In dialogue with Daniel Stern: A review and discussion of The Present Moment in Psychotherapy and Everyday Life

Abstract

Daniel Stern's concepts of “present moment” and “now moment,” with impending kairos, are described. In the latter, the patient demands the authentic presence of the analyst. If the analyst can open himself to the patient, he proposes that this will result in more profound changes in the patient's implicit knowing than verbal interpretations in the narrative domain would lead to. The value of intersubjectively relating and dwelling more in the phenomenal than in the narrative dimension is highlighted. A similarity to the works of the existential psychoanalyst Harold Kelman is shown. The author agrees with, but also problematises, a tendency to favour the implicit, devaluing verbal understanding and interpretation, which may result in the patient not seeing the primitive levels in his inner life. For this purpose, works from D. W. Winnicott, Jessica Benjamin and Christopher Bollas, as well as others, are used. The author concludes that object relations and intersubjective theory need to complement each other that further, there is a need to give words to the middle-ground between the phenomenal and narrative dimensions.     

等级数据的测量不变性检验及影响因素模拟研究

研究介绍了针对等级数据的模型建构（LRV,潜在反应变量模型）和参数估计（WLSMV）方法,以及在此基础上的测量不变性检验（DIFFTEST）方法,同时采用蒙特卡洛模拟研究方法,考察样本总量大小、组间样本量对比情况、阈值差异程度、量表长度等因素,对DIFTEST进行针对等级数据的测量不变性检验效果的影响情况,以及WLSMV估计方法下的参数复原情况。研究结果发现WLSMV估计方法参数的复原效果很好;DIFFTEST的一类错误概率达到可接受水平,在大样本情况下、组间样本量基本相等、阈值差异程度较大时,DIFFTEST检测力较好。在控制测量不变性遭受破坏的项目个数情况下,随着测验长度的增加,DIFFTEST的检测力下降。     

Moments of complexity and enigmatic action: a Jungian view of the therapeutic field

In presenting clinical case material for a panel on archetypes and/or primal phantasies an initial discussion of archetypes as emergent phenomena organizing 'moments of complexity' is given(1) . The relationship of such moments to 'moments of meeting' as developed by the Boston Change Process Study Group is commented on and explored within the context of the case. A condensed report of a multi-year analytic treatment of a bipolar patient having a severe trauma history is offered for discussion. Several unusual, enigmatic events are detailed to illustrate the occurrence of moments of complexity. Dreams highlighting psychological transformation stemming from a changing relationship to emerging archetypal material related to a psychotic process in the patient are offered to further detailed moments of complexity.     

Asymptotic efficiency of the pseudo‐maximum likelihood estimator in multi‐group factor models with pooled data

A multi‐group factor model is suitable for data originating from different strata. However, it often requires a relatively large sample size to avoid numerical issues such as non‐convergence and non‐positive definite covariance matrices. An alternative is to pool data from different groups in which a single‐group factor model is fitted to the pooled data using maximum likelihood. In this paper, properties of pseudo‐maximum likelihood (PML) estimators for pooled data are studied. The pooled data are assumed to be normally distributed from a single group. The resulting asymptotic efficiency of the PML estimators of factor loadings is compared with that of the multi‐group maximum likelihood estimators. The effect of pooling is investigated through a two‐group factor model. The variances of factor loadings for the pooled data are underestimated under the normal theory when error variances in the smaller group are larger. Underestimation is due to dependence between the pooled factors and pooled error terms. Small‐sample properties of the PML estimators are also investigated using a Monte Carlo study.     

Do hospital treatments represent a ‘teachable moment’ for quitting smoking? A study from a stage-theoretical perspective

Hospital treatments are assumed to be a ‘teachable moment’. This phenomenon, however, is only poorly conceptualised and untested. A stage-theoretical perspective implies that a cueing event such as hospital treatments is a teachable moment if a stage progression, change of cognitions, or both occur. This concept is examined in a cross-sectional study by comparing smokers in two treatment settings, an emergency department (ED) and inpatient treatment after elective surgery, with smokers in a control setting. Setting differences were hypothesised in stage distribution, and levels of and stage differences in social-cognitive factors under control for possible confounders. Stage, social-cognitive factors and possible confounders were assessed in 185 ED smokers, 193 inpatient smokers and 290 control smokers. Compared to control smokers, ED and inpatient smokers were in higher stages; they perceived fewer risks and cons; inpatient smokers reported more concrete plans. Stage differences in self-efficacy among ED and inpatient smokers differed from those among control smokers, but the former corresponded more strongly to the theoretical stage assumptions. The results suggest that hospital treatments lead to a stage progression and change of corresponding cognitions, and thus represent a ‘teachable moment’. Stage-matched interventions should be provided but consider differences in cognitions to be effective.     

