‘And when you were a child?’: how therapists working with parents alongside individual child psychotherapy bring the past into their work

When a child is offered psychotherapy, it is common that regular meetings will be offered to the parents. However, there are debates in the literature about the degree to which such parent work should include a focus on the parents’ own childhood experiences. This study aimed to examine the way that those offering parent work as part of a study evaluating the treatment of adolescent depression dealt with this issue in their work with parents, both in the study and in routine clinical practice. Design: five therapists were interviewed on the subject of working with parents’ childhood experiences within parent work parallel to child psychotherapy. Data were analysed qualitatively, using Interpretative Phenomenological Analysis. Findings: participants described the need to consider the different parameters of this work to individual adult therapy; in addition, participants felt that it was necessary to negotiate permission to work on the parents’ childhood experiences. They also spoke of making use of insight into the repetition of the parents’ history, the analysis of parental projections and offering containment within the relationship; this varies from the ‘transference work’ of individual therapy and a different style of interpretation was described. Conclusions: there is a need to give more attention to the neglected field of working with parents alongside individual child psychotherapy, especially at a time when such work is under threat within many public services. There are particular technical issues related to work with parents’ own childhood histories that are different to how one might work in individual therapy with a parent.     

Neglecting neglect: some thoughts about children who have lacked good input,and are ‘undrawn’ and ‘unenjoyed’

This paper looks at emotional neglect in the early years of life, and postulates some probable long-term sequelae of such neglect. It argues that there is a continuum of neglect; ranging from the severest form, as seen in institutional orphanages, to milder variations. A range of theoretical and research traditions, including developmental psychology, attachment theory and neuroscience are used, alongside psychoanalytic ideas, to attempt to delineate some of the key features and patterns that arise. A question is raised as to whether we have sufficient diagnostic categories or theoretical ideas to make sense of neglected children. Thought is given to the very specific clinical challenges of working with children who are neglected, and how the clinical task might differ from working with children who have suffered other forms of early damage, such as physical abuse. It is argued that these children suffer a multiple, overdetermined form of neglect; their initial neglect because of the form of caretaking they did (or did not) receive being compounded by their inability to use help and then also the tendency of professionals to similarly neglect these children, who can be difficult to relate to and hard to ‘warm’ to.     

Killing the dead: evolution of melancholic identifications underlying suicide attempts in adolescence

Psychic processes underlying suicidal behaviours during adolescence and their evolution are explored. A longitudinal study was conducted of thirty adolescent patients hospitalised following a suicide attempt. Clinical interviews were used combined with the Rorschach Test and the Thematic Apperception Test (TAT) a few days after the suicide attempt and one year later. Results initially showed common forms of psychic adjustment: melancholic identifications were linked to an excessive dependence on objects. One year later, these forms of psychic adjustment changed: for many adolescents, the melancholic identifications shifted and self-image improved. The emergence of representations of murder fantasies immediately after the suicidal behaviour allowed a possible transformation of violence into symbolisation. A case study illustrates these psychic changes.     

Improving Classroom Quality with The RULER Approach to Social and Emotional Learning: Proximal and Distal Outcomes

The RULER Approach to Social and Emotional Learning (“RULER”) is designed to improve the quality of classroom interactions through professional development and classroom curricula that infuse emotional literacy instruction into teaching–learning interactions. Its theory of change specifies that RULER first shifts the emotional qualities of classrooms, which are then followed, over time, by improvements in classroom organization and instructional support. A 2-year, cluster randomized controlled trial was conducted to test hypotheses derived from this theory. Sixty-two urban schools either integrated RULER into fifth- and sixth-grade English language arts (ELA) classrooms or served as comparison schools, using their standard ELA curriculum only. Results from multilevel modeling with baseline adjustments and structural equation modeling support RULER’s theory of change. Compared to classrooms in comparison schools, classrooms in RULER schools exhibited greater emotional support, better classroom organization, and more instructional support at the end of the second year of program delivery. Improvements in classroom organization and instructional support at the end of Year 2 were partially explained by RULER’s impacts on classroom emotional support at the end of Year 1. These findings highlight the important contribution of emotional literacy training and development in creating engaging, empowering, and productive learning environments.     

MODES OF IDENTIFICATION: FREUD'S CONCEPTS REORGANIZED

The author examines Freud's conceptualizations of identification, Melanie Klein's projective identification, and Anna Freud's identification with the aggressor and altruistic surrender of one's own instinctual impulses. After demonstrating that Freud's concept primary identification refers not to a process but to the state of being identified, he suggests the substitution of it with Sandler's term “oneness”. He notes that hysterical identification, narcissistic identification, and introjection are unconscious processes that lead to a state of oneness and that they can be distinguished clinically in terms of the emotional meaning that an object holds for the individual. Furthermore, it is shown that the concept of identification with the aggressor represents a defense mechanism of its own and a specific mode of narcissistic identification, which together with projections and hysterical re-identification play a decisive rôle in projective identification and altruistic surrender of one's own instinctual impulses.     

Some considerations on the capacity to be alone

This paper considers the lack of coherence of the psychoanalytic theories of the primary and secondary process. As a consequence, the interplay of primary and secondary process modes of thought cannot be conceptualised properly. Firstly, we summarize the results of an elsewhere-made metapsychological re-examination of both principles of mental functioning, and argue that Rapaport's distinction between a drive and a conceptual organization of memory, elaborated on by Siegfried Zepf is an extremely useful means of understanding primary and secondary process activity. As a central thesis, we state that primary process operates by affects, whilst secondary process utilizes concepts. The second part of the paper makes an attempt to show the dialectical relationship of affective and conceptual thought in the functioning of the living psyche. Temporarily dominating mental functioning, primary and secondary process thinking each utilize the other as a means, but never work purely within the psychic apparatus. It is shown that it is the specific interplay of primary and secondary process activity, which produces new adaptive substitutive formations. Some basic assumptions about the concepts of regression and progression are made to elucidate the shift from secondary to primary process dominance and vice versa.     

Mommy is only happy! Dutch mothers’ realisation of speech sounds in infant-directed speech expresses emotion,not didactic intent

Exaggeration of the vowel space in infant-directed speech (IDS) is well documented for English, but not consistently replicated in other languages or for other speech-sound contrasts. A second attested, but less discussed, pattern of change in IDS is an overall rise of the formant frequencies, which may reflect an affective speaking style. The present study investigates longitudinally how Dutch mothers change their corner vowels, voiceless fricatives, and pitch when speaking to their infant at 11 and 15 months of age. In comparison to adult-directed speech (ADS), Dutch IDS has a smaller vowel space, higher second and third formant frequencies in the vowels, and a higher spectral frequency in the fricatives. The formants of the vowels and spectral frequency of the fricatives are raised more strongly for infants at 11 than at 15 months, while the pitch is more extreme in IDS to 15-month olds. These results show that enhanced positive affect is the main factor influencing Dutch mothers’ realisation of speech sounds in IDS, especially to younger infants. This study provides evidence that mothers’ expression of emotion in IDS can influence the realisation of speech sounds, and that the loss or gain of speech clarity may be secondary effects of affect.     

Eating Disorder Recovery

Abstract

Qualitative studies addressing the eating disorder recovery process from the client's point of view are notably absent in the literature. For this case study, we conducted a retrospective examination of the recovery process, as recounted by a 37-year-old female who was diagnosed with anorexia nervosa, binge eating/purging subtype at the age of 30. Two in-person interview sessions provided insight into coping skills, multidisciplinary intervention strategies, and long-term treatment challenges. In sum, the client's perspective can add new information to the understanding of eating disorder recovery from feminist and other theoretical frameworks.     

不同特质焦虑水平的选择性注意偏向

高特质焦虑个体常表现出对威胁性刺激的选择性注意偏向的特点。然而其潜在的神经机制目前仍不清楚。通过记录高、低特质焦虑者各17名进行情绪加工时的ERP,比较了两组个体在选择性注意偏向发生的时间进程和相关的神经反应的差异。结果发现,高特质焦虑者诱发出更大的N1,进一步发现恐惧图片比中性图片诱发更大的N1;而低特质焦虑者诱发了更大的N2,特质焦虑得分越低, N2波幅越大。结果初步说明高特质焦虑者加工早期对恐惧图片分配了较多的注意资源,并且其抑制执行功能可能受损;而低特质焦虑者较晚开始区分恐惧图片和中性图片。这些结果提供了支持认知-动机模型的新证据。