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Journal of Projective Psychology and Mental Health: Volume 22, Number 1, Jan 2015 Editorial

1. Editorial: New Name, Old Game, Wilfred A. Cassell and Bankey L.Dubey, pages 1-2.

This year in the August issue of the American Journal of Psychiatry, Douglas C. Thomas Ph.D. et al ’s most interesting paper entitled “Modifying Resilience Mechanisms in at Risk Individuals: A Controlled Study of Mindfulness Training in Marines Preparing for Deployment” is worthy of serious consideration by readers of our journal.

The U S Government financial support enabled the authors to document not only the positive psychological effects of Mindfulness Fitness Training (MMFT), but also the psychophysiological benefits. Their impressive data reflected this as summarized: “Marines who received MMFT showed greater reactivity (heart rate d=0.43 and enhanced recovery heart rate d=0.67, breathing rate, plasma neuropeptide Y concentration after stressful training d=0.38 and attenuate blood oxygen- level-dependent signal in the right brain insula and anterior cingulate.”

Historically, the technique was originally envisioned by one of the researchers Dr Elizabeth Stanley. MMFT involves training a subject to deliberately focus on and thereby modify one’s body’s interoceptive functions. The investigators defined it as “A mental mode characterized by full attention to present moment experience without elaboration, judgment, or emotional reactivity. It includes the ability to pay attention to, describe and act with full awareness of sensations, perceptions, thoughts and emotions (Kabat-Zinn J.1990). In recent years it has generated a considerable amount of interesting research studies (Blankenship, 2013, Turner, 2014, Tomfohr et al, 2014, Turner,2014).

Hopefully this scientific statistically documented study might challenge members of our SIS Society to further advance knowledge regarding the preparation of individuals anticipating future stressful events, by replicating such fundamental research employing the enrichment of SIS projective technology. We know that directing an individual’s somatic awareness to focus on inner aspects of the body can be technically achieved by utilizing SIS “Inkblot” visual stimuli. These have the power to drop the away from the external world and focus on specific internal regions. After all, many of our members in India have long been familiar with Yoga methodology for altering consciousness.

Recall that the state of Patanjali’s Ashtanga (Eight steps) yoga has been documented by many psychophysiologic studies (Gruzelier, 2005, Kriyananda, 2014, Revonsuo, et al, 2009) and Like MMFT, such yoga involves a subject focusing awareness on sensory feedback from internal sources. With training, the individual acquires powers to alter the physiological process under consideration. It may be recalled that the expert yoga meditation such as “Pranayam, Dhyan and Samadhi” significantly alters ill understood mind-body processes otherwise beyond conscious control.

The significant state of Dhyana (meditation) is the most powerful stage before Samadhi. It helps in realization of actual situation under meditation/deep concentration. The mind helps in selecting best alternatives out of many workable solutions under this state. By yogic practices, we can increase the power of our mind and ultimately can reach a blissful state which reduces tension, anxiety and many psychological problems. Moreover, there are considerable research studies suggesting that it also helps in promoting healthy body functions (Kriyananda, 2014, Manickam, 2010, Shamasunder, 2008).

While Dr. Johnson’s group has done excellent work, what is the advantage of coining a new name like “Mindfulness” without mentioning the rich historical yoga meditation? We now ask some of the younger members of SIS to take up the psychophysiologic challenge and move ahead. It is an old game. We predict that your yoga background will enable you to play the game better!

2. SIS Symbols of PTSD & the Need for Empathy in Therapy, David Brock, Wilfred A. Cassell, Charles Tyrone, Christensen Maureen, B.L. Dubey, Janssen Halia , Reeves Leigh and Searcy Laurel, pages 3-8.

A major underlying aspect of all medical therapies involves the degree of positive empathetic linkage extending from the clinician to the sufferer (Norfolk, T., Birdi, K. & Walsh, D.). This especially applies for those tormented by recurrent intrusive childhood traumatic memories - the basis of Posttraumatic Stress Disorder (PTSD). In such situations, the clinician created a supportive empathic bond that provides an essential foundation of psychotherapy. Moreover when the treatment plan encompasses “Body-Mind-Spirit '' theoretical principles, the resultant empathetic bridge optimizes the prognosis. Yet such occupational exposure over time, in vulnerable care providers may induce empathetic “Secondary Traumatization''. This article illustrates typical professional risk factors by presenting a case history study of a victim of PTSD who was traumatized by severe stress throughout childhood and adolescence.

3. Adult Attachment, Personality and Patient-Analyst Communication: A Case Study, Nadine J. Kaslow, Nicole L. Fischer, Sara E. Pollard, Abigail Powers and Susan L. Reviere, pages, 9-23.

