Opening to the otherwise: The discipline of listening and the necessity of free‐association for psychoanalytic praxis

It is argued that only free‐association methodically opens the discourse of self‐consciousness (the representations available to reflective awareness) to the voicing of the repressed. The method is key to Freud's originality and the sine qua non of any genuinely psychoanalytic process. Clinical procedures which do not prioritize a steadfast and ongoing commitment to this method (instead emphasizing either interpretative formulations, as decisive acts that appear to fix and finalize the meaning of a particular lived experience, or the vicissitudes of transference‐countertransference in the immediate treatment situation) all too readily entrap the treatment, limiting its capacity to divulge the power of unconscious processes. Influenced by Laplanche, Freud's 1920 principles of lifefulness and deathfulness (the binding and unbinding of psychic energy in representations) facilitate an understanding of the unique significance of free‐associative discourse in opening the representational textuality of self‐consciousness to the voicing of that which is otherwise than representationality and reason. The ‘otherwise’ is intimated as the returning force of the repressed, as the ‘unfathomable navel’ of ‘thing‐presentations,’ experienced and expressed within the text of awareness, yet not translatable into the law and order of its logical and rhetorical reflections. Free‐associative discourse thus affects self‐consciousness in a way that is radically different from other creative procedures (‘psychosynthetic’ or integratively interpretive). In this respect, the status of free‐associative praxis as necessary for a genuinely psychoanalytic process is justified.     

A Reanalysis of Occupation and Suicide: Negative Perceptions of the Workplace Linked to Suicide Attempts

Suicide is the ultimate outcome of poor psychological well-being; however, there is a paucity of research examining the link between occupation and suicide, despite early academic interest and the known importance of work to our everyday lives. We propose that this body of research was abandoned prematurely, and we provide a reanalysis by integrating the Job Characteristics Model and the Conservation of Resources model with extant suicide research. Specifically, we hypothesize that work design characteristics (job autonomy, task variety, physical demands) and threats to personal resources (absence of viewing work-as-career, work-family conflict, family-work conflict, job dissatisfaction) are linked to suicide attempts via depression and suicidal ideation. Utilizing three measurement occasions and 2,855 participants from the AddHealth database, our findings indicate that job autonomy, task variety, work-family conflict, family-work conflict, and job dissatisfaction all indirectly contribute to employees' suicide attempts via depression and suicidal ideation. Thus, negative employee perceptions of the workplace environment have much more severe consequences than is typically examined. Based on these results, we provide recommendations for developing a theoretically derived nomological net around suicidal behavior in an organizational context, and offer strategies for managers and employees to construct a work environment that is conducive to employee well-being.     

Association between obesity and suicide in woman,but not in man: a population-based study of young adults

The relationship between obesity and suicide risk is still unclear with controversial research results. The aim of this study is to investigate the relationship between obesity and suicide risk for men and women in a population-based study of young adults. This is a cross-sectional population-based study that identified young adults between 18 and 35 years of age. Suicide risk was investigated through the structured clinical interview Mini. Weight and height were assessed, and participants were classified as normal-weight body mass index (BMI < 30) or obese (BMI > 30). The prevalence of obesity was of 19.9% of the total sample (n = 1953). Obesity was more prevalent among women and participants between 27 and 35 years of age. Suicide risk was present in 13.0% of the sample and more prevalent among women. In our study we found an association between obesity and suicide risk for women, but not for men. Obesity was associated with a higher prevalence of suicide risk in women. Given the strength of the relationship between BMI and suicide, identifying the mechanisms associated with obesity, especially for women, can lead to new insights into the prevention of suicide risk     

A case-control study of hopelessness and suicidal behavior in the city of Athens,Greece. The role of the financial crisis

This study aimed to examine the psychometric properties of Beck Hopelessness Scale (BHS) in Greek patients with a recent suicide attempt, the predictive ability of BHS especially in terms of age and the possible effect of the financial crisis on hopelessness as it has been identified as a significant suicide risk factor. The study included a total of 510 individuals, citizens of Athens, Greece. Three hundred and forty individuals (170 attempted suicide patients, and 170 -age and gender- matched healthy individuals used as controls) completed BHS before the financial crisis onset (from 2009 to 2010). A sample of 170 healthy individuals also completed the BHS after the financial crisis onset (from 2013 to 2014), when the impact of the austerity measures was being felt by the Greek society. The Greek BHS version demonstrated good psychometric properties and a sufficient degree of internal consistency. Attempted suicide patients (M = 9) presented higher hopelessness than the controls (M = 3). The patients’ age positively correlated with hopelessness (r_s = .35, p < .001), and the ROC curve revealed that the BHS ability to discriminate the individuals with pathological rates of hopelessness from those without, strengthened as age increased. No significant differences were found between the individuals evaluated before (M = 3) and after (M = 3, p > .05) the crisis onset. Nevertheless, regarding the latter group, the women, the younger individuals, the less educated, the unemployed and the participants with low or mediocre self-reported financial status presented increased hopelessness. Our findings suggest that BHS could be a useful instrument especially when screening for suicide risk in people of older age, and that the financial crisis in Greece had a greater impact on subgroups of the population regarding hopelessness.     

