Losing a training analyst for ethical violations: A candidate's perspective

The author presents her experience as the analysand of a training analyst who was investigated and expelled for ethical violations with another patient, including sexual-boundary violations, during her analytic training. While boundary violations by training analysts are not uncommon, the particular trauma experienced by 'bystanders' such as candidates and supervisees is not discussed in the literature, nor the response of institutes to the educational problems that are generated. The author illustrates the complications for candidates that arise from the dual roles of training analyst as educator and analyst when he or she faces investigation or censure, including isolation and secrecy, which promote various splits in the candidate, analytic dyad and group, as well as loyalty conflicts. The discussion covers three phases of the author's experience as a candidate-analysand, namely the period encompassing the institute's ethics investigation, the announcement of findings to her and to the institute as a group, and the ensuing individual and group dynamics generated by her analyst's expulsion from the institute and revocation of his medical license. Theoretical perspectives are utilized to understand the group regression, including contamination and contagion fears, which occurred in the wake of the training analyst's expulsion, and the impact of these processes on the candidate, including the pressure to function as a 'container' for projections of the group. Implications and recommendations for candidates and institutes are made for dealing helpfully with trainees who are affected by the process of dealing with a training analyst's ethical violations. Short-term and longer-term outcomes of the experience are considered.     

Infant observation: A range of questions and challenges for contemporary psychoanalysis1

The author attempts to integrate several perspectives within the field of infant observation that reflect the analyst's personal experience as a clinician, as a professor at the analytic institute and as a researcher in the field of psychoanalysis. Can infant observation contribute to analytic technique, theory and training? If so, what would be the nature of such contribution? To answer these questions, the author reviews the literature on infant observation from Freud to the present, highlighting Latin American contributions to this subject. She makes reference to the role of technological innovations, which have allowed videotaping, repeated observations, temporal segmentation and computerized programs, thus giving rise to microanalytic research. This discussion prompts the question about the contributions made by systematic research to clinical practice. To tackle this question, the author presents both a clinical vignette taken from her personal experience, and the current debate on this subject as it appears in the work of Daniel Stern and André Green. Finally, she presents some conclusions that are part of an ongoing debate in the psychoanalytic field.     

"仁"——医德的元德

医德是医学道德的简称,具言之,它是指医务人员在医疗卫生服务的职业活动中应该具备的仁爱、救死扶伤等的品德,是道德德目在医务人员身上的内化,也是对医务人员必须具备的最起码的要求.我们评价一个医生,首先是直面他的医德,医德是医生形象的体现,没有医德的医生即使技艺再高超,也算不上一个完整意义上的医生,"无德不成医".事实上一个医德低下的医生,他的技艺也不会高超的.     

医者不可不慈仁，病者不可猜鄙——构建和谐的医患关系

医患和谐是医学的本质要求。目前医患关系紧张是在市场经济和高科技背景下,价值选择和制度安排失当造成的。要充分利用传统文化的资源,同时适应时代要求,在价值选择和制度安排上促进医患和谐。     

国外卫生“守门人”制度功能演变对我国的启示与思考

卫生体制的改革是令各国政府关注的世界性议题。对卫生系统的研究既要关注宏观结构的转变又要关注微观具体政策的功能,既要考虑政策实施的刚性又要注重发挥市场的配置效应。着重讨论非市场体制的代表英国、市场体制的代表美国、混合体制的代表澳大利亚三个国家“守门人”的特征功能,及不同时期其角色和功能的演变,尤其是对我国现行医疗体制的启示与思考。     

患者医疗高付费的社会文化背景断想

“看病贵”的原因之一即病患者主观方面的医疗高付费的表现形式及文化背景包括在趋祈“神灵”的求医心理支配下崇尚名医名院;受“药须贵,医须贿”观念的影响,在医疗活动中以高付费求取感情踏实;富有阶层追求高于一般社会水平的生活享受和精神享受;至爱亲朋在病人重病期间或弥留之际以高额费用寄托伦理亲情。     

老年下背痛诊断的思考

医患关系是医务人员与患者在医疗过程中产生的特定医治关系,是医疗中人际关系的核心。近年来,我国的医患矛盾有激化趋势。以心理动力学方法来描述普通医患关系中医、患双方的心理互动过程,并对维系正常医患关系所需的医、患双方的心理学特征作出设想。     

广西部分人群艾滋病相关知识态度调查

通过对广西部分人群在预防艾滋病知识和对艾滋病人态度方面的情况调查,了解我区开展艾滋病健康教育的现状,探讨完善我区艾滋病预防宣传教育体系的途径;我区部分人群预防艾滋病知识知晓率高低不够均衡;我区艾滋病预防宣传教育收效明显,但有待完善。     

阴阳神化与继善成性——宋明儒对《系辞·上传》第五章第一节的阐释

《系辞·上传》第五章是《易传》中最重要的一章,而其释义适巧又未有定论。之所以未有定论,在于其丰富解读的可能性。本文取宋明儒对此章第一节的疏解,分为不相统属的三系五说。综括而言,如本章由阴阳变化之动力论"道",特殊处在于:既直接就天道论述,但又从切近可持的"阴、阳"势能为论述点,则其论述法可划归于"即用显体"的方式。《系辞》之所谓"善",或由阴阳变化之生生不已立论,或由人之自觉地承继天道处言善。所谓"性",则或从万物所受命于阴阳而成其具体生命处说;或由万物之既成之后,复归于天道处说;或由人(或万物)之自成乃因天道之赋性处说。本文既分别展示此节蕴义的丰富,且见此章可为《易传》形上学性格之标示,也表现宋明儒者间诠释立场的差异。     

面孔识别动态增益效应研究综述

近年来,研究者围绕动态面孔识别中的动态增益效应开展了一系列的研究。本文围绕面孔熟悉程度和面孔的活动类型两个方面对与动态增益效应有关的一系列动态面孔认知研究进行了总结,并对不同研究的差异进行了比较和分析。最后,对动态面孔认知规律、眼动模式和脑机制等研究方向上的发展进行了展望。