Issues surrounding sibling death during-adolescence

This paper will examine the inability of adolescents to mourn their siblings and the resultant isolation from family and peers caused by their insistence on a stance of normalcy. The issues of adolescence—consolidation of ego identity, emotional separation from the family, and the concomitant greater investment in the peer group—are all impacted upon by the death of a sibling. An examination of the effect of sibling death on this process will show how the inability of the adolescent to pass through the separation individuation process of adolescence or to give up the libidinal cathexis of the lost object (the goal of mourning) leads to an emotional overinvestment in the family of origin.     

IMPEDIMENTS TO INTIMACY

Research results indicate that intimate contact can profoundly affect health and well-being. The capacity for intimacy, however, differs from person to person. Given its origin in the symbiotic phase of development and its being influenced by the separation-individuation process, the capacity for intimacy is subject to disruption by fear of object loss and fear of merger. In this article, I examine these and other fears as impediments to intimacy. Because of the affective engagement between patient and analyst, these impediments can best be studied, understood, and treated within the psychoanalytic relationship. This article is an expanded version of a paper presented as part of the “Love and Intimacy” panel at the conference of the National Membership Committee on Psychoanalysis in Clinical Social Work: “Psychoanalysis: Changing in a Changing World,” March 13, 2004.     

Toward Less Fixed Internal Transformations of Gender Commentary on: Melancholy Femininity and Obsessive—Compulsive Masculinity: Sex Differences in Melancholy Gender by Meg Jay,Ph.D.

While highly commending this cross-disciplinary exercise and agreeing with Jay and Butler that children may indeed mourn the loss of erotics with same-sex parents as they identify and develop in a gendered fashion, this author highlights, in both Butler and Jay's interesting further refinements of Butler's position in their use of Freud's 1917 paper on “Mourning and Melancholia,” a lack of attention to the significant aggression that Freud also included in this early formulation concerning the lost object. A consideration of such affects is well taken, but this author prefers a less sparse and monolithic linear clarity about how girls grow into sexed and gendered women. She feels the limitation here of the use of later analytic theory such as Loewald's rich account of internalization.     

The Male Way of Mourning Divorce: When, What, and How

Based on the literature on divorce, this paper explores the distinct ways in which men mourn the losses inherent in the breakup of a marriage. It argues that men have a distinct way of mourning that differs from that of women. They start the mourning process later than women, mourn the loss of their home and children more than the loss of their wives, and tend to express their mourning through actions rather than in words or obvious emotional manifestations of grief. The paper considers possible reasons for these behaviors and their implications for practitioners.     

“I Am Not Who I Thought I Was”: Use of Grief Work to Address Disrupted Identity Among Hispanic Adolescent Immigrants

Immigration from Latin America to the United States is often an escape from difficult circumstances, but with this gain comes a loss of identity. This can be a special burden for adolescents, who are thrown into a new culture and environment while in the process of identity formation. Using case studies from my work as a psychotherapist in a community mental health clinic, I will describe this special turmoil and a way in which Latino immigrant teenagers can be helped to resolve it. Psychodynamic grief work aimed at helping them mourn the loss of identities and valued capacities through emigration can reduce self-destructive enactments and support them in the adolescent task of forming an identity.     

Auctioning or assigning an object: some remarkable VCG mechanisms

We construct a variant of the Vickrey auction of a single object where the surplus is split in exogenously fixed shares between the seller and the buyers, up to a margin of error vanishingly exponentially as the number of buyers grows. When the object is the common property of the participants, we can similarly construct VCG mechanisms with a vanishingly small cash transfer to the residual claimant. For any integer q, 3 ≤ q ≤ n, we find the mechanism guaranteeing to each participant a fair share of the qth highest valuation, while minimizing the worst possible ratio of the cash transfer to the efficient surplus. We perform a parallel analysis when the object is undesirable. We compare the cash lost to the largest spread between individual valuations, and obtain the same trade-offs between fairness and the relative loss of surplus.     

Labiaplasty and the Melancholic Breast

This article is an attempt to think through the sociosymbolic dimensions of the phenomenon of nonmedical or cosmetic surgical reduction of the labia minora, an interventionist medical practice that is gaining currency in the contemporary Western context. The article seeks to navigate the symbolic meaning of labial excision in the contemporary Western “postfeminist” context. I suggest that the desire for labiaplasty is embedded in a dialectical narrative of femininity that draws upon a specifically postfeminist distinction between desirable sexuality and undesirable maternity. I use the Kleinian theory of melancholic loss to argue that the contemporary desire for labiaplasty is indicative of a failure of mourning and the inability to establish the maternal breast as a good internal object in the psychosocial formation of the feminine body-ego. I argue that because the mother’s breast cannot be legitimately mourned, the female body is compelled to abject its reproductive, animal materiality.     

