Three Phases of Treatment with Borderline and Psychotic Patients

Three distinct, yet overlapping, phases of treatment emerge when working with some borderline and psychotic patients. This are patients who test the ordinary limits of psychoanalysis, but can profit from its deep exploration. The first phase is colored by acting out, interpersonally and intrapsychically. An analytic envelope of containment is necessary to sustain the treatment. Interpretive holding and containing help the patient find a psychic receptacle capable of detoxifying violent projections. Many of these patients terminate prematurely. The second phase is centered around the patient's defensive use of the death instinct to extinguish or destroy certain parts of their mental functioning. This difficult standoff between parts of the patient's mind becomes replicated in the transference. The third phase reveals the more fundamental problem of paranoid～schizoid anxieties of loss and primitive experiences of guilt. These include fears of persecution and annihilation. Some patients abort treatment in the first or second phase and never work through the phantasies and feelings of loss. Nevertheless, much intrapsychic and interpersonal progress is possible. Given the instability and chaotic nature of these patient's object relations, the analyst must be cautiously optimistic in their work and realize the potential to help the patient even when presented with less than optimal working conditions.     

'To walk the last bit on my own' - narcissistic independence or identification with good objects: issues of loss for a 13-year-old who had an amputation

This paper describes two years of psychotherapy with Michael, a 13-year-old boy who had undergone a recent emergency amputation of his leg and hip for bone cancer. The work follows Michael's struggle with the enormity of the loss, in the face of his, as well as the system's, use of denial. The amputation as an 'attack' on his physical and emotional autonomy strikes at his early adolescent development. The therapeutic process is aided by his capacity 'to go back to the unhappiness'. The therapy develops from his initial shock, to despair and self-blame, as he struggles with a tendency - in the middle period of the therapy - to lose his mind as well as his leg in a retreat to withdrawal and mindlessness, or to mania. He struggles between an omnipotent, at times self-destructive, wish to 'go it alone', versus a capacity to feel sad and to value life. His capacity to think about the trauma and to find meaning emerges. The paper raises questions about whether some trauma can ever be fully assimilated, and whether, for Michael, the mourning process could lead to a reintegrated sense of self and of a 'psychic intactness', dependent on the survival of his good 'internal couple'. Hospital and ward-based child psychotherapy and its limitations are explored.     

Changes in Negative Reciprocity as a Function of Age

Standard economic models assume people exclusively pursue material self‐interests in social interactions. However, people exhibit social preferences; that is, they base their choices partly on the outcomes others obtained in a social interaction. People care about fairness, and reciprocity affects behavior. This study examines the differences in negative reciprocity (costly punishment for unfair divisions) as a function of age. Sixty‐one kindergarteners (5‐year‐olds), 53 second graders (8‐year‐olds), and 57 sixth graders (12‐year‐olds) played a dictator game or a mini–ultimatum game either with a human proposer or with a random machine that determined the division between the two players. By keeping the divisions between the players constant and varying the source of the unfair proposal, we were able to differentiate between reciprocity‐based and inequality‐aversion preferences. We found that kindergarteners proposed and accepted unfair divisions regardless of the source of the offer, behaving according to the standard economic model. Children in the sixth grade tended to reject unfair offers from a human proposer but accept unfair divisions from a random device, indicating the emergence of negative reciprocity preferences by age eight (and contrary to inequality aversion). Children at this age also tended to give more fair offers in the ultimatum game than in the dictator game, indicating the emergence of strategic thinking. Copyright © 2012 John Wiley & Sons, Ltd.     

A naturalistic study of the impact of message framing on highway speeding

Speeding is the most common road violation, and is one of the main causes of crashes. To protect road users, authorities use sanctions and preventive measures to prompt drivers to observe speed limits. However, the efficacy of prevention messages varies according to a number of factors, among which risk framing is important. We ran a study to test whether gain is more effective than loss (framing effect). Four anti-speeding messages were presented on variable-message signs, along one side of a busy 8-lane highway in France (speed limit: 130 km/h – 80 mph), during 6 weekends. Within a between subject design, the messages differed in orientation (gain vs. loss vs. no message) and theme (crash vs. fuel consumption). The drivers’ speed was recorded on the highway 2 km (1.25 miles) after the sign (6486 recordings of speed). The results showed that speed was lower when a message was displayed than in the control condition, and when the message was gain-framed rather than loss-framed. These effects were stronger on the left lanes (overtaking lanes). Hence, gain framed messages are recommended for prevention campaigns at least when no risk factor is salient.     

