The existential neurosis.

This is an attempt to clarify existential literature by distinguishing among the relevant behavioral manifestations those that are psychopathological and those that signify mental health. Existential neurosis emerges as chronic meaninglessness, apathy, and aimlessness. The premorbid identity out of which this neurosis may come involves definition of self as nothing more than an embodiment of biological needs and a player of social roles. The premorbid identity can be undermined, producing existential neurosis, by stresses such as threat of imminent death, social upheaval, and acute awareness of superficiality. Discussion of the premorbid identity leads to postulation of the ideal identity as expressive of not only the biological and social sides of man, but the psychological side as well. The psychological side includes symbolization, imagination, and judgment. Developmental hypotheses for premorbid and ideal identities are presented, and general implications of the position are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of public exposure in moral and nonmoral shame and guilt.

Although scholarly traditions assume that shame results more from the public exposure of a transgression or incompetence than guilt does, this distinction has little empirical support. Four studies, using either undergraduate participants' responses to hypothetical scenarios, their remembered experiences, or the coding of literary passages, reexamined this issue. Supporting traditional claims, public exposure of both moral (transgressions) and nonmoral (incompetence) experiences was associated more with shame than with guilt. Shame was also more strongly linked with nonmoral experiences of inferiority, suggesting 2 core features of shame: its links with public exposure and with negative self-evaluation. The distinctive features of guilt included remorse, self-blame, and the private feelings associated with a troubled conscience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The analyst's role in healing: Psychoanalysis-plus.

We argue that the original structuring of psychoanalytic treatment is based upon an unsound foundation. The questions we raise about the bases of early treatment make understandable the subsequent evolution of substantial changes, and make plausible our recommendation of still further changes. We propose that the nuanced use of techniques of explicit support, consolation, suggestion, persuasion, and advice, all used in healing across many ages and societies, be added to traditional psychoanalytic treatment. These techniques are inconsistent with the analyst's neutrality, a fundamental characteristic of the analyst's stance in the original model. The demonstration that the analyst's own values, beliefs, expectations, and theories profoundly influence all of the analyst's interventions leads us to reconsider the concept of neutrality. The possible risks associated with using these recommended explicit techniques mandate that their use requires the same discriminating judgment as is used to determine whether and when an interpretation is presented. Whether use of these additional techniques, which we have termed "psychoanalysis-plus," will enhance treatment effectiveness is an empirical, not a theoretical, question. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The existential psychotherapy of phobias.

Describes the existential psychotherapy of phobic patients. The failure of much contemporary psychotherapy is based in an insufficient psychology of the phobic process. The phobic mechanism is intentional and derives from the focused awareness patients have of their own vulnerability in a certain situation and an attempt to preempt the situation by the creation of a mythology that permits a degree of control and a concomitant loss of awareness of the experience to be avoided. The psychotherapy of phobic patients is comprised of 5 stages. Patients must be assured as to the correctness, integrity, and limited effect of their anxiety. They then come to see the intentionality and integrity in their phobic structures and subsequently recognize their power over the process should they be willing to restructure their way of being in the world. The 4th step occurs with the reclamation of the specific knowledge and feelings that patients have attempted to render unconscious. The final stage is the constant attentiveness to the interpersonal process and the suffering and survival of the primary difficulty. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The existential concept of death.

Comments on B. Vandenburg's (see record 1992-12211-001) article on epistemology and an existentialist consideration of development. If the existentialist prospects of death are to be included in a beyond-epistemic consideration of developmental issues, it is necessary to examine the status of the concept of death as an existential given, not subject to developmental changes over the life span. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The shame of American education.

Recent analyses of American schools and proposals for school reform have missed an essential point: Most current problems could be solved if students learned twice as much in the same time and with the same effort. It has been shown that they can do so (a) when the goals of education are clarified; (b) when each student is permitted to advance at his or her own pace; and (c) when the problem of motivation is solved with programmed instructional materials, so designed that students are very often right and learn at once that they are. The theories of human behavior most often taught in schools of education—particularly cognitive psychology—stand in the way of this solution to the problem of American education, but the proposal that schools of education simply be disbanded is a step in the wrong direction. Teachers need to be taught how to teach, and a technology is now available that will permit them to teach much more effectively. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The widening scope of shame.

