Psychological Distress in a Sample of Teachers

This article describes a cross-sectional study of the links between job-related stressors and depressive and psychophysiologic symptoms and morale in 67 New York City teachers. The teachers' mean score on the Center for Epidemiologic Studies Depression Scale (CES-D; M = 13.03) was higher than might be expected from average community residents. The teachers also tended to express dissatisfaction with their jobs. The CES-D and the Psychophysiologic Symptom Scale were correlated as highly as their reliabilities would permit, a finding consistent with the view that the CES-D and the Psycho physiologic Symptom Scale measure the same construct, nonspecific psychological distress. The correlational findings suggest that distress is distinct from job-related morale, which was indexed by measures of motivation to continue teaching and job satisfaction. The results of regression analyses, which controlled for sociodemographic factors, indicated that the level of job strain (frequency of ongoing stressors) is more closely related to psychological distress and low morale than episodic stressors, including crimes in which the teacher was victim. The regression analyses also indicated that colleague support was related to lower symptom levels and higher morale.     

A Method for the Study of Personality Reactions in Preschool age Children by Means of Analysis of their Play

This investigation studied variability in visual thresholds for six subjects for 50 consecutive days. The results show the following:

1. Session-to-session variability agrees closely with the variability estimates made by Hecht and Zegers.

2. No periodic or cyclic trends appeared for the group or for any individual subject.

3. For all six subjects for the first 15 days of testing, a learning phenomenon was observed for the mean and standard-deviation data. There was a slow rise over the last 10 days of testing for the mean, but not for the standard-deviation data. (A discussion of the possible causes of the rise of the mean over the last 10 days suggested the influence of extraneous factors, such as boredom and fatigue.)

4. No effect of the menstrual cycle upon the threshold values was found.

4. No effect of the menstrual cycle upon the threshold values was found.     

Psychological Researches in Schizophrenic Language and Thought

Seventy-two five- to seven-year-old boys were exposed to televised adult models and were then administered tests of resistance to deviation (moral behavior), moral choice, and moral judgment level. Boys exposed to a model who said he would resist deviating from a prohibition and who supported his statement with a morally realistic justification were subsequently more likely to use that model's statements to guide their own moral behavior and moral choice than were boys exposed to a model advocating resistance to deviation with a morally autonomous justification. Realistic models expressing a deviating moral choice led to more deviating moral choices in observers than did autonomous deviating models. The moral judgment levels of the boys were not significantly affected by the models. The boys' moral behavior was predictive of their moral choice while moral judgment level was not significantly related to the other two indices of morality.     

In sickness and in health: An exploration of some of the unconscious processes involved in the decision by family caregivers to place a family member with dementia in residential care

This paper explores the feelings, conscious and unconscious, evoked by the difficult decision to place a family member with dementia into residential care. In an exploratory study I interviewed five people who had made this decision with a view to exploring some of the unconscious processes involved in their decision-making. The interviews were interpreted paying attention to my understanding of the transference and my countertransference feelings and as triangulated by a psychodynamic supervision group.

Intimate contact with ageing and death evokes fears about mortality and activates primitive anxieties. The progress of dementia may amplify primitive or psychotic states of functioning, particularly those involving evacuatory projection, and family carers may resort to splitting off unbearable feelings of anxiety which such projections can evoke and may contribute to their decision to look for residential care.

Once placed in residential care different dynamics evolve and further difficult questions arise: how often to visit; whether and when to dispose of the person's possessions and ultimately how to grieve. The focus of this paper is, as far as it is possible, on the partner without dementia as an individual and the impact of their relative's dementia on their lives.     

“My graduation is my mother's funeral”: Transformation from the paranoid-schizoid to the depressive position in fear of success,and the role of the internal saboteur

Abstract

Freud's conflation of neurotic and existential guilt is challenged in this paper. A study of fear of success in a female analysand is presented that illustrates the resolution of this syndrome through a mourning process in which the neurotic guilt of Melanie Klein's paranoid-schizoid position is transformed into the existential guilt of Klein's depressive position. An evolution within the depressive-position existential guilt is seen as the analysand mourns and separates from an internal mother and father, who are hostile to her developmental needs. This evolution involves the transformation of an idealizing transference, symptomatically enacted through gradations of vicarious living through the analyst, being profoundly transformed into the analysand's active creation of an identity in the world. Simultaneously, the internal world becomes alive in psychic fantasy. This transformation also involves the modification of an internal sabotaging psychic structure, which had been compelled by the dissociated punitive reaction of an internalized angry mother of separation trauma, employing the unconscious re-enactment of an early infant illness. Split-off envy and split-off self-sabotage become consciously owned through the grieving of existential guilt, as visceral experience is converted into symbolization.

Susan Kavaler-Adler. “Meine Graduierung ist das Begräbnis meiner Mutter”: Transformation von der paranoidschizoiden zu der depressiven Position in der Furcht vor Erfolg – und die Rolle des innerenSaboteurs.

