Retirement and the Contemporary Family

Summary

Profound changes in the nation's demographic patterns have transformed life for contemporary Americans. People 65 years of age and over now comprise a much larger segment of the population. They are both living longer and living more healthily. An additional 27 years has been added to the life span of the child of 1985 as compared to a child born in 1900, so that the problems and solutions of today will not be final but must continue to command the attention of the public. These changes are affecting family life. The meaning of retirement has changed. The timetable for retirement is a new one. The needs of the retiring and retirement population have changed. The article discusses new ways of confronting these needs. Eldercare is seriously affecting the workplace. The seeming dilemma, faced especially by female employees, in choosing between working at a career and providing home care for a vulnerable relative, may have a resolution. More outside help is available to the family than at any earlier period so that helping an aging relative no longer has to mean dedicating one's entire life to providing eldercare. The ideal still is to maintain independent living for both the active and frail elderly as long as practically possible. Family and friends of the frail elderly no longer have to carry the burden alone. A spectrum of in-home services is available to families across the land.     

Psychotherapie mit Älteren: Zielsetzungen, Möglichkeiten und Grenzen

Age should not be considered a detriment to entering into a therapeutic relationship as psychotherapy with those in the 60+ age group has been shown to be useful and yield successful long-term results. Beyond the therapeutic method used, working with seniors (or the elderly) demands additional generally achievable objectives. Specifically, those from the field of psychoanalytic theory employ treatment methods such as relaxation and creative processes which have been found to be helpful and well-received by seniors. Focused short-term therapy and group therapy are the dominant methods used with this age group. It is important to note that the pairing of a senior with a younger therapist may constellate particular emotional difficulties on the part of the therapist. In particular, the therapist needs to be aware of her/his own unfamiliarity with the patient's earlier life phases, as well as the therapists's fear of her/his own aging process and a reverse unconscious transference. However, chronological age in and of itself is not a contraindication for a successful psychotherapy.     

Disordered Eating and Gender Identity Disorder: A Qualitative Study

The association between disordered eating and gender identity was examined in a sample of 20 (11 female-to-male, 9 male-to-female) transgender Finnish adults, aged 21–62 years. Using semi-structured interviews, participants' own understanding of the underlying causes of their disordered eating was analyzed, as well as the effect of gender reassignment on eating behaviors and cognitions. A majority of the participants reported current or past disordered eating. Participants most frequently described strive for thinness as an attempt to suppress features of one's biological gender, or accentuate features of one's desired gender. Gender reassignment was primarily perceived as alleviating symptoms of disordered eating.     

Activity and Masochism

The author draws on his own experience of traumatized states to explicate what he calls the ontological unconscious—the loss of one's sense of being. He proposes that it is in the process through which emotional experience comes into language that the sense of being is born, and that the aborting of this process brings a loss of the sense of being. The loss and regaining of one's sense of being are profoundly context-dependent, hinging on whether the intersubjective contexts of one's living prohibit or welcome the coming into language of one's emotional experiences.     

Functional activity and effective connectivity of the posterior medial prefrontal cortex during processing of incongruent mental states

The neurocognitive components of Theory of Mind reasoning remain poorly understood. In particular the role of the posterior medial prefrontal cortex in the processing of other's mental states such as beliefs that are incongruent with one's own knowledge of reality is not clear‐cut. It is unknown whether this region is involved in computing discrepant mental states or in subsequently resolving a response conflict between the discrepant others' and one's own beliefs. To test this, we adapted a false belief paradigm for the separate inspection of functional brain activity related to (1) the computation of diverging beliefs and (2) the subsequent consideration and selection of another's or one's own belief. Based on statistical parametric findings from functional neuroimaging, we employed dynamic causal modelling combined with Bayesian model selection to further characterize the interplay of resulting brain regions. In the initial computation of diverging beliefs, the posterior medial prefrontal cortex (pMPFC) and the bilateral temporoparietal cortex were crucially involved. The findings suggest that the bilateral temporal cortex engages in the construction and adjustment of diverging mental states by encoding relevant environmental information. The pMPFC inhibits this stimulus‐bound processing which helps to compute discrepant mental states and process another's false belief decoupled from one's own perception of reality. In the subsequent question phase the right temporoparietal cortex showed increased activity related to switching to and reconsidering another's beliefs in order to select the correct response. Hum Brain Mapp 35:2950–2965, 2014. © 2013 Wiley Periodicals, Inc.     

