Unconscious Group Research Articles

Prediction of minimally conscious state with somatosensory evoked potentials in long-term unconscious patients after traumatic brain injury

To evaluate the predictive power of somatosensory evoked potentials (SEPs) for minimally conscious state (MCS) in long-term unconscious patients after traumatic brain injury (TBI). SEPs were recorded in 58 patients with duration of unconsciousness >30 days after TBI. SEPs were classified into three grades. Predictors including age, sex, Glasgow Coma Scale (GCS), and cause of injury were also analyzed, respectively. The outcome was divided into two groups including unconscious group and MCS group. The outcome was assessed at 12 months after TBI. In 58 patients, 22 of 58 were minimally conscious, 3 of 58 dead, and 33 of 57 were still in vegetative state at 12 months after TBI. SEPs grade (p = 0.001) and GCS (p = 0.010) were significantly associated with the outcome. The area under the receiver operator characteristic curve of SEPs was 0.891 ± 0.048 (p < 0.001; 95% confidence interval, 0.798-0.984) for predicting outcome, and of GCS score was only 0.746 ± 0.066 (p = 0.002; 95% confidence interval, 0.616-0.876). The accuracy of the whole model for predicting unconscious and MCS was 91.7% and 86.4%, respectively. The overall correct prediction was as high as 89.7% (p < 0.001). SEPs are excellent in predicting the outcome of long-term unconscious patients after TBI. SEPs should be considered more often and more routinely used after TBI.

Trust in Online Collaborative Groups: A Constructivist Psychodynamic View

Trust represents one of the most critical issues facing online collaborative groups. The growth of online courses and programs and the growth of collaborative learning pedagogical strategies through the text-based online environment can make trust issues more salient. According to Allen and Searman (2010), the 17% growth rate for online student enrollment far exceeds the 1.2% growth of the increases in the student population. Additionally, more than 25% of higher education students now take at least one online course. The use of online collaborative learning has grown rapidly in the past 15 years. Many educators in adult and higher education recognize the need to use active and contextual learning, such as collaborative learning to better address adult learning needs (Merriam, Caffarella, & Baumgartner, 2007). Collaborative learning can help to mitigate early online course instructional approaches that often resembled traditional teacher-led instruction and resulted in high attrition rates (Boshier, Mohapi, & Boulton, 1997). As the use of online collaborative groups increase, the need to understand trust issues becomes vital. Yet, it is difficult to answer the question of how trust is developed and maintained within these groups and how trust issues influence collaborative processes and outcomes. The research on trust in the online collaborative groups (OCG) shows contradictory results. For example, the often recommended social measures, such as team building exercises and communication tools that are designed to facilitate a successful learning environment, decrease (Jarvenpaa, Shaw, & Staples, 2004) or increase (Walther & Brunz, 2005) trust in the OCG. Furthermore, the current models for trust (i.e., Dirks & Ferrin, 2001 ; Mayer, Davis, & Schoorman, 1995) that are used in OCG trust research focus on conscious and rational approaches to understanding trust, but fail to account for the unconscious aspects. For example, Dirks and Ferrin contend that the direct trust model as seen in Mayer et al.'s work is more appropriate for structured settings. A strongly structured situation has clear processes to produce outcomes with little ambiguity and uncertainty. Individuals assess low trust risks in these situations and are able to act in trusting ways. The OCG however, is less structured with high ambiguity and uncertainty. The learners are asked to work on ill-structured problems and accept responsibility for their learning (Bruffee, 1999). Jarvenpaa et al. (2004) concludes that these models, which are used in most OCG trust literature, are helpful, but fail to account for the moderate trust effects. The moderate models are best for weak structures with high ambiguity and uncertainty. The weak structure forces the person to immediately attend to the task and leaves little time to assess trust risks. The person is thus left to rely on their past perceptions of trust. Although the moderate trust models provide an important element to trust issues in the OCG (Jarvenpaa et al., 2004), these models largely ignore the unconscious nature of past trust experiences that influence a person's ability to assess trust in the OCG. This paper examines trust issues in the OCG from a psychodynamic view; unconscious meaning making processes at work within the OCG and their effect on individual and group trust issues. The paper ends with a few suggestions for instructors on how to help groups recognize and resolve these issues. The Psychodynamic Perspective on Trust The psychodynamic perspective (Bion, 1961; Ringer, 2002; Smith & Berg, 1987) refers to the experience of unconscious group and social processes. These processes are simultaneously both a source and a consequence of unresolved and unrecognized group conflict for the group as a whole and individual members. This paper focuses on those processes that affect trust by looking at what is needed for collaborative learning. …

