Norbert Freedman

Kinetic behavior in altered clinical states: approach to objective analysis of motor behavior during clinical interviews.

This paper presents a scheme, derived both rationally and empirically, for the analysis of body movements occurring spontaneously in psychotherapeutic interviews. Focussing on hand movements, a distinction is made between two broad, conceptually different, and independent classes of movements: those accompanying speech (object-focussed), and those involving some form of self-stimulation but not speech-related (body-focussed). Furthermore, different kinds of object-focussed movements are identified according to their integration with and primacy vis-a-vis speech. Observations on two paranoid patients, each at two different points in his treatment, suggest that the coding scheme can reflect the patients altered clinical states.

Psychological differentiation as a factor in conflict resolution.

Previous studies have shown that persons matched in level of differentiation are likely to develop greater interpersonal attraction in the course of an interaction than are mismatched persons. These studies were all conducted in situations where the interacting persons were working toward a common goal. To test the hypothesis that situational variables may moderate match-mismatch effects, the present study investigated these affects when the interacting persons were in conflict. Based on their performance in tests of field dependence-independence, subjects were selected as relatively high or relatively low in level of differentiation. Three kinds of dyads were composed-high-differentiation/high-differentiation, low-differentiation/low-differentiation, and high-differentiation/low-differentiation--and their task was to reconcile conflict on an issue about which they were known to disagree. It was predicted that because of the more accommodating quality of low-differentiation persons, dyads including one or two such subjects would more often reconcile their disagreements and show greater interpersonal attraction than would dyads consisting of two high-differentiation subjects. Both predictions were confirmed, supporting the hypothesis that the outcome of match or mismatch is mediated by situational variables.

Hands, Words, and Mind: On the Structuralization of Body Movements During Discourse and the Capacity for Verbal Representation

Harold Bloom (1973), in his quest to depict the relationship of one poet to another, put forth a forceful idea—the anxiety of influence. The poet, in his effort to preserve the integrity of his creative thought, must continually ward off the intrusion of his predecessors. He turns his energies upon himself to retain this autonomy, and often achieves it at terrible cost. The verbal dialogue in human discourse is far from a poetic dialogue, but, it too, is governed by the anxiety of influence.

Depression in a Family Practice Elderly Population

This study addresses several major methodologic issues in the assessment of depressive illness among the elderly family practice patients living in the community. These include the selection of screening locale, the definition of depression in the elderly, and the evaluation of age trends within this group. The family physicians office is viewed as the optimal screening locale; this facility serves as the chief link between the elderly patient and the community health care system, for psychologic as well as physical complaints. In the definition of depression, a type of depressive illness particularly affecting the elderly may be distinguished from a syndrome more characteristic of depression in the population at large. Emphasis is laid on viewing aging as an evolving process rather than as a steady state. A pilot study of 166 chronically ill family practice patients living in the community was conducted. A large proportion of them, all without previously diagnosed psychiatric impairment, had elevated depression scores according to the Zung Depression Status Inventory. Distinct symptom clusters characteristic of depression in the aged were identified. The data also suggested a systematic age trend, with different peaks of depression for men and women within the elderly age range.

On kinetic filtering in associative monologue

... mechanically ... I raised to my lips a spoonful of the tea in which I had soaked a morsel of the cake. No sooner had the warm liquid, and the crumbs with it, touched my palate than a shudder ran through my whole body, and I stopped, intent upon the extraordinary changes that were taking place. An exquisite pleasure had invaded my sense, but individual, detached, with no suggestion of its origin ... I was conscious that it was connected with the taste of tea and cake ... I decided to attempt to make it reappear. I shut out every obstacle, every extraneous idea, I stop my ears and inhibit all attention to the sounds which come from the next room ... I compel it for a change to enjoy that distraction which I have just denied it, to think of other things, to rest and refresh itself... I place in position before my minds eye the still recent taste of that first mouthful, and I feel something start within me.. . something that has been embedded like an anchor at a great depth ... Undoubtedly what is thus palpitating in the depths of my being must be the image, the visual memory which, being liked to that taste, has tried to follow it into my conscious mind ... Will it ultimately reach the clear surface of my consciousness ... each time the natural laziness which deters us from every difficult enterprise ... has urged me to leave the thing alone, to drink my tea and to think merely of the worries of to-day ... and suddenly the memory returns. The taste was that of the little crumb which ... on Sunday mornings ... when I went to say good day to her in her bedroom, my aunt Leonie used to give me, dipping it first in her own cup of real or of lime-flower tea. (Proust 1928: 54-57)

Body movement and verbal encoding in the congenitally blind.

