Paul Verhaeghe

Powerlessness and Impossibility in Special Education: a Qualitative Study on Professional Burnout from a Lacanian Perspective

This article describes how experiences of professional burnout and difficulty in the job are linked to people’s expectations concerning the outcomes they aim to realize. Based on a random sample of respondents to a burnout questionnaire, two groups of special educators were interviewed. The interview data are interpreted taking Lacanian psychoanalytic theory about how people deal with their subjective lack as a point of departure. We conclude that burnt out people can be characterized by their imaginary stance towards outcomes (they cherish clear images of the products of their efforts, feel powerless, tend to fuse with the other, have the impression that the other is taking advantage of them and feel unable to speak freely). By contrast, the group with a low burnout score can be typified by their symbolic distance towards their job experiences and outcomes (they support the other in the process of realizing outcomes, feel impossibility, react with creativity and speak freely).

Relationship Patterns in Alexithymia: A Study Using the Core Conflictual Relationship Theme Method

Background: Alexithymia is a disturbance in regulating affective states. Clinical observations suggest that alexithymic patients relate to others in a specific way. This paper explores whether specific relationship or transference patterns are typical of alexithymia. Sampling and Methods: Relationship patterns were assessed by means of the Core Conflictual Relationship Theme method, standard categories version. This method examines transference patterns and was applied to clinical interview data collected from a sample (n = 31) of mental health outpatients. Alexithymia was assessed by means of a score on the 20-item Toronto Alexithymia Scale corrected for the degree of depression (measured by the Beck Depression Inventory-II). Data were analysed by means of the leaps and bounds regression algorithm for selecting optimal subsets of indicators and by bootstrapping to determine 95% confidence intervals. Results: First, we observed that alexithymia can be meaningfully explained by typical wishes, typical subjective perceptions of how others respond and one’s own typical responses to others. This result indicates that the more marked a patient’s alexithymic traits are, the more probable it is that specific transference themes come to the fore. Second, a set of three core indicators of trait alexithymia was mapped: little concern about being good to others, a strong perception of others as cooperative, and weak levels of reacting to others and to conflict by means of somatic symptoms. Conclusion: Alexithymia is related to a double interpersonal indifference: not much is expected from others, nor is there a personal urge to fulfill the expectations of others. Moreover, in alexithymia somatic symptoms proved to be non-reactive to interpersonal situations. Implications for diagnosis and treatment are highlighted. Limitations of our study are that alexithymia was only assessed with a self-report measure and that conclusions are based only upon data from a heterogeneous mental health sample.

ACTUAL NEUROSIS AS THE UNDERLYING PSYCHIC STRUCTURE OF PANIC DISORDER, SOMATIZATION, AND SOMATOFORM DISORDER: AN INTEGRATION OF FREUDIAN AND ATTACHMENT PERSPECTIVES

Starting from a contemporary critique of the DSM-IV, this paper argues that the diagnostic categories of panic disorder, somatization, and undifferentiated somatoform disorders can be understood as belonging to a common type of psychopathology—i.e., the Freudian actual neuroses. In addition to their strong clinical similarity, these disorders share an etiological similarity; and the authors propose a combination of Freud’s focus on this type of patient’s inability to represent an endogenous drive arousal with the post-Freudian focus on separation anxiety. An etiological hypothesis is put forward based on contemporary psychoanalytic attachment theory, highlighting mentalization. Concrete implications for a psychoanalytically based treatment are proposed.

The Depressive Experiences Questionnaire as a measure of psychoanalytic constructs reported to be measured.

This study presents an empirical test of Coyne, Thompson, and Whiffens statement that the Depressive Experiences Questionnaire does not measure the psychoanalytic constructs it is supposed to measure. Convergence was evaluated between the Depressive Experiences Questionnaires Dependency and Self-criticism scales and clinicians ratings on hysterical/anaclitic and obsessional/introjective personality styles in a sex-balanced sample of 56 Flemish outpatients. In line with expectations from Blatts research paradigm, convergence was observed between the Dependency scale and ratings on hysterical/anaclitic style in the full sample as well as female and male samples separately; convergence between the Self-criticism scale and ratings on obsessional/introjective style was only observed for men. This study yielded no evidence for divergence of the Depressive Experiences Questionnaire and Blatts psychoanalytic theory. Research is needed to evaluate the sex-specific validity of these subscales.

The depressive experiences questionnaire: On using a student-based scoring program for a clinical sample

In both clinical and nonclinical samples, the Depressive Experiences Questionnaire is scored with a program that computes factor scores by using means, standard deviations, and item-loadings of a student sample. The underlying assumption of the use of this program in clinical samples is that factor scores computed on the basis of the student factor solution are similar to factor scores computed on the basis of a clinical factor solution. Consequently, both series of scores should lead up to the same conclusions when studying associations with theoretically related variables. This assumption has not been tested although the questionnaire has been used in research for almost 30 years. In the present paper an alternative scoring program was constructed, based on the factor solution of a clinical sample (N = 400) to assess whether scores of this clinical scoring program are associated in the same way with different types of depressive symptoms and interpersonal problems as the scores of the original (student-based) program. Analysis gave results inconsistent with the assumption and did not support the use of the student-based scoring program in the clinical sample. Further, results suggest that standards for assessing factorial similarity used in confirmatory factor analysis might be too lenient.

