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PubMed2004

Religious and spiritual aspects of family assessment.

Childhood emotional and behavioral problems have increased over the past several decades, and the consequences of these behaviors have an impact on the entire family. The role of the family in these problems is clearly an important consideration for the child psychiatrist. A specific understanding of how the family's spiritual worldview or religious convictions impact clinical problems has been underappreciated. The religious orientation or spirituality of parents influences various aspects of family life, from ideals about marriage and family to specifics regarding child rearing. This article reviews the goals of assessment of family religious or spiritual worldview, which include empathically engaging the family of a child in treatment, developing a formulation of how these spiritual factors impact general family functioning, and determining whether the family's religion and spirituality are a resource for treatment or a contributor to disorder. The spiritual and religious assessment of the family facilitates the development of a treatment plan.

Adolescent↗

PubMed1999

The broken mirror. A self psychological treatment perspective for relationship violence.

Clinicians face formidable challenges in working with male perpetrators of domestic violence. Many treatment programs use a confrontational approach that emphasizes male entitlement and patriarchal societal attitudes, without honoring the genuine psychological pain of the abusive male. Although some men with strong psychopathic tendencies are almost impossible to treat, the majority of spouse-abusing males respond best to an empathic, client-centered, self psychological approach that also includes education about sociocultural issues and specific skill building. Understanding the deprivations in mirroring selfobject functions from which these men typically suffer facilitates clinical treatment response. While insisting that men take full responsibility for their abusive behavior, treatment approaches can still be most effective by addressing inherent psychological issues. Group leaders who can offer respect for perpetrators' history, their experience of powerlessness, and their emotional injuries in primary relationships are more likely to make an impact.

Cultural Characteristics↗

PubMed1994

The role of the intellect in the process of defense.

Ordinary intellectual capacities can be used for defensive as well as adaptive purposes. The author focuses on how a particular aspect of the intellect--language skills--can serve defensive functions. Using clinical examples, he examines how the defense "mechanism" of isolation operates through the use of common verbal formulas, through the deletion or substitution of conjunctions, through vagueness and indefinite reference. Other expressions of isolation include shifting emphasis away from what is important, excessive generalizing, and the development of an elliptical private language. He concludes with a discussion of how clinicians can learn both to listen to the patient empathically and to recognize and work with these defensive operations.

Adult↗

PubMed1994

[Self object and interpersonal emotions. Identification of own mirror image, empathy and prosocial behavior in the 2nd year of life].

This paper deals with the development of empathy during the second year of life. Empathy is defined as understanding another person's emotional state by vicariously sharing this state. In contemporary discussion, empathy is not clearly distinguished from emotional contagion, in which the Subject is indistinctly incorporated into the other person's mood. Most authors must therefore stipulate additional cognitive mechanisms, such as perspective taking, or even a theory of mind, to supply the empathic observer with the insight that it is, and remains, another person's emotional state which he shares. Contrary to this notion, the present paper proposes that insight is mediated by the particular quality of the empathical response itself and that self-objectification is the only relevant precondition of empathy, since it allows drawing a clearcut distinction between the emotional domains of self and other. Since self-objectification is also responsible for recognizing oneself in a mirror, empathy should emerge simultaneously with self-recognition. This was tested in an investigation on 36 girls and boys aged 14 to 22 months. In two separate sessions the subjects underwent a "rouge test" for self-recognition and were confronted with a person in need, who demonstrated grief. Empathy was operationalized by prosocial interventions. The study replicates the results of a previous investigation (Bischof-Köhler, 1988, 1991) with a modified empathy-eliciting situation. In both experiments, only those Subjects who recognized themselves tried to help, whereas non-recognizers stayed indifferent.

Body Image↗

PubMed2003

[Mother-infant mental health from viewpoint of relationship disturbance].