The self across the senses: an fMRI study of self-face and self-voice recognition

There is evidence that the right hemisphere is involved in processing self-related stimuli. Previous brain imaging research has found a network of right-lateralized brain regions that preferentially respond to seeing one''s own face rather than a familiar other. Given that the self is an abstract multimodal concept, we tested whether these brain regions would also discriminate the sound of one''s own voice compared to a friend''s voice. Participants were shown photographs of their own face and friend''s face, and also listened to recordings of their own voice and a friend''s voice during fMRI scanning. Consistent with previous studies, seeing one''s own face activated regions in the inferior frontal gyrus (IFG), inferior parietal lobe and inferior occipital cortex in the right hemisphere. In addition, listening to one''s voice also showed increased activity in the right IFG. These data suggest that the right IFG is concerned with processing self-related stimuli across multiple sensory modalities and that it may contribute to an abstract self-representation.     

L’intime conviction des magistrats : subjectivation pénale et conflit subjectif dans un cas d’inceste

In the French law tradition, jurors and judges have to use their intimate conviction to judge not only the reality of the act, but also the intention of the author and his/her spirit. This article builds upon the logic and confrontation of elements of prosecution and defense; deriving along with other motifs from the necessary personnal implication of the magistrate in the construction of his or her judgement and continued support of it. However, adressing the process of intimate conviction from a psychoanalytic perspective exposes third level of conflict: one between mental cognitions; one between trust and distrust regarding one's own representations, and another regarding one's own affective tendencies, which have to keep away. Our objective is to study how the judges, subjectively, appropriate or not the conflict induced by legal texts on intimate conviction. Drawing on an analysis of interviews with judges about a rape case that occurred within a family, with no other element of proof than the weight of the testimony and the avowal of the victim, we extrapolate how the subjectivation of the criminal act is dependent upon the relationship judge had with his or her own capacity to withstand the psychic conflict it induces.     

Autobiographies,récits et témoignages : rôle et sens des souvenirs d’enfance

Childhood memories are present in most literary, philosophical or even scientific writings. To speak of oneself means to give priority to certain periods of one's life, to omit others and to give childhood memories a place that can change the meaning and objectives of the narrative. By using the analytical method, the author from biographies that have marked history, questions the functions of childhood memory in the construction of the narrative of one's own life. The author successively analyses the theoretical quarrels about the age of the first memory, the links with the characteristics of memory, the place of childhood memories in the forms of the biographical narrative with the current shift towards fiction, dominant themes among life events and relationship to the psychopathological clinic. The nature of the memory, the time elapsed between the moment it is placed and the moment it is narrated, seems difficult to specify. The same is true of the amplification or cancellation of what happened, especially as other life events intervened, sometimes traumatic. It analyses the underlying elements of self-knowledge and the deviations induced by the new pressures of the media world that make every story slip into fiction.     

Psychiatrische Erkrankungen im Alter – Bedeutung und Besonderheiten

As the population of seniors increases, the number of those who suffer mental illness increases as well. Seniors suffer the effects of loss and isolation more frequently than other segments of the population, especially through the death of a spouse and friends, loss of profession through retirement and loss of familiar roles. They also deal with a greater amount of illness as more than 75% of those over 70 years old experience at least five physical ailments or impediments. The burden of care falls on those most closely related to the senior, especially so in cases of dementia. With age comes an increased risk of cognitive impairment, which is important to recognize and address. Compared with the general population, there is a higher rate of suicide and depression among seniors. Treatment through medication and psychotherapy needs to increase. The makeup of today's seniors is psychologically quite different from that of the previous generation; this is especially true for women. The seniors of this generation will advance their demands for a better quality of living, which with regard to their emotional and spiritual well-being will likely result in an increased demand for psychotherapy.     

Dynamic cultural modulation of neural responses to one's own and friend's faces

Long-term cultural experiences influence neural response to one''s own and friend''s faces. The present study investigated whether an individual''s culturally specific pattern of neural activity to faces can be modulated by temporary access to other cultural frameworks using a self-construal priming paradigm. Event-related potentials were recorded from British and Chinese adults during judgments of orientations of one''s own and friend''s faces after they were primed with independent and interdependent self-construals. We found that an early frontal negative activity at 220–340 ms (the anterior N2) differentiated between one''s own and friend''s faces in both cultural groups. Most remarkably, for British participants, priming an interdependent self-construal reduced the default anterior N2 to their own faces. For Chinese participants, however, priming an independent self-construal suppressed the default anterior N2 to their friend''s faces. These findings indicate fast modulations of culturally specific neural responses induced by temporary access to other cultural frameworks.     

