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Self-efficacy, outcome expectations, and fantasies as predictors of alcoholics' postreatment drinking.

The usefulness of distinguishing between alcoholic patients' expectations and their fantasies about treatment outcome was examined. Results at 6 and 12 months follow-up did not support the results of research with nonalcoholic participants which related better outcomes to a combination of positive expectations and negative fantasies about future drink-related situations. Higher self-efficacy expectancy at intake, however, was associated with better clinical outcome. Findings supported Bandura's (1986) contention that outcome expectations add little information on prediction beyond that explained by self-efficacy expectancy. The clinical implications of these results are discussed.

Adult↗

Self-regulation of goal setting: turning free fantasies about the future into binding goals.

Fantasy realization theory states that when people contrast their fantasies about a desired future with reflections on present reality, a necessity to act is induced that leads to the activation and use of relevant expectations. Strong goal commitment arises in light of favorable expectations, and weak goal commitment arises in light of unfavorable expectations. To the contrary, when people only fantasize about a desired future or only reflect on present reality, expectancy-independent moderate goal commitment emerges. Four experiments pertaining to various life domains supported these hypotheses. Strength of goal commitment was assessed in cognitive (e.g., making plans), affective (e.g., felt attachment), and behavioral terms (e.g., effort expenditure, quality of performance). Implications for theories on goal setting and goal striving are discussed.

Adolescent↗

[Music therapy used on a patient in the terminal stage of cancer who narrated a tale based on her fantasy].

Music therapy was used on a patient in the terminal stage of cancer who described a fantastic tale built around her imagined pregnancy. We believe that psychiatric intervention was successful through the introduction of music therapy as part of her palliative treatment. Particularly notable in this case was that the patient dealt with the development of ascites by telling a fantastic tale related to a pregnancy--i.e., becoming pregnant with the therapist's child. Her tale started by statements such as "I am pregnant and suffering from morning sickness" and "I am in the third month of pregnancy with the child of my therapist." This progressed in parallel with the actual changes in her physiological symptoms. Among the attending physician, the patient, and her family, this imaginary tale was an important means of communication. The theme of pregnancy, love, and family developed from an unconscious dynamic process between the physician and patient, which could be interpreted as a family-related story originating in the mind of a terminally ill patient. Through this family romance with a major theme of pregnancy, the patient was able to sense her physical crises. This process may be thought of as a product of the so-called "mythgenerating capacity" under limited conditions, which was proposed by Ellenberger. Being aware of this situation, the attending physician and others in charge of her care did not insist on negating her story: instead they accepted her fantasy, and through it they succeeded in establishing psychiatric communications. The process may be considered a form of the narrative approach that is currently attracting attention. In this example, the "process of mourning" and "stages of accepting death" in the terminal state found an outlet in the creation of a fantasy. We believe that this case illustrates the important role of communication between the physician and a patient through the acceptance by the former of a fantastic tale given by the latter; and of a psychotherapeutic intervention, i.e., a sincere interaction between them through music therapy.

Aged↗

Unconscious identification fantasies and family prehistory.

Discovery of the fact that a subject identifies in an obvious way with another is at first only the awareness of a present process: involuntary mimesis, obedience to early 'identifying designations' or simple imitation deliberately carried out. Much psychic work remains to be done before we can think of such phenomena as 'screen-identifications'. The psychoanalytic interpretation of these dynamic formations will lead to the resolution of genuine 'identification complexes' through the reconstruction of scenarios which I have named 'unconscious identification fantasies'. These fantasies stage characters from the infantile prehistory and family saga of a subject who may be compelled to live out in his behaviour, symptoms, dreams, or even sometimes delusions, episodes pertaining to the past existence of the 'ego's visitors' linked to the most archaic processes that constitute the personality.

Adult↗

Behavioral and fantasy measures of fear of success in children.

Fear of success was assessed for 61 fifth-, seventh-, and ninth-grade children using Horner's and Baruch's "fantasy" measures and a behavioral measure developed by the authors. Males and females did not differ significantly on fear of success as measured by the fantasy technique. Developmentally, male fear of success remained unchanged in the three grades tested, while female fear of success decreased from grade 5 to grade 7. The behavioral measure of fear of success tapped a drop in achievement striving in grade 7 for the female subjects. Results are discussed in light of a "situational" versus personality theory of the development of fear of success.

Achievement↗

Treatment of obsessive homosexual pedophilic fantasies with medroxyprogesterone acetate.

