Clarifying the intersubjective perspective: A reply to George Frank.

Replies to G. Frank's (see record 1998-10061-006) commentary on R. D. Stolorow's (see record 1997-38544-002) summary of the assumptions and implications of the intersubjective theoretical system of psychoanalysis. Clarifications are offered regarding the intersubjective perspective as it relates to (1) other "schools" of psychoanalysis, (2) objective reality, (3) invariant principles that unconsciously organize experience, (4) aim vs method of analysis, (5) the patient's history, (6) the intrapsychic world. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Deconstructing the myth of the neutral analyst: an alternative from intersubjective systems theory

A critique is offered of four conceptions of neutrality that have been prominent in the psychoanalytic literature: neutrality as (1) abstinence, (2) anonymity, (3) equidistance, and (4) empathy. It is argued that once the psychoanalytic situation is recognized as an intersubjective system of reciprocal mutual influence, the concept of neutrality is revealed to be an illusion. Hence, interpretations are always suggestions, transference is always contaminated, and analysis are never objective. An alternative to neutrality is found in the investigatory stance of empathic-introspective inquiry. This mode of inquiry is sharply distinguished from the prescribing of self-expressive behavior on the part of analysis, and the distinction is illustrated with a clinical vignette.     

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)     

The theory of the mind of the autistic child]

It has been suggested that hypnosis techniques may have the potential to enhance eyewitness memory in forensic investigations. However, laboratory research shows that increases in recall with hypnosis techniques are often associated with decreases in accuracy, false confidence in incorrect information, and increased suggestibility to leading questions and misleading post-event information. These problems limit the usefulness of hypnosis as an interviewing procedure. However, in practical investigations, many factors associated with hypnosis, apart from the hypnotic induction itself, might lead to memory enhancement compared with standard police interviews. For example, hypnotic interviewers, because of their psychological, clinical, and interpersonal skills, may be better interviewers than police officers. They may use effective interviewing strategies such as those associated with the "cognitive interview"; a procedure which has the potential to enhance recall by approximately 35% without the problems of memory distortion associated with hypnosis. It is concluded, therefore, that a cognitive interview procedure should be used in preference to hypnosis.     

Psychodynamic play therapy with a high-functioning autistic child.

The increasingly dominant and sound view of autism as a developmental disorder has led to adoption of highly structured behavioral interventions and abandonment of psychoanalytic approaches. This article intends to reaffirm the relevance of traditional psychodynamic play therapy to the milder variants of the autistic syndrome. The therapy process with one high-functioning autistic child is examined and discussed in the context of autistic pathology and psychodynamic theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Psychoanalytic treatment: An intersubjective approach.

Reviews the book, Psychoanalytic treatment: An intersubjective approach by Robert D. Stolorow, Bernard Brandchaft, and George E. Atwood (see record 1987-98240-000). This is an extremely interesting and well-argued book that, with its carefully chosen clinical cases, appears to demonstrate the value of the intersubjective approach and the integrative power of Kohut's ideas. However, in doing so it raises some fundamental issues in the study and understanding of psychoanalysis both as a theory and as a therapy, and it is these that the reviewer wants to examine in this review. These issues concern the relation of hermeneutics, science, and the scientific method to the practice, theory, and understanding of psychoanalysis. The reviewer argues that Stolorow and colleagues fail to present a hermeneutic case because psychoanalytic therapy goes beyond such confines, and they certainly make no scientific case for their claims. Their books falls uneasily between science and hermeneutics. Nevertheless, if we apply hermeneutic criteria to their case studies as they would wish, the reviewer thinks it is fair to say that they tell a convincing story and one that suggests that the intersubjective approach is, indeed, a useful one meriting considerable further study. What is needed is something that is truly difficult, to develop a scientific approach to a subjective world. If this could be done, then real progress could be made in the development of psychoanalytic ideas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acquisition of American sign language by a noncommunicating autistic child

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents. Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1-2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1-2 ppm, the clearance values for hemoperfusion were some 5-7 times higher than those for hemodialysis. In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquats less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.     

A perspective on child psychoanalysis 1994: The recognition of relational theory and technique in child treatment.

The central assertion of this article is that child psychoanalysts have been moving toward relational theory and practice in recent years. However, the lingering influence of drive theory and associated analytic technique is evident in a common tendency to ignore the impact on the patient of what the analyst does and says in the analytic interaction. Clinical examples illustrating this point are taken from the published work of Freudian, Kleinian, and Winnicottian analysts. Discussion of the cases focuses on explicating the points at which the analytic work presented does or does not focus on the here-and-now interaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The treatment of craniosynostosis: an ethical perspective

A 55-year-old man with diabetes mellitus developed diplopia and experienced difficulty in moving his eyes in the vertical plane, especially downward. Horizontal movement of each eye was normal with exotropia. Magnetic resonance imaging revealed small and high signals on both sides of the midbrain near the interstitial nucleus of Cajal (INC). Based upon the recent experimental evidence, we speculate that bilateral lesions involving the INC may have caused downward gaze palsy in our patient.     

Psychotherapy from an international perspective.