Infants can adapt themselves and their relationship with their caregivers in a way incomparable to any other stage in life. Infants are innately motivated to communicate with people and to actively take part in human social interaction. The question is how to provide an environment that facilitates such potentials for each particular infant and its family. Japan strove to improve the physical aspect of maternal and infant care after the second World War and yielded a nation-wide perinatal and infant screening system that produced a world minimum infant mortality rate and more than 80% compliance rate of infant checkups. Instead, infant abuse and infants with development disorders and psychosomatic symptoms has alerted the professionals to improve their approach. In addition, the increasing incidence of child abuse, juvenile crimes, eating disorders and other emotional and behavioral problems of children and adolescents has alerted the government and public to reconsider the importance of early intimate relationship. Creating a secure base for families to enjoy nurturing companionship with their infants is now common goal of infant mental health in Japan. As professionals we try to introduce a more dynamic, natural, non-judgmental empathic approach to support troubled infant care-giving systems. Whichever problem an infant may suffer, whether a problem of body or mind, its mother is bound to suffer and much more so in Japan with its old values for divine motherhood, stigmas associated with abnormality and new demands for perfect mothering. It should be acknowledged more and more that a well-meant effort on the side of infant workers cannot yield beneficial outcomes for mothers and infants unless we take into full account the importance of the complex intertwining of diverse factors, including the infant's predisposition, the mother's upbringing and past trauma and quality of the attachment system supporting the mother and family interaction. It is here that an urgent need to introduce infant mental health exists. Health professionals exchange, having shown their clinical attitudes and knowledge to their trainees, mutual nurturing companionship among workers, infants and families, which is the spirit of infant mental health. The dawn of infant mental health is steadily breaking in Japan.

Child Rearing↗

PubMed2006

The empathic brain: how, when and why?

Recent imaging results suggest that individuals automatically share the emotions of others when exposed to their emotions. We question the assumption of the automaticity and propose a contextual approach, suggesting several modulatory factors that might influence empathic brain responses. Contextual appraisal could occur early in emotional cue evaluation, which then might or might not lead to an empathic brain response, or not until after an empathic brain response is automatically elicited. We propose two major roles for empathy; its epistemological role is to provide information about the future actions of other people, and important environmental properties. Its social role is to serve as the origin of the motivation for cooperative and prosocial behavior, as well as help for effective social communication.

Automatism↗

PubMed1976

Assessing the empathic potential of student teachers of the emotionally disturbed.

Two instruments currently used to assess empathic ability of teachers are examined and found to be inaccurate measures for teachers of the emotionally disturbed. It is noted that empathy in teaching is different from that in psychotherapy, and that adaptation of instruments used in therapy is inappropriate for educators. Suggestions for identifying the empathic teacher of disturbed children, and recommendations for developing measuring devices, are offered.

Affective Symptoms↗

PubMedDate not supplied

Human relations with dental personnel.

This review of psychological notions and outline of experiential training can be employed as a sensitizing device to heighten dental care providers' awareness of the psychosocial aspects of dentistry. Additionally, the objective of further developing personal effectiveness is based on the premises that (1) the value of techincal skills can be enhanced by a clear and empathic appreciation for the consumer and (2) the care provider's command of his own interpersonal effectiveness can be facilitated by an appreciation for his current skill level.

Adult↗

PubMed2003

Anguish and despair in adolescents with eating disorders--helping to manage suicidal ideation and impulses.

Adolescents struggling against anorexia nervosa or bulimia nervosa often experience self-punishing thoughts and behaviors, including self-mutilation, and suicidal ideation and attempts. These arise out of the profound anguish and despair frequently experienced by these young people. This paper outlines four particularly salient clinical themes underlying this despair that have significant implications for treatment. A practice perspective is discussed which emphasizes empathic listening and the development of a strong therapeutic alliance with the adolescent. Treatment recommendations draw from narrative theory and practice, and from feminist perspectives. The paper also draws on cognitive therapy and on recent developments in the areas of spirituality and motivational enhancement. Involving the distressed adolescent's family is also addressed.

Adaptation, Psychological↗

PubMed1986

Biopsychosocial approach to premenstrual syndrome.

Premenstrual syndrome is a constellation of behavioral, physical and psychologic symptoms that occur every 28 days in some women of childbearing age. A multidimensional, biopsychosocial approach, combining stress reduction, increased exercise and proper diet, has been found effective in treating this syndrome. Medications can be added to relieve symptoms. The cornerstone of this approach is empathic understanding.

