The Effect of Attachment Insecurity in the Development of Eating Disturbances across Gender: The Role of Body Dissatisfaction

The present study examined the effects of insecure attachment on the development of negative body image as a contributing factor to the development of disturbed-eating patterns in male and female university students. Participants were nonclinical male (n = 100) and female (n = 381) university students. Administering self-report questionnaires, the authors assessed demographic information (gender, age), anthropometric data (Body Mass Index [BMI], age), romantic attachment (ECRS-R; R. C. Fraley, N. G. Waller, & K. A. Brennan, 2000), body dissatisfaction (BSQ), and disturbed eating (EAT-26). The authors found body dissatisfaction to fully mediate the relationship between attachment anxiety and disordered eating in women. Body dissatisfaction mediated anxious attachment and dieting in men. In addition, attachment avoidance had a direct impact on eating behaviors for both genders, without the mediation of any variables measured in this study. The findings of the present study suggest that the anxiety and avoidance dimensions of attachment insecurity affect eating behaviors differently, and the effects are different across genders. The authors discuss results in the context of therapeutic interventions design.     

Action across emptiness

This paper examines how autism may affect the processing and containing of emotions and sensations. At the beginning of life we can hypothesise that the baby develops two means of processing experience: containment that involves a sensory and mimetic trace of relational experience (proto-containment) and containment which, through the α function and projective and introjective functions translates feelings into meaning (♀/♂). Both these means of processing emotional experience remain active throughout life but oscillate the one with the other. The main hypothesis of this work is that the autistic child is not able to oscillate between real containment (♀/♂) and a primitive form of proto-containment. The author aims to explore, through clinical material, the factors which may promote this oscillation. Autistic children often use non-verbal communication. The author examines how a particular type of action can cross the relational void in the therapeutic relationship through a process that can transform feelings of great distress in the analyst via acts that can be described as an Act of Faith, as described by Bion. This form of action that can cross the void is like an artistic performance.     

‘Only connect’ – a sexually abused girl's rediscovery of memory and meaning as she works towards the transition from a therapeutic community to a foster-family

This paper looks at the role of individual psychotherapy with a severely sexually abused girl in a therapeutic community, and the place of this work as she makes the transition into foster-care. It emphasizes the importance, not only of the individual work, but also of the drawing together of the work around the child, particularly at such a critical time. There is discussion of the ideas of ‘deadness’ versus ‘aliveness’ in the therapy, and detailed case material is used.     

Individual treatment needs in the therapeutic environment of a special school

This paper is about the therapeutic process and technique in psychotherapy with deprived children. The need to monitor as a coherent whole both the broader environmental setting and the movements of the transference is illustrated by clinical case material. It is concluded that a) the child's attack on the setting and therapeutic relation has to be picked up and contained both in the transference relationship and in the broader network by the team-work, and b) by carefully following the transference, the child can be helped to a dependent relationship inside which feelings can be made sense of, thus furthering resilience by achieving a better ability to separate good qualities of the self from self-destructive, anti-social aspects of the internal object.     

Intelligence is differentially related to neural effort in the task-positive and the task-negative brain network

Previous studies on individual differences in intelligence and brain activation during cognitive processing focused on brain regions where activation increases with task demands (task-positive network, TPN). Our study additionally considers brain regions where activation decreases with task demands (task-negative network, TNN) and compares effects of intelligence on neural effort in the TPN and the TNN. In a sample of 52 healthy subjects, functional magnetic resonance imaging was used to determine changes in neural effort associated with the processing of a working memory task. The task comprised three conditions of increasing difficulty: (a) maintenance, (b) manipulation, and (c) updating of a four-letter memory set. Neural effort was defined as signal increase in the TPN and signal decrease in the TNN, respectively. In both functional networks, TPN and TNN, neural effort increased with task difficulty. However, intelligence, as assessed with Raven's Matrices, was differentially associated with neural effort in the TPN and TNN. In the TPN, we observed a positive association, while we observed a negative association in the TNN. In terms of neural efficiency (i.e., task performance in relation to neural effort expended on task processing), more intelligent subjects (as compared to less intelligent subjects) displayed lower neural efficiency in the TPN, while they displayed higher neural efficiency in the TNN. The results illustrate the importance of differentiating between TPN and TNN when interpreting correlations between intelligence and fMRI measures of brain activation. Importantly, this implies the risk of misinterpreting whole brain correlations when ignoring the functional differences between TPN and TNN.     

