'I noticed': The emergence of self-observation in relationship to pathological attractor sites

The author highlights self-observation as an important goal of psychoanalysis, separate from other concepts with which it is often confounded. To support this position, he presents clinical and developmental data, as well as observations by psychoanalysts on recent findings by cognitive neuroscientists. He introduces the term 'pathological attractor sites' to capture the challenge in moving from the belief in the reality of one's own thoughts to self-observation. Clinical techniques to deal with this specific challenge are presented.     

植物状态的残存脑功能和意识研究

综述了有关植物状态患者对外加刺激脑反应的功能成像研究文献,着重讨论了研究发现的非典型激活的临床价值以及植物状态患者是否存在意识的功能脑成像证据。     

“Tell me more about this…”: An examination of the efficacy of follow-up open questions following an initial account

In information gathering interviews, follow-up questions are asked to clarify and extend initial witness accounts. Across two experiments, we examined the efficacy of open-ended questions following an account about a multi-perpetrator event. In Experiment 1, 50 mock-witnesses used the timeline technique or a free recall format to provide an initial account. Although follow-up questions elicited new information (18–22% of the total output) across conditions, the response accuracy (60%) was significantly lower than that of the initial account (83%). In Experiment 2 (N = 60), half of the participants received pre-questioning instructions to monitor accuracy when responding to follow-up questions. New information was reported (21–22% of the total output) across conditions, but despite using pre-questioning instructions, response accuracy (75%) was again lower than the spontaneously reported information (87.5%). Follow-up open-ended questions prompt additional reporting; however, practitioners should be cautious to corroborate the accuracy of new reported details.     

NARCISSISTIC DEFENSES IN THE DISTORTION OF FREE ASSOCIATION AND THEIR UNDERLYING ANXIETIES

This paper examines particular distortions in the process of free association characteristics of patients with narcissistic personality disorders. The author proposes that the dominant narcissistic transference developments typical of the early and middle phases of the analytic treatment of these patients are reflected in these distortions of free association. This paper gathers the various patterns that these defensive distortions present, along with technical interventions geared to deal with them.     

The Recaptured Scale Technique: A Method for Testing the Structural Robustness of Personality Scales

Tellegen and Waller advocated a complex and time-consuming scale construction method that they called “exploratory test construction.” Scales that are constructed by this method—such as the Multidimensional Personality Questionnaire (MPQ)—are presumed to be more “psychologically coherent” and “robust” than scales constructed by other means. Using a novel procedure that we call the “recaptured scale technique,” we tested this conjecture by conducting a megafactor analysis on data from the 411 adult participants of the Minnesota Study of Twins Reared Apart who completed the MPQ, the MMPI, and the CPI. We extracted and obliquely rotated 21 factors from a matrix of gender-corrected tetrachoric correlations for the 1,102 nonredundant items of the three omnibus inventories. Robustness of the 11 MPQ scales was assessed by the degree to which these factors recaptured the MPQ item groupings. Our results showed that nine factors were clearly recognizable as MPQ scales and two additional factors represented a bifurcation of an MPQ scale. A higher-order factor analysis of all 21 factor scales yielded five factors that clearly resembled the Big Five. Our results provide strong support for (a) the method of exploratory test construction, (b) the structural robustness of most MPQ scales, and (c) the utility of the recaptured scale technique.     

Interpretation and method

Abstract

Interpretation started as the central tool of psychoanalytic theory, but it has undergone changes, just as the theory it was based on has evolved. Not only have these significant changes been determined by cultural trends, but different authors have also contributed to their evolution through their approaches to various other pathologies besides neurosis. Today, the cure process is divided between those who believe that therapeutic efficiency should be based on the different interpretation models, and those who maintain that it can be only sustained by the modifying capacity of the therapeutic relationship. Both positions are supposedly upheld by the results of tests that both models believe are sufficient proof but that, in the current author's opinion, lead back to the type of pathology they arose from, although they may at times attempt to cover the entire theoretical spectrum. The position upheld by Gedo—who considers that the psychoanalyst's intervention will depend on the degree of evolution that the pathology has achieved—is of great interest for specific practice. Hence, the more primitive levels require a treatment founded on holding, whereas more evolved pathologies require a more classic level of interpretation. This implies that the stages of a particular patient's evolution may require interventions at different levels, even though these may be founded on different theoretical models. This model, which we may brand as eclectic, is basically the one we find underpinning different theoretical models, which effectively appear to integrate others.     

A process study of long-term treatment: comparing a successful and a less successful outcome

This study examined therapist technique and patient change in emotional experiencing and defense mechanisms in the successful and unsuccessful long-term psychoanalytic treatments of two male patients. Two consecutive sessions every 6 months were analyzed for each patient. Therapist interventions, patient defense mechanisms, and patient emotional experiencing were assessed using the Psychodynamic Intervention Rating Scale, Defense Mechanism Rating Scale and the Experiencing Scale, respectively. Between and within-session analyses were conducted to determine the impact of the patient’s defensive functioning and experiencing on therapist interventions, and the effect of therapist interventions on those same two patient variables. Pearson’s Coefficient was utilized for between-session analysis; within-session analysis tracking moment-to-moment changes in patient and therapist functioning was performed using lag sequential analysis. Across therapy, therapist use of Interpretive Interventions was associated with increased emotional engagement and decreased defense maturity; the use of Supportive Interventions had the opposite effect. Within-session analysis revealed that use of Supportive Interventions when emotional engagement is low, followed by interpretative interventions, occurred in the successful case. Persistent use of Supportive Interventions in the context of low emotional engagement was observed in the unsuccessful case. This study suggests that failure to stimulate emotional engagement through interpretation can negatively affect therapeutic outcome.     

Emerging Trauma Therapies: Critical Analysis and Discussion of Three Novel Approaches

Trauma-related disorders and treatment have gained increasing attention in the last 3 decades, spurring the development of novel treatment approaches. Many of these are incorporated into clinical practice despite lacking a solid evidence base or unbiased analyses to facilitate interpretation of existing information. Although treatments might draw on elements from validated therapies, questions regarding the incremental efficacy of new approaches persist. Three novel therapies that might warrant further examination include energy psychology, yoga, and brainspotting. The emergence of novel, trauma-related therapies is examined, and the history, theory, practice, and evidence base of these 3 specific therapies are outlined. Directions for future work are discussed. Expositions such as this might serve as a helpful resource for clinicians seeking discernment regarding treatment for posttraumatic stress disorder.