Finer Distinctions: Variability in Satisfied Older Couples’ Problem‐Solving Behaviors

This study utilized observational and self‐report data from 64 maritally satisfied and stable older couples to explore if there were meaningful differences in how couples approached marital disagreements. Using a typology approach to classify couples based on their behaviors in a 15‐minute problem‐solving interaction, findings revealed four types of couples: (1) problem solvers (characterized by both spouses’ higher problem‐solving skills and warmth), (2) supporters (characterized by both spouses’ notable warmth), (3) even couples (characterized by both spouses’ moderate problem‐solving skills and warmth), and (4) cool couples (characterized by both spouses’ greater negativity and lower problem‐solving skills and warmth). Despite the differences in these behaviors, all couples had relatively high marital satisfaction and functioning. However, across nearly all indices, spouses in the cool couple cluster reported poorer marital functioning, particularly when compared to the problem solvers and supporters. These findings suggest that even modest doses of negativity (e.g., eye roll) may be problematic for some satisfied couples later in life. The implications of these typologies are discussed as they pertain to practitioners’ efforts to tailor their approaches to a wider swath of the population.     

Unreliable Bodies: A Follow‐up Twenty Years Later by a Mother and Daughter about the Impact of Illness and Disability on their Lives

We are a mother and daughter, both health care professionals, who offer a follow‐up to an article we published twenty years ago about the impact of each other's ongoing, serious medical problems on our relationship. In this article, we contribute a long‐term perspective on the differences between having an illness that is well or poorly understood by medical professionals and the lay community. We also discuss health in the context of identity formation and life stage, as during this interval the daughter left home, graduated college, married, and had two children. Also in this period, the mother survived a third breast cancer and other life‐threatening illnesses. We discuss the impact of these experiences on each other and in other important relationships in our lives. Current discourses on daughters of breast cancer survivors do not fit our experience and we speculate about why our story differs. We find that although we continue to contend with serious medical issues that impact our own, each other's, and our families' lives, nonetheless, our lives are rich, rewarding, and “appropriate” for our life stage. That is the news.     

Deployment‐Related Benefit Finding and Postdeployment Marital Satisfaction in Military Couples

Extensive research has evaluated potential negative effects of military deployments on romantic relationships. Comparatively few studies have examined potential positive effects of such deployments. In stressful situations, benefit finding (BF) has been found to be linked with better functioning on both individual and interpersonal levels. This study reports on deployment‐related BF in a sample of 67 male service members (SMs) who deployed at least once since 9/11/2001 and their wives. Couples completed measures of marital satisfaction at baseline (an average of 1 year postdeployment) and follow‐up 4–6 months later. At follow‐up, SMs also provided data on symptoms of posttraumatic stress, and both partners provided reports of deployment‐related BF. Multivariate path analysis controlling for SMs' PTSD symptom severity revealed that wives' BF was positively associated with increases in SMs' relationship satisfaction. These findings suggest that wives' responses to deployment may be more influential than SMs' responses to deployment on military couples' relationships. This pattern indicates that support for spouses during deployments is essential; furthermore, such support should include an emphasis on trying to facilitate personal growth in spouses.     

Caregiver Expressed Emotion and Psychiatric Symptoms in African‐Americans with Schizophrenia: An Attempt to Understand the Paradoxical Relationship

Expressed emotion (EE) is a family environmental construct that assesses how much criticism, hostility, and/or emotional over‐involvement a family member expresses about a patient (Hooley, Annual Review of Clinical Psychology, 2007, 3, 329). Having high levels of EE within the family environment has generally been associated with poorer patient outcomes for schizophrenia and a range of other disorders. Paradoxically, for African‐American patients, high‐EE may be associated with a better symptom course (Rosenfarb, Bellack, & Aziz, Journal of Abnormal Psychology, 2006, 115, 112). However, this finding is in need of additional support and, if confirmed, clarification. In line with previous research, using a sample of 30 patients with schizophrenia and their primary caregivers, we hypothesized that having a caregiver classified as low‐EE would be associated with greater patient symptom severity. We also aimed to better understand why this pattern may exist by examining the content of interviews taken from the Five‐Minute Speech Sample. Results supported study hypotheses. In line with Rosenfarb et al. (2006), having a low‐EE caregiver was associated with greater symptom severity in African‐American patients. A content analysis uncovered some interesting patterns that may help elucidate this finding. Results of this study suggest that attempts to lower high‐EE in African Americans may, in fact, be counterproductive.     

The Impact of Couple Therapy on Service Utilization among Military Veterans: The Moderating Roles of Pretreatment Service Utilization and Premature Termination

Couple therapy reduces relational and individual distress and may affect utilization of other health services, particularly among higher service utilizers. Although average decreases in service utilization are predicted among recipients of couple therapy, low utilizers of services may appropriately increase use. The relationship between couple therapy and service utilization was examined among a sample of 179 U.S. military veterans who received treatment in Veterans Affairs (VA) specialty couple therapy clinics. Consistent with hypotheses, overall mental and physical health visits decreased from the 12 months preceding couple therapy to the 12 months following treatment. Moderator analyses showed that decreases were greatest among individuals who were rated by their therapist as having completed a full course of couple therapy, suggesting that change was attributable to intervention. Pretreatment service utilization also moderated observed change—higher utilizers’ use of services decreased substantially, whereas lower utilizers’ slightly increased. Cost analyses revealed that the estimated per person mean cost in our sample decreased by $930.33 in the year following compared to the year prior to couple therapy, as per 2008 VA cost data. As service utilization data were only available for one partner and only for 1 year posttherapy, the true magnitude of this effect may be underestimated. Our findings are relevant to policy makers as they demonstrate that couple therapy reduces average service utilization and associated costs and addresses calls for analyses of cost effectiveness of systemic interventions.     

