Psychological Dilemmas Research Articles

Tensions and dilemmas in clinical psychology’s relationship with the service user movement

In this article I discuss dilemmas which arise as psychologists and service users work more closely together, in particular when the clinical psychology profession presupposes that its interests and those of service users are synonymous, when they may not be.

Understanding Dissociation and Insight in the Treatment of Shortness of Breath with Hypnosis: A Case Study

Training in hypnosis is particularly valuable for the physician seeking to better appreciate the interplay between mind and body. Through such experiences the physician can learn that presentation of symptoms often is affected by patients' psychological states, and that symptoms sometimes serve as solutions for patients' psychological dilemmas. The presented case study demonstrates how an 11-year-old's complaint of shortness of breath becomes an opportunity for an appropriately trained physician to provide treatment by helping the patient to engage his inner resources. The case illustrates the strength of hypnosis for accessing resources outside of conscious awareness and use of dissociative language to both support and alter the patient's defenses. We discuss the role of hypnosis when working psychodynamically with a patient, and whether and when insight is important or necessary for change of behavior.

Ethical dilemmas in sport psychology: A dialogue on the unique aspects impacting practice.

Ethical dilemmas in sport psychology: A dialogue on the unique aspects impacting practice.

Gender Dysphoria and Gender Change in an Adolescent with 45,X/46,XY Mixed Gonadal Dysgenesis

This is a report of a 13-year-old 45,X/46,XY patient who was assigned as female gender and had feminizing surgery during infancy. Psychological problems became progressively more severe from childhood to incapitation by age 13 years. Gender identity reversal was performed after extensive physiological testing. Because he wanted to have corrective surgery, his external genitalia sex reassignment was made male from female. There were surgical problems with his phalloplasty; after surgery at infancy there was reduction of the phallus with recession of the glans to the typical clitoral location. Genital response during sexual activity and satisfaction after reconstructive surgery for male genitalia are as yet unknown. This patient is a typical example for medical, psychological and surgical dilemmas of sex reassignment and the problems of early corrective surgery. Sufficient brain virilisation associated with undervirilised external genitalia is an important problem for assignment of gender identity.

Contested Terrain: Gustave Courbet's Hunting Scenes

Unlike the decorative and propagandist royal commissions and the paintings of fantastic Oriental hunts that flourished in mid-nineteenth-century France, Gustave Courbet's hunting imagery became a vehicle for self-inquiry and the reinvention of history painting. Courbet's writings and his revision of the genre engage in dialogue with the notions of hunting as a native heritage and masculine sport and the established tropes of the noble stag and the melancholy artist. The psychological intensity, ethical dilemma, and social struggles embedded in the hunting scenes resonate with themes central to the contemporaneous discourses on natural history and animal rights.

Crafting Flesh, Crafting the Self: Violence and Identity in Early Nineteenth-Century German Literature (review)

