Might Relationship “Techniques” Extend the Reach, Efficacy, and Efficiency of the Psychotherapies? The Challenge of Treatment-Resistant Outpatients

Study-based clinical observations and two premises are presented as indications for a need to identify therapeutic relationship techniques or the like that can extend the reach and efficiency of the psychotherapies. The premises are: (1) advances in psychotherapy practice and research now highlight one of the field's most longstanding challenges, signified by terms like treatment resistance; and (2) some proportion of outpatients whose problems are resistant to the psychotherapies (and medications) have marked limitations in the capacity to relate positively and productively to others, including therapists. Thus, ironically, they cannot optimally utilize a treatment modality that largely has developed to ameliorate problems relating to others.     

"以病人为中心"医疗服务模式的理念与发展

纵观20世纪医疗服务的发展历程,医疗服务的发展经历了“以疾病为中心”的传统医疗服务模式到“以病人为中心”的新的医疗服务模式的转变;目前,以“以病人为中心”的医疗服务模式已经成为我国现代医院改革与发展的主题。因此,在阐述医疗服务模式变革与发展的基础上,系统论述了“以病人为中心”的医疗服务模式的内涵与特点,新的理念、新的认识,也带来了新的希望,新的医疗服务模式将不断地改善与提高人们的健康状况与生活质量。     

Beyond the Frontstage: Trust, Access, and the Relational Context in Research with Refugee Communities

This paper examines the role of trust and the concept of access as they affect the relational context in which community research, and research with refugee communities in particular, is conducted. Sociologist Irving Goffman's metaphor of frontstage and backstage behavior is used to illustrate the complexity and importance of developing of relations of trust, and thereby gaining "backstage" access, in communities that are generally closed to outsiders. It is argued that gaining authentic ("backstage") access to refugee communities, as well as other communities that have developed a self-protective insularity, is essential if we are to gather data that accurately reflect the actual beliefs, feelings, and experiences of community members. The paper then examines the puzzling lack of discussion regarding issues of trust, access, and the relational context in the literature on refugee mental health. Explanations for this apparent inattention are sought in the influence of the prevailing scientific paradigm that guides most research with refugees, and that shapes the values of the field's "gatekeepers," the editors and reviewers of scholarly journals. Throughout the paper, key points are illustrated with examples drawn from the author's research with refugees from Guatemala, Bosnia, and Afghanistan.     

Not “Filed Away as Finally Dealt With”

This essay considers some historical, clinical, and personal dimensions of Sandor Ferenczi's contributions to psychoanalysis. It uses a clinical framework to develop a new perspective of the Freud–Ferenczi relation (and of its impact on the development of psychoanalysis), which despite smoldering conflict, persisted for twenty-five years and was Freud's longest-lasting intimate friendship. A case is made for the open, undefensive, experience-drenched basis of Ferenczi's work to assure its continuing usefulness to the psychoanalyst of today, which, as is demonstrated, can lead in surprising directions.     

A dialogue of unconsciouses. A contribution to the panel 'Jung and Ferenczi--the emergent conversation'

I want to explore the notion of 'mutual introjection, the developmental essence of an autobiographical dialogue', an idea that has recently crystallized in the continuing collaborative work of Gershon J. Molad of Israel and myself concerning the autobiographical contribution to the dialogue between analysis (Molad & Vida 2002). One of the sources of this crystallization is the experience of my consultative relationship with a Jungian colleague, who, after reading some of this collaborative work, paraphrased Jung's implication that if, in the course of treatment, the doctor is not as transformed as the patient, nothing has happened (1946). In this paper, I want to breathe some life into these theoretical-sounding words: 'mutual introjection, the developmental essence of an autobiographical dialogue'.     

Exploring dynamics of abusive lesbian relationships: preliminary analysis of a multisite,qualitative study

This paper presents preliminary results from a multisite, qualitative study on violence in lesbian relationships. A framework for conducting community-based, empowerment research that draws on theories of community psychology, feminism, and postmodernism is presented. The study was designed to understand the dynamics of abusive lesbian relationships and social service providers' responses to the abuse. Results from 80 in-depth interviews with lesbians who have experienced relationship violence are examined with a particular focus on a pattern of first relationships being abusive and a theme of shifting power dynamics. Analysis of focus group discussions with 45 feminist service providers (e.g., counselors, shelter workers, social workers, healthcare providers) reveals the difficulties in assessing the power dynamics of abusive same-sex relationships and in developing appropriate responses when relying on heterosexually gendered models developed to address men's violence against women. The preliminary results present implications both for how we theorize and research this form of violence, and for improving the practices and policies of social services that work with lesbian, gay, bisexual, and transgendered communities.     