Acculturation Conflict,Cultural Parenting Self‐Efficacy,and Perceived Parenting Competence in Asian American and Latino/a Families

Parents from immigrant backgrounds must deal with normative parenting demands as well as unique challenges associated with acculturation processes. The current study examines the independent and interactive influences of acculturation conflict and cultural parenting self‐efficacy (PSE; e.g., parents’ confidence in instilling heritage, American, and bicultural values in their children) on perceptions of general parenting competence. Using data from 58 Asian American and 153 Latin American parents of children in grades 6–12, ethnic differences were also explored. Results suggest that lower acculturation conflict is associated with higher perceptions of general parenting competence for both Asian and Latin American parents. Higher cultural PSE is associated with higher perceived general parenting competence for Latino/a parents only. One significant interaction was found, and only for Asian Americans, whereby the negative association between acculturation conflict and perceptions of parenting competence was weaker for those who felt efficacious in transmitting heritage messages. Results are discussed in light of clinical implications and the need for further recognition and study of culturally relevant factors and frameworks among families from immigrant backgrounds.     

Self‐disclosure,trauma and the pressures on the analyst

This paper argues that self‐disclosure is intimately related to traumatic experience and the pressures on the analyst not to re‐traumatize the patient or repeat traumatic dynamics. The paper gives a number of examples of such pressures and outlines the difficulties the analyst may experience in adopting an analytic attitude – attempting to stay as closely as possible with what the patient brings. It suggests that self‐disclosure may be used to try to disconfirm the patient's negative sense of themselves or the analyst, or to try to induce a positive sense of self or of the analyst which, whilst well‐meaning, may be missing the point and may be prolonging the patient's distress. Examples are given of staying with the co‐construction of the traumatic early relational dynamics and thus working through the traumatic complex; this attitude is compared and contrasted with some relational psychoanalytic attitudes.     

The words we work with that work on us: clinical paradigm and cumulative relational trauma

This paper addresses a gap between analytic clinical theory and practice which emerges when examining the words we work with via textual and narrative research of case histories. Both subject matter and methodology fit with the remit of conceptual research in psychoanalysis, currently ranging from inductive to nomothetical approaches. Research of clinical language reveals an implicit account of human nature and the world which undergirds clinical practice. Based in the critical philosophy of the previous century, this is termed clinical paradigm. Such implicit views are induced rather than explicitly taught during analytic training, and need to be spelled out in order to become available to discourse and difference of opinion. Textual research shows these implicit pre‐clinical attitudes to be inherently pessimistic and thus too similar to the views of self and others found in cumulative relational trauma. Moreover, clinical accounts tend to normalize subtly antagonistic forms of relating, recently recognised as micro‐trauma. Importantly, this contravenes the agapic orientation of our theories and ethics. Paradigmatic reflection as a form of professional individuation addresses this gap. This includes a more optimistic outlook which can be traced through the philosophical implications of quantum theory.     

Advances in functional brain imaging technology and developmental neuro‐psychology: their applications in the Jungian analytic domain

Analytical psychology shares with many other psychotherapies the important task of repairing the consequences of developmental trauma. The majority of analytic patients come from compromised early developmental backgrounds: they may have experienced neglect, abuse, or failures of empathic resonance from their carers. Functional brain imagery techniques including Quantitative Electroencephalogram (QEEG), and functional Magnetic Resonance Imagery (fMRI), allow us to track mental processes in ways beyond verbal reportage and introspection. This independent perspective is useful for developing new psychodynamic hypotheses, testing current ones, providing diagnostic markers, and monitoring treatment progress. Jung, with the Word Association Test, grasped these principles 100 years ago. Brain imaging techniques have contributed to powerful recent advances in our understanding of neurodevelopmental processes in the first three years of life. If adequate nurturance is compromised, a range of difficulties may emerge. This has important implications for how we understand and treat our psychotherapy clients. The paper provides an overview of functional brain imaging and advances in developmental neuropsychology, and looks at applications of some of these findings (including neurofeedback) in the Jungian psychotherapy domain.     

The possessions at Loudun: tracking the discourse of dissociation

Embedded in the history of dissociation is the best known case of possession in European history, the 17^th century possessions at Loudun, France (1632‐1638). The exorcisms and the trial drew crowds from all over Europe, the outcome prefiguring the direction in which the Western science of mind would be carried. The published debate about the possessed and obsessed Ursuline nuns of Loudun spans four centuries. One can track how theorizing about dissociation changed over time, with psychological contributions by Jean Martin Charcot, Georges Gilles de la Tourette, Pierre Janet, Michel Foucault and Michel de Certeau. Freud's psychoanalytic notion of demonological neurosis emphasized defensive strategies and a diabolic parody of adulthood. Jung's concepts of demonism and possession highlighted dissociated complexes that assimilate the ego and unseat the self, rendering a life ‘provisional’. Dissociation as possession provides a through‐line in Jung's Collected Works, from his 1902 dissertation to one of the last essays he wrote, in 1961. Within the context of psychotherapy, therapists and patients work towards psychological containment, consciously reorienting themselves to the presence of unconscious factors, personifying, embodying and thereby incorporating images of dissociated Otherness into the experience of selfhood.