Review of book: Melvin R. Lansky and Andrew T. Morrison (Eds.) The Widening Scope of Shame. Hillsdale, NJ: The Analytic Press, 1997, xviii = 437 pp. Reviewed by Karen J. Maroda. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The experience of shame in psychotherapy supervision.

Notes that shame is a complex and powerful experience that is difficult for therapists to address. The purpose of this article is to help therapists on both sides of the supervision dyad have a better understanding of shame and its defenses. In order to elucidate the inevitable shame that arises in supervision, this article first describes the nature of shame, beginning with its early manifestations in interpersonal relationships with primary caregivers. It also includes a short section on the adaptive nature of shame. Because individuals develop characteristic ways of coping with it, it is suggested that shame may be concealed from oneself and others through withdrawal, avoidance, attack on self, and attack on others. These characteristic reactions to shame are discussed in detail because they influence how shame is manifested. Four vignettes illustrate how each defensive reaction may be manifested in supervision, and suggestions for minimizing the adverse impact of shame are proffered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment following sexual abuse discovery: The role of shame and attributional style.

This study examined adjustment following sexual abuse as a function of shame and attributional style. One hundred forty-seven participants (83 children and 64 adolescents) were seen at the time of abuse discovery and again 1 year later. Once adjustment at abuse discovery was accounted for, shame and attribution style explained additional variation in subsequent adjustment, whereas abuse severity did not. A pessimistic attribution style at abuse discovery moderated the relation between severity of abuse and subsequent depressive symptoms and self-esteem. The relations between abuse severity and these outcomes were significant only at high levels of pessimistic attribution style. Of note, patterns of change in shame and attribution predicted which children remained at risk or improved in adjustment. In addition, age and gender differences were found in adjustment over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of second-intention healing in periocular reconstruction

Second-intention healing is a time-honored method of wound management. Its role in periocular reconstruction, however, is currently controversial. The objectives of this thesis are threefold: to evaluate carefully the outcomes in a cohort of patients treated by this technique, to provide a comprehensive review of published reports, and to formulate recommendations and guidelines for appropriate application in selected patients. Eyelid and periorbital defects after excision of periocular tumors were allowed to heal by second intention in 59 patients. The locations of the wounds were the medial canthus (n = 32), lower eyelid (n = 20), upper eyelid, (n = 4), glabella (n = 2), and nasojugal fold (n = 1). Five excised areas involved the eyelid margin, and in three patients the defect included the canalicular system. The size of the defects ranged from 3 x 3 mm to 22 x 27 mm. The average duration of follow-up was 19 months (range, 6 months to 8 years). The functional and cosmetic results were satisfactory in 49 patients (83%). Complications occurred in 10 patients and included ectropion, medial canthal webbing, trichiasis, eyelid notching, and hypertrophic scarring. Only two patients, however, required secondary repair. Healing by second intention is a safe, effective, and inexpensive alternative to surgical reconstruction after tumor excision in selected patients.     

Being present in the face of existential threat: The role of trait mindfulness in reducing defensive responses to mortality salience.

Terror management theory posits that people tend to respond defensively to reminders of death, including worldview defense, self-esteem striving, and suppression of death thoughts. Seven experiments examined whether trait mindfulness—a disposition characterized by receptive attention to present experience—reduced defensive responses to mortality salience (MS). Under MS, less mindful individuals showed higher worldview defense (Studies 1–3) and self-esteem striving (Study 5), yet more mindful individuals did not defend a constellation of values theoretically associated with mindfulness (Study 4). To explain these findings through proximal defense processes, Study 6 showed that more mindful individuals wrote about their death for a longer period of time, which partially mediated the inverse association between trait mindfulness and worldview defense. Study 7 demonstrated that trait mindfulness predicted less suppression of death thoughts immediately following MS. The discussion highlights the relevance of mindfulness to theories that emphasize the nature of conscious processing in understanding responses to threat. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The worship of food: An existential perspective.

Suggests that a religious-existential (RE) understanding of compulsive eating serves as a useful adjunct to traditional forms of treatment for this disorder. The RE approach is suggested for patients who use compulsive eating as a maladaptive form of worship. This approach combines standard cognitive-behavioral (CB) techniques with introspective-exploratory (IE) interventions. Successful dieters derive initial benefit from CB interventions and follow-up benefit from IE interventions. Patients begin by identifying and altering dysfunctional habits and follow up by identifying and transforming the values underlying those habits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expectancy–value relationships of shame reactions and shame resiliency.

