“THE PROMISE” in patients and in Ibsen's “A Doll's House”

Some people are possessed by a need for, and an inordinate intensity of narcissistic promise. The prospect of entitlement can be conscious or unconscious. Being made happy (and being rescued from difficulties) is expected to be guaranteed and brought about by a current psychic representation (imago) of a parental figure from early childhood. This kind of symbiotic tie is illustrated by clinical material from a patient, and by two heroines of Ibsen's plays: Nora, from The Doll's House, and Hedda Gabler, from the play of the same name. The three women have different reactions to the non-fulfillment of what the patient called “THE PROMISE.”     

Resonance and Ambiguity—about Metaphorical Thinking

This presentation is based on the theory, presented by the author, of the development of the mind and its psychoanalytic treatment as a stage-specific continuum, applicable in principle to all levels of disturbed and arrested mental development. This paper focuses on the nature of attainment and mediation of understanding with psychotic, borderline and neurotic patients, and the significance of successful conveyance of understanding as related to the general goal of psychoanalysis, to achievement of a structural change in the analysand's representational world and, finally, to the question of the main curative factor in psychoanalytic treatment. After discussing all these questions, the author ends up giving the conveyance of stage-specific and individual understanding a central place in all of them. The goals of understanding and psychoanalysis in general seem to be more-or-less identical. Starting and continuing new structuring internalizations in the patient's world of experience is primarily motivated by conveyance of the analyst's stage-specific and individual understanding, and thereby leading to alleviation or elimination of consequences of the developmental arrest. It seems thus warranted to conclude that conveyance of the stage-specific and individual understanding seems to be the central curative element in the psychoanalytic interaction.     

Is God's call more than audible? A preliminary exploration using a two‐dimensional model of theistic/spiritual beliefs and experiences

Among spiritual individuals, auditory hallucinations (AHs) are often accompanied by positive affectivity (PA) suggesting that such coincidental affective valence might gainfully demark spiritual from comparable non‐spiritual aberrant perceptions. Yet nearly all of the relevant past religiosity/spirituality research has been limited to AHs and/or known groups (Evangelicals, epilepsy patients, etc.). Using a community sample (N = 485), this article explores whether unusual perceptual experiences (UEs) more generally (not simply AHs) together with PA predict participants' self‐reported spirituality. Specifically, a dual marker hypothesis developed from affect attribution theory—in which UE, PA, and their interaction predict spirituality in a non‐additive positive fashion—is proposed and confirmed (even after controlling for socio‐demographics). The estimators reveal that spirituality is disproportionately elevated for high scorers on both predictors. These results are consistent with previous known‐group studies and support recent speculation that the affective–cognitive interpretation of perceptual aberrations might be a key feature of spirituality and one that potentially demarks it from psychosis. Moreover, the correlation between spirituality and PA varies depending upon one's UE level; a result not anticipated by the incumbent positive psychological theory of spirituality.     

Reducing the Linear Perception of Nonlinearity: Use of a Physical Representation

Research shows that while judging accumulations of quantities over time (e.g., money in a bank account or CO₂ in Earth's atmosphere), people assume that the shape of the accumulation is similar to the shape of the inflow (i.e., people rely on a correlation heuristic). Relying on the correlation heuristic is particularly worrisome for Earth's climate, as judging the CO₂ accumulation according to its emissions (inflow) would underestimate the actual (nonlinear) increase. This misperception undermines the seriousness of climate problem and results in wait‐and‐see behavior. We report two experiments where the effectiveness of a physical representation is compared with graphical and text representations in reducing people's underestimation of nonlinear accumulation in different contexts and problems. A physical representation presents an accumulation using a picture that works as a metaphor. In the first experiment, participants drew the shape of an accumulation over time relying on physical or graphical representations in one of two contexts: carbon dioxide and marbles. Although the participants underestimated the accumulation in both contexts, underestimations were reduced in the physical representation compared with the graphical representation. In the second experiment, we extended the evaluation of physical representations against both text and graphical representations in two different climate problems (with linearly increasing or decreasing inflow). Again, underestimations of the accumulation were reduced in the physical representation compared with the other two representations, regardless of the nature of the problem. We discuss implications of using the physical representation for improving people's estimates of nonlinear CO₂ accumulation. Copyright © 2011 John Wiley & Sons, Ltd.     