The author provides a context for a series of papers on the state of psychotherapy and psychotherapy integration in different parts of the world. He points out that differences in cultural values and assumptions are as important to consider in attempting a comprehensive integration of different points of view in our field as differences in theoretical orientation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Valproic acid treatment of epilepsy in autistic twins

Ultrasound-guided percutaneous core biopsy technique was studied in 15 consecutive patients with chronic Achilles tendon disorder defined as persisting local pain during daily activities, localized pain and swelling on palpation 2-5 cm proximal to the calcaneal insertion. Ultrasound verified widening of the tendon and low echogenous areas at the site of pain. Percutaneous biopsies were taken from both the low echogenous areas and the normoechogenic tendon tissue. Of 104 core biopsies 99 were representative. Open biopsies were taken from the macroscopically injured and normal tendon for comparison. Core and open biopsies of the low echogenous and macroscopically injured tendon showed similar histopathology. In 10 patients the core biopsy was performed under local anesthesia with limited subjective symptoms. Five of these patients were operated 18-41 days later. No adverse effect was found referring to the biopsy taken a few weeks prior to surgery. No complications occurred. We conclude that the percutaneous core biopsy, guided by ultrasound and performed under local anesthesia, can be used under clinical and experimental in vivo studies for improving knowledge on pathoanatomy and healing processes of the Achilles tendon.     

Family psychology from an Israeli perspective.

A perspective of family psychology in Israel is drawn against a background of evolving indigenous elaboration suited to Israel's unique circumstances (J. I. Good & A. Ben-David, 1995). Its development shows a progression from the original source of an enriching but dominant culture (J. J. Gergen, A. Gulerce, A. Lock, & G. Misra, 1996; E. Halpern, 1985) to a discipline growing within the Israeli geopolitical reality, constraints of academic infrastructures, and training resources. One can currently recognize a discipline that is increasingly congruent with its cultural texture as well as the histories and traditions of individual families in a multifaceted society. This evolution is thought to bear similarities to the course that family therapy originally took and to where the roots of family psychology can be found. To echo F. W. Kaslow's (1987, 1991) analysis of this evolution in the US, the heritage of family psychology in Israel also basically lies in mainstream psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Combat and human existence: Toward an intersubjective approach to combat-related PTSD.

The author proposes a short-term, intersubjective model for treating combat-related post-traumatic stress disorder (PTSD). Psychodynamic approaches to adult-onset PTSD lack the evidence and popularity of other approaches because adult-onset traumas are fundamentally distinct from the developmental, or childhood-based, traumas that psychoanalysis evolved to treat. An approach based in intersubjective systems theory can address this problem. The writings of Robert Stolorow (2007) in Trauma and Human Existence, which the author first read while deployed to Iraq as a psychiatrist, fundamentally changed his understanding of trauma and its treatment. The author gives an overview of Stolorow's ideas about trauma, and then describes his six-phase short-term intersubjective treatment approach. Extensive case material from a treatment that occurred in Iraq illustrates each of these phases. The author then compares his and Stolorow's views to those of other contemporary relational psychoanalytic writers. Future directions include the manualization and empirical testing of this approach in order to determine its replicability, its utility for therapists who lack extensive psychoanalytic training, and its generalizability to populations with adult-onset trauma outside the military. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Relations in families with a mentally retarded child from the perspective of the siblings

Five monoclonal antibodies (MoAbs) against Indian reference/vaccine strain of foot-and-mouth disease (FMD) virus subtype A22 (IND17/77) and a guinea pig antibody against a synthetic peptide representing amino acids (aa) 136-151 of VP1 polypeptide of A22 virus were used in the study. All the antibodies either failed to react or showed a reduced reactivity with trypsin-treated (TT)-146 S virus particles in enzyme-linked immunosorbent assay (ELISA), and could neutralize the infectivity of the reference virus. The antibodies were hence identified as specific to a trypsin-sensitive neutralizable antigenic site of the virus. Using the antibodies we isolated mutants which showed either no or reduced reactivity with the homologous as well as heterologous antibodies in ELISA. The mutants could not be neutralized with the respective antibodies but were efficiently neutralized with the serum from vaccinated cattle (BVS). These results indicated that the antibodies elicited in cattle following vaccination protected them adequately against the mutants selected and that the trypsin-sensitive neutralizable antigenic site of FMD A22 virus as identified by the MoAbs may not be dominant in eliciting a neutralizing antibody response in vaccinated cattle.     

Play and development from an ethological perspective.

Examined play from conceptual and empirical viewpoints to clarify its importance in development. Distinctions are made between the play of presymbolic and symbolic organisms and between play, exploration, and "application." A review of play in nonhuman animals indicates that play increases with phylogenetic status, is important for mature social development in more advanced species, reflects intentional activity, and is essential for the development of tool-using strategies. An exploration–play–application sequence is posited to help clarify the embedded role of play in the development of adaptive strategies. (64 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification of consistent responding to auditory stimuli by a functionally "deaf" autistic child

Although the severity of autistic children's unresponsiveness to external stimulation has been frequently reported, little empirical work has been conducted to specifically describe the nature of their unresponsiveness. The child who participated in this experiment was at varying times reported to be deaf, hard of hearing, or functionally deaf; and at other times was reported to have normal hearing. In this experiment, we measured his responses to systematically presented auditory stimuli in order to determine if there was any pattern to his responding. Two types of auditory stimuli were used: (a) white noise, consisting of most of the frequencies within the human range of hearing, and (b) the sound of a candy machine delivering candy. The results showed the following. (1) There was consistent responding to both the white noise and the candy feeder. (2) The thresholds for responding to the white noise were always consistent on a given day, but varied from day to day. (3) Responding to the candy machine stimulus always occurred at sound levels which were well below the threshold for the white noise. These results are discussed in terms of their implications for understanding autism, and in particular in terms of understanding the lack of speech development in mute autistic children.