Psicoterapia di coppia - Psicoterapia di gruppo Una dialettica possibile?

- Through the exploration of the "bond" concept (as expressed by Kaës) - which is the specific unconscious reality that emerges from the encounter of two or more subjects - work with couples is analyzed through the evolution of what the authors see as the most fruitful paradigms for clinical work. Our understanding of individual and group psychoanalytic psychotherapy is examined, and basic clinical theoretical tenets are identified during the meeting with the couple. We determine the cardinal concepts by which we explore the evergrowing complexity of emotional dynamics. The therapist needs to observe and investigate both inner and outer personal aspects, as well as reciprocal emotional dynamics in order to define not only the self but also the meaning of us. The authors examine different phases in the couple's life, and, more specifically, what happens within the couple when a newborn arrives. Particular attention is given to the construction of the couple's common setting. Referring to transference and counter-transference dynamics, analogies and differences between group psychotherapy and couple psychotherapy are outlined in order to establish a possible dialogue between the two approaches.Key words: bond, couple, group, transference, counter-transference, unconscious group organizers.

Temporal patterns of interstitial pyruvate and amino acids after subarachnoid haemorrhage are related to the level of consciousness—a clinical microdialysis study

Temporal patterns of brain interstitial amino acids after subarachnoid haemorrhage (SAH) were studied in relation to energy metabolite levels and to the severity of the initial global ischaemia as reflected by the level of consciousness at admission. Intracerebral microdialysis was used to measure brain interstitial amino acids and the energy metabolites glucose, lactate, and pyruvate during five days in 19 patients. Patients who were conscious (n = 11) were compared to those who were unconscious on admission (n = 8). Eight non-transmitter amino acids (alanine, asparagine, glutamine, isoleucine, leucine, phenylalanine, serine and tyrosine), as well as glycine and pyruvate showed a pattern of increasing concentrations starting at 60-70 h after the onset of SAH. The conscious patients showed more pronounced elevations of non-transmitter amino acids, glycine, taurine and pyruvate compared to the unconscious patient group. Pyruvate levels were initially critically low for all patients, then normalised in the conscious patients but remained low in the unconscious group. There was an increase of the cerebral interstitial levels of non-transmitter amino acids and glycine which correlated temporally to pyruvate levels, more pronounced in patients conscious on admission. Pyruvate levels in these patients normalised, but remained reduced in the unconscious patients. The increase of the non-transmitter amino acids and glycine could reflect an increased amino acid turnover in an attempt at repairing the injured brain, which could have been hampered by the lower pyruvate levels. Interstitial pyruvate may be a useful marker of the energy metabolic situation in the acutely injured brain.

Phantastic objects and the financial market’s sense of reality: A psychoanalytic contribution to the understanding of stock market instability

This paper sets out to explore if standard psychoanalytic thinking based on clinical experience can illuminate instability in financial markets and its widespread human consequences. Buying, holding or selling financial assets in conditions of inherent uncertainty and ambiguity, it is argued, necessarily implies an ambivalent emotional and phantasy relationship to them. Based on the evidence of historical accounts, supplemented by some interviewing, the authors suggest a psychoanalytic approach focusing on unconscious phantasy relationships, states of mind, and unconscious group functioning can explain some outstanding questions about financial bubbles which cannot be explained with mainstream economic theories. The authors also suggest some institutional features of financial markets which may ordinarily increase or decrease the likelihood that financial decisions result from splitting off those thoughts which give rise to painful emotions. Splitting would increase the future risk of financial instability and in this respect the theory with which economic agents in such markets approach their work is important. An interdisciplinary theory recognizing and making possible the integration of emotional experience may be more useful to economic agents than the present mainstream theories which contrast rational and irrational decision‐making and model them as making consistent decisions on the basis of reasoning alone.

