"Symposium: Three perspectives on Paul Dewald's The psychoanalytic process: A case illustration": Author's discussion.

Responds to the critiques by H. K. Golden (see record 1993-10605-001), J. Newirth (see record 1993-10620-001), and I. Hirsch (see record 1993-10607-001) concerning P. A. Dewald's (1972) patient analysis. Dewald confirms the influence of the analyst's theory and technique on the flow of the analysis and on the analyst's subsequent interpretation of the analysis and recognizes the multiplicity of approaches to analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An object relations perspective: The paranoid position and the development of identity.

Comments on the analysis of P. A. Dewald's (1972) patient and suggests that it offers an opportunity to compare the efficacy of theoretical and technical approaches to psychoanalysis. The author discusses how Dewald's theoretical system influences his understanding of the patient's symptoms and dynamics and how theory structures the interpretive process and goals of treatment. An interpretation of Dewald's patients' dynamics from the perspective of British object relations theory is presented. Discussion emphasizes the patient's failure to master the anxieties of the paranoid position and her related difficulties in not being able to consolidate a separate and autonomous identity as an adult woman. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arithmetic of a one- and two-person psychology: Merton M. Gill, an essay.

Presents a memorial essay on Merton M. Gill and his psychoanalytic beliefs. The author claims that Gill valued traditional psychoanalysis but saw limitations in its practice. According to the author, Gill focused on the transference-countertransference experience, maintaining that the dyad was unique. He agreed with the idea of 2 subjectivities, believing that each of the participants were shaped and shaping each other's psyche in this setting. He referred to this as a 2-person psychology, and maintained that there was also a 1-person psychology. Gill is credited for influencing novel conceptions about transference by highlighting the patient's plausible views of the transference. The author concludes that there is a need to establish whether there are significant differences between a 1- and a 2-person perspective. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The effects of goal setting and group size on performance in a social dilemma.

Examined the effect of self-set personal and assigned group goal setting on an individual's behavior in 3- and 7-person groups confronted with a social dilemma. 274 Ss earned between $1.82 and $4.94 by investing money in either a personal account or a group account. Self-set personal goals that were compatible with an assigned group goal led to higher group performance than self-set incompatibly high ("greedy") personal goals. Collective-efficacy in making money, outcome expectancies that cooperation with others leads to the attainment of the group's goal, and group goal commitment correlated positively with group performance. Ss in 7-person groups (N?=?28) were less cooperative than those in 3-person groups (N?=?26). Ss in 7-person groups had lower collective-efficacy, lower outcome expectancies, and lower commitment to the group goal than did Ss in 3-person groups. Furthermore, individual performance in 7-person groups was significantly lower than individual performance in 3-person groups. A social dilemma appears to be a boundary condition for the normally positive effect of group goal setting on group performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of jury size, evidence complexity, and note taking on jury process and performance in a civil trial.

A total of 567 jury-eligible men and women who were assigned to 6- or 12-person juries saw a videotaped civil trial that contained either 1 or 4 plaintiffs. Half the juries took notes, whereas the remainder did not. Six-person juries that did not take notes awarded multiple plaintiffs the highest amounts of compensation. Six-person juries also gave the highest punitive damages when they did not take notes and judged multiple plaintiffs. The punitive awards of 6-person juries were highly variable compared with 12-person juries. Multiple plaintiffs also increased the unpredictability of jury punitive awards. Twelve-person juries deliberated longer, recalled more probative information, and relied less than 6-person juries on evaluative statements and nonprobative evidence. Limitations and implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Collective induction.

Tested whether a cooperative group could induce a general principle that none of the group members could have induced alone. 300 college students served as Ss. Individuals, 4-person groups, and 5-person groups attempted to induce a general rule that partitioned a deck of standard playing cards into exemplars and nonexemplars. Both 4-person and 5-person groups required fewer trials to solution than individuals, and both had a higher proportion of plausible hypotheses than individuals. A social combination analysis indicated that both 4- and 5-person groups were successful at recognizing and adopting correct inductions when inductions had been proposed by individual group members: If proposed by 1 member, correct inductions were recognized either on the trial on which they were proposed or on a subsequent trial; if proposed by 2 or more members, correct inductions were almost always recognized on the trial on which they were proposed. In contrast, collective induction in the strong sense of a correct group induction that none of the group members had proposed as an individual induction was rare. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conjoint versus one-person family therapy: Some evidence for the effectiveness of conducting family therapy through one person.