The Netherlands and Flemish-Speaking Belgium

Publisher Summary The Wechsler tests is one of the most used, individually administered, standardized measures for assessing intelligence in children and adults. The primary purpose of intelligence testing is to classify individuals based on their overall level of cognitive functioning. The Dutch version of the Wechsler Intelligence Scale for Children—Third Edition (WISC-III) has been published recently after a research project of nearly two years. It concerned a joint adaptation process for the Dutch speaking population in the Netherlands and in Flanders, the Dutch-speaking part of Belgium. The objectives were to develop new norms, actual test items in which new technological and social developments are taken into account., and attention to be paid to the factor structure of the WISC-III since research indicated that four factors had been found in the U.S. tests and a new subtest Symbol Search had been added.

(Inhibiting) Factors for (Un)Sustainable Behaviour in Relation to the Effects of Education for Sustainable Development: The Role of Psychological Constructs, Neurotransmitters and Ideological Impact on Consumer Behaviour

Despite several decades of Education for Sustainable Development, it seems that there is still no massive transition in (individual) consumer behaviour from ‘unbridled’ to sustainable and thus so that we still notice an absence of widespread responsible lifestyles. It has been documented numerous times that there is a gap between knowledge of and positive attitude towards addressing unsustainable behaviours, and the actual individual’s behaviour when it comes to sustainable lifestyles. The question now is: what is causing this gap? Our research focuses on the different factors that influence sustainable (consumer) behaviour changes. We will use psychoanalytical models (Lacan) to try and find out how satisfaction of materialistic needs works, the effect of consumption patterns on the brain, the impact of political and ideological influences on behaviour(al changes),… The goal is to create a systems model that would allow us to better understand consumer behaviour and that hopefully will bring suggestions on how to change education models for sustainable development. The research will use a multidisciplinary approach and hopes to explain why behaviour is so hard to change and why current programmes (such as the 4E and 7E-model) based on cognitive behavioural therapy are not as effective.

The depression conundrum and the advantages of uncertainty

According to the WHO (2012), the prevalence of unipolar depressive disorders is rising, even in those places where mental health treatments are widely available. The WHO predicts that these disorders will be the leading contributor to the global burden of disease by 2030. This sobering projection fits poorly with how psychological treatments for depression are presented in the mainstream scientific literature: as highly effective therapies, based upon a sound understanding of the causes of distress. There is a clear discrepancy between the rising prevalence figures on the one hand, and the confident claims of this effectiveness research on the other. This discrepancy prompts a set of complex interlinked questions, which we have called ‘The Depression Conundrum.’ In search of a partial answer, the aim of our study was to critically analyze five meta-analytic studies investigating the effectiveness of psychological EBTs for depression, all of which had been published in high impact factor journals. Our examination established a number of methodological and statistical shortcomings in every study. Furthermore, we argue that the meta-analytic technique is founded upon problematic assumptions. The implications of our analysis are clear: decades of quantitative research might not allow us to conclude that psychological EBTs for depression are effective. The uncertainty and questions raised by our findings might act as a catalyst to broaden the way in which depression and associated therapies are researched. In addition, it might contribute toward a more vigorous and interdisciplinary debate about how to tackle this soon-to-be global public health priority number one.

Hulpvraag en therapeutische relatie bij onverklaarde chronische vermoeidheid

SummaryHelp-seeking preferences and therapeutic relationship in unexplained chronic fatigueResearch indicates that in functional somatic disorders the request for therapeutic help is related to either medical symptoms or interpersonal problems. We test whether a specific type of request for help is present in a sample of primary care patients with either chronic fatigue syndrome; a chronic cardiovascular or auto-immune disease; or a minor medical condition.In this study 155 primary care patients were recruited through 52 primary care practitioners: 52 chronic fatigue syndrome (CFS) patients; 52 patients with a cardiovascular or auto-immune disease; 51 patients with a minor medical condition. Interpersonal problems were assessed by means of the Inventory for Patients’ Request for Help (HLV). Chronic Fatigue Syndrome was measured with the Checklist Individual Strength (CIS); alexithymia was assessed by means of the Toronto Alexithymia Scale (TAS-20); and the driven and impatient interpersonal functioning by the Jenkins Activity Survey (JAS).nResults indicate that CFS patients have a significantly more consumer related request for help with the emphasis on symptom reduction. Prolonged and debilitating fatigue was significantly related to a request for medical and liaison-psychiatric help; a help request in a more impatient functioning is related to higher complaint behavior; and alexithymia was related to a request for specific medical aid. We found no specific therapeutic relationship in Chronic Fatigue Syndrome.nWe conclude that the exact status of the therapeutic relationship in CFS and cardiovascular or auto-immune disease remains undecided, but clearly the request for consumer help and symptom reduction is related to CFS as a population.