Moved to tears: Technical considerations and dilemmas encountered in working with a 13-year-old boy with acquired quadriplegia 1

This paper is about therapeutic work with David, a 13-year-old boy who, at the age of 5, was the victim of a hit-and-run road traffic accident resulting in quadriplegia. The circumstances leading to the accident and its sequelae reveal a particularly complex picture, which combines early emotional deprivation and trauma. Although cognitively intact and able to speak, David could not move. Yet he created movement in others through a desperate necessity, by communicating via the employment of extreme projective forces. The highly complex presentation of emotional, psychic and bodily damage in the child, and in particular, David's physical paralysis, has had a profound impact upon what I have come to think of as the ‘mindbody’ of the therapist. Winnicott has talked of the infant's ‘psyche/soma’. Here I want to extend the notion and consider the bodily impact of projections in particular and how these have a powerful emotional and physical resonance on the ‘mindbody’ of the therapist, especially in therapy with a young person whose body is damaged. In this paper, I consider technical challenges and dilemmas encountered in the work, including the complex interplay of transference/countertransference phenomena. This unusual presentation of a boy in extraordinary circumstances led to considerations of psychoanalytic method and interpretative activity, which may be viewed as being inspired by ‘emotional truthfulness’.2 2 Alex Dubinskey (Chair ACP conference 2004) commenting on aspects of this work used the term ‘emotional truthfulness’.

Dans cet article, l'auteur raconte son travail thérapeutique auprès de David, âgé de 13 ans, qui à l'âge de 5 ans fut victime d'un accident de la circulation avec délit de fuite, accident qui le laissa tétraplégique. Les circonstances qui aboutirent à l'accident et à ses séquelles forment un tableau particulièrement complexe mettant en jeu des carences affectives précoces et des traumatismes. Bien que ses capacités cognitives ne fussent nullement atteintes et qu'il fut capable de parler, David ne pouvait pas bouger. Par l'urgence désespérée de son discours, transmise grâce à des projections extrêmement puissantes, il réussissait à susciter du mouvement chez ses interlocuteurs. La présence conjointe et extrêmement complexe de dommages affectifs, psychiques et corporels chez cet enfant – et notamment sa paralysie physique – eut un impact profond sur ce que l'auteur en vient à appeler l'“ esprit-corps ” du psychothérapeute. D. W. Winnicott a parlé du “ psyché-soma ” du jeune enfant. Dans son texte, l'auteur élargit cette notion, notamment pour prendre en considération l'impact corporel des projections, ainsi que leur résonance émotionnelle et physique massive sur l'“ esprit-corps ” du thérapeute, surtout lorsque son patient est une personne jeune dont le corps est endommagé. L'auteur explore les défis et dilemmes techniques rencontrés au cours de son travail, y compris le jeu complexe de phénomènes transférentiels et contre-transférentiels. Ce traitement, inhabituel, avec un garçon dans des circonstances sortant de l'extraordinaire soulève des questions concernant la méthodologie psychanalytique et l'activité interprétative, questions qui peuvent être considérées comme étant inspirées par la “ véracité émotionnelle ”.

Dieser Artikel ist über die therapeutische Arbeit mit David, einem 13-jährigen Jungen, der im Alter von 5 Jahren das Opfer eines Unfalls mit Fahrerflucht war, der zu einer Querschnittslähmung führte. Die Umstände, die zu dem Unfall führten und seine Folgen legen ein besonders komplexes Bild dar, das frühe Vernachlässigung und Trauma kombiniert. Obwohl David kognitiv intakt war und sprechen konnte, konnte er sich nicht bewegen. Doch schaffte er Bewegung aus verzweifelter Notwendigkeit in anderen, indem er mit mithilfe der Benutzung von extremen projektiven Kräften kommunizierte. Die höchst komplexe Präsentation von emotionalem, psychischem und körpelichem Schaden in dem Kind und insbesondere Davids körperliche Lähmung, hatte eine tiefe Auswirkung auf das, was ich nun den ‘mindbody’ (Gemütskörper) des Therapeuten nenne. Winnicott sprach vom Psyche/Soma des Babies. Hier möchte ich diesen Begriff ausweiten und besonders die köperliche Auswirkung der Projektionen betrachten und wie diese eine starke emotionale und physische Resonanz auf den ‘mindbody’ des Therapeutens haben, insbesondere in der Therapie mit einer jungen Person, deren Körper beschädigt ist. In diesem Artikel betrachte ich technische Herausforderungen und Dilemmas, denen man in dieser Arbeit begegnet, einschliesslich der komplexen Wechselwirkung von Übertragungs/ Gegenübertragungsphänomenen. Diese ungewöhnliche Behandlung mit einem Jungen in aussergewöhnlichen Umständen führten zu Überlegungen zur psychoanalytischen Methode undzur Deutungsaktivität, die von ‘emotionaler Wahrheit’ inspiriert wird