The purpose of the study was to examine the prevalence of object- and body-focused hand movements of the congenitally blind individuals engaged in an encoding task and to determine the relation of these movements to verbal performance. Ten Ss participated in a 5-min. videotaped monologue. The video portion was coded for hand movements using Freedmans categories of analysis. The audio portion was scored for grammatical complexity according to a system developed by Steingart and Freedman. It was found that: (1) Blind Ss engaged only in body-focused movements; object-focused movements were almost completely absent. (2) Blind Ss displayed significantly greater amounts of body-focused (primarily finger-to-hand) movements than a group of sighted Ss observed in a previous study. (3) There was a correlation of .51 between finger-to-hand movements and verbal fluency and a correlation of –.53 between body-touching and verbal fluency. (4) Ss with a prevalence of finger-to-hand movements showed significantly greater language skill at encoding complex sentences which portray descriptions of patterned, interrelationships among experiences, while Ss with a predominance of continuous body touching gave a less skillful language product in this regard. The findings indicate the central role of motor activity in ongoing thought construction. They also indicate that for the blind, finger-to-hand motions contribute to the evocation of sensory experiences as a necessary pre-condition for linguistic representation.

SELF-TOUCHING, PERFORMANCE, AND ATTENTIONAL PROCESSES

Previous observations in our laboratory suggested that self-touching, the continuous movements of the hands on the body or onto each other, would increase during periods of attentional disruption or interference. The present study explored this notion further by testing whether or not variation in self-touching is associated with variation in performance in three different experimental tasks. The results indicate that certain types of continuous self-touching are consistently and significantly associated with three different performance measures. Since performance in a task is usually viewed as involving attentional processes, the present findings suggest a link between activity of hands and variations in the effective deployment of attention.

On receiving the patient's transference : The symbolizing and desymbolizing countertransference

This is an empirical study of the therapists experience of the patient, delineating the boundaries between empathy and constructive and destructive forms of counter-transference. The unique step was taken of focusing a video camera on the therapist in order to trace the therapists nonverbal behavior during listening. The same therapist was observed first in a “not-so-difficult” and then in a “difficult” session; the sessions could then be distinguished along dimensions of rhythmicity or arrhythmicity of nonverbal behavior. These observations suggested three modes of experiencing the patient: empathy marked by rhythmicity, a symbolizing counter-transference marked by a transitory arrhythmicity, and a desymbolizing countertransference marked by continuous arrhythmicity. The congruence of these formulations based on direct observation of therapist behavior and ones derived from retrospective reconstructions of analysts in sessions (Schwaber, Jacobs, and Lasky) was explored and was found to enhance the validity of the proposed formulations.

The hospitalization proneness scale as a predictor of response to phenothiazine treatment. II. Delay of psychiatric hospitalization.

To further explore the influence of personality factors on response to phenothiazine treatment, we examined the relationship between the hospitalization proneness scale (HPS) and the effectiveness of phenothiazine treatment in delaying hospitalization for those patients hospitalized during the course of their clinic treatment. The 129 hospitalized patients were part of a larger cohort of 446 chronic schizophrenic outpatients randomly assigned to placebo, promazine, and chlorpromazine and treated under double blind conditions. The patients in this sample were hospitalized after from 1 to 114 months of continuous outpatient treatment. The patients were divided into hospitalization prone and nonprone groups on the basis of the HPS. The HPS consists of measures of the patients effectiveness in social interactions, cognitive performance, and social attainment assessed at intake. The findings indicate that the number of months the patient was able to remain in outpatient treatment prior to hospitalization is the result of an interaction between the specific drug received and level of HPS score (p < .01). A multiple range test indicated that among prone patients, those treated with either chlorpromazine or promazine remained in treatment for a significantly longer period of time than comparable placebo-treated patients (p < .05). On the other hand, nonprone patients treated with chlorpromazine were hospitalized after a significantly shorter period of time than nonprone patients treated with either placebo or promazine (p < .05). In addition, chlorpromazine-treated nonprone patients were hospitalized significantly earlier than chlorpromazine-treated prone patients (p < .01). The results were discussed in terms of the relationship between the personality attributes measured and the sedative characteristics of the drugs employed. The implications of the findings to drug treatment and future research were also discussed.

The upward slope: a study of psychoanalytic transformations.

In an examination of twelve audiotaped psychoanalytic sessions, the authors, using both quantitative and qualitative methods, observed a stepwise progression in mental organization, which they term the upward slope. Its constituents include a phase of regression (desymbolization and the agony of equivalence), a phase of transition (disruptive enactment leading to transitional space), and a phase of reorganization (triangulation leading to symbolic synthesis). The hypothesis of a phase-specific progression is advanced, wherein different forms of mental functioning evoke distinct dynamic processes of psychic repair. The authors present detailed clinical summaries of the sessions they examined, as well as their own observational comments, to illustrate these ideas.