Ex cathedra : Teaching,transference and knowledge 1

This paper explores the ex cathedra effect in psychoanalysis. It starts with the impact of the analyst's chair (cathedra) on the ‘knowledge’ derived from the analytic exchange–in particular, the structural alignment between the analyst and the client, and the ex cathedra authority transferred to analytic interpretations. It is argued that this authority–and the compulsion to ‘know’ that underlies it–is inevitably subverted by the unconscious processes it attempts to capture (through knowledge), in particular by transference, whose embossed and hollowed out forms, and various contusive elaborations (the bezoaric, caddis, karaoke and medusa effects), vitiate the linearity and closure of a set cognitive system (knowledge). The paper then moves on to examine how this ex cathedra effect has impacted on teaching–the transferral of this knowledge in trainings, notably in universities, where psychoanalysis has become a ‘discipline’, and how transference effects have inevitably and variously subverted (some may say corrupted) the teaching process. In particular, it suggests that the academic validation of clinical trainings hides an ex cathedra dogmatism–a pretence of formal knowledge and critical assessment which forecloses creative engagement with the unconscious.     

The co-constructed therapy alliance and the technical and tactical quality of the therapist interventions in psychotherapy

This study sought to describe a brief review of studies conducted on the therapeutic alliance, taking into consideration therapeutic process and outcomes. We seek to reflect about the need to encourage the communities who engage in and conduct research on clinical practice not only to implement surveys of empirically validated measures of therapeutic outcomes, but also make them a regular practice among all clinical mental health psychotherapists. We therefore suggest the following paradigm – the Practice Based on Evidence of Results (PBER) – as a way to improve the quality of technical and tactical interventions of psychotherapists     

Negotiating ending: A qualitative study of the process of ending psychotherapy

Objectives: When psychotherapy is open-ended, the question of termination is a matter for negotiation. A model based on both content and the process of ending may explain how ‘good enough’ psychotherapies can be brought to ‘good enough’ endings.

Design: Twelve processes of ending were explored through a combination of audio recordings made during therapy sessions and post-therapy interviews with clients and therapists. Therapies had been tailored to the needs of the clients and were based on a broad spectrum of theoretical affiliations.

Methods: A procedure for systematic text condensation was used on a case-by-case basis. Issues surrounding the initiation and negotiation of ending were pointed out in each case and were then compared across cases.

Results: The initiation of ending and exchanges concerned with when and how to end therapy unfolded as a concerted process because both parties seemed to be aware that the theme of ending contained a potential challenge to the alliance. Dual affect regulation, implicit communication and a future-oriented perspective were important features. Structural elements such as schedule changes and temporary breaks served several psychological functions. Therapies seemed to reach ‘good enough’ endings when the client and therapist joined in their efforts to resolve basic ambivalences embedded in the decision to terminate contact with the affirmation of a continuing emotional bond.     

Repurposing process measures to train psychotherapists: Training outcomes using a new approach

Aims: First, this paper presents the rationale for a novel approach to training counsellors in which measures for psychotherapy process research are taught to students before moving on to teaching basic empathic reflections and interventions. The rationale for this is that client process measures can be re‐purposed to help orient and sensitise trainees to key in‐session moments. Second, we present a training outcome study that assesses the effectiveness of this approach. Method: Using an experiential‐integrative therapy approach, a 13‐week training program was used to teach psychotherapy skills and process research measures to22 clinical graduate students taken from two cohorts. As part of the course, trainees conducted several single sessions with volunteer clients on four separate occasions. Training outcomes were measured using both trainee and client reports. Results: Compared to baseline, therapists reported significant and steady gains (all p's<.05) in session management, reducing their anxious self‐awareness, and in improved sense of self‐efficacy, with the latter having the largest effect (partial Eta Sq.=.381). Discussion: While the findings provide some support for a new training strategy, a dismantling design is needed next to more closely examine the process‐measure approach to training.     

Mind the gap: On learning a foreign language in an adult education institute

Abstract

This article speculates on why adults wish to learn a foreign language and reflects on the learning process itself, as it progresses in an adult education course.     