The FOCUS Family Resilience Program: An Innovative Family Intervention for Trauma and Loss

This article describes the core principles and components of the FOCUS Program, a brief intervention for families contending with single or multiple trauma or loss events. It has been administered nationally to thousands of military family members since 2008 and has been implemented in a wide range of civilian community, medical, clinical, and school settings. Developed by a team from the UCLA and Harvard Medical Schools, the FOCUS Program provides a structured approach for joining with traditional and nontraditional families, crafting shared goals, and then working with parents, children, and the entire family to build communication, make meaning out of traumatic experiences, and practice specific skills that support family resilience. Through a narrative sharing process, each family member tells his or her story and constructs a timeline that graphically captures the experience and provides a platform for family discussions on points of convergence and divergence. This narrative sharing process is first done with the parents and then the children and then the family as a whole. The aim is to build perspective‐taking skills and mutual understanding, to reduce distortions and misattributions, and to bridge estrangement between family members. Previous studies have confirmed that families participating in this brief program report reductions in distress and symptomatic behaviors for both parents and children and increases in child pro‐social behaviors and family resilient processes.     

The role of the insular cortex in taste function

In spite of over 30 years of research, the role of the Insular Cortex (IC) in taste memory still remains elusive. To study the role of the IC in taste memory, we used conditioned taste aversion (CTA) for two different concentrations of saccharin; 0.1% which is highly preferred, and 0.5% which is non-preferred. Rats that had been IC lesioned bilaterally with ibotenic acid (15 mg/ml) before CTA showed significant learning impairments for saccharin 0.1% but not for saccharin 0.5%. To test CTA memory retention, rats lesioned a week after CTA training became completely amnesic for saccharin 0.1% yet only mildly impaired for saccharin 0.5%. Interestingly, the resulting preference for either concentration matched that of IC lesioned animals when exposed to either saccharin solution for the first time, but not those of sham animals, implying that IC lesions after CTA for either saccharin solution rendered complete amnesia, irrespective of the original preference. Our data indicate that an intact IC is essential for CTA learning and retention, as well as for an early neophobic response, but not for taste preference itself. Our data supports a model where the IC is involved in general taste rejection.     

The ability to process emotional information predicts loss aversion

On the basis of previous research it was hypothesized that alexithymia is associated with a higher tolerance for losses. This hypothesis is extended to explore whether the putative link between loss aversion and alexithymia remains once traits associated with risk taking (sensation seeking) and broad based personality traits (the Big 5) are controlled. Participants (N = 260) completed indices of alexithymia, sensation seeking and the Big 5 and both a riskless (endowment effect) and risky (lottery task) measure of loss aversion. It was found that the higher the alexithymia score the lower the loss aversion for both riskless and risky decisions even when sex, sensation seeking and the Big 5 are taken into account. The implications for this finding are discussed in the light of a neurological explanation of the relationship between alexithymia and loss aversion.     

赢者诅咒：心理机制、影响因素及应对策略

赢者诅咒是指在拍卖情境中, 竞价者为了获得拍卖品会过高估计其价值, 竞价成功以后当他发现其价值和自己之前的期望不一致时所产生的一种“诅咒”心理。赢者诅咒现象普遍存在于企业的资产拍卖、兼并重组、博彩游戏、投资决策等领域。损失规避和过度自信理论是赢者诅咒的主要心理机制, 而其影响因素主要有竞拍商品价值的不确定性、竞价人数、信息因素和竞价经验等。赢者诅咒的应对策略主要包括联合竞标、信息共享和学习。未来对赢者诅咒的研究需要进一步探讨赢者诅咒的心理机制、研究范式及本土化等问题。