Riassunto: In questo articolo si parla del lavoro terapeutico con David, un bambino di 13 anni che, all'età di 5 anni, fu vittima di un incidente stradale che portò alla quadriplegia. Le circostanze che portarono all'incidente e la sua sequela rivelano un quadro particolarmente complesso, nel quale emerge un misto di deprivazione emotiva precoce e trauma. Sebbene David fosse abile cognitivamente e potesse parlare, egli non poteva muoversi. Eppure il bambino generava movimento negli altri attraverso una disperata necessità, comunicando con l'uso di estreme forze proiettive. Il presentarsi di un danno nel bambino altamente complesso nella sua dimensione emotiva, psichica e corporea, ed in particolare, la paralisi fisica di David, hanno avuto un profondo impatto su ciò che ho iniziato a pensare come il ‘corpomente’ del terapeuta. Winnicott ha parlato dello ‘psiche/soma’ del neonato. L'autrice vuole nell'articolo estendere la nozione e considerare l'impatto corporeo delle proiezioni e come queste abbiano una risonanza emotiva e fisica molto forte sul ‘corpomente’ del terapeuta, soprattutto nella terapia con un ragazzo giovane il cui corpo è stato danneggiato. Nell'articolo considero le sfide tecniche e i dilemmi incontrati nel lavoro, compreso il gioco complesso dei fenomeni transferali e controtransferali. Il trattamento insolito con questo bambino in circostanze molto particolari ha portato a considerazioni riguardo al metodo psicoanalitico e all'attività interpretativa, che si possono considerare come ispirati da ‘verità emotiva'¹     

Dissimilar effects of task‐relevant and interpersonal threat on independent–interdependent self‐construal in individuals with high self‐esteem

Previous research has indicated that individuals with high trait self‐esteem (HSEs) become more independent and less interdependent after experiencing a task‐relevant threat. However, these studies have not investigated other sources of ego threats, such as interpersonal threats. Therefore, the moderating effects of the degree of trait self‐esteem on task‐relevant and interpersonal ego threats were investigated in relation to independent, or interdependent self‐construal. It was predicted that in HSEs, the level of task‐relevant stress would be positively–negatively related to their independence–interdependence, whereas the level of interpersonal stress would be negatively–positively related to their independence–interdependence. In individuals with low trait self‐esteem (LSEs), the two types of stresses and independent–interdependent self‐construal may not have a significant relationship. We conducted a questionnaire survey with undergraduates. Correlational analysis of the results indicated that in HSEs, greater task‐relevant stress was related to heightened independence, whereas greater interpersonal stress had the opposite effect, indicating lower independence and heightened interdependence. However, these stresses were not related to the self‐construal of LSEs. These findings suggest that task‐relevant and interpersonal threat could have differential effects on independent and interdependent self‐construal for HSEs, but not in LSEs.     