Children's Judgments of Certainty and Uncertainty on a Problem Where the Possible Solutions Differ in Likelihood

In this study the author examined why children and adults think they need to eat. Preschoolers through adults were provided with physiological, social, psychological, and routine causes for eating breakfast, lunch, snack, and dinner, and were asked to either agree or disagree with the causal responses provided. A 4 Reason × 4 Meal repeated measures analysis of variance revealed significant main effects for meals and reasons, as well as significant Meal × Reason and Meal × Reason × Grade interactions. The effect sizes ranged from 0.1 to 0.7. Across all age groups, participants acknowledged physiological needs and desires (fulfilling hunger and needs to stay healthy) and routine (e.g., it is dinner time) as the primary causes for eating breakfast, lunch, and dinner. However, for snack physiological needs were the primary reason. Second-grade students onward spontaneously produced biological justifications such as the need for energy and nutrition as important reasons for food consumption. These results lend support to the developmental model that children's and adults’ understanding of eating changes in middle childhood.     

Delusions and Hallucinations as a Reflection of the Subcultural Milieu Among Psychotic Patients of the 1930s and 1980s

Delusions and hallucinations reported in the social histories of 150 patients admitted to an East Texas state hospital during the 1930s and of 150 patients admitted during the 1980s were examined for content that would characterize and contrast the patient subcultural milieu of the two time periods. Patients admitted during the 1930s tended to reflect the material deprivation and personal powerlessness of the great depression in delusions of great wealth and positive “special powers.” The hallucinatory visions and voices of the 1980s patients reflected a more threatening and negative subcultural milieu, with more visions of blood, snakes, and dead people or animals. Command hallucinations to hurt, to kill, or to do “perverse things” would also suggest that the subculture milieu of the 1980s had become more dangerous.     

The paradox of evolution

In the second (and expanded) version of Origin of the Species, Darwin introduces the term “advanced progressive development” in an attempt to describe the development of the more complex species from the simpler ones. More than 100 years have passed since Darwin tried to qualify and conceptualize the directional question of evolution, and very little progress has been made regarding the subject. The appearance of the species, from the simple to the more complex, is today an empirical fact, one which is no longer dependent upon any theory, including that of Darwin. This work examines the subject of advanced development in evolution by attempting to answer a few basic questions: What parameters may be used to evaluate complexity? Can any rules or order be identified as to the development of the species? Is the mechanism of “natural selection” sufficient to explain the direction or ‘purpose’ of evolution? Can the human race be included within the “rules” of Darwin's evolutionary theory?

The purpose of this essay is to develop and represent a new conceptual framework. Through this, it will be possible to offer a principle answer to all four questions.     

Dynamic processes in emotion regulation choice

ABSTRACT

Because emotion regulation (ER) processes operate over time, they potentially change the context in which subsequent ER processes occur. To test this proposal, fifty-two healthy participants completed the ER choice task. Thirty standardized low- and high-intensity negative images were used to generate different emotional contexts in which participants selected between distraction or reappraisal strategies to decrease the intensity of their negative emotion. Participants then implemented their selected strategy and rated their negative emotion. Using a dynamic perspective, we examined as predictors of ER strategy choice, in addition to current stimulus intensity, several contextual factors from the immediately preceding trial: preceding stimulus intensity and strategy choice, and the intensity of negative affect following the previous strategy implementation and thus preceding the current trial. Results replicated earlier findings that participants are more likely to choose distraction for high-intensity images. Extending earlier findings, selecting reappraisal in the preceding trial and greater negative affect preceding the current trial were associated with lower odds of choosing distraction. The lack of significant interactions among the current and preceding trial factors suggests that these effects on ER choice were direct and not through moderating the effect of current stimulus intensity. These findings support dynamic theories of ER.     

Sexual abuse as a theme in group-analytic therapy

The group-analytic approach, which emphasises the individual in a network of group relationships, is described with reference to the subject of sexual abuse in childhood. Three different National Health Service psychotherapy groups run by the author provide contrasting examples of how the theme, originating in an individual participant, was manifested in the dynamics of the group-as-a-whole. The therapeutic significance to the individual and the group is explored.