage increased efforts to identify these factors and to develop behavior change interventions.     

A classmate in distress: schoolchildren as bystanders and their reasons for how they act

Research has shown that bystanders more often fail to or are slower to help a victim in emergency when there are other bystanders than when there are not. The study presented in this paper is a qualitative case study with a focus on students’ own reasons why they do not help a classmate in emergency when there are other children witnessing the emergency situation in the real-life classroom case studied. Grounded theory methods were used to analyse the data. The individual conversations with the students indicated a variety of definitions of the specific distress situation when they recalled and talked about the classroom incident. During the process of the analysis seven concepts of definitions associated with passive or non-intervention bystander behaviour were constructed and grounded in the empirical material: trivialisation, dissociation, embarrassment association, busy working priority, compliance with a competitive norm, audience modelling, and responsibility transfer. Relations between these concepts of definitions were also analysed. However, this study is a first step and a first report from an ongoing study about school children as helper and bystander.     

肺保护策略机械通气的再评价

通常认为急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)患者应用肺保护策略机械通气可降低病死率,主要由于潮气量的降低。对已发表的随机对照研究再次分析,发现平台压与患者病死率明显相关。平台压低于30cmH2O时,潮气量可以在一定范围内增加,不影响患者预后。但选择小潮气量可能对病人有害。随机对照研究在试验设计、统计学分析、病人同质性等方面依然存在很多问题。从现有资料看,潮气量和平台压都很重要。