不只是“谈话疗法”：精神分析治疗中的非言语维度

精神分析治疗在很长一段时间里被视为“谈话疗法”,其治愈机制是将潜意识的内容意识化,语言解释在其中发挥关键作用。自20世纪末开始,越来越多分析师强调非言语交流在治疗中的作用。非言语交流不仅能够为咨访双方提供更丰富的交流形式,还能通过互动中的“相遇时刻”,实现对患者过去经验的重组,改变其有缺陷的内隐关系知晓。非言语交流和语言交流能够在治疗中发挥互补作用,未来的精神分析心理学要继续加强对非言语领域的研究。     

The Aha! Moment: The Cognitive Neuroscience of Insight

ABSTRACT— A sudden comprehension that solves a problem, reinterprets a situation, explains a joke, or resolves an ambiguous percept is called an insight (i.e., the " Aha! moment"). Psychologists have studied insight using behavioral methods for nearly a century. Recently, the tools of cognitive neuroscience have been applied to this phenomenon. A series of studies have used electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) to study the neural correlates of the " Aha! moment" and its antecedents. Although the experience of insight is sudden and can seem disconnected from the immediately preceding thought, these studies show that insight is the culmination of a series of brain states and processes operating at different time scales. Elucidation of these precursors suggests interventional opportunities for the facilitation of insight.     

Integrating clients' moment‐to‐moment ratings into psychotherapy research: A novel approach

Counselling and psychotherapy researchers have considerably advanced the field's understanding of psychotherapy processes and how they relate to treatment outcomes. Despite these advances, little is known about the client's perspective of changes in psychotherapy processes that occur throughout a given session (i.e. micro‐processes). To address this gap, this article describes the novel application of methods that assess participants' moment‐to‐moment ratings to psychotherapy research. This method entails recording psychotherapy session content that clients and other potential raters (e.g. therapists, researchers) later review while simultaneously providing continuous ratings of psychotherapy processes (e.g. helpfulness, alliance). In addition, moment‐to‐moment ratings can facilitate significant events research by prompting researchers to elicit client feedback about the moments that are rated the most and least positively. However, few studies have used these methods in the context of psychotherapy research. Studies incorporating these methods may yield findings that advance psychotherapy research, training efforts and clinical practice. For example, studies may examine how the magnitude and timing of clients' moment‐to‐moment ratings of psychotherapy processes are associated with treatment outcomes, therapist ratings and physiological processes (e.g. heart rate variability). Trainee therapists and their supervisors may also use clients' moment‐to‐moment ratings to facilitate attunement to verbal and non‐verbal indicators of moments perceived more positively and negatively. Last, these methods can produce findings that are highly relevant to clinical practice, where therapists routinely navigate fluctuations in psychotherapy processes (e.g. alliance ruptures) that can be assessed using moment‐to‐moment ratings.     

REFLECTIONS ON JANET ZUCKERMAN AND LISA HORELICK’S “THE AFFECTIVE EXPERIENCE OF THE ANALYST IN THE EXTRA-ANALYTIC MOMENT”

A review and amplification of the article by authors Horelick and Zuckerman regarding the clinical phenomena of encountering patients (analysands) outside of the physical boundaries of the consultation room. Their clinical examples and the literature used to buttress their position and in particular the open disclosure of the deeply personal reactions they experienced are examined and used as launching points for further understanding. Ferenczi, Balint, Freud and other luminaries are incorporated into the topic of extra-analytic encounter, in an attempt to further demystify this inevitable and unplanned moment of disclosure, which, much like resistance and countertransference offer more opportunity than obstacle.