Hypothesized that it would be possible to achieve the goals of family therapy (structural family change and symptom reduction) by working primarily with 1 family member. 37 Hispanic families with a drug-using member were assigned to conjoint or 1-person therapy. Data were analyzed using a mixed-design (repeated measures plus a between-group independent variable) ANOVA, with treatment as the between-group independent variable and time of assessment (intake, termination, and follow-up) as the repeated measure. Results indicate that both conditions were highly effective in improving family functioning and that 1-person family therapy was slightly more effective in reducing identified patient symptomatology. Clinical and practical issues and implications for the current theory and practice of family therapy are discussed. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conjoint versus one-person family therapy: Further evidence for the effectiveness of conducting family therapy through one person with drug-abusing adolescents.

35 Hispanic-American families in which the identified patients (mean age 17 yrs) had problems associated with drug abuse were assigned to 1 of 2 brief strategic family therapy modalities—conjoint family therapy, conducted with the whole family or at least major subsystems of it, and 1-person family therapy, which involved only the identified patient. Consistent with a previous study by the present authors (see record 1984-07368-001), 1-person therapy was as effective as conjoint therapy in improving individual and family functioning and more effective in sustaining improved family functioning at follow-up. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in the language of a schizophrenic patient during psychotherapy.

A method of linguistic analysis (Bousfield et al, 1958) is applied to the speech of a schizophrenic patient to demonstrate the changes that have occurred in the course of psychotherapy. The analysis showed that as the patient's behavior became less disorganized, so did his speech; however, the content of his speech revealed constriction of ideation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of xenobiotic metabolizing enzymes in arylamine toxicity and carcinogenesis: functional and localization studies

Familial apolipoprotein C-II (apo C-II) deficiency is an autosomal recessive genetic disorder characterized by fasting hypertriglyceridemia and accumulation of chylomicrons in the plasma. To elucidate the genetic defect, the apo C-II gene of a neonatal Japanese patient (C-IITokyo) was analyzed. Nucleotide sequence analysis showed a G+1 to C transversion at the donor splice site of intron 2 (INT2 G+1 to C). Restriction fragment length polymorphism analyses of the patient's family members with Hph I showed that the patient was homozygous and the parents were heterozygous for the INT2 G+1 to C mutation. Although consanguinity could not be demonstrated, haplotype analysis of the C-II gene revealed the identity of the patient's alleles on the mutation, suggesting that the parents had a common Japanese ancestor. Sequence analysis of the patient's cDNA isolated from peripheral blood lymphocytes revealed that the INT2 G+1 to C mutation causes skipping of exon 2, which encodes the initiation codon, and results in deficiency of apo C-II proteins. The outstanding feature of our patient was that he showed severe hypertriglyceridemia beginning in the neonatal period, a feature not reported in a case of apo C-II deficiency (C-IIHamburg) with the same mutation as our patient. A previous report of another case of apo C-II deficiency (C-IIToronto) suggested that the apo E4 isoform is associated with higher levels of plasma triglycerides in subjects heterozygous for the apo C-II mutation. Determination of the apo E isoform of our patient revealed that apo E4 was coinherited with the INT2 G+1 to C mutation, whereas the apo E isoform has been reported to be E2/3 in C-IIHamburg. We speculate that apo E4/4 aggravated the hypertriglyceridemia in our patient with apo C-II deficiency.     

The intersubjective perspective and the client-centered approach: Are they one at their core?

Reviews the change from a 1-person to a 2-person psychology in psychoanalysis. In particular, R. D. Stolorow's (1994) intersubjectivity theory is presented and then contrasted with the client-centered approach to therapy. It is concluded that contemporary client-centered therapy is a 2-person psychology, and that well-trained client-centered therapists do reflect on their own subjectivity and how it influences the client. With their important similarities it seems that the client-centered and self psychology approaches to therapy are one at their core. Self psychology has more elaborate theorizing about the therapy process, while the client-centered approach is interested in applying its principles outside of therapy so that people can live more constructively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnosemantic analysis of cognition in the alcoholic patient

Ethnosemantic analysis, a research method developed by structural anthropologists and linguists for studying "alien" cognitive domains, would be a useful tool for therapists who treat the alcoholic patient. In this paper a method is developed that would enable a therapist to focus upon aspects of the alcoholic patient's cognitions that are operative in the patient's drinking behavior. Three sorts of objectively derived information are obtained: (1) a list of cognitive factors that threaten the patient's self-concept, (2) a taxonomic sorting of these factors, and (3) a measure of the differential stressfulness of these factors to the patient. All three of these information outputs are semantically produced by the patients themselves.     

The role of the transitional realm as an organizer of analytic process: Transitional organizing experience.