John: Some thoughts on mourning

The perennial question, “Do children mourn?”, forms the backdrop to this discussion of a treatment which spans a 10-year period. Both clinical as well as cultural factors are examined and an effort is made to assess the effect of the loss on the patient's character.     

Overvaluing the therapist: The search for a good object

Summary In this paper, an attempt was made to relate clinical practice to theory as it provides direction in working with transference manifestations presented by a patient entering therapy with an immediate need to overvalue the therapist. The problem was related to the patient's inability to tolerate separation (object loss) because of failure to develop ego precipitates leading to her own positive self-image. The conditions for developing a positive self-image were outlined. Vignettes from the patient's history were offered to illustrate the problem in practice.     

What is a problem?

Among others, the term “problem” plays a major role in the various attempts to characterize interdisciplinarity or transdisciplinarity, as used synonymously in this paper. Interdisciplinarity (ID) is regarded as “problem solving among science, technology and society” and as “problem orientation beyond disciplinary constraints” (cf. Frodeman et al.: The Oxford Handbook of Interdisciplinarity. Oxford University Press, Oxford, 2010). The point of departure of this paper is that the discourse and practice of ID have problems with the “problem”. The objective here is to shed some light on the vague notion of “problem” in order to advocate a specific type of interdisciplinarity: problem-oriented interdisciplinarity. The outline is as follows: Taking an ex negativo approach, I will show what problem-oriented ID does not mean. Using references to well-established distinctions in philosophy of science, I will show three other types of ID that should not be placed under the umbrella term “problem-oriented ID”: object-oriented ID (“ontology”), theory-oriented ID (epistemology), and method-oriented ID (methodology). Different philosophical thought traditions can be related to these distinguishable meanings. I will then clarify the notion of “problem” by looking at three systematic elements: an undesired (initial) state, a desired (goal) state, and the barriers in getting from the one to the other. These three elements include three related kinds of knowledge: systems, target, and transformation knowledge. This paper elaborates further methodological and epistemological elements of problem-oriented ID. It concludes by stressing that problem-oriented ID is the most needed as well as the most challenging type of ID.     

Implications of intersubjectivity for supervisory practice

Different aspects of a case will be emphasized depending on the theoretical lens used to understand it. Intersubjectivity theory will be used in case discussion to illustrate how our focus in the case shifts with different theoretical orientations. By using intersubjectivity, the multiple subjectivities: patient, therapist and supervisor’s influence on the therapeutic process are highlighted. Case material is discussed in the context of death and loss.     

CLIENTS ROLE CHOICES: UNEXPLORED FACTORS IN INTERVENTION DECISIONS

The role of the client in social work interventions has not been extensively explored in the professional literature. However, the client role varies significantly in different models of care and carries vast differences in the expectations and behaviors required of clients in the process. Clients’ individual characteristics, preferences, and expectations make them better suited to some approaches than others. This paper explores the change in perspectives on consumers emerging in the field and analyzes client role factors in four intervention models. It will also discuss the “fit” between the client and the particular approach as well as implications for outcomes and evidence-based practice.     

Communication problems in the intensive care unit

Hospitalization in an intensive care unit is often physically uncomfortable and socially disorganizing. The ordinary forms of conversational participation that generate and sustain a sense of agency are breached when the patient cannot communicate in socially consensual “real time.” Using my own experience in an intensive care unit, I describe how delayed speech, through the use of an alphabet board, frequently leads to a host of interactional problems and mutual accusations about character. I attempt to show that the fabric of self and the perception of quality of care are achieved through “real time” communication. I also describe the differential communicative structure of those who will not and those who will use my alphabet board. Those using the board exhibit, through board employment and through the “local” topics discussed, a depth of common culture between them and me.     

“Separation Guilt” in Women Who Initiate Divorce

This paper explores the “separation guilt” of women who initiate divorce. The paper argues that the gender-specific processes of separation individuation and socialization that women undergo in childhood make them vulnerable to similar guilt feelings when they initiate divorce, only towards the husband they are leaving. It further argues that these feelings may impair their post-divorce adjustment. The paper illustrates these points with two case studies, one showing how the woman’s separation guilt thwarted the development of new intimacy, the other showing how it impaired her maternal functioning. Recommendations are made for treatment and research. Nehami Baum Ph.D., is a lecturer at the School of Social Work at Bar Ilan University. She is a social worker with experience in both public and private practice. Her special interests include non-death related loss, divorce, men in therapy, treatment termination, social work students’ professional identity formation, guilt, and social work in times of terror and political tension.     