Influence of Social Perception and Social Monitoring on Structural Priming

Although structural priming has been considered to be an independent cognitive process, recent evidence suggests that structural priming is modulated by sociocognitive factors such as social perception; speakers are more likely to mimic the sentence structure of a socially desirable interlocutor than the structure of a less desirable interlocutor. This study aims to further address the role of sociocognitive factors in language use by investigating how individual differences in social perception and tendency to align with others (i.e., social monitoring) modulate same‐verb structural priming. In particular, we investigate how likely students are to repeat a sentence structure of a teacher depending on their perception of the teacher and their social monitoring tendency. Our results demonstrate that students’ tendency to imitate a sentence structure of the teacher is positively influenced by their perception of the teacher but negatively by social monitoring. We suggest that the effects may be accounted for in terms of their influence on attention and memory encoding.     

孔子是怎样解释《周易》的

孔子与《易》是有密切关系的,抛开《史记》和帛书的记载不言,仅就《论语》中两条最直接的材料来看确实如此。"加我数年……"当为孔子五十之前所说。五十之前,孔子也曾学《易》,而孔子认为知天命之年尤需学《易》。"不占而已"表明孔子解《易》以德,判定吉凶不需要占筮,而是取决于人的德性。孔子以"生生之德性"解《易》,以"道德必然性"解"天命",通过揭去《周易》的神秘外衣,发掘并发展其天人之学,将隐微难言的性与天道托诸于显著的人道德性,发展出天人合一的德性学说。     

Chinese college students' general and relationship‐specific representations of adult attachment: Variable‐centred and person‐centred analysis

Formerly, researchers often treated adult attachment as a trait‐like construct with consistency across relationship contexts. However, recent studies have shown that people possess multiple relationship‐specific attachment representations, and inter‐correlations among them are only in a small‐to‐medium range. The aim of this study is to test whether these variable‐centred results could be replicated in China and further supplement them with a person‐centred analysis focusing on identifying prototypical patterns of multiple working models across relationships. We administrated measurements of general and four relationship‐specific (mother/father/best friend/romantic partner) working models and indicators of psychological adjustment upon 302 Chinese college students. Results from variable‐centred analysis demonstrated the cross‐relationship variability in working models. Furthermore, global indicators of psychological adjustment were better predicted by general models, while relationship‐specific indicators were better predicted by corresponding relationship‐specific models. These results largely replicate previous Western studies, supporting the existence of multiple attachment representations in China. In person‐centred analysis, a latent profile analysis identified four typical classes of working model profiles: all‐average, all‐secure, romantic‐insecure and peer‐secure. These classes differed not only in the cross‐relationship variability of their working models, but also in their levels of psychological adjustment. These interesting patterns may have theoretical implications and are worthy of further examination.     

The nature and consequences of topic avoidance in Chinese and Taiwanese close relationships

Two studies examined topic avoidance in Chinese and Taiwanese opposite‐sex friendships and romantic relationships. Five areas of topic avoidance emerged through analytic induction and cluster analysis: negative appraisal, relational issues, sexual issues, politics, and personal experience. Partner protection, negative relational impact, and self inefficacy emerged as the most common reasons for avoidance. Results revealed that friends, relative to romantic partners, engaged in higher levels of topic avoidance. Taiwanese participants, moreover, avoided discussing politics to a greater extent than did mainland Chinese participants. Lacking closeness was the main reason behind avoidance of political discussion. Topic avoidance was also linked to relationship quality, as relational satisfaction negatively predicted relational issue avoidance and topic avoidance breadth (i.e. the number of topics regularly avoided in the relationship). The authors explain these and other findings based on Chinese cultural codes and historically‐embedded concepts that shape interpersonal interaction.