This longitudinal case study examines the association between a patient’s attachment style and personality characteristics and communication between the patient and analyst. The measures used for this case analysis of a creative writer include the Adult Attachment Interview (AAI), the Minnesota Multiphasic Personality Inventory – version II (MMPI-II), and the Mergenthaler qualitative data scoring system for patient-therapist communication using the Therapeutic Cycles Model (TCM). Results revealed that the level of the patient’s security of attachment improved over the course of the psychoanalysis, although not to the extent that would be optimal. Moreover, he became significantly more coherent in his attachment narratives. His personality profile suggested that he is often socially isolated, and that his creative tendencies may make him feel like an outcast. MMPI results also suggested a mild-to-moderate level of psychological distress and that he may have difficulty engaging in treatment. However, the patient showed marked communication improvements with the analyst over the course of 18 months with regard to reflecting behavior, perceptions of depth of the treatment, feelings of connection with the analyst and a greater sense of security in the relationship, and writing experience. However, there was decline in some of these reports near the end of treatment, which might have been reflective of negative feelings toward termination. Overall, the patient showed significant benefit from the psychoanalysis as evidenced by increased attachment security, more coherent narrative descriptions, and more positive writing behavior.

4. A Study on Social Desirability Biases in Rorschach Inkblot Test, Roshan Lal Dewangan and Prasanta Kumar Roy, pages 24-29.

Social desirability bias represents tendency to present oneself in a socially desirable or positive manner to others. As there is high possibility of faking good or bad in objective psychological tools, many psychologists rely more on projective psychological assessment to identify any personality pathology or clinical symptoms with the believe that projective tools are protected from social desirability biases, but there is lack of research to pinpoint this belief. In the present study authors tried to examine whether a more ‘socially accepted role- response’ can affect a subject's responsiveness to Rorschach cards. 60 college students were divided equally in 3 different instructional groups randomly and were presented with the same set of Rorschach responses to identify. Three groups were informed that responses were given by a convicted criminal, a talented student and a severe mental patient respectively. Responses included contents like popular, sexual, aggression, anatomical, isolate etc. Comparison of three instructions failed to find any significant association of instructional set and identification of Rorschach response to suggest minimum possibility of social desirability biases in Rorschach.

5. Figure Drawing Techniques with Older Adults: A 30 Year Perspective, Paul E. Panek, Bert Hayslip, Jr., Sharon Rae Jenkins and Amanda Kay Moske, pages 30-47.

Panek, Wagner and Kennedy-Zwergel (1983) and Hayslip and Lowman (1986) have reviewed the use of expressive personality tests with older adults. In this context, the present review presents and discusses the research on human figure drawing techniques (HFD) with older adults during the past 30 years since those reviews. Findings are presented for age differences, and the differentiation of diagnostic groups. These are discussed in the context of the assessment referral questions most common with older adults and the challenges of geriatric assessment for which HFDs are suitable tools. Conclusions and recommendations regarding the use of HFD with older adults are presented, as are the implications for future research using HFD with older persons.

6. Cultural Basis of Psychopathology and Modified Therapeutic Stances: Case Illustrations, Somdeb Mitra and Nilanjana Sanyal, pages 48-57.

Culture is the lens or template we use in perceiving, constructing, defining and interpreting reality. People from different cultural contexts are expected to define and experience reality in different ways. The views of therapies developed in the western individualistic culture and Indian collectivistic culture are strikingly different. Therefore, to successfully treat the patients reared up in Indian culture, the therapist – mostly trained in therapies developed in the west – must remain aware of these influences and approach them in a way that is congruent to their belief system. The case presentations illustrate religious and cultural factors markedly influenced the therapeutic intervention. The first case illustrates the psychopathology of a Schizotypal patient and the second one presents with features of Hypochondriacs – following the ICD 10 (WHO 2006). An attempt is made to formulate the psychopathology following the western models and illustrate how the cultural factors influence the presentation. Furthermore, attempts have been made by the therapist to tailor the interventions developed in the west in accordance with the Indian philosophical and cultural modes. It is argued that, until empirically validated Indian psychotherapies are developed and therapists are trained well enough to utilise the Indian methods of therapy, such attempts towards integration can be beneficial. Utilisation of such an approach is likely to reduce resistance in the patients and enhance compliance, and thus have widespread clinical significance.

7. Sensitivity of Exner’s Comprehensive Scoring System in Detecting Specific Delusions in Psychotic Patients: Preliminary Observations, Satya Dhar Dwivedi, pages 58-61.

The present study was an attempt to gather preliminary observations to explore if Exner’s Comprehensive Scoring System is sensitive enough to tap and discriminate various kinds of disorders of content of thought, specifically, delusion of infidelity in persons with psychotic illness. The sample consisted of 5 patients having delusions of infidelity and 5 patients having other delusions drawn from inpatients of Institute of Mental Health and Hospital, Agra. Psychotic Symptom Rating Scale (Haddock et al. 1999) was used for understanding of severity of delusions. Rorschach Inkblot Test was administered and scored in accordance with the Exner’s Scoring System. The findings revealed that none of the scoring variables of the Exner scoring system could differentiate the groups.

8. Metacognition-Based Cognitive Therapy in Social Phobia- A Case Study, Kasturi Thakur and Prasanta Kumar Roy, pages 62-71.

The new era is the witness of an emerging concept - Metacognition, and this perspective is contributing towards the effective understanding and treatment of psychopathology. This Case study investigated the role of metacognition and focused on the changes resulting from the use of Metacognition based Cognitive Therapy in a case of Social Phobia. Studies from the west had laid down not only the framework of metacognition but had delineated its importance in anxiety disorders as well but, there is a dearth of research in the Indian context. An attempt was made to explore the concept with respect to anxiety disorder with the help of a case study diagnosed with social phobia.

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