摘要:

In psychoanalytic treatment insight does not necessarily lead to change, because psychoanalysis has not yet integrated into its theory and technique the full significance of two determinants: (1) the resistances arising from the patient's environment, and (2) the role played by the patient's will in his/her analysis. This paper is focused on the second determinant.Freud's elucidation of repression and other defences challenged the assumption that the will operated in an uncomplicated, straightforward manner. When, however, neurotic fears, secondary gain, or guilt underlying the inhibited or misdirected will are thoroughly analysed, patients are enabled to strive for their long‐range aims, as clarified during the course of their analysis.Psychoanalytic theory has not recognized the will for two reasons. (1) Its theory is committed to determinism, which does not characterize its practice. Psychoanalysis does not predict outcome as required by philosophical determinism, but traces it backwards to find that it is meaningful, and not arbitrary or purposeless. (2) It attributes ‘willing’ to the ego, along with other multifarious functions, which confounds the development and operation of distinct functions, and distracts attention from the phenomenological investigation of each separate fun

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02805.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The authors focus on a family therapy, construing the process of change within an object‐relations theory integrated with psychodynamic thoughts about Holocaust survivors. Specifically, the authors concentrate on the mutual influence of parents and their children as figures for a two‐way identification, and on the potential constructive role the offspring may have in promoting change, in this case reparative change, in the family. A clinical illustration of such a family treated by one of the authors illustrates this aspect. The disturbed intra‐familial relationships in the history of each parent led to the development of pathological internalized object relations. This was reinforced by traumatic life‐events, especially with the father who was a Holocaust survivor. Serious problems developed in marital life and in relation with the children. Couple therapy alone did not seem successful. The couple who lived in a sado‐masochistic collusion for years could not change. Only after including the children in the therapy did the family's relations improve. Confrontation with some positive aspects of the family which the children represent may have been a factor in this change. The couple were able to resynthesize and integrate positive aspects of themselves as represented and reinforced by their children. It seems that reparation through the children helped modify all relations in t

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02806.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A sample of 200 thoughts obtained from 50 depressed patients at the beginning of a course of cognitive therapy were analysed within the context of Beck's cognitive theory of depression. The results indicated that, of the three elements of the negative cognitive triad, negative view of self and of the world occurred more frequently than negative view of the future. Correspondingly, the principal themes referred to self‐deprecation and a hostile world, with hopelessness occurring less frequently; inter‐ and intra‐personal situations were equally represented. Anxious mood was reported as often as depressed mood with anger, directed inwards or outwards, being less frequent. Two raters were able to label the five logical errors listed by Beck reliably, although there was a certain degree of overlap; arbitrary inferences were the most frequent and personalization the least frequent. Emotions, themes and errors were not indiscriminately related; anger was predominantly associated with themes of hostile world and ‘shoulds’; ‘selective abstraction’ was predominantly associated with depression and ‘arbitrary inference’ with anxiety; ‘selective abstraction’ was predominantly associated with ‘shoulds’ and ‘arbitrary inference’ with ‘illness’ themes. The conclusion was that Beck's early analysis of depressed thinking is valid

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02807.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Short‐term personal construct therapy was implemented with a group of elderly people, and its effects on their psychological states evaluated using content analysis scales. The states of these elderly were compared with those of two groups, one of well‐functioning elderly and the other a group of elderly who were matched with the psychotherapy group for age, sex and type of chronic illness. Neither control group had psychotherapy. When compared with the fully functioning group immediately after therapy, the psychotherapy group showed less anxiety and depression. When compared with the matched group on follow‐up 12 weeks later, they showed less anxiety, depression and indirectly expressed anger, and more feelings of competence as well as other good fee

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02808.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The accuracy of assessments of Type A behaviour made using different methods is the focus of active debate. Presented here are preliminary meta‐analyses regarding:(a)internal consistency, test—retest and parallel forms reliabilities of the most frequently used questionnaire (Jenkins Activity Survey);(b)inter‐rater and test—retest reliabilities of the most prospectively valid method (Friedman Structured Interview); and(c)correlations and percentage classification agreement between these measures. The findings generally suggest highly statistically significant yet moderate effect strengths for these various psychometric pro

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02809.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

This paper is concerned with how Type A and B subjects perceive themselves. Subjects first completed a unidimensional A type measure, then rated themselves and their ideal selves on various personality traits. As expected, Type A was associated with negative self‐ratings and high actual‐ideal self‐discrepancy scores. However, it is argued that self‐evaluation in negative terms by Type As is not necessarily synonymous with low self‐esteem. Negative self‐ratings may be an important factor in the aetiology and maintenance of the Type A behavi

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02810.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The Eating Attitudes Test (EAT) and another questionnaire aimed at sociodemographic and body shape information were administered to an adolescent population of 1554 students from Barcelona in the 12–19 age group. The highest scores on EAT were obtained by girls, older adolescents, overweight adolescents, adolescents practising restrictive diets, adolescents considering themselves obese and those wishing to modify their body size. The same characteristics were associated with EAT scores higher than 30 (the cut‐off score, established by the authors of the questionnaire, above which the anorexic population is placed). Results are analysed in terms of sociocultural pressures on adolescents, particularly females, who are subjected to the ‘culture of slender

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02811.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A study was designed to examine the hypothesis that occupational stress in nurses is a function of how they perceive their work environment. Sixty‐five nurses on four mixed‐sex wards were interviewed using a nursing stress and work environment scale. Demographic data including age, sex and nursing status were also collected. ‘Work overload’ and the ‘death and dying’ of patients were identified as the major sources of stress for all the nurses. In general, although there was little difference between the specialized and non‐specialized groups of nurses in the degree of stress experienced, the work environments were found to be dissimilar. The reported level of dissatisfaction with their work environment combined with certain demographic characteristics were found significantly to predict the degree of stress experienced. These findings have implications for the organization of the ward and for the skills taught to nurses by which stress may be managed

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02812.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

This report reviews treatment studies of post‐traumatic stress disorder (PTSD). Much of the literature is descriptive and concentrates on particular treatment modalities without attempting to integrate these different approaches into the wider body of knowledge about PTSD. No study has randomly assigned patients to experimental and control groups.The treatment of 56 patients with PTSD is described, highlighting issues which influence the choice of approach and focus of therapy. These issues are seldom mentioned in the PTSD literature and include the unusual difficulties involved in developing a therapeutic alliance, the role of non‐specific elements and the treatment of coexistent psychiatric disorders which are frequently present. The need to consider separately the degree of disturbed attention and arousal, the nature of the traumatic preoccupation and the patient's social and occupational functioning are stressed.The lack of knowledge about the natural history of PTSD and the different effectiveness of treatments in the acute and chronic stages are other uncertainties about the treatment of PTSD. Consideration of these points has led to a series of recommendations for future studies of the treatment of P

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02813.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The rate of psychiatric morbidity and levels of psychological well‐being and distress were assessed in groups of dialysis, renal transplant and general practice patients. Dialysis patients suffered from significantly higher rates of psychiatric morbidity, with 43 per cent falling into the probable psychiatric case range on the GHQ. Results from the Mental Health Inventory also showed dialysis patients to have a significantly poorer level of psychological adjustment than the other groups. While positive mental health states in dialysis patients were not significantly different from transplant and general practice controls, higher rates of psychological distress were found in patients on dialysis. Distress was characterized by a loss of emotional control and higher levels of depressio

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1989.tb02814.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY