Reflective Capacity: An Antidote to Structural Racism Cultivated Through Mental Health Consultation

Effecting a paradigm shift from “reproductive health” to “reproductive justice” within the perinatal field requires changes simultaneously at the levels of the individual healthcare provider and the system of care. The Infant-Parent Program at the University of California, San Francisco (UCSF) has extended its pioneering infant and early childhood mental health consultation to perinatal service systems applying an infant mental health approach to programs caring for expecting and new parents. In partnership with two nursing programs, UCSF consultants direct their efforts at supporting reflective practice capacities and use-of-self in patient–provider relationships. Both nursing programs serve vulnerable groups of expectant and new parents who grapple with challenges to health and well-being stemming from structural racism. As reflective capacities are supported within the consultation case conferences, providers spontaneously identify the need for tools to effectively address issues of race, class, and culture and to combat structural racism throughout the healthcare system. Policies and procedures that uphold structural racism cease to be tolerable to providers who bring their full selves to the work that they are trained to do. Using these nurse consultation partnerships as organizational case studies, this article describes a range of challenges that arise for providers and delineates steps to effective engagement toward reproductive justice.     

Shifting shadows: shaping dynamics in the cultural unconscious

Jung has suggested that wars, social upheavals and religions are 'but the superficial symptoms of a secret psychic attitude unknown even to the individual himself, and transmitted by no historian ...' (Jung 1964, para. 315; emphasis author's). With a focus on South Africa and some dream material, I explore this idea with particular emphasis on the cultural unconscious and the emerging theory of cultural complexes. Different cultures demand the repression of different aspects of the self and have different ways of actualizing a moral code. These repressions are part of what make up a dynamic and shifting cultural complex which inevitably plays a part in historical change. In turn, historical change plays its part in shifting these dynamics. In the analytic setting via the transference and countertransference, we are familiar with what is being repressed in relation to shadow dynamics, complexes and obsolete defences. Such dynamics relate to themes of boundary, identity and otherness which, in turn, reach back to early infantile strivings as well as forward in the service of unfolding. Central to this dynamic is the absorption of cultural attitudes--including that which must be repressed, allowed in or defended against. Major political shifts--historical change--inevitably affect cultural dynamics, 'secret psychic attitude(s)' and shifting shadows.     

现象学如何理解符号与含义?(一)

现象学把近代思想的主客体的对立关系及其思维模式化解为意向活动与其构造的意向相关项之间的意向性联系,从而将自己定位在以心理体验活动为研究对象的心理学和以思维内容为研究对象的逻辑学之间。这个基本思维态度和思维方式也体现在现象学对语言、符号和意义的理解与分析上。本文试图通过对胡塞尔第一逻辑研究的意向分析的重构来展示现象学分析的这一基本特征,同时也指明语言问题在胡塞尔现象学中的重要位置。     

Pluralism and Ambivalence in the Evolution of Morality

Much good work has been done on the evolution of human morality by focusing on how “selfish genes” can give rise to altruistic human beings. A richer research program is needed, however, to take into account the ambivalence of naturally evolved biopsychological motivators and the historical pluralism of human morality in religious systems. Such a program is described here. A first step is to distinguish the ultimate cause of natural selection from proximate causes that are the results of natural selection. Next, some proximate causes are suggested as possible conditions of biological and emotional valuing as well as of customary social morality and individual rational ethical thought. Finally, different moral perspectives of Confucianism, Hinduism, Buddhism, and Christianity are briefly presented in order to illustrate how one might inquire about the selection of a variety of biopsychological and cultural proximate causes that enable the evolution of a plurality of religious moral systems.     

RESPECTING HUMAN DIGNITY: CONTRACT VERSUS CAPABILITIES

Abstract: There appears to be a tension between two commitments in liberalism. The first is that citizens, as rational agents possessing dignity, are owed a justification for principles of justice. The second is that members of society who do not meet the requirements of rational agency are owed justice. These notions conflict because the first commitment is often expressed through the device of the social contract, which seems to confine the scope of justice to rational agents. So, contractarianism seems to ignore the justice claims of the severely cognitively impaired. To solve this problem, Martha Nussbaum proposes the capabilities approach. The justifiability condition, on this approach, is met by the idea of overlapping consensus. This essay argues that overlapping consensus cannot meet liberalism's justifiability condition, nor is it more inclusive of the cognitively impaired. Therefore, we have reason to retain the contract device and look for another way to ensure that liberalism respects the justice claims of all.     

树的神话的象征意义及其心理分析探索

世界各民族都有一些有关树木的神话传说,在这些故事中,渗透着丰富而又深刻的心理分析思想。本文以荣格的心理分析理论为基础,通过介绍世界各民族有关世界树的神话,探索树的象征意义及其作为一种原型意象所传达的无意识的信息,并与古今释梦理论相结合,阐述树及其神话的临床心理分析意义。     

Transference, the transcendent function, and transcendence

People in analysis come into direct contact with the transcendent – that which surpasses not only our ego consciousness but the whole psyche – through the transcendent function working in the transference–countertransference field. Reductive and synthetic methods of interpretation of transference, in both objective and subjective levels of meaning, inaugurate moving the ego out of center stage into the process of relating to the Self. The transcendent function is the means of enlarging psychic space in the transference field to make room for coinciding opposites and a 'creative solution' that arises from their conversation. That solution, or set of symbols, addresses us with such compelling authority that Jung likens it to 'the voice of God', A clinical case illustrates the connection of transference, the transcendent function, and the experience of the transcendent which, I believe, we must identify as such in order to go on relating to it.     

Parenting stress and competence among mothers of young children with substance use disorders: The roles of trauma and reflective functioning

Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale-Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mothers with SUDs who had young children. Two multivariate regression analyses found that (1) lower parental reflective functioning and higher posttraumatic stress symptoms were associated with higher parenting stress, and (2) only higher posttraumatic stress symptoms were associated with lower levels of parenting sense of competence. Findings underscore the importance of addressing trauma symptoms and PRF when aiming to improve parenting experiences for women with an SUD.