The seventh penis: towards effective psychoanalytic work with pre‐surgical transsexuals

The author reflects on his contrasting analytic work with two transsexual patients. He uses three previous psychoanalytic studies (Stoller, Morel and Lemma) to explore whether effective analytic work with the issues driving a person's determined wish for sex reassignment surgery (SRS) is possible. Particular consideration is given to how such work might navigate a path between traumatizing and pathologizing the patient on the one hand and avoiding important analytic material out of fear of so doing on the other. The author proceeds to ask whether it is possible to tell in advance, with any degree of reliability, who is and who is not likely to benefit from surgery. He considers certain diagnostic issues in relation to these questions. Illustrations are given of how, in practice, countertransference anxieties about psychopathologizing transsexual patients can contribute to significant difficulties in working clinically with them. It is argued that the understanding and containment of such anxieties could eventually lead to more effective analytic work, and that such work might be further facilitated by considering the contribution of mind‐body dissociation to transsexualism.     

Information presentation format moderates the unconscious-thought effect: The role of recollection

The unconscious-thought effect occurs when distraction improves complex decision-making. In two experiments using the unconscious-thought paradigm, we investigated the effect of presentation format of decision information (i) on memory for decision-relevant information and (ii) on the quality of decisions made after distraction, conscious deliberation or immediately. We used the process-dissociation procedure to measure recollection and familiarity. The two studies showed that presenting information blocked per criterion led participants to recollect more decision-relevant details compared to a presentation by option. Moreover, a Bayesian meta-analysis of the two studies provided strong evidence that conscious deliberation resulted in better decisions when the information was presented blocked per criterion and substantial evidence that distraction improved decision quality when the information was presented blocked per option. Finally, Study 2 revealed that the recollection of decision-relevant details mediated the effect of presentation format on decision quality in the deliberation condition. This suggests that recollection contributes to conscious deliberation efficacy.     

Dissociative identity disorder and ambivalence

While many theorists have argued that dissociative identity disorder (DID) is a case of multiple selves or persons in a single body, I maintain that DID instead should be understood as involving a single self who suffers from significant disruptions to self-consciousness. Evidence of overlapping abilities and memories, as well as the very logic of dissociation, supports the claim that DID results from internal conflict endured by a single self. Along these lines, I will maintain that alter-formation should be understood as the result of extreme emotional ambivalence. While it is true that subjects with DID exhibit volitional conflict, as Frankfurt [1988. The Importance of What We Care About. New York: Cambridge University Press; 1999. Necessity, Volition, and Love. New York: Cambridge University Press] maintains, I argue that these incompatible volitions have a deeper source: conflicting desires and affective stances concerning basic emotional needs that are not easily abandoned. A single subject turns to different alter-personalities as a way to cope with pervasive inner conflict while at the same time hiding contradictory impulses from herself.     

The psychoanalyst's normal and pathological superegos

The first section of the paper explores a number of differing views regarding the concept of the superego, essentially in terms of its formation and its functions. Two broad theories of superego development, both of which were introduced by Freud, are described. The first takes the superego to be principally oedipal in origin; the second traces the superego to an earlier period. The controversy about the usefulness of the concept of the death instinct is also implicated in the different views. It is then suggested that it is worthwhile to distinguish between a normal superego and a pathological superego and that these two distinct models of the superego are implicit in the work of both Freud and Klein. Strachey's (1934) views on the nature of the mutative effect of psychoanalytic treatment are briefly reviewed in the light of this distinction. It is suggested that Strachey was hesitant in clarifying the full implications of his views, particularly regarding the reasons for the difficulty the psychoanalyst will experience in making a transference interpretation. It is argued that the difficulty will relate to the psychoanalyst's anxiety about having sufficiently worked through the countertransference, particularly in relation to superego functioning. Two brief clinical vignettes are considered in support of this view. The last section of the paper offers some comments on the emotional development of the psychoanalyst and the ways that maturing as a psychoanalyst will involve a certain mellowing of the analyst's stance and a greater tolerance of the patient's prerogative to bring the full range of his or her personality into the treatment.     

道德困境研究的范式沿革及其理论价值

通过评述道德困境研究范式的发展过程, 系统阐释了经典两难法、加工分离法、CNI模型法和CAN算法的优缺点和理论价值。后来的研究范式均在一定程度上克服了之前研究范式的局限。加工分离法克服了经典两难法的加工纯粹性假设等局限, CNI模型法在加工分离法基础上进一步分离了道德困境决策的多种心理过程, CAN算法则修正了CNI模型法的序列加工的不恰当预设。研究范式的沿革启示研究者综合应用新方法来解决研究争议和重新审视以往道德理论, 合理应用新方法来探索其他具有潜在冲突性的研究议题。总之, 本文为道德困境及相关研究提供了方法学参考。     

Weak evidence for increased motivated forgetting of trauma-related words in dissociated or traumatised individuals in a directed forgetting experiment

Motivated forgetting is the idea that people can block out, or forget, upsetting or traumatic memories, because there is a motivation to do so. Some researchers have cited directed forgetting studies using trauma-related words as evidence for the theory of motivated forgetting of trauma. In the current article subjects used the list method directed forgetting paradigm with both trauma-related words and positive words. After one list of words was presented subjects were directed to forget the words previously learned, and they then received another list of words. Each list was a mix of positive and trauma-related words, and the lists were counterbalanced. Later, subjects recalled as many of the words as they could, including the ones they were told to forget. Based on the theory that motivated forgetting would lead to recall deficits of trauma-related material, we created eight hypotheses. High dissociators, trauma-exposed, sexual trauma-exposed, and high dissociators with trauma-exposure participants were hypothesised to show enhanced forgetting of trauma words. Results indicated only one of eight hypotheses was supported: those higher on dissociation and trauma recalled fewer trauma words in the to-be-forgotten condition, compared to those low on dissociation and trauma. These results provide weak support for differential motivated forgetting.     

人工语法学习中习得知识的分离:基于信号检测论和结构知识的视角

习得知识的意识觉知问题一直以来是内隐学习领域的研究热点和难点。以加工分离程序来分解击中率和虚报率、以结构知识中意识和无意识测量为视角,采用2（测验方式：SDTT,SKT）×2（学习程度：30试次,60试次）混合设计,试图去分离人工语法学习中习得的意识知识和无意识知识。结果发现：（1）学习程度影响到习得的无意识知识,但还未影响到习得的意识知识;（2）在分离人工语法学习的习得知识上,SDTT的敏感性高于SKT;（3）SKT夸大了元认知中的意识成分。