The author describes a male patient with obsessive homosexual pedophilic fantasies treated with psychotherapy and medroxyprogesterone acetate (MPA), a progestin with antiandrogen activity. Long-acting MPA was administered for a 2-month period and caused a prompt and drastic reduction in fantasies and in the anxiety and depression generated by them. MPA was observed to have psychological benefits that outlived its physiologic activity.

Adult↗

Unconscious symbiotic fantasy: a ubiquitous therapeutic agent.

Evidence is presented that supports the proposition that the deliberate or inadvertent activation of unconscious fantasies of symbiotic gratification can have an ameliorative effect on psychopathology of various kinds. The evidence includes (1) clinically based reports scattered in the psychoanalytic literature on the role of symbiotic gratification in everyday living, in nonanalytic therapies viewed as effecting transference improvements, in meditation, in group activity therapies, and in psychoanalytic treatment, and (2) data from a large number of laboratory experiments coonducted with double-blind procedures and other stringent investigatory controls. In addition to providing powerful support for the clinically derived proposition, the laboratory results allow for extending that proposition and for a more precise delineation of the fantasy that produces symptom amelioration, which when expressed in its verbal form, is most often conveyed by the words Mommy and I are one.

Fantasy↗

[Do infants have fantasies?].

The author develops a three-stage theory of mental processes. In his view the first psychic imprints take the form of sensory-motor schemata (Piaget), perception-affect-action patterns (Lichtenberg) and generalized representations of interaction (Stern). At the age of one-and-a-half, mental activity begins to exist in the form of the ability to freely evoke images. In this way the child is able to transcend reality and to think in terms of things which are absent or have never really existed. At this stage active imagination sets in, combining the real and the possible. The closing stage of this development is the linguistic encoding of the mental. The author suggests reserving the term "fantasy" for the second and third stages and discusses the implications of this proposal for the concept of unconscious fantasy.

Fantasy↗

["I am Dr. Germany." Right radical fantasies as disguised communication in psychoanalytic therapy of an adolescent patient].

Using the analytic psychotherapy of a teenager as an example the readiness for right-wing extremist identifications during adolescence is described. The author evaluates which specific therapeutic interventions triggered the right-wing extremist fantasies of the patient in the treatment situation using Robert Langs's communicative theory as a guideline. The fantasies can be seen as enciphered messages with which the adolescent reacts to the therapist. In conclusion the author points out the biographical and developmental aspects of the patient's "Germany" imago.

Adolescent↗

On the occurrence of incest fantasies.

Incest fantasies are often regarded as suggesting important ego or superego deficits. Actually, some nonpsychotic patients are found to experience such fantasies. In these cases the phenomenon occurs when certain psychogenetic and psychodynamic factors are present.

Adult↗

The relation between individual differences in fantasy and theory of mind.

The relation between early fantasy/pretense and children's knowledge about mental life was examined in a study of 152 3- and 4-year-old boys and girls. Children were interviewed about their fantasy lives (e.g., imaginary companions, impersonation of imagined characters) and were given tasks assessing their level of pretend play and verbal intelligence. In a second session 1 week later, children were given a series of theory of mind tasks, including measures of appearance-reality, false belief, representational change, and perspective taking. The theory of mind tasks were significantly intercorrelated with the effects of verbal intelligence and age statistically controlled. Individual differences in fantasy/pretense were assessed by (1) identifying children who created imaginary characters, and (2) extracting factor scores from a combination of interview and behavioral measures. Each of these fantasy assessments was significantly related to the theory of mind performance of the 4-year-old children, independent of verbal intelligence.

Age Factors↗

The relationship of male self-report of rape supportive attitudes, sexual fantasy, social desirability and physiological arousal to sexually coercive stimuli.

Studies have supported the finding that sexually coercive behavior exists between males and females on college campuses and that when women say "no" to sexual behavior, men do not believe them. This study utilized penile plethysmography to investigate male sexual arousal to rape myth scenarios in a college population. The scenarios portrayed a woman who said "no" to sexually coercive intercourse behavior by a male. Results indicated that a low level of social desirability, sexual fantasies involving group sexual activity, as well as hurting and being hurt by a partner were associated with greater levels of physiological responding to coercive stimuli. Supportive attitudes about rape showed no relationship with physiological responding, yet did correlate with the sexual fantasy of being hurt by a partner, which was itself related to increased sexual arousal to sexually coercive audio stimuli.

Adolescent↗

A self-psychological study of a shared gambling fantasy in Eugene O'Neill's Hughie.