The use of narrative analysis and psychoanalytic exploration of group processes in multicultural training

AbstractNarrative techniques combined with psychoanalytically oriented exploration of group processes can enhance the training of mental health professionals. This paper demonstrates their implementation in multicultural training. It is suggested that a study group can become a “resonant box” – a transitional space where experiences of immigrants, as conveyed in their narratives, meet the reactions of the listeners and together create the “sound” of the narrative. Narratives may resonate in contents as well as in processes: in the thoughts and emotions that students express, in their unconscious reactions and resistances as well as in unconscious group processes. When recognized and explored these contents and processes may become a source of insight into the experiences of the narrator. Copyright © 2008 John Wiley &amp; Sons, Ltd.

Uptake Behavior of Thallium-201 in Hindlimb Muscles of Rats

[Purpose] We aimed to examine the uptake and retention behavior of the radioisotope thallium-201(201Tl) in 5 hindlimb muscles, the soleus (Sol), plantaris (Pla), gastrocnemius (Gast), extensor digitorum longus (EDL), and tibialis anterior (TA). [Subjects] Male Wistar rats. [Methods] Three experiments were perfomed: 201Tl uptake and retention as a function of time after intravenous injection; uptake and retention under general anesthesia and in the conscious state; Analysis in hindlimb suspension model rats. [Results] There were significant differences between the uptake rates of Sol and other muscles. The uptake rates of the conscious group muscles were significantly higher than those of the unconscious group; the ratio of Sol/EDL uptake was approximately 2.5 for the conscious animals, although that for unconscious animals was 1.3. In hindlimb-suspended rats, no significant differences between Sol and EDL uptake rates were seem throughout the course of the experiment. [Conclusion] In summary, rat skeletal muscles are very sensitive to uptake and retention of 201Tl and are markedly dependent on time from injection, state of consciousness and on the muscular trophicity. The results of the present study suggest that 201Tl may contribute to physiological evaluation of muscle in rehabilitation science.

Complex Choices Better Made Unconsciously?

Complex Choices Better Made Unconsciously?

Joining a Group’s Task: The Discovery of Hope and Respect

When engaged with others in tension-filled dialogue, the temptation is for us to treat the other disrespectfully by unconsciously choosing an exclusive subgroup in our minds to belong to, and assigning the other to a devalued group. Unconsciously asserted exclusive membership allows us to deny the ways in which, by disconnecting the other, we are also alienating parts of ourselves. Using three stories, the author explores the notion of unconscious group membership and raises the possibility of discovering a shared membership in the midst of conflict. Internalized shared group membership can constitute a mediating “third” to a dyad in apparent opposition. The shared internal context both contains and defines the pair within a task and set of values that can be used to transcend apparent conflict.