Identifying the ‘if’ for ‘if-then’ plans: Combining implementation intentions with cue-monitoring targeting unhealthy snacking behaviour

Implementation intentions aimed at changing unwanted habits require the identification of personally relevant cues triggering the habitual response in order to be effective. To facilitate successful implementation intention formation, in the present study, planning was combined with cue-monitoring, a novel way to gain insight into triggers for unhealthy snacking. It was tested whether keeping a cue-monitoring diary and tailoring implementation intentions accordingly improves plan effectiveness. A 2 Monitoring (cue-monitoring, control)?×?2 Planning (implementation intention, goal intention) between subjects design was adopted. Participants (N = 161) monitored their unhealthy snacking behaviour for a week using either a cue-monitoring or a control diary. Participants then formulated a goal intention or an implementation intention tailored to their personal cue. Snacking frequency and caloric intake from unhealthy snacks were examined using a seven-day snack diary. The results did not indicate an interaction but yielded a main effect of Monitoring. Cue-monitoring either or not combined with implementation intentions reduced unhealthy snacking behaviour compared with control. Findings emphasise the effectiveness of cue-monitoring, suggesting that on the short term, cue-monitoring suffices to decrease unhealthy snacking, without additional benefit from planning. Future research should examine whether supplementing cue-monitoring with implementation intentions is required to establish long-term behaviour change maintenance.     

Prevalence and correlates of sexual morbidity in long-term breast cancer survivors

Objective: Breast cancer survivors report adverse sexual effects (sexual morbidity) such as disrupted sexual function, sexual distress and body dissatisfaction. However, most studies have failed to evaluate the persistence of these effects in long-term survivors. The present study comprehensively assessed the prevalence and predictors of sexual/body image problems among survivors three or more years post diagnosis.

Design/outcome measures: Eighty-three breast cancer survivors completed surveys a median of seven years post diagnosis. Survey items probed demographic, diagnostic and clinical information, in addition to sexual activity, sexual function (Female Sexual Function Index [FSFI]), body image, and distress regarding body changes and sexual problems (Female Sexual Distress Scale-revised; FSDS-R).

Results: Seventy-seven percent of all participants and 60% of sexually active participants qualified for sexual dysfunction based on the FSFI. Between 37 and 51% met criteria for female sexual dysfunction, based on two FSDS-R clinical cut-offs. Body satisfaction was worse than normative values, while body change stress was mid-range. Notable sexual morbidity predictors included mastectomy, which was associated with worse sexual/body change distress, and post-treatment weight gain, which predicted greater body dissatisfaction/body change stress.

Conclusions: Breast cancer survivors report substantial sexual morbidity years after treatment, especially after mastectomy or post-treatment weight gain. Breast cancer patients and their providers should be aware of these potential sexual effects.     

Comparing implementation intention interventions in relation to young adults’ intake of fruit and vegetables

This study tests whether the effectiveness of implementation intention-based interventions to increase fruit and vegetable intake in a young adult population can be enhanced using additional pre-intervention instructions and alternative formats; namely, an ‘if-then’ implementation intention versus a more general, ‘global’ plan that does not explicitly link a situational cue with a goal-directed response. Participants (N?=?557) completed pre-test measures of planning, motivation and behaviour with respect to increasing their fruit and vegetable intake before being randomised to a 3 (intervention format: control vs. ‘if-then’ vs. ‘global’ implementation intentions)?×?2 (pre-intervention instruction vs. no pre-intervention instruction) between-participants design. Results revealed a significant intervention format by time interaction, such that intake significantly increased by 0.50 portions in the if-then format condition compared with 0.31 in the global format and 0.01 in the control condition. These results suggest that ‘if-then’ manipulations are superior in promoting behaviour change in an applied setting. The use of pre-intervention instructions had no additional effect on behaviour, providing evidence for the efficacy of implementation intentions even when experimenter demand is reduced. Evidence is also presented to suggest that reported increases in intake are not related to demand characteristics.