Freuds Verschmelzung von neurotischer und existentieller Schuld wird in dieser Arbeit in Frage gestellt. Eine Studie der Furcht vor Erfolg bei einer weiblichen Analysandin wird dargestellt und sie zeigt die Auflösung dieses Syndroms durch einen Trauer-Prozess in dem die neurotische Schuld von Melanie Klein′s paranoid-schozoider Position in die existentielle Schuld von Klein′s depressiver Position umgewandelt wird. Eine Evolution innerhalb der depressiven Position und existentieller Schuld wird gesehen als die Analysandin trauert und sich von der inneren Mutter und dem Vater trennt, die gegenüber ihren Entwicklungsbedürfnissen feindlich eingestellt sind. Bestandteil dieser Evolution ist die Umwandlung einer idealisierenden Übertragung, symptomatisch inszeniert durch Abstufungen vikariierenden Lebens durch die Analytikerin und gründlich umgewandelt in die aktive Schöpfung einer Identität in der Welt der Analysandin. Simultan wird die innere Welt in psychischer Phantasie lebendig. Diese Umwandlung involviert auch die Modifikation einer inneren seelischen Struktur, die durch die dissoziierte strafende Reaktion einer internalisierten ärgerlichen Mutter eines Trennungs Traumas aufgezwungen worden war, wobei eine unbewußte Reinszenierung eines frühen kindlichen Traumas eingesetzt wurde. Abgespaltener Neid und abgespaltene Selbst Sabotage werden dem Bewußtsein zugänglich durch ein sich Grämen in existentieller Schuld so wie viszerale Erfahrung in Symbolisierung umgesetzt wird.

Susan Kavaler-Adler. “Mi graduación es funeral de mi madre”: La transformación desde la posición esquizoparanoide a la depresiva en el miedo al éxito, y el rol del saboteador interno.

La combinación de la culpa neurótica y la culpa existencial de Freud is puesta en duda. Se presentará un estudio sobre el miedo al éxito de una analizanda mujer para ilustrar la resolución de este síndrome a través de un proceso de duelo en el cual la culpa neurótica de la posición esquizo-paranoide de Melanie Klein se transforma en la culpa existencial de la posición depresiva de Klein. Como una evolución dentro de la posición depresiva la culpa existencial es vista mientras la analizanda hace el duelo y se separa de su padre y madre internalizados, quienes son hostiles hacia sus necesidades de desarrollo. Esta evolución involucra la transformación de una transferencia idealizada actuada sintomáticamente a través de gradaciones de formas de vida sustitutivas a través de la analista, para pasar a ser una de transformación profunda en la activa creación de la identidad de la analizanda en el mundo.Simultáneamente su mundo interno toma vida en la fantasia psíquica. Esta transformación también involucra la modificación de la estructura psíquica interna saboteadora, que había sido impuesta por la reacción punitiva disociativa de una madre enojada internalizada por el trauma de separación, empleando la reactivación inconsciente de una enfermedad de la infancia temprana. La envidia y el autosabotage escindidos se vuelven conscientes a través de la aflicción de la culpa existencial, así como la experiencia viceral es convertida en simbolización.     

Projective identification fifty years on: A personal view

Since its introduction by Melanie Klein in 1946 the concept of projective identification has inspired, baffled, rankled, but always mesmerized its adherents and opponents alike. I offer in this paper a brief outline of the concept's development over the past fifty years by way of some thoughts on a personal journey of discovery surrounding its meaning and clinical usefulness to my work as a child therapist. I would like to suggest that definitions in current use seem to be derived more from adult work than from work with children, which has sometimes skewed the debate surrounding the concept in a particular direction. In both its conceptual guises, namely, as an unconscious 'phantasy' and as an interpersonal feature of the transference, projective identification is a logical extension of certain aspects of Klein's work with small children. In child work too the developmental status of the concept comes more into focus.     

Author biographies

This paper describes how an application of psychodynamic principles and techniques in a school setting can open up perspectives and insights into aspects of loss and mourning, which result in the personal and professional growth of individuals. It discusses applied psychoanalytic work in relation to its clinical base in the consulting room, in particular family work, and exemplifies this with a variety of cases.     

The Oedipus complex as observed in work with couples and their children

In work with couples where there is a child referred to a Child and Adolescent Mental Health Service, there are opportunities to observe and to work with unresolved Oedipal issues brought by the parents to the task of creating a family. These conflicts can be seen enacted by the child or children, either internally or externally. Examples are given from five cases: the first two from brief family work where the children are under five and the difficulties are to some extent resolved. The next two demonstrate more intractable problems of psychopathology where the parental Oedipal conflicts are handed down to the next generation, and the paper concludes with an example of couple work in relation to individual therapy with a child, where despite the pressure of considerable pathology in the parents' backgrounds there is a will to integration and progress is made.     

‘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.