Leadership Development From A Systems Psychodynamic Consultancy Stance

This research aims to measure the impact of a leadership development programme presented from the systems psychodynamic stance. The aim was to develop psychoanalytically informed change leaders to lead change and transformation in the continuously changing and transforming New Economy network organisation. In order to do this, a group relations training programme was presented for 30 leaders. Qualitative assessment using grounded theory during post-intervention focus groups interviewing indicated the group’s awareness of psychodynamic leadership behaviour such as the regression towards frequent pathological leadership personality characteristics, regression towards unconscious group- and organizational processes such as the basic assumption group, the covert coalition and socially structured defense systems against change and transformation. Insight was also gained in the new leadership role and the taking up of personal authority in the network organisation that needs to function as a systemic whole. Limitations in the study are noted and Recommendations are made to enhance change leader skills for leadership in the New Economy network organisation. OpsommingHierdie navorsing poog om die impak van ‘n leierskapsontwikkelingsprogram wat aangebied is vanuit die sistemiese psigodinamiese perspektief, te evalueer. Die doel was om psigoanalitiese ingeligte leiers te ontwikkel om verandering en transformasie in die gedurige veranderende en transformerende Nuwe Ekonomie netwerk organisasie, te lei. Ten einde dit te bolwerk is. ‘n Groep -verhoudinge-opleidingsprogram is aangebied vir 30 leiers. Kwalitatiewe evaluasie deur van begrondingsteorie gebruik te maak gedurende, die post-intervensie fokus groepe het ‘n groepbewustheid aangedui van psigodinamiese leierskapgedrag soos die regressie na dikwelse patologiese leierskapspersoonlikheidskenmerke, regressie in onbewustelike groep- en organisatoriese prosesse soos die basiese aanname-groep, die koverte-koalisie- en sosiaal-gestruktureerde-verdedigingsisteme teen verandering en transformasie. Insig is ook in die nuwe leierskap rol en die opneem van persoonlike outoriteit in die netwerk organisasie wat moet funksioneer as ‘n sistemiese geheel, bekom. Aanbevelings word gemaak om die leierskapsrol in verandering in terme van vaardighede in die Nuwe Ekonomienetwerkorganisasie, te bevorder.

Cisternal MHPG level inversely correlates with Glasgow Coma Scale after aneurysmal subarachnoid hemorrhage

We measured the concentrations of monoamines and amino acids in the cisternal cerebrospinal fluid obtained from 15 patients after aneurysmal subarachnoid hemorrhage. Based on the Glasgow Coma Scale (GCS), the patients were divided into two conscious (GCS always 14 or better from the third post-operative day to Day 12; n = 8) and unconscious groups (n = 7). We examined the concentrations of monoamines and amino acids between the two groups and evaluated the correlation between the concentrations and the GCS at CSF sampling. The concentration of MHPG was significantly higher in the unconscious than in the conscious group from Days 4 to 12. A significant inverse correlation was observed between the MHPG concentration and the GCS (r = -0.635, p < 0.0001). Measuring the cisternal MHPG concentration may be useful for estimating convalescence after subarachnoid hemorrhage. [Neurol Res 2001; 23: 795-800]

The courage to stay in the moment

In 1934, James Strachey wrote that the active ingredient of psychoanalysis was the mutative interpretation. Even at this early date, Strachey observed that a relatively small proportion of the analytic literature was concerned with the mechanisms for change implicit in the analytic model. In this paper, the author proposes two modifications of Strachey's ideas. One is that it is a moment, an event, and not an interpretation as such that creates change. The author terms this the ‘mutative moment’. The other modification is the proposal of an unconscious internal group matrix as an image of the structure of self. This is a self that is at one and the same time, internal and external, individual and social. Building upon Freud, the object relations theorists, Kohut and the work of group analysts, the author pinpoints where and how change occurs in both individuals and in groups. The active ingredient of change is the focus on the here-and-now, a perspective common to both therapists and counsellors. As an understanding of the meaning of this focus develops, it becomes apparent that it takes courage to stay in the moment.

Jury Deliberation: An Observation Study

In this article, the way that the jury works is considered from a group-analytic perspective. Observational fieldwork of simulated jury deliberations is presented. The data was gathered from a joint funded Home Office and Law Commission project at the Socio Legal Studies Centre, Oxford in 1995. Inferences are drawn from the observations and the unconscious group processes are considered. The efficacy of the jury process is discussed.

The Formation of Objects in the Group Matrix: Reflections on Creative Therapy with Clay

This article describes an experimental group experience where five people worked in silence for 20 minutes around a 2 ft square slate using clay as a medium for communication as part of a creative therapy session on an inpatient psychiatric ward. The interaction culminated in a group sculpt. It is suggested that the process of the sculpting may throw some light on the formation of objects in the unconscious group matrix. The article is intended as a contribution towards the debate about the potential symbiosis between group analysis and the creative therapies (Waller) as well as the basis for further investigation into Rey's question about the formation of objects — therein the formation of objects in the evolution of the group matrix.