The use of child drawings to explore the dual↔group analytic field in child analysis

Awareness that the child is part of a complex relational system has ensured that all child analysts agree on the necessity of establishing a therapeutic alliance with the parents. Unconscious conflictual dynamics involve the child analyst and include him, from the time of the initial consultation, in an analytic field that is closer to that of a group than to the bi‐personal set‐up of therapy with adults. Through a clinical example, the author hypothesizes that the child’s drawings and play can be viewed as tools capable of mapping the unconscious emotions present in an analytic field that extends beyond the analyst–child couple. Play and drawings can be used in the relationship with the parents not in an explanatory sense, but as a probe with which to explore the universe of unconscious emotions present in the group field. The images or the story of the play used with this particular modality prove to be an attractive pathway that is effective in facilitating the alpha function of each of the members of the group. Furthermore, in this sense, they create the conditions for an occasion through which the parents can become more aware of their own unconscious emotions that have been entrusted to the child and expressed through his symptomatology. The possibility for the little group of subjects involved in a child analysis for oscillation in a dual–group field permits not only a shared experience of knowledge, but also a shared creativity aimed at knowledge of emotional truth (O).     

Occupational Therapy Students' Development of Therapeutic Communication Skills During a Service-Learning Experience

This qualitative study examined the effect community-based service-learning experiences had upon occupational therapy students' therapeutic communication skills and their application of theoretical concepts. After their semester-long course was completed, six students de-identified and voluntarily submitted their weekly reflective journals for retrospective analysis in accordance with Giorgi's strategies (1985 Giorgi , A. ( 1985 ). Phenomenology and psychological research . Pittsburgh , PA : Duquesne University Press . [Google Scholar], 1997 Giorgi , A. ( 1997 ). The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure . Journal of Phenomenological Psychology , 28 , 235 – 261 .[Crossref] , [Google Scholar]). Two analysts identified eight themes: developing trust, establishing boundaries, communication, client-centered care, breakdown of preconceptions, increased self-awareness, power of pride, and power of occupation. Educators are urged to use service-learning experiences to facilitate student interpersonal skill development and integration of theoretical knowledge.     

‘The bereaved therapist speaks’. An interpretative phenomenological analysis of humanistic therapists' experiences of a significant personal bereavement and its impact upon their therapeutic practice: An exploratory study

Aim: The aim of the research was to explore the under‐researched area of therapists' personal bereavement and its impact upon their therapeutic practice. Method: Data were collected via semi‐structured interviews with four humanistic therapists and were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Four master and eight subordinate themes emerged from the rich data collected that exemplified both convergence with and divergence from the small body of extant literature on therapist bereavement and current thinking in thanatology. The findings suggest that bereavement is a unique experience that can affect the individual's personal and social identity and worldview. It can also be a transformative experience resulting in personal growth and a renewed sense of self and agency. In terms of professional practice, the findings suggest that the lived experience of the grieving process, mediated by supportive supervision, enabled participants to experience deeper levels of empathy and connectedness within their therapeutic relationships. Conclusion and implications: Bereavement is an experience that can profoundly impact upon therapists' personal identity and assumptive world. Such an experience can have an equally profound impact upon their therapeutic practice. There are therefore implications for students, trainers, therapists and supervisors particularly in terms of self‐care and the use of the ‘self’ in therapy. Further research needs to be undertaken in order to explore in greater depth the intersection between personal bereavement and therapists' evolving personal and professional identity development.     

On Countertransference

Drawing on non-clinical experience and with reference to relevant literature, this article examines countertransference and its impact on the development of a secure frame, focusing in particular on the countertransference dream and on its significance within the therapeutic relationship.     

A Two-Systems Approach to the Treatment of a Disturbed Adolescent

Abstract

This article is based upon die rich conceptual and technical framework for understanding and treating sadomasochistic psycho-pathology presented by the Novicks (this volume). Specifically, the Novicks' “two-systems” approach to self-regulation is applied to the treatment of a disturbed adolescent boy. Examples of “open” and “closed” functioning are presented as well as the role of underlying defensive omnipotent beliefs and fantasies. The clinical utility of this model, the pivotal role of the therapeutic alliance, and the significance of clinical work with the family through all stages of the treatment process are illustrated.