Collecting loss

ABSTRACT

‘Collecting Loss’ develops themes from Pleasures Taken (Mavor, Duke University Press, 1995) with an emphasis on the fetishization of photographs and old clothes (exemplified, on the one hand, in Elin O'Hara Slavick's own girlhood dresses that she has stitched with haunting memories of her childhood, and on the other hand in the lush photographs taken by Sally Mann and the Victorian photographer Clementina Hawarden). As Christian Boltanski has written: ‘What they [clothing and photographs] have in common is that they are simultaneously presence and absence. They are both an object and a souvenir of a subject, exactly as a cadaver is both an object and a souvenir of a subject.’ Reading an old photographic album made by her own grandmother against other maternal collections of plenitude (whether they be old clothes or photographs or domestic bric-a-brac), Mavor reveals how such accumulated goods are made to fill in for the pangs of loss: lost childhoods, lost family histories, lost memories, lost friends. Mixing corporeality and critical theory, Mavor engages with Emily Apter's notion of ‘maternal collectomania’ as a site of provocative meanings worthy of placement alongside more conventional discourses on visual representation and collecting.     

Altruistic and Vicarious Fear of Crime: Fear for Others and Gendered Social Roles

Fear for others as distinct from personal fear is an understudied phenomenon. Relying on qualitative data, this paper explores gender differences in fear for others and identifies differences linked to social roles. For men, a paternal protector role characterized fears expressed mostly for their wives. For women, a maternal caretaker role characterized fears expressed for their children, elderly parents, and siblings. This paper offers a new way to conceptualize fear for others based on making distinctions between the object of fear and active or nonactive responses: kinship-based altruistic fear, kinship-based vicarious fear, general altruistic fear, and general vicarious fear.

Maternal Work and Child Overweight and Obesity: The Importance of Timing

Previous studies have found that increased work by mothers results in an increased likelihood that children are obese. Building upon this work, this study uses data from the National Longitudinal Survey of Youth-Child Supplement to investigate whether the timing of maternal work matters to this relationship. Fixed effects models found that maternal work at ages 9–11 and 12–14 was related to an increased rate of overweight during the same periods, while work at ages 6–8 resulted in a decreased rate of obesity in the same period and later at ages 9–11, a novel finding. Subgroup analyses found that effects were confined to families who were relatively low income and to children who grew up with single mothers.     

The Tango of Loving Hate: Couple Dynamics in High-Conflict Divorce

This article explores the dynamics of couples embroiled in high-conflict divorce through the theoretical prism of British object relations theory. Such couples are often characterized by primitive object relations, and use splitting and projection as a way of “being in the world.” The fear of the ex-spouse’s retaliation is accompanied by fear of their own destructiveness and a desire to make reparation; however, attempts at reparation at this level of relational functioning rarely achieve reconciliation. In fact, such dynamics create a cycle of terror, retaliation, and failed reparation attempts that in turn leads to further terror, splitting and projection, with the resulting outcome often a high-conflict divorce.     

Marital treatment following early infant death

In recent years, clinicians have become increasingly more aware of the high risk of psychiatric disability when parents are unable to mourn the loss of a stillborn baby or a neonate. The literature discussing the psychodynamic functions of this mourning process and the social as well as intrapsychic defenses against it is examined. A clinical illustration suggests how difficulty in acknowledging the ongoing significance of the infant's death can have major ramifications within both the marital relationship and the treatment context. Countertransference issues are found to be particularly important.     

Effects of prenatal care on maternal postpartum behaviors

Most research on the effectiveness of prenatal care has focused on birth outcomes and has found small or no effects. It is possible, however, that prenatal care is “too little too late” to improve pregnancy outcomes in the aggregate, but that it increases the use of pediatric health care or improves maternal health-related parenting practices and, ultimately, child health. We use data from the Fragile Families and Child Wellbeing birth cohort study that have been augmented with hospital medical record data to estimate effects of prenatal care timing on pediatric health care utilization and health-related parenting behaviors during the first year of the child’s life. We focus on maternal postpartum smoking, preventive health care visits for the child, and breastfeeding. We use a multi-pronged approach to address the potential endogeneity of the timing of prenatal care. We find that first trimester prenatal care appears to decrease maternal postpartum smoking by about 5 percentage points and increase the likelihood of 4 or more well-baby visits by about 1 percentage point, and that it may also have a positive effect on breastfeeding. These findings suggest that there are benefits to standard prenatal care that are generally not considered in evaluations of prenatal care programs and interventions.