Travel behavior changes and responses to advanced traveler information in prolonged and large-scale network disruptions: A case study of west LRT line construction in the city of Calgary

The objective of this study was the investigation of travel behavioral effects of the reduction in traffic capacity resulting from the construction of the West LRT (Light Rail Transit) line in the city of Calgary, Alberta, Canada. Travelers’ responses to real-time information providing traffic updates and advisory detours due to lane/road closures were also examined. The West LRT alignment extends approximately 8.2 km from downtown into the city’s southwest. Many road closures took place in the vicinity of the LRT line construction zones, inducing significant delays to traffic. Data on travelers’ behavioral responses and responses to real-time information were obtained by conducting a survey on a sample of users of the main road affected by the construction. The survey also investigated the effects of West LRT line construction on drivers’ daily commutes, including increases in travel times, mode choices, alternate route choices, and selection of sources of information on traffic conditions. A significant change in the selection of transportation mode was caused by West LRT construction. Throughout the construction period, there was a decrease in the percentage of respondents who reported private vehicles as their first choice and an increase in the percentage of respondents who preferred public transit as their first and second choices. Radio was found to be the most preferred source for traffic updates and detour advice, followed by variable message signs (VMS). The findings of the en-route information model showed that driving experience, employment status, travel time and purpose, and desire for pre-trip information had significant effects on traveler’s rerouting decisions after getting en-route information through VMS. The results from this study are of interest for understanding behavioral changes for the purposes of traffic management, mitigation schemes and design of advanced traveler information systems in response to network disruptions.     

My word! Interference from reading object names implies a role for competition during picture name retrieval

A related word prime has been found to interfere with picture naming after unrelated intervening trials (word-to-picture interference). Recently, Stroop-type picture–word interference effects have been interpreted in terms of a postlexical response exclusion process rather than a competitive lexical selection process. An experiment is reported that examines whether word-to-picture effects could reflect response exclusion mechanisms and, more generally, strategic processing of the word prime. Forty-eight volunteer university students named aloud sequences of semantically related (and unrelated) word primes and picture targets, separated by two unrelated filler stimuli. On half of the trials, participants were asked to count backwards in threes from a random number presented immediately after naming the prime word. They were also given a surprise recall test at the end of the naming block. Results for naming times and errors indicated a main effect of relatedness; semantic interference effects were not dependent on the unfilled gap following the word prime trial and were also not tied to episodic recall of prime words. The data indicate that slowed picture naming times are more likely to emerge from processes intrinsic to word prime naming rather than controlled processing and do not readily fit the postlexical response exclusion account. The results are considered in relation to two recent accounts of interference over unrelated trials, which refer to some form of competition at, or prior to, lexical access.     

Solving distant analogies reduces belief-based responding in transitive inference

ABSTRACT

Previous research demonstrated that relational processing in transitive inference problems can be disrupted by belief-based content. Given the premises, The horse is larger than the goat, and The goat is larger than the elephant, accepting the valid conclusion, The horse is larger than the elephant suggests use of relational processing whereas accepting the invalid conclusion The elephant is larger than the horse indicates belief-based responding. This research examined whether solving analogies influenced participants’ reliance on belief-based or relational processing. Participants generated solutions to either distant analogies (e.g. nose:scent::antenna: ______) or near analogies (e.g. nose:scent::tongue:______) before evaluating the conclusions of transitive inference problems that were valid (V) or invalid (I) and believable (B), unbelievable (U) or neutral (N). Solving distant analogies eliminated belief-based responding (possibly reflecting improved inhibitory control) and facilitated relational responding on VU problems.     

Environmental enrichment results in cortical and subcortical changes in levels of synaptophysin and PSD-95 proteins

Experience-dependent plasticity is thought to involve selective change in pre-existing brain circuits, involving synaptic plasticity. One model for looking at experience-dependent plasticity is environmental enrichment (EE), where animals are exposed to a complex novel environment. Previous studies using electron microscopy showed that EE resulted in synaptic plasticity in the visual cortex and hippocampus. However, the areas in the brain that have been examined following EE have been limited. The present study quantified potential synaptic plasticity throughout the brains of C57BL/6 mice using an enzyme-linked immunosorbent assay (ELISA) for two synaptic proteins, synaptophysin and PSD-95. EE resulted in increased synaptophysin and PSD-95 levels through major brain regions, including anterior and posterior areas of the forebrain, hippocampus, thalamus, and hypothalamus. However, no changes in synaptophysin were detected in the cerebellum. These results demonstrate that EE results in an increase in levels of both pre- and post-synaptic proteins in multiple regions of the brain, and it is possible that such changes represent the underlying synaptic plasticity occurring in EE.     