Reviewed by: Crafting Flesh, Crafting the Self: Violence and Identity in Early Nineteenth-Century German Literature Walter Stewart John B. Lyon, Crafting Flesh, Crafting the Self: Violence and Identity in Early Nineteenth-Century German Literature. Lewisburg, PA: Bucknell UP, 2006. 280. pp. John Lyon presents an engaging and original analysis of works that deal with wounded human bodies in the German literature of the early nineteenth century. His focus is on four separate works: Hölderlin's Hyperion, Brentano's Godwi, Kleist's The Broken Pitcher, and Büchner's Danton's Death. He applies a different philosophical foundation to each work. Thus, Hyperion is seen from Fichte's subject/object perspective; Godwi is scrutinized vis à vis Freud's ideas on trauma; The Broken Pitcher is analyzed with respect to Walter Benjamin's theories on power and violence; and Büchner's Danton's Death is examined employing the psycholinguistic theories of Jacques Lacan. Lyon first explains the theory of wounding and violence on the body as it has developed as a theme over the last thirty years through sundry studies by Wolfgang Sofsky, Lindsay French, Elaine Scarry, David Morris, and others. Lyon uses the term "wounded" primarily in a physical sense since "Both wounding and the pain that it produces cause a radical division between subject and object" (15). Each analysis expands this concept of identity to include a number of allied preoccupations such as psychology, philosophy, politics, art, and linguistics. In fact, Lyon's analysis of wounding in these works not only provides a fresh take on each piece but also elucidates the concept of identity in its richest meaning in remarkable and new ways with respect to German Romanticism as such. And so we view the elegiac hero Hyperion as a divided self who ends his story with dissolution of his identity. This occurs in the first instance as a result of physical wounds that he himself has suffered, even as he wounds others. For Lyon, Hyperion becomes a "self who views himself in terms of subject and object, asserting the Fichtean categories of 'Ich' and 'Nicht-Ich'" (33). That Hyperion concludes the work as divided reveals a psychosomatic state that disallows his wished for completeness, or as Lyon insists: "The image of the wound as a representative of consciousness thus puts wholeness of self at an unattainable remove" (77). Meanwhile, the seldom analyzed Godwi focuses on the problem of trauma itself, and Lyon is careful to set the stage of his argument by employing ideas from Freud's Pleasure Principle where he voices "notions of consciousness resulting from trauma, of a repetitive compulsion, and of conflicting fundamental drives" (86). Accordingly, Lyon sees Brentano's focus on the wound as "a metaphor for the experience of traumatic loss, and the scar represents the psychological persistence of trauma" (87). Godwi is unable to rise above his psychological wounds and particularly the psychological scarring he has suffered from past relationships. Even the church-like museum created by his father colors his memories negatively because he always associates it and his father with violence. But the outcome also is Freudian in that Brentano portrays Godwi as being simultaneously possessed by the opposing drives of sex and death that Freud suggests "both stem from the Wiederholungszwang, a compulsion to repeat original traumatic experience" (94). Indeed, this is a primal traumatic, destructive experience that must leave the protagonist wounded, caught up in a repetitive cycle, and as a consequence unable to fully understand or resolve the psychological dilemma that plagues him. Lyon's study of Kleist's The Broken Pitcher is analyzed in light of Walter Benjamin's "Critique of Violence" and his arguments concerning political power. This perspective presents a powerful and insightful look at the work that is often only referenced as Germany's most successful Lustspiel. But Lyon reveals so [End Page 240] much more about the interplay of the characters here in which "physical violence abounds" (123). The afflicted Adam evokes dissonance on every level; yet, he is at the center of the play in which he is at once the perpetrator of violence as well as the one responsible for upholding the law. Adam's afflictions, thus...

Surgical, Medical and Psychological Dilemmas of Sex Reassignment: Report of a 46,XY Patient Assigned Female at Birth

This is a report of a 16 year-old 46,XY male who was reassigned female and had feminizing surgery during infancy because of what was judged to be inadequate genital masculinization. This patient had a dysgenetic testis that was shown to be producing testosterone during infancy. Although initially the reassignment appeared to be successful, psychological problems became progressively more severe during childhood to incapacitation by age 10 years. After it was verified that he had a male sexual identity, reassignment as male began, initially by living as a boy, then with testosterone therapy. Staged phalloplasty surgery was begun at age 16 years. Currently he has an adult-sized penis, although its function is not yet clear. Sadly, none of the steps to align his sex assignment to his perception as male has significantly alleviated his psychological issues and he continues to be severely impaired and socially compromised. Major issues include the crippling psychiatric disease that is resistant to psychotherapy and surgical problems with phalloplasty after surgery at infancy that involved reduction of the phallus with recession of the glans to the typical clitoral location. The glans was left intact at the anterior base of the phallus. Genital responsiveness during sexual activity and satisfaction are as yet unknown.