Nimodipine in Acute Ischaemic Cerebral Hemisphere Infarction

A double-blind placebo-controlled trial was designed to evaluate the efficacy of oral nimodipine and to compare two different doses in the treatment of acute hemispheric stroke (120 and 240 mg/day). Of 884 possible stroke referrals, 214 were randomised into the trial and 181 cerebral infarctions were available for analysis. Overall there was no statistically significant difference (p = 0.49) in mortality or neurological outcome. However, a strong trend in favour of nimodipine was seen throughout the study. A significant benefit was seen (p = 0.06) in less severely affected patients, i.e. conscious stroke patients vs. unconscious group. 120 mg/day of nimodipine was found to be better than 240 mg/day in our study.

Cerebral blood flow and metabolism following subarachnoid haemorrhage: cerebral oxygen uptake and global blood flow during the acute period in patients with SAH

Forty-eight patients with subarachnoid haemorrhage were studied with repeated rCBF and CMRO2 measurements. Cortical rCBF was measured using xenon-inhalation technique. CMRO2 was calculated as AVDO2 x CBF. When first studied the 29 conscious patients showed relative hyperaemia with CBF at 50 ml and reduced CMRO2 at 2.17 ml. In the following week CBF decreased to 41. CMRO2 remained reduced and constant. The 19 unconscious patients showed initially pronounced reduction in CMRO2 to 1.26, followed by gradual increase to 1.73 in 4-5 days. Simultaneously CBF increased from 18 ml to slightly above 30 ml. In the conscious patients the early reduction in CMRO2 and the concomitant luxury perfusion may be explained by global ischaemia because of very high ICP at the time of the haemorrhage. The reduced CBF in the unconscious group could be due to increased ICP, as ventricular drainage increased CBF to levels of relative hyperaemia as demonstrated in one case. As no decrease in CMRO2 was seen during the first 2 weeks, it is suggested that ischaemia at the time of aneurysm rupture is the most important single factor in reduction of global CMRO2.

The unconscious ego-ideal and analytic group psychotherapy

The theoretical position of this paper is that the essential character of the ego-ideal, a part of superego functioning, is unconscious, universal, and functions automatically. Precursors to superego development and ego-ideal formation begin at early preoedipal levels, and derivations in adult behavior contain primitive aspects. Ego-ideal is perfectionistic and impossible to obey;therefore, projection of this phenomenon as well as its activity leads to disappoinment, anger, anxiety, depression and despair. Pseudomoral injunctions frequently rationalize and disguise early primitive aspects of unconscious superego development and ego-ideal formation. These points are illustrated by clinical material, showing the therapeutic action in the group which leads to a modification of this critical, self-defeating aspect of adult functioning.

Unconscious Planning in a Natural Work Group: A Case Study in Process Consultation

Gustafson and Cooper have developed a theory of "unconscious group planning" based on the work of Weiss and Sampson. Up to now they have used and developed the theory to clarify and modify the practice and study of Tavistock Self-Study Groups. The authors believe that the theory can be applied to natural work groups as well. They examine the protocol of a day's meeting of the management team of a social service organization. By examining the latent and manifest content of the protocol and by studying the impact of their own interventions as consultants to the team, they show how the group was unconsciously struggling to solve a developmental problem. Most importantly, the group was trying to discover how to criticize their beloved leader in the face of his fear that if they did he might abandon them. The authors suggest that the theory of unconscious group planning may enable theorists and consultants to better understand the problem-solving processes of natural work groups.

Cooperative and Clashing Interests in Small Groups. Part I. Theory

Exploitation is as old as our knowledge of society and recurs continually in almost every social organization that we know, while cooperation is less common, more private, and continually breaking down. The authors are interested in routes that small groups discover for running against this exploitative current of history. The ordinary danger in new small groups is that divergent interests will be neither recognized nor balanced. Members will have contradictory plans for the use of the group situation, often unconscious, which are managed by ignoring or negating one or both parties. The authors have found, however, that groups are also capable of unconcious collective planning to handle these collisions. They describe five major principles of unconscious group planning, illustrate these principles in the narratives of two contrasting small groups, and compare this new theory with the classical perspectives on small-group dynamics.