Killing Me Softly

Abstract

“Forced termination” of psychoanalysis occurs when the analyst electively terminates the treatment for reasons of his own, independent of the clinical indications for termination. The author describes his own experience with the forced termination of his training analysis. The literature is reviewed, with an emphasis on the attitude of each author regarding the straggle around the decision. The author explores sources of general ethical knowledge, the ethical foundations of the analyst-analysand relation ship, and the application of these ideas to psychoanalysis. From these princi ples, the ethical problems of forced termination are derived and examined. The author proposes reforms to address these problems.     

Dropping Out of Couple Therapy

Abstract

Current literature on dropouts in marriage and family therapy includes few studies that focus exclusively on couple therapy and only a limited number of qualitative studies. Clients' perceptions of premature termination are seldom considered. This qualitative case study describes, from both the clients' and the therapist's perspectives, one couple's experience of dropping out of couple therapy after three, sessions. Findings from this case study are compared with existing literature and a fourfold typology of dropouts is proposed. We offer recommendations for future research of dropouts in couple therapy.     

RACE DIFFERENCES IN TERMINATION AT WORK: THE ROLE OF EDUCATIONAL INEQUALITY

Prior research has demonstrated that race, at least to some extent, is related to employment decisions such as selection and performance appraisals. However, little prior research has addressed the impact of race on employment termination. The current study investigates whether race is related to employment termination and highlights the importance of education, an important component of human capital, in understanding racial differences in termination. Results based on 548 employees from a large hotel chain indicate that race is related to termination; however, race is not predictive of termination when education is included in the regression analysis as a predictor. These findings support the notion that a societal level variable (i.e., education) is an important factor in reducing racial inequality in employment practices.     

Strategies for Securing Commitment to Treatment from Individuals Diagnosed with Borderline Personality Disorder

Individuals diagnosed with borderline personality disorder (BPD) are notoriously difficult to engage in treatment. The purpose of this paper is to highlight therapeutic strategies that are likely to facilitate early alliance in therapy with individuals diagnosed with BPD. The seven strategies include, collaborative assessment, the use of contracts, motivational interviewing, linking treatment targets to client goals, commitment strategies, validation, and the use of metaphors. Clinical vignettes are presented to elucidate the concepts described and demonstrate their use in clinical practice.     

Responding in the squirrel monkey under fixed-ratio schedules of stimulus termination

Key pressing was maintained under a fixed-ratio schedule in which electric shock was scheduled for delivery at a fixed time (t seconds) after each stimulus onset, and every n^th response terminated the stimulus and initiated a timeout from shock. Under this procedure, the higher the rate of responding, the briefer the duration of the stimulus presentation and the lower the frequency of shock delivery. The effects of several schedule parameters were studied to determine whether the maintenance of responding was dependent on an inverse relation between response rate and shock frequency. Shock rate and shock frequency were made independent of response rate by decreasing the value of t to 0.5 second and delivering shock only during the first presentation of the stimulus after a fixed time, including stimulus and timeout durations, had elapsed since the previous shock. The experiments showed that shock frequency and response rate are inversely related when t is of relatively long duration compared to the value of the fixed-ratio parameter, but that a decrease in shock rate or frequency due to a high rate of responding is not necessary for the maintenance of responding under a fixed-ratio schedule of stimulus termination.     

Differential effects of cocaine and pentobarbital on fixed-interval and random-interval performance

Reports have indicated that the behavioral effects of a drug can be related to the nondrug control rate of behavior in the absence of the drug. To investigate the purported relationship between control rate and drug rate, squirrel monkeys were trained under a fixed-interval 300-s schedule of stimulus-shock termination, a procedure that engendered a wide range of response rates. A light illuminated the experimental chamber during the fixed interval, and the first lever press after 300 s had elapsed terminated the light for 30 s and precluded an electrical stimulus to the tail. Following acute intramuscular administration of cocaine (0.03-0.56 mg/kg), overall rate increased and different control rates of responding, during different parts of the fixed interval, converged toward a common rate. Subsequently, the schedule was changed to a multiple fixed-interval 300-s random-interval 300-s schedule; performance during the random-interval component was characterized by steady responding at a uniformly high rate. Analysis of fixed-interval and random-interval performances following acute cocaine administration revealed convergence of response rates toward a common, uniform rate. Pentobarbital (0.3-10.0 mg/kg) only decreased overall rate, and different control rates of responding during the fixed interval did not converge toward a common rate. The results indicate that this type of analysis can be useful in comparing pharmacological agents from different classes and that the rate at which responding becomes uniform can provide a quantitative behavioral end point for characterizing drug effects on behavior.     