Assisted Human Reproduction: Psychological and Ethical Dilemmas

Assisted Human Reproduction: Psychological and Ethical Dilemmas

How Psychological Assessment Taught Me Compassion and Firmness

In this article, I reflect on 2 specific assessment experiences and how they helped me grow as a person and as a psychologist. I believe that practicing assessment creates opportunities for personal growth in assessors because (a) to truly understand difficult clients, we must find personal versions of their psychological dilemmas in ourselves, which we might otherwise never be called on to face, and (b) to be effective as assessors, we must say difficult things to clients in plain nonjudgmental language, which forces us to develop courage and wisdom.

Book Review: Assisted human reproduction: psychological and ethical dilemmas

Book Review: Assisted human reproduction: psychological and ethical dilemmas

Gestalt Therapy: Past, Present, Theory, and Research.

Orthodox gestalt therapy suffered a rather unfortunate fate; gestalt theory has been poorly articulated, and gestalt techniques have received minimal empirical validation. These weaknesses are, in part, a consequence of F. Perls’s biographical history, which led to an integration of disparate theoretical models that were exacerbated by F. Perls’s haphazard, idiosyncratic personal style. However, recent empirical research suggests that the 2-chair technique is superior to other therapeutic interventions for conflict splits, decisional conflict, marital conflict, and unfinished business and that the 2-chair technique is as effective as Rogerian and cognitive–behavioral therapies. Although F. Perls’s techniques may have been generated largely from his idiosyncratic personality characteristics, these techniques have some validity for very specific psychological dilemmas. Classical Gestalt Theory and Perls’s Eccentricities

The Transformation of Psychology: Influences of 19th-Century Philosophy, Technology, and Natural Science

Back to table of contents Previous article Next article Book Forum: Historical, Philosophical, and Religious PerspectivesFull AccessThe Transformation of Psychology: Influences of 19th-Century Philosophy, Technology, and Natural ScienceLESLIE M. LOTHSTEIN, Ph.D., LESLIE M. LOTHSTEINSearch for more papers by this author, Ph.D., Hartford, Conn.Published Online:1 Mar 2003https://doi.org/10.1176/appi.ajp.160.3.607AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail What began as a seminar at York University in Toronto supported by a grant from the Gersten Foundation was transformed into a marvelous collection of essays focusing on the more complex psychohistorical social forces that led to the foundations for the science of psychology. Looking beyond the simplistic version of most psychological textbooks on the history of the science of psychology, the authors take us on a historical journey from the beginning of the 19th century, when Kant expressed his skepticism that psychology would ever become a true natural science, to the 20th century, in which the foundations of the science of psychology were well established. “How was it possible,” the authors ask, “that the transformation took place so rapidly?”In 11 chapters we are provided with a narrative that takes us into the complex world of the development of psychology as a science, including 1) Darwin’s theory of evolution, 2) phrenology, 3) theories of memory, 4) psychological technology and the World Colombian Exposition in 1893 in Chicago, 5) mathematical psychology and empiricism, including Fechner’s “golden section” as a mathematical proportion of visual beauty, 6) Ernest Mach’s replacement of the concept of causation with the concept of function, 7) the invention by Charles Babbage of the analytical engine as a precursor to robotics and information systems, 8) the technology of the “tempest prognosticator” in 1851 presented at the Great Exhibition in London as a “device intended to predict the weather by using the presumed instinct of leaches,” 9) an examination of the influence of the philosophies of Hegel and Kant on modern psychology, 10) an exploration of Marx and Dilthey’s theories and the concept of cogitamus or “we-think,” which deals with the relevance of a social context in history and human thinking as opposed to Descartes’s “Cogito ergo sum” and the development of a natural science of human beings and empathy, and, finally, 11) an examination of the impact of genetic and embryological influences on early development (focusing on the prenatal environment and the so-called critical period) and the biological underpinnings of modern psychology. What a journey!Throughout the first part of the book, we are taken on a political journey in which religion and philosophy are set up as a gauntlet for the psychological “secularists” and the concept of the natural world is seen as superseding metaphysics. One example is worth noting as we hear about it in today’s parlance. The authors introduce us to Tyndal’s writings on the efficacy of prayer and Gaulton’s reactions by writing a text on the “statistical inquiries into the efficacy of prayer” in 1872. These controversies set the stage for looking at history as a basis for many of our current dilemmas in psychology on how to measure ideas and behavior in real life.For most of us, the origins of the science of psychology are grounded in Wundt’s theory of memory and the recognition of the importance of experimental design, Fechner’s introduction to psychophysics, Ebbinghaus’s laboratory for the study of memory, and Gaulton’s introduction to statistics and measurement of mental abilities. The authors take us deep into the historical, religious, secular, mathematical, materialistic, anthropological, and physiological foundations of psychology. Unfortunately, the current divorce of psychology and philosophy has left the mental health profession with a theoretical void as new technologies, best practices, and standards of care are mistaken for a theory and philosophy of psychology. Without appeal to the history of psychology, and lacking a grounding in philosophy, the field of psychology seems doomed to a new technological reductionism and confined to a fate of never fully knowing what it is all about as a science.At times this book was difficult to read. There are aspects of the prose that are tedious and cumbersome. Some of the pictures, however, are superb, and, as the philosopher Spinoza reminded us, all things worth knowing are as difficult as they are rare. The ideas presented in this book are well worth knowing.Edited by Christopher D. Green, Ph.D., Marlene Shore, Ph.D., and Thomas Teo, Ph.D. Washington, D.C., American Psychological Association, 2001, 280 pp., $39.95. FiguresReferencesCited byDetailsCited byNone Volume 160Issue 3 March 2003Pages 607-608 Metrics History Published online 1 March 2003 Published in print 1 March 2003