Timing at the Start of Associative Learning

Some theories of associative learning imply that time plays a fundamental role in the acquisition process. Consistent with these theories, this paper presents evidence that the time from the onset of a conditioned stimulus (CS) until presentation of the unconditioned stimulus (US) is learned very rapidly at the start of training. We report two autoshaping studies and a study on aversive conditioning in goldfish in which we examine timing at the start of conditioning. We also review data from a number of other conditioning preparations, including fear-potentiated startle, appetitive conditioning in rats, and eyeblink conditioning in rabbits, that report conditioned response (CR) timing early in training. Acquisition speed and the very first expressions of conditioned responding often show sensitivity to the time of US presentation. In instances where temporal control is slowly expressed, it is likely due to performance factors, not to slow learning about time. In fact, the learning about time may be a necessary condition for associative learning.     

No Time of Day Modulation or Time Stamp on Multiple Memory Tasks in Rats

Various demonstrations of “time stamp” effects in the animal learning literature have reinforced the idea that circadian information is encoded as part of a combined internal/external representation of context and that this contextual information is utilized for complex retrieval processes supporting memory. The goal of the present series of experiments is to assess this idea by manipulating training/testing circadian times on a battery of learning and memory tasks commonly used in the rodent. The data obtained from five experiments using four different learning and memory paradigms provide no evidence for “time stamp” effects on place memory, context memory (aversive or appetitive), or S-R habit learning.     

Coaching

Zusammenfassung Coaching ist in Wirtschaftsunternehmen weit verbreitet. Angesichts der stetig steigenden Ver?nderungsgeschwindigkeit der Arbeits- und pers?nlichen Lebenswelten suchten zun?chst Führungskr?fte professionelle Coaches, die ihnen als vertraute Gespr?chspartner zur Seite standen. Coachingma?nahmen werden aber auch zunehmend von Politikern, Medienvertretern, Künstlern und Freiberuflern nachgefragt. Die derzeitigen Coachingkonzepte enthalten zumeist eine Kombination von allgemein-psychologischen, kognitiv-verhaltensorientierten, psychodynamischen und systemischen Techniken, modifiziert durch die Lebenserfahrung und Weltanschauung der Coaches. Es existiert eine Vielzahl eklektischer Praktiken, die theoretisch nicht koh?rent begründet und wissenschaftlich nicht verl?sslich evaluiert sind. Da Coaching in der Praxis h?ufig eine Form von Psychohygiene und Psychotherapie für Gesunde darstellt, ist es nahe liegend die Ergebnisse psychotherapeutischer Theoriebildung, Praxiserfahrung und Forschung als Grundlage des Coaching zu nutzen. Drei wissenschaftlich fundierte Aspekte des Coaching lassen sich herausstellen: Die hilfreiche Beziehung, kognitiv-verhaltensorientiertes Training und psychodynamisches Verstehen. Darüber hinaus ist es viel versprechend die Methoden der Psychotherapieforschung zur Untersuchung von Ergebnis und Prozess von Coachingma?nahmen anzuwenden.      

试论《周易》的原初意义与现代意义

文章首先阐述了考察《周易》价值的方法,然后运用这一方法全面考察了《周易》的原初意义与现代意义。作者认为,《周易》的产生标志着中华民族抽象思维能力的关键性跃迁;《周易》的内容折射着当时的自然、社会和人文状况,记载着古代先民对于当时复杂的自然、社会和人生问题的特别关注与初步思考;《周易》的人生智慧和行为原则,反映着趋利避害和预见未来的价值取向;《周易》的思维方式汇集着当时的思维工具和认识方法,表达着最初的终极关怀和哲学意识。而《周易》所提供的始源性材料,有助于我们从根源性上来把握中华文化及其当代特点;易学史的演变与发展则为我们更好地把握历史文化发展进程提供了重要的思想资料;《周易》所表达的人生智慧和思维方式对于当今人类把握现实与面向未来也具有极为重要的启示和借鉴意义。