Existence and the existential quantifier

This paper draws a distinction between the existential quantifier and the symbol ‘∃’ used to express it, on the one hand, and existence and ‘exists’, on the other. It argues that some popular arguments in metaphysics, including arguments against vague existence and arguments against deflationary metaontology (which views ontological disputes as lacking substance), are guilty of fudging this distinction. The paper draws some lessons for metaphysical debate about existence and highlights some heretofore ignored and attractive positions in logical space.     

Art in existential psychotherapy with couples and families

The authors describe and outline how art can be used in existential psychotherapy to help a couple or family uncover, discover, and make use of the meanings and meaning potentials to be found in marital and family life. In existential psychotherapy with couples and families, art can be used to help the members of the relationship notice meaning potentials in the future, honor meaning potentials that have been actualized and deposited in the past, and discover new ways to actualize meaning potentials in the here and now.     

Thoughts and feelings and things: A new psychiatric epistemology

Epistemology — the study of knowledge — is a philosophical discipline with close ties to psychiatry. When epistemologists address specific questions about how knowledge is actually realized by human beings, their philosophy must be informed by empirical studies of the sort psychiatrists now take up in a variety of forms. As this paper describes, psychiatrists can likewise improve their understanding of human psychology through a deeper appreciation of philosophical analysis in epistemology.The aim of this article is to introduce a unifying framework within which the experience from different approaches to psychiatry — (1) the conceptual schemas of cognitive psychiatry, (2) the mental structures of psychoanalytic psychiatry, (3) the categorical forms of existential psychiatry, and (4) the neural pathways of biological psychiatry — can all be applied productively to the central question of epistemology. By establishing a broad understanding of the problem of knowledge, this new view of epistemology is developed within the idiom of each psychiatric approach. In addressing themselves to a unitary problem, these diverse psychiatric approaches are themselves revealed, not as competing points of view, but as complementary views of a single subject. The result is a new epistemology that can not only bring the insights of psychiatry to philosophy, but can also contribute to the care of patients when psychiatrists bring this broader view to their clinical work.     

Patient preference as a predictor of outcomes in a pilot trial of person-centred counselling versus low-intensity cognitive behavioural therapy for persistent sub-threshold and mild depression

The aim of this analysis was to explore whether pre-treatment intervention preferences were related to outcomes for patients with persistent sub-threshold and mild depression who received one of two treatment types. Thirty-six patients took part in a two-arm, parallel group, pilot randomized controlled trial that compared short term (3 month and 6 month) outcomes of person-centred counselling (PCC) compared with low-intensity, CBT-based guided self-help (LICBT). Patient preferences for the two interventions were assessed at baseline assessment, and analysed as two independent linear variables (pro-PCC, pro-LICBT). Eight out of 30 interactions between baseline treatment preferences and treatment type were found to be significant at the p < .05 level. All were in the predicted direction, with patients who showed a stronger preference for a treatment achieving better outcomes in that treatment compared with the alternative. However, pro-LICBT was a stronger predictor of outcomes than pro-PCC. The findings provide preliminary support that treatment preferences should be taken into account when providing interventions for patients with persistent sub-threshold and mild depression. It is recommended that further research analyses preferences for different treatment types as independent variables, and examines preferences for format of treatment (e.g. guided self-help vs. face-to-face).     

“My graduation is my mother's funeral”: Transformation from the paranoid-schizoid to the depressive position in fear of success,and the role of the internal saboteur

Abstract

Freud's conflation of neurotic and existential guilt is challenged in this paper. A study of fear of success in a female analysand is presented that illustrates the resolution of this syndrome through a mourning process in which the neurotic guilt of Melanie Klein's paranoid-schizoid position is transformed into the existential guilt of Klein's depressive position. An evolution within the depressive-position existential guilt is seen as the analysand mourns and separates from an internal mother and father, who are hostile to her developmental needs. This evolution involves the transformation of an idealizing transference, symptomatically enacted through gradations of vicarious living through the analyst, being profoundly transformed into the analysand's active creation of an identity in the world. Simultaneously, the internal world becomes alive in psychic fantasy. This transformation also involves the modification of an internal sabotaging psychic structure, which had been compelled by the dissociated punitive reaction of an internalized angry mother of separation trauma, employing the unconscious re-enactment of an early infant illness. Split-off envy and split-off self-sabotage become consciously owned through the grieving of existential guilt, as visceral experience is converted into symbolization.

Susan Kavaler-Adler. “Meine Graduierung ist das Begräbnis meiner Mutter”: Transformation von der paranoidschizoiden zu der depressiven Position in der Furcht vor Erfolg – und die Rolle des innerenSaboteurs.

