Immediate and Latent Interlimb Transfer of Gait Stability Adaptation Following Repeated Exposure to Slips

The authors trained 21 participants by using blocked-and-mixed exposure to right-side slips and then caused them to slip unexpectedly on the untrained left side. Authors retested participants with a right slip and a left slip at 1 week, 2 weeks, 1 month, and 4 months. The authors found that preslip stability on the first untrained left slip improved and was significantly greater than that on the first right slip, which probably contributed to the reduction in incidence of falls from ~30% to ~10%. Postslip stability and base of support (BOS) slip velocity were similar to those on the first right slip and much lower than those on the last right slip. Increases in pre- and postslip stabilities and BOS slip velocity during the left slip led to reductions in backward balance loss (BLOB) from ~95% on initial left slip to ~60% and to ~25% on the 1st and 3rd retest sessions, respectively. In contrast, BLOB remained at a constant ~40% level on the right slip of the same retest sessions. The results indicate a partial immediate transfer and a possible latent transfer.     

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.     

The mathematical abilities of children with cochlear implants

Research has shown that cochlear implants give rise to improvements in speech recognition and production in children with profound hearing loss but very few studies have explored mathematical abilities in these children. The current study compared the mathematical abilities of 24 children with cochlear implants (mean age 10 years 1 month) to a control group of 22 hearing children (mean age 9 years 8 months). The math questions were categorized into questions that tapped into arithmetic or geometrical reasoning. It was predicted that the cochlear implant group would perform below the hearing group on the arithmetic questions but not the geometrical reasoning questions. Unexpectedly, the results showed that the cochlear implant group performed significantly below the hearing group on both types of math questions, but that this difference was mediated by language skill as assessed by vocabulary knowledge. The clinical implications of these results and possible future research results are considered.     

Post natal depression,the mother's conflict and parent – infant psychotherapy

This paper sets out to consider a psychodynamic approach to postnatal depression. In particular, it examines the advantages of psychodynamic parent?–?infant psychotherapy both as a treatment model, and also as a way of thinking that can help to formulate a theory of the postnatal period. An illustration is provided in the clinical account of the therapy of a couple and their nine-week-old infant. The author draws on this example, and on findings from psychoanalytic theory, infancy research, evolutionary biology and anthropology to suggest an integrated understanding of the postnatal state of mind and its challenges.     

To know or not to know: an application of Bion’s K and –K to child treatment1

The authors discuss an application of Bion’s conceptualisation of thinking and non-thinking states (K and –K links) to the treatment of a nine-year-old girl. The authors consider Bion’s interrelated concepts such as K and –K, container/contained, maternal reverie, and the development of thinking through alpha function to be highly applicable to child treatment. The afore-mentioned conceptual elements are used to elucidate case material over two consecutive hours. A K link is established between therapist and patient, the fragility of which link is then demonstrated by its deterioration into a –K link. Complex issues about knowing and not knowing are central in this girl’s clinical presentation. She was conceived through in vitro fertilisation (IVF), and subsequently diagnosed with cerebral palsy. The authors consider the emotional impact of this origin story and how the parents relate to it. The authors discuss how parents sometimes cope with perceived losses by wishing to shield or protect their children. This can have repercussions for children’s efforts to know (K) and not to know (?K). The fear that emotional knowledge will be too painful to bear can interfere with ‘learning from experience’. Bion’s premise that the purpose of analysis is the growth of the mind is synonymous with the child analyst’s goal of fostering development and understanding impediments to development.     

Maternal attitudes towards pre-natal substance abuse,medical care,and treatment in a historically disadvantaged South African community

This study explored maternal substance abuse and the access to pre-natal medical care and treatment for substance abuse during pregnancy. Respondent mothers (n?=?102; mean age?=?27.8 years, SD?=?10.9 years) were from Mitchell’s Plain, a historically disadvantaged South African community. The mothers completed a mixed methods interview on the context and influences of their substance abuse during their pregnancy. Findings suggest that these mothers adopt the drug taking behaviour in their social environment. Women with prior histories of substance abuse were active consumers and dependent on drugs while childbearing. These findings may be important for possible intervention strategies among this particular group of vulnerable women.     