Personality problems among adults molested as children

Pervasive and persistent personality problems concerning personal safety, trust in others' and one's own judgements, self-esteem, control of one's own behaviour and one's environment, and connection with other people, appear to be common among adult clients who were sexually abused in childhood. It is postulated that schema theory may provide a useful explanatory link between such childhood experiences and later personality problems. To the extent that this is a valid proposition, schema-focused cognitive therapy is suggested as the treatment of choice for these problems in this client group.     

Compassionate authenticity: a treatment model for working with women with low libido

Women often report taking care of others at the expense of their own well-being in the name of being compassionate. As a result, they may experience a drop in vital energy, including a drop in sensual energy and libido, and a rise in resentment towards their sexual partners, ultimately leading to a lack of satisfying sexual relationship for both partners. A theoretical framework is proposed based on the author's original idea of compassionate authenticity. According to this theory, the most compassionate act a partner can give is one's own authentic presence in the relationship, as this promotes genuine intimacy and sensual flow. This paper guides the reader in the application of the compassionate authenticity treatment model to work with clients with low libido. The model involves the intentional application of an eclectic approach that addresses three critical treatment goals: (1) building acceptance of and curiosity about one's sensuality; (2) differentiating from one's sexual partner/s; and (3) redefining sexual and emotional caretaking.     

Religioese Erlebnisse Bei Schizophrenen

Two cases of the schizophrenia are reported with phenomenological discussion of their religious experiences of Christian nature that appeared in the course of the illness. These experiences are so similar to the conversion and continue in the subsequent spiritual life of these patients and exert influences deeply upon the healing process of the illness. Their experiences of Christian nature didn't appear suddenly, but arose as consequence of a concentration of conflicts that had been accumulated up to that time similar to the phenomena of thc conversion. The problem of the insight into the illness was also refereed; the attitude toward the illness changed after the religious experiences into an “affirmative attitude with positive acceptance of one's own illness.”     

Subjective quality of life and standard of living: a 10-year follow-up of out-patients with schizophrenia

In 1984, a study in Göteborg, Sweden, reported the quality of life of 61 outpatients with schizophrenia (DSM-III) to be low, despite their high standard of living. The respondents used an instrument (QLS-100) developed by the author to indicate which of 100 items they considered to be unsatisfactory. Interviews captured objective conditions of the patients' lives and their quality-of-life goals for each unsatisfactory item. The results of the study led during the late 1980s to deliberately individualized services, aimed at helping patients to attain their own quality-of-life goals. In total, 40 of the subjects took part in a 10-year follow-up. The 1994 study showed that the incidence of living alone in one's own home increased. Overall quality of life remained unchanged. Although still low, quality of life increased significantly in three of 14 domains, namely contacts, inner experiences, and knowledge and education. The reasons for these improvements and the maintained overall quality of life could be that patients increased their ability to interact with the environment, that they increased and/or modified their aspirations in the light of available resources and/or deficits, and that housekeeping assistance and service were provided conditional on the patients' own quality-of-life goals and needs.     

Index Vol. 21

Survivors of tragedy are often robbed of their voice. Shame and fear following trauma encourage silence and a tendency to hide. Dissociation, initially a coping mechanism, leads to discontinuity and fragmentation and ultimately undermines one's sense of identity. Telling one's story is an empowering experience that potentially restores a sense of continuity and wholeness.

The author, a child survivor of the Holocaust, a psychoanalyst, and the author of an award-winning memoir, draws on her personal experience to highlight various aspects of autobiographical narrative and its potential for facilitating the healing process.

Although relatively few psychoanalysts have written their memoirs, a number have used their own lives disguised as case material. Further, there is a current trend in clinical psychoanalysis toward greater personal expression and self-disclosure. The impact of analyst self-revelations on the therapeutic process has been researched by Dr. Richman and is further discussed in this presentation.     