This study investigated expectancy–value predictors for experiencing shame from test feedback and the possible consequences of these shame reactions. Those who experienced shame included a broader range of students than previously thought, including some high achievers who had high self-perceptions of competence. Main expectancy–value predictors of shame were lower self-efficacy ratings and higher intrinsic as well as extrinsic goal orientations. Also, although having important future goals for which the course had instrumental value was not predictive of inducing shame, such goals appeared to exert influence on whether a person would be resilient from a shame reaction with increased motivation, motivated behavior, and higher academic exam scores. If students believe they have the capabilities and are committed to a clear future goal for which the course grade or course information is relevant, then a shame reaction may be a warning signal that current actions are not in line with future goal attainment. For these students, a personal evaluation of goal commitment may result in increased motivated behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of the existential perspective on morality.

Comments on B. Vandenburg's (see record 1992-12211-001) article on epistemology and an existentialist consideration of development, taking exception to his assertion that existential consideration, described as crucial to moral development, is absent in Piaget (1965) and Kohlberg's (A. Colby and L. Kohlberg, 1984) cognitive model. It is argued that no such term as moral development exists in existentialism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of shame on the psychoanalysis of a borderline child.

Clinical psychoanalysis has ignored shame as the source of psychopathology, despite a burgeoning literature. Here the authors present an analysis carried out with a hospitalized child diagnosed as borderline. The analyst's efforts to interpret the patient's self-concealing behaviors elicited intensified shame reactions not clearly understood at the time. Here the authors explore the evolutionary and developmental origins of shame as a primary affect modifying the interest the organism has in novel stimuli. The authors briefly explain why clinicians overlook the relationship of shame to both psychopathology and psychoanalytic technique. In this case, the illness, based largely on the child's chronic experience of humiliation, remitted in response to the supportive influence of an extraordinarily sensitive hospital setting combined with the analyst's growing willingness to accept the child's positive response to being accepted on his own grounds. These laid the foundation for a psychoanalytic process to take place. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting PTSD symptoms in victims of violent crime: The role of shame, anger, and childhood abuse.

To examine the role of cognitive-affective appraisals and childhood abuse as predictors of crime-related posttraumatic stress disorder (PTSD) symptoms, 157 victims of violent crime were interviewed within 1 month postcrime and 6 months later. Measures within 1 month postcrime included previous physical and sexual abuse in childhood and responses to the current crime, including shame and anger with self and others. When all variables were considered together, shame and anger with others were the only independent predictors of PTSD symptoms at 1 month, and shame was the only independent predictor of PTSD symptoms at 6 months when 1-month symptoms were controlled. The results suggest that both shame and anger play an important role in the phenomenology of crime-related PTSD and that shame makes a contribution to the subsequent course of symptoms. The findings are also consistent with previous evidence for the role of shame as a mediator between childhood abuse and adult psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of selected cell growth factors in the wound healing process

Growth factors, naturally occurring proteins secreted by different cells or tissues, play very important role in accelerating the wound healing process. Growth factors are mainly released from macrophages, neutrophils, lymphocytes, platelets and fibroblasts and induce cells to migrate, divide or produce other factors required for wound healing. These factors bind to target cells via specific cell-surface receptors and may elicit inhibitory or stimulatory responses, depending on interactions with other factors and the cellular environment into which they are liberated. Systemic growth factors, such as growth hormone and local epidermal growth factor, fibroblast growth factor, platelet-derived growth factor, transforming growth factor i and insulin-like growth factor show to enhance wound healing. Growth factors stimulate fibroblasts proliferation and chemotaxis, collagen synthesis, reepithelialization and angiogenesis. Although growth factors are not widely available for clinical use, many are studied actively to determine their role in the acceleration of wound healing. Results of animal experiments and preliminary clinical trials demonstrate that specific uses growth factors may become the new mode of therapy in wound healing process.     

The meaning of shame: Toward a self-affirming identity.

Considers that shame becomes inevitably bound up with the process of identity formation which underlies man's striving for self, for valuing, and for meaning. The experience of shame is a fundamental sense of being defective as a person, accompanied by fear of exposure and self-protective rage. The shame-inducing process involves one significant person breaking the interpersonal bridge with another. Original shame inducement occurs prior to language development; it is precipitated by parental failure to respond appropriately to a child's needs and by parental anger toward the child. The process of restoring the severed interpersonal bridge enables one to transcend shame and begin to develop a self-affirming identity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)