Freuds Verschmelzung von neurotischer und existentieller Schuld wird in dieser Arbeit in Frage gestellt. Eine Studie der Furcht vor Erfolg bei einer weiblichen Analysandin wird dargestellt und sie zeigt die Auflösung dieses Syndroms durch einen Trauer-Prozess in dem die neurotische Schuld von Melanie Klein′s paranoid-schozoider Position in die existentielle Schuld von Klein′s depressiver Position umgewandelt wird. Eine Evolution innerhalb der depressiven Position und existentieller Schuld wird gesehen als die Analysandin trauert und sich von der inneren Mutter und dem Vater trennt, die gegenüber ihren Entwicklungsbedürfnissen feindlich eingestellt sind. Bestandteil dieser Evolution ist die Umwandlung einer idealisierenden Übertragung, symptomatisch inszeniert durch Abstufungen vikariierenden Lebens durch die Analytikerin und gründlich umgewandelt in die aktive Schöpfung einer Identität in der Welt der Analysandin. Simultan wird die innere Welt in psychischer Phantasie lebendig. Diese Umwandlung involviert auch die Modifikation einer inneren seelischen Struktur, die durch die dissoziierte strafende Reaktion einer internalisierten ärgerlichen Mutter eines Trennungs Traumas aufgezwungen worden war, wobei eine unbewußte Reinszenierung eines frühen kindlichen Traumas eingesetzt wurde. Abgespaltener Neid und abgespaltene Selbst Sabotage werden dem Bewußtsein zugänglich durch ein sich Grämen in existentieller Schuld so wie viszerale Erfahrung in Symbolisierung umgesetzt wird.

Susan Kavaler-Adler. “Mi graduación es funeral de mi madre”: La transformación desde la posición esquizoparanoide a la depresiva en el miedo al éxito, y el rol del saboteador interno.

La combinación de la culpa neurótica y la culpa existencial de Freud is puesta en duda. Se presentará un estudio sobre el miedo al éxito de una analizanda mujer para ilustrar la resolución de este síndrome a través de un proceso de duelo en el cual la culpa neurótica de la posición esquizo-paranoide de Melanie Klein se transforma en la culpa existencial de la posición depresiva de Klein. Como una evolución dentro de la posición depresiva la culpa existencial es vista mientras la analizanda hace el duelo y se separa de su padre y madre internalizados, quienes son hostiles hacia sus necesidades de desarrollo. Esta evolución involucra la transformación de una transferencia idealizada actuada sintomáticamente a través de gradaciones de formas de vida sustitutivas a través de la analista, para pasar a ser una de transformación profunda en la activa creación de la identidad de la analizanda en el mundo.Simultáneamente su mundo interno toma vida en la fantasia psíquica. Esta transformación también involucra la modificación de la estructura psíquica interna saboteadora, que había sido impuesta por la reacción punitiva disociativa de una madre enojada internalizada por el trauma de separación, empleando la reactivación inconsciente de una enfermedad de la infancia temprana. La envidia y el autosabotage escindidos se vuelven conscientes a través de la aflicción de la culpa existencial, así como la experiencia viceral es convertida en simbolización.     

Childhood Maltreatment and PTSD: Spiritual Well-Being and Intimate Partner Violence as Mediators

Childhood maltreatment places individuals, including African American women who are undereducated and economically disadvantaged, at risk for developing posttraumatic stress disorder (PTSD) symptoms. Participants were 192 African American women with a history in the prior year of both a suicide attempt and intimate partner violence (IPV) exposure. They were recruited from a public hospital that provides medical and mental health treatment to mostly low-income patients. A simple mediator model was used to examine if (a) existential well-being (sense of purpose) or religious well-being (relationship with God) mediated the link between childhood maltreatment and adult PTSD symptoms. Sequential multiple mediator models determined if physical and nonphysical IPV enhanced our understanding of the mediational association among the aforementioned variables. Findings suggest that existential well-being mediated the association between childhood maltreatment and adult PTSD symptoms in a simple mediator model, and existential well-being and recent nonphysical IPV served as sequential multiple mediators of this link. However, religious well-being and physical IPV were not significant mediators. Findings underscore the importance of enhancing existential well-being in the treatment of suicidal African American women with a history of childhood maltreatment and IPV.     

The role of religion in moderating the impact of life events on material life goals: some evidence in support of terror management theory

How would religion and a life event carrying an existential threat (LEET) jointly impact a person's life goals of becoming wealthy and successful in one's career? Goal reprioritisation, socioemotional selectivity, and gerotranscendence theories predict a shift away from material goals following a LEET, independent of the effect of religion. However, terror management theory (TMT) predicts that the effect of death thoughts depends on one's prevailing cultural values. As religion can be regarded as a culture, it is possible that Christians' and non-believers' material life goals would be differentially altered by LEET. Data from 1259 young Chinese adults reveal no main effect of LEET, but a strong effect of religion. Moreover, there was an interaction effect between LEET and religion on material life goals: LEET weakened material goals for Christians but not for non-believers. These findings suggest that TMT is more suitable than the other theories for predicting life goal changes.