"Hitomishiri" as a Japanese Concept of Stranger Anxiety and Anthropophobia

We have considered a feeling of “Hito-mishiri” and anthropophobia as a state of personal relations that is closely related to the special consciousness that one realizes oneself to belong to the inside or the outside circle, postulating that a feeling of shame underlies “Hitomishiri”. The statistical survey of the images over “Hitomishiri” revealed that double-structural characteristics is seen in a feeling of personal relations. In this connection anthropophobia and “Hitomishiri” were also discussed. “Hitomishiri”, however, should be considered in another aspects when it is felt in a certain personal relations; one of the aspects is a response to one's consciousness of others arising from one's awareness of own body. These two kinds of consciousness are two cooperative alternatives for the mental integrity; one's own consciousness corresponds to others‘, and in consequently both interact with each other as two cooperative alternative factors for the mental integrity in which, if one becomes conscious, others respond to it. Therefore, a feeling of “Hitomishiri” forms a pair with one's awareness of body, normally an unnoticed, neutral background for consciousness, which is obtained through one's sense that feels something from with in a certain physical state, as the relations of one in the inside to others in the outside circle is disclosed by the emotional disturbance in one's environs. It seems to be characteristic of hypochondriac trait, that it is initiated in the proess where one experiences a unpleasant, unstable feeling, and trys to exclude it because one always lives with pleasant, stable feelings with those who are in the same inside circle. For this reason, we should not ignore the historical background with regard to that a desire for self approval is controlled by the emotional, cultural conditions in Japan. It seems to be somewhat difficult at present to perform detailed analysis of “Hitomishiri,”“shame”, and anthropophobia, because there are few of comparative studies on them available. If we continue investigation of anthropophobia and orthopsiaphobia in the direction on as so far discussed, it will serve to make deeper analysis of these psychological disturbances that are popular in Japan.     

Enduring Mothers,Enduring Knowledge: On Rape and History

Abstract

Different terms are used to describe the intergenerational transmission of trauma. Faimberg (1988) speaks of the telescoping of generations to explain an unconscious identification process occurring across generations, thereby thickening a history that—at least in part—does not belong to the patient's generation. Kestenberg (1990), writing about the second and third generation from the Holocaust, speaks of transposition to describe the situation in which there is reliving, without conscious awareness, of the experience of another generation as though it were one's very own experience. What is clear is that when there is silence and absence, the past repeats in the present, and the victim—as well as future generations—are burdened. Grief and intolerable pain cannot be hidden, not from the victim, nor from the generations that follow.     

Psychotherapie im Alter: Zusammenfassung der Podiumsdiskussion

The discussion showed the importance of the interdisciplinary alliance between psychology and medicine. In psychotherapy with seniors both the unconscious and spiritual processes are deeply meaningful and important aspects of the work. Resource-oriented models of the therapeutic work stand far more in the foreground than treatment methods based on pathological concepts of aging. There was a controversial discussion regarding questions of affect and models of life during the aging process. Overall, it appears important that there is a place in the society where emotion could be allowed, articulated and accepted. Another central concern lay in finding a mode of life in which individual life choices and optimum mobility for seniors are possible. In general, one of the most important factors of the lively community between people is that social interaction helps to carry the burdens and losses that are a part of aging. It should be a task of the therapy to discover, discuss and promote such resources with the client.     

Stress and behavioral risk among young expectant couples

Few studies have explored stress and coping among adolescents who are expecting a baby. In particular, young men's experiences during pregnancy have largely been ignored, despite the fact that a young man's experiences and behaviors carry implications for his own, his partner's and his child's health. This study examined the association between maternal and paternal experiences of stress during pregnancy with one's own and one's partner's health behaviors and depressive symptoms among 294 young expectant couples in the U.S. Multilevel modeling showed that one's own experiences of stress were associated with more unhealthy behaviors and more depressive symptoms among both expectant mothers and fathers. Paternal experiences of stress were predictive of more maternal conduct problems, while maternal experiences of stress were predictive of more paternal depressive symptoms and less paternal substance use. These findings highlight the importance of social relationships in affecting health behaviors and mental health among expectant adolescents.     

The neural basis of one's own conscious and unconscious emotional states

The study of emotional states has recently received considerable attention within the cognitive and neural sciences. However, limited work has been done to synthesize this growing body of literature within a coherent hierarchical, neuro-cognitive framework. In this article, we review evidence pertaining to three interacting hierarchical neural systems associated with the generation, perception and regulation of one's own emotional state. In the framework we propose, emotion generation proceeds through a series of appraisal mechanisms – some of which appear to require more cognitively sophisticated computational processing (and hence more time) than others – that ultimately trigger iterative adjustments to one's bodily state (as well as to the modes of processing in other cognitive systems). Perceiving one's own emotions then involves a multi-stage interoceptive/somatosensory process by which these body state patterns are detected and assigned conceptual emotional meaning. Finally, emotion regulation can be understood as a hierarchical control system that, at various levels, modulates autonomic reactions, appraisal mechanisms, attention, the contents of working memory, and goal-directed action selection. We highlight implications this integrative model may have for competing theories of emotion and emotional consciousness and for guiding future research.