Similarities in the rate-altering effects of white noise and cocaine.

The effects of white noise and cocaine on squirrel monkeys' fixed-interval responding were compared to determine whether the presentation of an exteroceptive stimulus could produce rate-altering effects of the type typically observed following drug administration. To investigate the relationship between control response rate and response rate in the presence of drug or noise, the monkeys were trained under a fixed-interval 300-s stimulus-shock termination schedule in order to generate a wide range of local response rates. A light illuminated the experimental chamber during the interval and, after 300 s elapsed, a lever press during a 3-s period terminated the light and precluded the occurrence of a harmless electrical stimulus that otherwise was delivered at the end of the 3-s period. Each interval was followed by a 30-s timeout during which the chamber was darkened and responses had no consequences. Following intramuscular administration of cocaine, different rates of responding characteristic of control performance converged toward a common rate and, at an appropriately high dose, response rate during the fixed interval became more uniform. When white noise was presented continuously during a given session, different response rates also converged toward a common rate and, at an appropriate intensity, response rate became more uniform. Interactions were obtained when cocaine and white noise were presented together, indicating the possibility of a common behavioral mechanism of action. The results suggest that rate-altering drug effects may be, in part, a result of the ability of drugs to produce nonspecific stimulus effects similar to those observed for exteroceptive stimuli.     

Beyond commitment: entrenchment in the buyer–seller exchange

A specific empirical finding in the buyer–seller literature – initially discovered by Moorman, Zaltman, and Deshpande and subsequently replicated by Grayson and Ambler – still suffers from incomplete explanation. In business-to-business marketing, why do some long-term buyers appear to trust their providers a great deal but not use the service provided? This research endeavours to more fully explain this ‘dark side’ of relationship selling by integrating work on the economic theory of entrenchment with Dwyer, Schurr, and Oh's seminal buyer–seller framework. The result is a modified conceptual model of the buyer–seller exchange in which potential seller entrenchment follows Dwyer et al.'s courting and commitment stages. Motivated by Dwyer et al.'s urging to examine their model using a negotiation lens, this research then borrows two contrasting orientations from the negotiation literature and offers propositions regarding how buyers and sellers interact at each stage of the exchange. In addition to enriching understanding of how buyers and sellers negotiate in the courting and commitment stages, this research is the first to offer insight into how both sides might negotiate when faced with seller entrenchment.     

Between Cultures

Abstract

A hospital is an institution established to pursue one principal primary task: the care and treatment of the sick. In some hospitals, other important tasks - for example, training and research - must also be undertaken. There may at times be conflict about the relative importance of these tasks. Within the hospital, a large number of heterogeneous groups must coexist, communicate and co-operate to achieve the primary task. Each group is composed of individuals. Each individual has his own motivation for belonging to that group and for working within the hospital. The individual's roles within his own group, his relationship with other subgroups and his place within the hospital as a whole are to a considerable degree determined and driven by his unconscious impulses and needs. Within a gynaecological unit the levels of anxiety and other primitive emotions may be particularly high. Here, issues of life, death and sexuality are constantly being confronted. A strong defence system is therefore likely to operate at both an individual and a social level. This may either enhance or hamper the work effort.     

Unplanned pregnancies and abortion counselling: Some thoughts on unconscious motivations

Abstract

My experience of abortion counselling¹ over ten years has shown me the importance of understanding the unconscious dynamics behind an unplanned and unwanted pregnancy. Unless these dynamics are made conscious and understood, the experience of abortion may have to be repeated again and again. Both becoming pregnant and having an abortion often involve unconscious conflicts and fantasies originating in a woman's early development and reflecting her relationship with her mother. These may be acted out via an unplanned pregnancy and decision to have an abortion. The central task of abortion counselling is to address and make links with the unconscious processes, and in particular help the pregnant woman recognize and acknowledge her ambivalent feelings. In this way the counselling makes use of the opportunity to reflect provided by the crisis situation of the pregnancy.