[Correction Notice: An erratum for this article was reported in Vol 26(2) of Psychoanalytic Psychology (see record 2009-04869-002). The author’s name was incorrectly printed in the toc and in the author byline. The author’s name should read Joseph A. Cancelmo, PsyD, FIPA, Institute for Psychoanalytic Training and Research (IPTAR)] D. W. Winnicott's construct of the transitional realm of human experience has been widely applied and creatively extended since its introduction more than half a century ago. The author describes the extension of this construct beyond its roots in the phase-specific need for the transitional object to a paradigm for psychic structuralization. He then considers a larger implication of this construct as an organizer and vehicle of transformation in analytic process via the transference. In this more elastic use of Winnicott's construct, the analytic process becomes organized along the lines of the earliest transitional experiences: the developmental progression from a nascent to a separate self, the organization of drive experience via the other, and the sorting out of one's own mind in terms of subjectivity and objectivity. Transitional organizing experience is used as shorthand for these far-reaching structural and dynamic transformations that take place within and between patient and analyst in the dyadic interplay of the analytic process. Via familiar dynamic constellations that emerge within the analytic process, the analytic dyad comes to reexperience (as a 2-person psychology) and reorganize (as a 1-person psychology) toward less "pathological" transitional forms of experience, allowing for a resumption in development of creative transitional space. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What I do with what you give me: Therapeutic action as the creation of meaning.

The thesis of this article is that the essence of analytic change lies not in what the analyst offers, but in what the patient creates from the analyst's provisions, whether these offerings are interpretations, functions, or an emotional impact. This concept of analytic change implies a clinical strategy in which interpretations are viewed as necessary preparations. The analyst's role is not only to understand, but also to facilitate the patient's creative use of interpretation by opening a therapeutic space. The inclusion of the patient's creation of new meaning in the theory of therapeutic action implies a clinical strategy in which the analyst facilitates the patient's creation, In such an analytic stance, the analyst opens therapeutic space for the patient to create new possibilities. A clinical illustration demonstrates a strategy that combines discovery and the promotion of the patient's creation of new meaning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The disintegration of superEBA cement in solutions with adjusted pH and osmolarity

OBJECTIVE: To determine how physicians respond to a request for an expensive, unindicated test. DESIGN: Cross-sectional observational study. SETTING: Four sites of a group-model HMO. PARTICIPANTS: Thirty-nine internist volunteers. INTERVENTION: A standardized patient requesting magnetic resonance imaging (MRI) of the head to rule out multiple sclerosis (MS) was inserted unannounced into physicians' regular schedules. The patient's only complaint was fatigue with no neurologic symptoms. MEASUREMENTS AND MAIN RESULTS: Physicians and standardized patients completed assessments after each visit. Thirty-five (90%) of 39 physicians "had no idea" that the patient they saw was the standardized patient, and the remaining four participants (10%) were only "somewhat suspicious." Three (8%) of the physicians agreed to the MRI at the initial visit, and eight (22%) said they might order an MRI in the future. All doctors who refused the MRI told the patient this was based on lack of a medical indication for the test; seven (19%) also cited the test's expense. Twenty physicians (53%) of 38 agreed to a neurology referral. In response to the standardized patient's concerns, nine physicians (23%) verbalized that MS is scary, and four (10%) asked the patient about their friend's experience with MS. A few physicians appeared to dismiss the patient's concerns, such as by telling the patient they were being "paranoid." CONCLUSIONS: Few physicians agreed to a standardized patient's request for a medically unindicated MRI, but more than half agreed to refer this patient to a specialist. As physicians practice cost-conscious medicine, they may need to focus on good communication to maintain patient satisfaction.     

Milieu countertransference in treatment of borderline patients.

Describes milieu countertransference as a collective phenomenon in which the treatment staff as a group experiences regressions in functioning that, because of the operation of the patient's ego defenses, essentially mirror the level of functioning in the patient. When properly identified and treated, the milieu countertransference can benefit treatment both as a means to better understand the patient's experience and as a tool for active intervention in remediation of the patient's pathological development. A case report, involving a 14-yr-old male, is presented to illustrate the issues and interventions involved in the milieu countertransference developed in the treatment of a borderline patient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The meaning of empathy: Reply to Maryhelen Synder.

Replies to M. Snyder's (see record 1993-06522-001) comment on his article (see record 1991-16137-001) in which he described his patient's perception of an adverse therapeutic outcome. A patient's traumatic experiences in early childhood may be so severe that even adequate empathy may not be "heard" by the patient. In certain instances, a patient's difficulties in living may prove insurmountable and the patient will not stay in therapy long enough for the early damage to be repaired by corrective emotional experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catabolism of lipoprotein-X induced by infusion of 10% fat emulsion

A rare case of malignant schwannoma is described. The patient's main presentation was that of pain. The patient had no other symptom, particularly that related to the space-occupying lesion in the skull base that also was filling the pterygoid space. A 5-year cure was achieved by combined therapy of radiation and radical surgery. The rarity of these cases makes it impossible to do a comparative analysis including randomized clinical trials for outcome studies to find the optimal treatment for each patient.