Attitudes toward the unconscious

As a keynote to a conference bringing together psychoanalysts and analytical psychologists, this paper addresses different mythic attitudes toward the unconscious, Starting with the caricatures of Oedipus and Narcissus that the author feels Jung and Freud originally projected onto each Other in the course of their quarrel. He moves on to the fairytale-like stories of Perseus and Beauty and the Beast to discover mote complex images of the stance taken in relation to the unconscious by present-day analysts: working within both die Jungian and the Freudian traditions.     

Courteous service: Its assessment and modification in a human service organization

We evaluated strategies to increase behaviors associated with courteous provision of service by 3 staff members of a human service agency. Training included written instructions, practice, and performance feedback. A lottery procedure was introduced to maintain courteous service after training. The results of a multiple baseline design across the 3 participants showed marked increases in courteous behaviors following training. These effects were maintained at 3-, 5-, and 8-month follow-ups. Consumers' satisfaction with service also increased. These findings suggest that simple training and reinforcement procedures can enhance courtesy afforded those who receive service from public and nonprofit organizations.     

Fragmentation and Narcissism

The paper focuses on the articulation of two areas of theory: that of development of the self through fragmentation and differentiation and that of narcissism in early psychological development, and its pathology later in life. Jungian ideas concerning the self and individuation (including those developed by Fordham) are linked with psychoanalytic ideas, notably Kohut's, and related to the concepts of narcissism and ego-development. In this the focus is on a revaluation of the negative overtones of 'fragmentation' and 'narcissism' and an indication of their place in the process of individuation. It is pointed out that a varying emphasis in the analyst on what are called the biological and ethological aspects of these theories will have important implications for the treatment of patients. The theoretical position is illustrated by a lengthy clinical example involving a case of early injury to the self which suggests the pathology of narcissistic character disorder. But the case also illustrates the contribution to development of fragmentation and narcissism, which are revalued here as the 'part-for-the-whole' and as one of the 'motors' of individuation. Working within a perspective that prioritizes the importance of the drive towards relationship, it is recommended that the analyst learns to respect and value phenomenologically the contribution of fragmentation and narcissism to normal development, if true healing is to occur.     

'The Rich Squander Money by the Thousands'

Following the publication of an unknown letter of Jung's on the theme of the possibility of liberal dictatorship, the authors have presented the actual letter that prompted Jung's reply and a further letter from the 16–year-old boy in Kansas. An interview with Jung in Hearst's International Cosmopolitan Magazine conducted by H.R. Knickerbocker in 1938 initially prompted the boy to write to Jung and the interview, which has been published, is summarized. Economic and financial themes were prominent in the boy's mind and links are made to earlier discussions in this Journal about these matters.     

Cultural attitudes: in contexts of argumentation and explanation

Traditionally, attitudes are supposed to predict behavior. However, due to their poor performance, we are sometimes advised to abandon the notion. The present study attempts to preserve the concept but takes attitudes to be evaluative goals accomplished through interactional, especially argumentative and explanatory activities. The paper uses reasoned-discourse analysis and demonstrates the attainment of positive attitudes towards the Dutch by expatriate Chinese intellectuals in the Netherlands by attending to a variety of argumentative and explanatory strategies in their interview talk. Results suggest that there is good empirical reason to believe that attitudes are accomplishments of communicating actors' rhetorical contextualizations.     

Primary health care for women: What is it and who provides it?

Recent federal policy has highlighted historically underrecognized women's health issues. Women comprise the majority of the population, especially the elderly. Women's health care needs, utilization patterns, and outcomes vary from those of men, and often among each other. Primary health care services for women are multidisciplinary and emphasize prevention, education, and early intervention as well as treatment. Psychologists and other primary health care providers can collaborate to provide their services in a cost-effective manner that optimizes quality of care and comprehensive health care.     

Evaluating pediatric psychology consultation services in a medical setting: An example

We examined the nature of referrals to a health center-based pediatric psychology service from 1990 to 1993 and assessed the satisfaction of health professionals with these services. Archival evaluation of 1467 records showed that over half of the consultation requests came from general pediatrics, pediatric neurology, and surgical services and that 70% of the psychological services were delivered on an outpatient basis. The most frequent referrals were for cognitive/neuropsychological evaluation and externalizing behavior problems. Pediatric psychology trainees were involved in 94% of the consultations. Survey of health professionals (n = 143) indicated very high overall satisfaction with the quality of services delivered. Presenting problems yielding the greatest likelihood for future consultation requests were behavior problems, child abuse, coping with illness, and depression/suicide. Results are discussed in the context of previous evaluations of pediatric psychology services and recommendations for future evaluation research.     

Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Health and behavior: The coming together of science and practice in psychology and medicine after a century of benign neglect

For thousands of years, physicians had available only a few drugs with which to minister to patients and the practice of psychology was an integral and therapeutically powerful component in the practice of medicine. Thus, good bedside medicine consisting of empathy, compassion, and a nurturant attitude toward the ill individual was a major component of the physician's armamentarium until relatively recently. However, the explosion in scientific knowledge in biology, physiology, chemistry, and microbiology which began a century ago and has continued through the twentieth century helped produce several generations of physician specialists and subspecialists with little knowledge of the powerful role psychological factors play in health and illness. As a result, practitioners of medicine and practitioners of psychology have had little or no contact during most of this century. However, as advances in microbiology, public health, and nutrition have eradicated many of the infectious diseases, infirmities associated with one's lifestyle have replaced the latter as the major causes of death today. One offshoot of this shift is that after a century of benign neglect, physicians and psychologists have rediscovered a common ground in the arena labeled health and behavior. Some factors responsible for these recent developments are highlighted.This article was an invited address delivered to a group of Japanese health psychologists as part of a Health Sciences Seminar in Tokyo on July 24, 1993. Concurrent with its publication here in English, it is being published in the Japanese language in the March 1994 issue of the journal,Japanese Health Psychology.