M. Powell Lawton's Three Dilemmas in the Field of Environment and Aging

Three scholarly dilemmas have characterized Powell Lawton's career: basic versus applied research; theory-driven versus empirically-dominated research; and the intrinsic psychological dilemma of person-environment transactions. These themes serve as an organizing framework for the analysis of the discipline of environment and aging studies. Researchers in this field share a social mission as well as the responsibility to gain theoretical and applied knowledge for intervention that can improve the quality of older people's lives. At the same time, research in this field hinges on the willingness of those who are supposed to benefit from the research, to try it out, and use the results. The chapter is an attempt to use Lawton's seminal contribution to this field in order to look to the future of theory, practice and policy in environment-aging studies.

Ethical Dilemmas in Sport Psychology: Discussion and Recommendations for Practice.

The practice demands required of sport psychologists often complicate the direct and specific fulfillment of several ethical regulations. Many practitioners face specific issues of confidentiality and the appropriate use of informed consent, challenges to practicing within areas of competence, issues regarding termination, and challenges that arise from multiorganizational demands and the formation of multiple relationships. Although ethical guidelines established by the American Psychological Association direct practice in order to protect both the client and the practitioner from difficult and dangerous situations, these guidelines typically pertain directly to traditional practice efforts. Within sport psychology, although ethical practice requires consideration of established guidelines, the specific demands of the population and setting complicate traditional adherence to such parameters. Sport psychologists must be flexible in their practice and carefully consider how the Ethics Code can both benefit athlete-clients and minimize inherent practice difficulties.

Sex, Masculinity, and the "Yellow Peril": Christian von Ehrenfels' Program for a Revision of the European Sexual Order, 1902-1910