Bromocriptine↗

PubMed1975

Empathy and altruism.

The psychophysiological responses of 60 subjects were measured as they observed a performer play a roulette game. Half of the subjects were led to believe that they were similar to the performer in personality and values, and half were led to believe that they were dissimilar. Half of the subjects in each condition believed that the performer won money and experienced pain as he played the game, and half believed that he performed a cognitive and motor skill task. Subjects who observed a performer who ostensibly experienced pleasure and pain exhibited greater psychophysiological reactions than subjects who did not. Subjects who believed they were similar to the performer tended to react more strongly than subjects who believed they were different from him. Similar subjects also reported identifying most with the performer and feeling the worst while he waited to receive shocks. It was concluded that the similar subjects empathized most with the performer who appeared to experience pleasure and pain. When required to make a choice between helping themselves at a cost to the performer or helping the performer at a cost to themselves, the subjects who reacted most empathically behaved most altruistically. The results were interpreted as casting some light on century-old questions about the human capacity for altruism.

Adult↗

PubMed2000

Self-regulation of affect in attention deficit-hyperactivity disorder (ADHD) and non-ADHD boys: differences in empathic responding.

This study examined differences in empathy and other emotions between boys with and without attention deficit-hyperactivity disorder (ADHD). Empathy was measured by an empathy response task (ERT) and through self- and parent reports of emotion. On the ERT, children responded verbally to 8 fictitious stories. Results from the ERT revealed that boys with ADHD were less empathic than boys without ADHD. Boys with ADHD less frequently matched the emotion they identified in the character with the one identified in themselves and gave fewer character-centered interpretations in their descriptions of the character's emotion. Parent-report data revealed that boys with ADHD exhibited more behavioral manifestations of sadness, anger, and guilt than did boys without ADHD. No differences were found, however, on measures of emotional intensity or emotional reactions to external contingencies. The results are discussed with respect to current theories of ADHD.

Affect↗

PubMed1985

A comparison of four empathy instruments in simulated patient-medical student interactions.

Prior investigations of empathy in medicine have used several available instruments for assessment, including a scale developed by Hornblow, Hogan's empathy scale, the Carkhuff-Truax empathic understanding scale, and the Barrett-Lennard relationship inventory. The purpose of the study reported in this article was to investigate the intercorrelations of the scores on these four instruments when used in a medical student-simulated patient interaction. The results showed that measures of empathy based on observed behavior of the students were highly intercorrelated but that empathy self-assessed by the students themselves as having that trait did not correlate significantly with any of the behavior-based measures. No significant effect on these findings was attributable to the timing of the instrument administration, to the students' interpersonal skills training or experience in taking histories and performing physical examinations, or to the sex of the students and the observers.

Clinical Competence↗

PubMedDate not supplied

Untangling the links of parental responsiveness to distress and warmth to child outcomes.

This study demonstrated separate linkages between 2 features of positive parenting--responsiveness to distress and warmth--and different aspects of children's socio-emotional functioning, in a sample of 106 children (6-8 years old). As expected, mothers' and fathers' responsiveness to distress, but not warmth, predicted better negative affect regulation. Maternal responsiveness to distress also predicted children's empathy and prosocial responding. Maternal warmth, but not responsiveness to distress, was linked to better regulation of positive affect and (in boys only) to greater peer acceptance. Additionally, negative affect regulation mediated between maternal responsiveness to distress and children's empathic responding. Positive affect regulation mediated between maternal warmth and boys' peer acceptance. The findings support a differentiated approach to positive parenting.

Adaptation, Psychological↗

PubMed2004

Effect of sex and gender on drug-seeking behavior during invasive medical procedures.