This paper presents an applied psychoanalytic study of Eugene O'Neill's two-character play, Hughie. Applying the constructs of self psychology, the play illustrates both the narcissistic features and the emotional and behavioral characteristics of compulsive gamblers. The study focuses particular attention on the role of narcissistic fantasies--with both grandiose and megalomaniacal features--in affecting, temporarily, the mood of the characters. Moreover, it is shown that a shared gambling fantasy--a "winner among winners"--enables them to experience a sense of camaraderie, humanness, and the illusion of kinship.

Journal Article↗

Infant colic syndrome--maternal fantasies of aggression and infanticide.

This study examined the impact of infant colic on the emotional state of the mother. Subjects were 23 pairs of mothers and their colicky infants. Structured interviews were conducted with mothers to elicit details around the colic episode and included (1) the emotional state experienced by the mother, (2) the quality and content of the mother's fantasies in response to her infant, and (3) the emotional impact on the parents. Explicit aggressive thoughts and fantasies were revealed by 16 (70%) of the mothers while six (26%) admitted thoughts of infanticide during their infant's colic episodes, a finding notable because previously this has not been documented in medical literature. All mothers experienced physical and psychological symptoms in response to their infant's colic. More than 90% of the mothers with a colicky infant experienced significant marital tension and disruption in their social contacts. The findings suggest that physician receptivity and skill in uncovering the physical and psychological impact of colic on parents is essential for the physical and emotional well-being of the family. Active support and counseling by physicians is critical to diminish any potential for abuse and infanticide in these infants.

Adult↗

Response to cigarette deprivation as a function of oral fantasy.

The role of oral fantasy in reactions of heavy smokers to smoking deprivation was studied. Experimental subjects were first evaluated with the Holtzman Inkblot Test to measure amount of oral fantasy. They also evaluated themselves on a number of Semantic Differential continua. Smoking deprivation followed. Retest Holtzman blots and Semantic Differential rating scales were then administered. Subjects also indicated number of somatic symptoms and body image distortions produced by deprivation. Control subjects followed the same paradigm except they smoked throughout the procedure. It was found that the greater the orality of experimental subjects the greater the number of somatic symptoms and body distortions they experienced following deprivation; and the more they viewed self as having shifted in a less favorable and less potent direction. Such relationships were absent in the control group.

Adult↗

Depersonalization, fantasies, and coping behavior in clinical context.

The main purpose of the present study was to determine the relation between specific dissociative experiences (depersonalization, fantasies) and self-reported coping behavior in a clinical (depression, anxiety, schizophrenia) and nonclinical sample (normal adults). Dissociative experiences were assessed with the Questionnaire of Experiences of Dissociation (QED) of Riley (1988) and coping behavior with the Stress-Process Questionnaire (SPQ; Janke, Erdmann, & Boucsein, 1985). A factor analysis of the QED items revealed a two-factor extraction: Factor 1 "depersonalization" and Factor 2 "fantasies/daydreams." The clinical group scored higher on the QED factor "depersonalization" and had more passive forms of coping behavior (resignation, social isolation, self-compassion, self-blame) than the normal adults. Similar correlation patterns were found for both groups: The QED factor "depersonalization" correlated highly with the coping behaviors "resignation," "social isolation," "self-blame," "self-compassion," and "rumination." No correlation between Factor 2 "fantasies/daydreams" and the coping behavior was found. Finally, correlations between depersonalization, trait anxiety, and personal need for structure were reported.

Adaptation, Psychological↗

Conviction and conversion: the role of shared fantasies about analysis.

This paper is an attempt to understand the origin of the analyst's conviction about both the patient's analyzability and the psychoanalytic endeavor. Clinical material will be used to illustrate the way that the intensity of the analyst's conviction is or isn't noticed or interpreted, by both patient and analyst. The primary hypothesis to be proposed is that the analyst's awareness of the transmission of conviction during conversion (or evaluation) can trigger recognition and use of a critical period for identification with an underlying mutual fantasy of intergenerational, analyst-patient conviction about analysis.

Adult↗

Sexual fantasies in the treatment of paraphiliac disorders: a bimodal approach.

An integrated cognitive-behavioral and focused psychodynamic treatment paradigm is described for the treatment of paraphiliac disorders. The important bridge which links these two modalities is the use of sexual fantasies as a point of therapeutic intervention. A brief review of the literature and one case is presented illustrating the promising nature of this methodology.

Adult↗