On surviving suicide in South India – exploring support mechanisms from the perspectives of survivors and service providers

The suicide rate in India (15.84) currently exceeds the global average (11.23) making suicide a significant public health concern. Although suicides in India are debated on medico-legal, socio-cultural, economic and political fronts, the help that is offered to people during times of crisis, before and after the attempt is very minimal. The paper aims to explore support mechanisms from the perspectives of 15 survivors, eight mental health professionals and seven traditional healers in south India. The data were analysed thematically and explored using Bourdieu’s theoretical concepts. Data indicated medical intervention as a prominent method with reservations towards psychological therapies. Reliance upon religious and traditional healing systems was culturally accepted source of support. The social and cultural power experienced by service users and service providers demonstrated a potential to influence behaviours, attitudes, decisions, approaches to services and strategies for support.     

Biblical narratives for positive psychology and suicide prevention: an evidence supported approach

Suicide is the ultimate outcome of a tragic view of life that is prevalent in ancient Greek writings. Indeed, over 16 suicides and self-mutilations can be found in the 26 surviving tragedies of Sophocles and Euripides. In contrast, only six suicides can be found in the Hebrew Scriptures, and only one suicide in the Christian Scriptures. In addition, the Hebrew Scriptures present numerous suicide-prevention narratives that are psychologically instructive. This paper examines evidence regarding seven risk factors for suicide and contrasts Greek and Biblical narratives to underscore the clinical and theoretical utility of the Biblical approach: (1) Feeling isolated and ignored; (2) Feeling one’s life is meaningless; (3) Feeling exiled from one’s home or homeland; (4) Feeling unable to be oneself with others; (5) Feeling alone in one’s life mission; (6) Feeling abandoned by one’s child; and (7) Feeling doomed by a dysfunctional family of origin.     

Lifestyle and mental health among school-going adolescents in Namibia

This study examined the association between lifestyle behaviours and psychological distress indicators among school-going adolescents. The analysis included 4 531 school children, 11–18 years of age, who completed the Namibia Global School-based Student Health Survey (GSHS) in 2013. Multivariable logistic regression analysis found that engaging in a greater number of harmful consumptive, sedentary and sexual risk behaviours carried an elevated risk for anxiety, suicide attempt and loneliness. Adolescents with co-occurring health risk behaviours have poorer mental health outcomes with socio-economic vulnerability.     

Assessing Biobehavioural Self‐Regulation and Coregulation in Early Childhood: The Parent‐Child Challenge Task

Researchers have argued for more dynamic and contextually relevant measures of regulatory processes in interpersonal interactions. In response, we introduce and examine the effectiveness of a new task, the Parent–Child Challenge Task, designed to assess the self‐regulation and coregulation of affect, goal‐directed behaviour, and physiology in parents and their preschoolers in response to an experimental perturbation. Concurrent and predictive validity was examined via relations with children's externalizing behaviours. Mothers used only their words to guide their 3‐year‐old children to complete increasingly difficult puzzles in order to win a prize (N = 96). A challenge condition was initiated midway through the task with a newly introduced time limit. The challenge produced decreases in parental teaching and dyadic behavioural variability and increases in child negative affect and dyadic affective variability, measured by dynamic systems‐based methods. Children rated lower on externalizing showed respiratory sinus arrhythmia (RSA) suppression in response to challenge, whereas those rated higher on externalizing showed RSA augmentation. Additionally, select task changes in affect, behaviour, and physiology predicted teacher‐rated externalizing behaviours four months later. Findings indicate that the Parent–Child Challenge Task was effective in producing regulatory changes and suggest its utility in assessing biobehavioural self‐regulation and coregulation in parents and their preschoolers. Copyright © 2016 John Wiley & Sons, Ltd.     

The buffering role of social support on the associations among discrimination,mental health,and suicidality in a transgender sample

Introduction: Per the minority stress framework, trans individuals often experience psychological distress given the unique stress engendered by gender identity–related discrimination. Prior research has identified social support as particularly important for psychological distress and has suggested that social support may moderate this relationship. The purpose of the current study was to explore the patterns of connections among discrimination, mental health, and suicidal ideation in trans individuals and whether social support moderates these relationships. Methods: Participants (N = 78) completed measures of these constructs as part of a national online survey. Results: A series of simultaneous multiple regressions found that harassment/rejection discrimination was a unique positive predictor of mental health symptoms and suicidal ideation, with depression positively predicting suicidal ideation. A mediational model indicated that the association between harassment/rejection discrimination and suicidal ideation was fully mediated by depression. Three moderated meditational models were run, and one yielded a significant interaction, such that discrimination predicted suicidal ideation most strongly when participants had low social support from a significant other in comparison to participants who had moderate or high support. Further, conditional direct effects identified that discrimination led to ideation only for individuals with low support from friends or a significant other but not for those with moderate or high support. Conclusions: Helping trans individuals cope with harassment and rejection, particularly by drawing on social support, may promote better mental health, which could help reduce suicidality in this population.