The Psychology of the persecutor — With reference to Costa Gavras's film Music Box

This paper is based on the author's interpretation of the film Music Box by Costa Gavras. The external and internal preconditions in the development of a persecutor are discussed in an attempt to understand the process from a socio-psychological as well as psychoanalytic viewpoint. During crises of a social nature, earlier coping strategies lose their validity, resulting in a narcissistic blow to the individual's ego. Earlier repressed primitive aspects of the personality are reactivated. When the individual is exposed to a totalitarian ideology which promises salvation from anxiety, paranoid processes become anchored and may dominate.

The protagonist in the film is approached as a case-study. By reviewing his present and past actions, the process by which the young man became a persecutor is exemplified as well as the long-term effects upon his object relations.     

The embodied analyst: from Freud and Reich to relationality

This paper presents the impact of clinical supervision on once-weekly psychoanalytically-informed training psychotherapy. The development of Oedipus complex theory is presented, culminating in Britton's work on the triangular space that opens up by working through the complex. The geometry of psychic space is described to highlight the importance of supervision, especially when training in therapy. The theme of spiders and cobwebs emerging from the clinical material provides a powerful metaphor for the tensions in psychic space. In the course of this training, the trainee therapist was at times less able to benefit fully from supervision, and thus the third position partially collapsed. Vignettes from anonymised clinical work are presented in the three ‘phases’ of this therapeutic process, illustrating the impact of the presence – and relative absence – of supervision.     

Conceptualizations of Social Class in Afrtican American Women:

This article addresses the multiple definitions of social class in African American people and how the therapist's understanding of these definitions is important in therapeutic interventions with African American women. The article discusses: (a) the traditional ways in which social class has been defined in social science and the limits of these conceptualizations; (b) the multiple definitions of class within the African American community; and (c) treatment concerns for African American women based on class issues. Clinicians working with African American and other women who vary by class should be able to assess how class variables influence their therapeutic interventions with these women.     

Psychometric evaluation of the eating disorder inventory (edi) in a clinical group

Abstract

This study examined the psychometric properties of the Eating Disorder Inventory (EDI) with a clinical sample of 79 female clients seen at an outpatient eating disorder program. The means and standard deviations for the bulimia nervosa subgroup in this study (n = 48) compared favorably with the bulimia group in the EDI Manual Supplement (1986) on all eight subscales, except Drive for Thinness. The present non-student sample had significantly lower scores on this particular subscale than did the norm group (mostly students). Another difference was that the local bulimic subgroup had significantly higher present and minimum weights (as a percentage of the expected average weight according to height). The EDI subscales also displayed respectable internal consistency reliability with this sample. In contrast to previous research, however, only five factors were found in a factor analysis rather than eight corresponding to the original subscales for the EDI. Differences between bulimic and a not-otherwise-specified (NOS) diagnostic groups were also found on both the EDI Ineffectiveness and Bulimia subscales (NOS had lower scores). The results of this study are discussed in terms of the importance of undertaking local standardization of tests in clinical settings.     

Using Stories in Dynamically Oriented Clinical Social Work

Abstract

This paper uses concepts from discourse analysis to understand the meaning making functions of narrative in clinical treatment and to describe the interactive processes through which these functions are achieved. “Negotiative” and “heuristic” narrative processes are described as they occur in ordinary conversation. The relevance of these concepts to clinical practice is then explored using case material.     

Failure to Mentalize: Defect or Defense?

ABSTRACT

The author reviews current thinking on the phenomena of failure to mentalize and provides an alternative to the structural defect point of view. Also included are some clinical implications of this alternative viewpoint.     

The Effect of Demographic Variables on Client Attachment Patterns to Clinical Social Workers

Abstract

Client attachment to therapist is a new topic in the field of clinical social work. Using attachment theory, this study examined the relationship between three types of client attachment to therapist (secure, avoidant-fearful, and preoccupied) and the following variables: marital status, age of participant, and gender of the social worker, among a sample of 174 mental health clients. The results showed that there is a significant relationship between a secure pattern and gender of the social worker. In addition, they showed a significant relationship between avoidant-fearful and preoccupied patterns and the marital status of the participants. Furthermore, the results indicated a significant relationship between a preoccupied pattern and the age of the participants. The findings of the current study have implications for the field of clinical social work in Kuwait.     

Thirty Years Later: An Oncologist Reflects on Kubler-Ross's Work

As compared with conventional vaccine production systems, plant-made vaccines (PMVs) are said to enjoy a range of advantages including cost of production and ease of storage for distribution in developing countries. In this article, we introduce the science of PMV production, and address ethical issues associated with development and clinical testing of PMVs within three interrelated domains: PMVs as transgenic plants; PMVs as clinical research materials; and PMVs as agents of global health. We present three conclusions: first, while many of the ethical issues raised by PMVs are familiar, PMVs add a new dimension to old issues, and raise some novel issues for ethicists and policy-makers; secondly, it is premature to promise broad applicability of PMVs across the developing world without having demonstrated their feasibility; thirdly, in particular, proponents of PMVs as a solution to global health problems must, as a condition of the ethical conduct of their research, define the commercial feasibility of PMVs for distribution in the developing world.