Psychosomatic Health: The Body and the Word

Abstract

Why do men get firsts and women gets seconds? This question is currently being debated by some in Oxford University, but not elsewhere, where men's educational under-achievement - in secondary-school league tables, for instance (see, e.g., Phillips 1993) - is more often a matter of concern. Stephen Frosh (1998) has considered both issues in terms of the way young men are constructed and construct themselves through performing and acting on prevailing stereotypes about men and masculinity. These stereotypes include recklessness, not caution, which Maryanne Martin (1998) says contributes to men getting firsts at Oxford by virtue of this trait being rewarded by Oxford University's tutorial and examination system.

In the following pages I too will talk about the equation of men with recklessness. Or, more accurately, I will talk about the way in which men and women act on nightmares and dreams that often glorify men, not least as reckless heroes, in large part because, despite the gains of feminism, glory is still more often men's than women's prerogative in male-dominated society, of which Oxford University is a prime example. I too will consider how this might contribute to men more often getting firsts, and to women more often getting seconds in finals in Oxford. I will end with some implications of my findings for therapy - at least, for the kind of therapy I do as a Freudian therapist. I will therefore begin with Freud.     

Robert Burns in the counsellor's chair: A socio-cultural analysis of the Burns myth

To illustrate how difficult endings are, this paper first cites an Italian therapist's experience of the use of time with university students in Naples and then associates to contrasting examples in the novel, art, music and the cinema. It uses a dialogue about ending in the film Brief Encounter as a possible paradigm for what is needed in brief therapy. It then refers to the work of James Mann on different experiences of time which underlie the resistance to brief work. How can brief therapy contain the paradox between finite and infinite time? Incorporating another model of therapeutic intervention with the use of Milton Erickson's attitude to time and the unconscious, the paper then moves on to a clinical example, where treatment consisted of an assessment and five sessions. Here the practice of not interpreting the transference is challenged, along with an exploration of the concept of transference to the organization and the use of pre-treatment ‘maternal reverie’ associations. Using the combination of informal trance-like states with a clear focus on the ‘here and now’, the process of the therapeutic relationship is then worked with in the case material.     

Pandora's box: An investigation of essay anxiety in adolescents

Abstract

This paper is an investigation into possible causes of essay anxiety experienced by adolescent students. The three students are presented as being representative of three broader categories: the non-starter, the non-completer and the non-exhibitor. Parallels are drawn between the student essay and student family relationships, and essay anxiety is explored in terms of the utilization of defences against the anxiety of loss. In the process, there is an attempt to appreciate some of the deeply rooted, inter-related, developmental factors - in particular, tolerance of aggressive impulses and the experience of the good object as modifying container - which might affect the student's ability to deal productively with an essay.     

Do Patients With Psychosis Experience Loss and Grief As a Result of Their Illness?

BACKGROUND: Depression and suicidality are frequently reported in patients with psychosis and schizophrenia, but the grief process that may be associated with this illness has not been systematically studied. In this study, we examined whether patients diagnosed with psychosis identify, grieve, and mourn losses engendered by the illness. METHOD: 24 patients diagnosed with psychosis in the past five years were surveyed to indicate whether their illness led to losses, and to describe their responses to the losses. Psychosis-related perceived losses were surveyed using three subscales of a loss and grief questionnaire (loss of self, self-care, and roles). Their relationship with beliefs about the illness, symptomatology, coping style, and self-efficacy and insight was studied. RESULTS: 23 (96%) patients named specific losses, and 16 patients (67%) reported feelings associated with grief and mourning. More than half reported loss of self-esteem at the onset of illness and only half saw themselves as having improved in the past month. Patients reported more loss within the past month than at the onset of illness. In the past month, patients with an intact sense of self experienced greater self-efficacy (r = .568, p < .004) while those with loss of self reported feelings of shame (r = ?.582, p < .003). Only patients with insight associated the onset of illness with loss. In the past month, most patients saw themselves as experiencing loss. DISCUSSION: The study results suggest that at some distance from diagnosis, patients still experience themselves as having much loss due to their illness. These unresolved feelings may indicate complicated mourning. Insight appears to be associated with the ability to look back at the onset of the illness and recognize that it engendered losses. Further study of the process of and barriers to grief and mourning is recommended. In clinical practice, the assessment of grief as a part of post-psychotic recovery could lead to providing more appropriate treatment and lead to a positive outcome.