Around the turn of the twentieth century European middle-class men were caught in a complex set of psychological dilemmas.' On the one hand, the social, legal, and economic disabilities faced by women gave middle-class men extraordinary opportunities for the sexual exploitation of women and girls, both within and outside marriage. On the other hand, both Christian tradition and a burgeoning feminist movement were leveling an unprecedented degree of public criticism at men's sexual behavior; both, in fact, tended to regard men's sexual irresponsibility and aggression as the central social evil of the age.' Hard drinking, sexual humor, violence, and frequenting brothels appear to have been integral parts of masculine identity in many areas, particularly in cities and at universities. But the middle class defined itself in part by elaborating, in opposition to the alleged dissolution and intemperance of the aristocracy and the lower classes, its own ethic of domesticity, sobriety, respectability, and self-control. This ethic was strengthened by the advance of medical knowledge regarding the long-term impact of sexually transmitted diseases, which underpinned a widespread perception that men's sexual indiscipline was a profound threat to the physical health of society at large, and by the intensifying suppression and stigmatization of male physical and sexual aggression through legal controls and sanctions.2 At the same time, there was intense concern over the decline of the European birthrate, as the growth of mass armies and imperialism made population more than ever the measure of national power. But middle-class families were increasingly forced to limit their fertility if they wished to maintain their standard of living.3 Masculine tradition demanded that men be independent, entrepreneurial, risk-takers, aggressive. But a growing proportion of middle-class men were white-collar employees and civil servants.4 Respectable culture demanded that men display emotional autonomy, self-reliance, or even self-containment; and it defined masculinity above all as rationality and

Ethical dilemmas in clinical psychology: a comparison of clinical psychologists working in secure and non-secure settings

Ethical dilemmas in clinical psychology: a comparison of clinical psychologists working in secure and non-secure settings

Families from assisted conception: Ethical and psychological issues

This article gives the findings of an in-depth study of the outcome for parents and children after assisted conception, namely in vitro fertilization and donor insemination. The study is of 54 families bringing up 110 children, 74 of whom were the result of these two medical interventions. The findings presented in this article deal specifically with the psychological issues and ethical dilemmas experienced by the parents of these two groups. Specific areas regarding in vitro fertilization are use of the term ‘test-tube baby’; religious and community attitudes to the use of assisted reproductive technology; and the effects of these attitudes on the families. The major issue of multiple births and their social outcomes is dealt with in the following article. The specific areas for donor insemination families are secrecy and reticence about the whole procedure; infertility as a continuing taboo subject; donor anonymity; and the resulting effect of donor anonymity on parenting children who do not have access to their full health and genetic family history. Reference is made to the findings of other relevant research. Practice and legal implications from the findings are presented.

Children From Assisted Reproductive Technology: The Psychological Issues and Ethical Dilemmas

Outcome research for children from ART is described. Anxieties in IVF parenting can be identified as lying in the ambivalent or critical attitudes of some community and religious groups to ART provisions, or in parents’ concerns to preserve personal privacy. How to tell the child about IVF causes concern. Issues when parenting is of multiple births are not covered in this paper. In donor conception families, the infertility of one partner can cause imbalance in the parenting commitment with distancing of the social father from the child, or an obsessive concern for them. Unresolved feelings of anger, shame and guilt about infertility can adversely affect family relationships in other ways. Keeping the use of donated gametes secret, which is almost universal, protects the infertile adult, preserves the anonymity of the donor, but deprives the child of information about their origins and of 50% of their family medical and genetic history. Research studies of family functioning, the experience of families who tell their children and the retrospective life histories of Dl adults are described and used to argue the urgent need for change in this area in medical practice and legislation.

Promises and Dilemmas of Critical Psychology

Promises and Dilemmas of Critical Psychology

Beyond the Dilemma of Cross-Cultural Psychology: Resolving the Tension between Etic and Emic Approaches

The dynamics of cross-cultural psychology derive from the basic dilemma between the etic and the emic approach. Following a critique of the two approaches, I attempt to resolve the tension between the two approaches by presenting a conceptual framework called the triarchic resonance principle. This principle explicitly takes the dynamic relationship between culture, individual and ecological task demands into account. This dynamic relationship is exhibited by three different perspectives of temporal development—ontogenetic development, cultural change and microgenetic development of ecological task demands—which are integrated into a common model. The conceptual framework is illustrated with examples from research on intelligence and perception.