On becoming textually active at Youthline,New Zealand

The phones hardly ring at Youthline New Zealand anymore; youth still have problems and seek help, but it mostly happens silently. This article reports on experiences of texting at a 24-hour crisis helpline for young people. To date, there has been no formal evidence base for this practice; however, for new practice, there never is. In prompting discussion, this article attends to the tight constraints that texting imposes, returning to the necessary and sufficient conditions of any effective therapeutic relationship particularly in regard to working with young people. New possibilities are demonstrated with emotional support being demonstrated even in the tightly constrained space of a text-based medium.     

The triumph of American psychiatry: How it created the modern therapeutic state

Over the past 170 years, American psychiatry has progressively asserted its authority over a larger segment of the American population. From the mid-1800s to the end of World War II, psychiatry had authority over the asylum population, which markedly increased in the first half of the twentieth century due to the influence of eugenics, an ideology that argued the ‘mentally ill’ had to be segregated from society. After the war, American psychiatry adopted Freudian conceptions of mental disorders, which enabled it to begin treating people in the community who were ‘neurotic’ in some way, which dramatically expanded its influence in society. Then, in the 1970s, when many in American society were questioning psychiatry’s legitimacy as a branch of medicine, the American Psychiatric Association (APA) responded by adopting a disease model for diagnosing mental disorders, which it set forth in the third edition of its Diagnostic and Statistical Manual. There were no scientific discoveries that led to this new model, but soon the APA was informing the American public that mental disorders were diseases of the brain, and that psychiatric drugs helped fix those diseases, ‘like insulin for diabetes.’ The APA, in concert with pharmaceutical companies, has successfully exported this belief system to much of the developed world. In order to break free of this ‘therapeutic state,’ the public needs to understand the history of how it came to be, and see the social injury it has caused.     

Differentiation of stages in joke comprehension: Evidence from an ERP study

This study aimed to investigate the mechanisms underlying joke comprehension using event‐related potentials (ERPs). Fourteen healthy college students were presented with the context of a story without its joke or nonjoke ending, and then, when the story ending was presented, they were asked to make a funny/unfunny judgment about these endings. The behavioral results showed that there was no significant difference between funny and unfunny items, which meant that subjects could understand funny items as easily as unfunny ones. However, the ERP results showed that funny items initially elicited a more negative ERP deflection (N350–450) over frontocentral scalp regions. Dipole analysis localized the generators in the left temporal gyrus and the left medial frontal gyrus; it is suggested that these areas might be involved in detecting the incongruent element in joke comprehension. Between 600 and 800 ms, funny items subsequently elicited a more negative ERP deflection (N600–800) over frontocentral scalp regions and a more positive ERP deflection (P600–800) over posterior scalp regions. Dipole analysis localized the generator in the anterior cingulate cortex (ACC), an area involved in the breaking of mental set/expectation and the forming of novel associations. Finally, funny items elicited a more positive ERP deflection (P1250–1400) over anterior and posterior scalp regions. Dipole analysis localized the generators in the middle frontal gyrus and the fusiform gyrus, areas that might be related to the affective appreciation stage in joke process. Unlike that of Coulson and Kutas (2001), the present study might support the hypothesis of a three stage model of humor processing (humor detection, resolution of incongruity and humor appreciation).     

Three Views of Artful Practice in Psychosocial Occupational Therapy

This qualitative study explored artfulness in the psychosocial practice of three occupational therapists through in-depth observation and interviews. Analysis focused on the therapist-client relationship, activity use, self-reflection, and the change process. Each therapist established an interpersonal connection while offering meaningful, engaging activities. In addition, each brought a distinct and unique personal view to treatment. Findings suggest that the art of practice in occupational therapy is constructed by the therapist's integrated balance of substance, form, and vision to achieve a coherent whole, which positively influences the personal views of substance, form, and vision in clients.     

Moses,Michelangelo and Freud: From an interlacement of stories in history to some suggestions for treatment theory

Abstract

The first part of this paper is inspired by Freud's interpretation of Michelangelo's Moses, which as the author shows, profoundly expresses Freud's subjectivity and personal features. With reference to clinical treatment, when the analyst “reasons” without considering his or her partner's position, the setting is lacking from a relational point of view. The consequence is that the analyst is missing a precious resource, that is, his or her patient and the documental sources he or she transmits in the analytic dialogue. In the second part of the paper, the author analyzes the nature of documental sources. This information pertains to both the patients’ pasts and their histories, expressing their rigid conservative needs, and to their evolution and transformational needs, in view of future possible change. Evolution needs are not visible, because they are implicitly present, and—according to the author—they could be recognized through the method of discrete details proposed by the Italian art critic G. Morelli. A broader vision of analytic listening is also considered: the past should be taken into account with the aim of interpreting the present and the future, as changing spaces. Change in therapy is announced through nonrepressed unconscious signals and by the language of the implicit. In the conclusion, the author exposes the connections of change, implicit, symbol, metaphorical language and waiting time.     

The devil and the deep blue sea: dyadic narcissism and the problem of individuation 1

This paper addresses issues of infantile gender identity as they are demonstrated through group processes amongst the carers of disturbed adolescents. It uses this and other clinical material to explore gender narcissism – both male and female. It examines how such narcissism is linked to sado-masochism, and how it can impede a healthy development towards bisexual and triadic functioning.