Betrayal And Paranoia: The Psychotherapist's Function as an Intermediary

We present an approach to the problem of structuring a therapeutic alliance with patients presenting paranoid symptoms, using both psychoanalytical and cognitive techniques. Initially, we focused on one of the main aspects of the paranoid worldview: the fear of being betrayed and the tendency to betray. This is a defense maneuver, through which patients deny their passivity, and the impotence in the relationship with their own internal needs and with the significant people in the external world, including the therapist. In our experience to build up a working relationship, both a psychoanalytical interpretation of unconscious conflicts and the cognitive analysis of dysfunctional beliefs are needed. Often, in more serious cases, the role of nonqualified object must be accepted at the beginning, due to the patient's need to be in control of the situation. Only then can a therapeutic phase begin, in most cases, through an integrated approach that includes pharmacological, psychodynamic, and cognitive modalities.     

Client Advocacy and Collaboration with Insurance and Laboratory Testing Agencies: A Case Study Illustrating Genetic Counselor Roles

Genetic counseling and the many roles a genetic counselor must assume to provide quality genetic health care are becoming increasingly complex, especially when the genetic condition is rare, and DNA testing is costly and not yet routinely used. A case study of a couple with a family history of retinoblastoma and their pursuit of DNA testing for prenatal diagnosis is presented. The case study illustrates the instrumental role of the genetic counselor in advocating for clients for genetic services such as DNA testing and in educating insurance companies in the nature and importance of such services to achieve improved client health care outcomes.     

Full statistical mediation of the relationship between trauma and depressive symptoms

Owing to the potentially devastating effects of trauma‐induced depression, explaining the relationship between trauma and depressive symptoms is important. In this study, we measured lifelong exposure to potentially traumatic events and depressive symptoms in 370‐female undergraduates. We also measured anxiety, past negative time perspective and dissociation as potential mediators. Trauma exposure and depressive symptoms were related with a small but significant effect size (r = .16). Trauma was not associated with dissociation. We found that past negative time perspective and anxiety were full statistical mediators of this trauma‐depressive symptoms relationship. These two mediators combined accounted for all of the variance in that association. Anxiety accounted for more of the variance than past negative time perspective. A proposed explanation is that trauma both affectively elevates anxiety and cognitively creates an enduring focus on the events. Chronic anxiety and a past negative time perspective may lead to depression over time. The clinical implications are possible explanations as to why some treatments work.     

Maladaptive repetition and career construction

The role of repeated maladaptive relationship patterns established early in life has been widely studied with the goal of understanding the various factors and processes that contribute to and occur during development and psychological adaptation. The effects of maladaptive patterns have also been studied with regard to the goal of guiding interventions. The present article is intended to highlight the contribution of Career Construction Theory (CCT) for the integration of the concept of maladaptive repetition into the theory and practice of career counseling. It begins with a constructivist conceptualization of maladaptive repetition and proceeds to situate this concept within the contexts of both CCT and the constructivist conception of career indecision. The article then presents a case study, discusses difficulties that arise during career decision-making, and analyzes the maladaptive cycle rupture considering the client's perspective about her transformation.     

Age differences in understanding precedent-setting decisions and authorities' responses to violations of deontic rules

Oral narrative skills are assumed to develop through parent-child interactive routines. One such routine is shared reading. A causal link between shared reading and narrative knowledge, however, has not been clearly established. The current research tested whether an 8-week shared reading intervention enhanced the fictional narrative skills of children entering formal education. Dialogic reading, a shared reading activity that involves elaborative questioning techniques, was used to engage children in oral interaction during reading and to emphasize elements of story knowledge. Participants were 40 English-speaking 5- and 6-year-olds who were assigned to either the dialogic reading group or an alternative treatment group. Analysis of covariance results found that the dialogic reading children’s posttest narratives were significantly better on structure and context measures than those for the alternative treatment children, but results differed for produced or retold narratives. The dialogic reading children also showed expressive vocabulary gains. Overall, this study concretely determined that aspects of fictional narrative construction knowledge can be learned from interactive book reading.     

ANALYTIC MIND USE AND INTERPSYCHIC COMMUNICATION: DRIVING FORCE IN ANALYTIC TECHNIQUE,PATHWAY TO UNCONSCIOUS MENTAL LIFE

Developed from established psychoanalytic knowledge among different psychoanalytic cultures concerning unconscious interpsychic communication, analysts' use of their receptive mental experience—their analytic mind use, including the somatic, unconscious, and less accessible derivatives—represents a significant investigative road to patients' unconscious mental life, particularly with poorly symbolized mental states. The author expands upon this tradition, exploring what happens when patients unconsciously experience and identify with the analyst's psychic functioning. The technical implications of the analyst's “instrument” are described, including the analyst's ego regression, creation of inner space, taking mind as object, bearing uncertainty and intense affect, and self‐analysis. Brief case vignettes illustrate the structure and obstacles to this work.     

肿瘤心理学的学科建构钩玄——兼论肿瘤患者心理支持要点

心理问题对肿瘤的发生、治疗和预后产生重要影响,相关研究已经提示了大量证据,受到人们广泛的重视。本文笔者阐述了肿瘤心理学学科构建的必要性及意义;提出了肿瘤患者发病前心理因素的作用方式(慢性应激和触发作用)、发病后的最主要心理特征(安全感缺失)、心理支持的核心目标(帮助患者重获安全感);强调此时给予心理支持类似于是亟需修补的"短板";并引入了笔者实践和理论总结基础上形成的肿瘤患者心理支持的操作方法。