RATIONALE AND OBJECTIVES: To assess how sex affects patients' drug-seeking, pain, and anxiety during interventional procedures. MATERIALS AND METHODS: Data from 159 patients were derived from two control groups of a prospective randomized trial. Seventy-six patients were male, 83 female. Patients in the standard group (n = 79) received the standard care typical for the institution; patients in the attention group (n = 80) had an additional empathic provider who stayed with them throughout the procedure. All patients were asked every 15 minutes to rate their pain and anxiety on 0-10 self-rating scales. All had access to intravenous sedatives and narcotics through a patient-controlled analgesia model. Univariate analysis of variance with a between-patient factor for group and another between-patient factor for sex was used. RESULTS: There was a significant interaction between group attribution and sex with regard to drug request and pain and anxiety ratings. Patients in the attention group requested significantly fewer drugs than patients in the standard group. Men asked for more drugs than women under standard care, but for less in the attention group. Pain and anxiety ratings for women were significantly lower in the attention group compared with standard treatment, but for men, there was no significant difference. CONCLUSION: Although both men and women benefit from the presence of an empathic provider during invasive medical procedures, men benefit more in terms of medication reduction, whereas women benefit more in terms of pain and anxiety reduction. Awareness of these gender-specific differences can aid in formulation of patient-specific treatment plans.

Adolescent↗

PubMed2004

Family processes that shape the impact of interparental conflict on adolescents.

This study draws on the family systems concepts of triangulation and wholism to investigate how interparental conflict may affect adolescents' psychological adjustment. An ethnically and socioeconomically diverse sample (N = 388) of 14- to 18-year-olds completed measures of interparental conflict, family relationships, internalizing problems, and externalizing problems. We found that triangulation into parental disagreements mediated the association between parental conflict and both internalizing and externalizing problems. Adolescents exposed to more frequent, intense, and poorly resolved conflict were more likely to feel triangulated, but this association was moderated by the nature of the alliances they had with their parents. Specifically, at low levels of interparental conflict, adolescents who had substantially stronger alliances with one parent than the other reported greater triangulation than those with more balanced alliances. At high levels of conflict, these groups reported similar degrees of triangulation. We also found that supportive parent-child relationships reduced adolescents' appraisals of threat and self-blame for interparental conflict, while more empathic relationships with siblings increased these appraisals. Finally, close relationships with fathers acted as a protective factor that reduced symptoms of maladjustment.

Adjustment Disorders↗

PubMed2002

Understanding embarrassment among those with autism: breaking down the complex emotion of embarrassment among those with autism.

Scenarios manipulating various factors within the emotion of embarrassment, such as whether or not an audience was present when an embarrassing act was committed, the type of audience present, empathic embarrassment, etc., were presented to high-functioning participants with autism and comparison groups of those with learning difficulties and typically developing participants matched for verbal and nonverbal mental age. Participants were required to rate the level of embarrassment of the protagonist and justify their responses. It was predicted that those with autism would differ significantly from the comparison groups in their ratings and also their ability to provide justifications. The results showed those with autism to have difficulty with such concepts as empathic embarrassment but showed a surprisingly good understanding of other variables manipulated such as the presence of an audience.

Adolescent↗

PubMed1988

Five studies testing two new egoistic alternatives to the empathy-altruism hypothesis.

The empathy-altruism hypothesis claims that prosocial motivation associated with feeling empathy for a person in need is directed toward the ultimate goal of benefiting that person, not toward some subtle form of self-benefit. We explored two new egoistic alternatives to this hypothesis. The empathy-specific reward hypothesis proposes that the prosocial motivation associated with empathy is directed toward the goal of obtaining social or self-rewards (i.e., praise, honor, and pride). The empathy-specific punishment hypothesis proposes that this motivation is directed toward the goal of avoiding social or self-punishments (i.e., censure, guilt, and shame). Study 1 provided an initial test of the empathy-specific reward hypothesis. Studies 2 through 4 used three procedures to test the empathy-specific punishment hypothesis. In Study 5, a Stroop procedure was used to assess the role of reward-relevant, punishment-relevant, and victim-relevant cognitions in mediating the empathy-helping relationship. Results of these five studies did not support either the empathy-specific reward or the empathy-specific punishment hypothesis. Instead, results of each supported the empathy-altruism hypothesis. Evidence that empathic emotion evokes altruistic motivation continues to mount.

Adult↗