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The dissatisfaction of patients with communication in health care has largely been addressed by providing more communication skills training. Research into why skills training might be ineffective has identified various factors, which include organizational resistance, personal defences against anxiety and a need for personal reflection and support. In one college of nurse education small group discussion and reflection had become established practice for students in their first and second clinical experience. The groups met once weekly and were facilitated by a nurse teacher. Discussion was unstructured and focused on the nurse's interpersonal relationship with his or her patients. This project examined one such group and sought to examine the use of small group reflective discussion by nurses about their patients as a means of improving interpersonal communication. The research was conducted over a period of 6 months with nine student nurses meeting once weekly during their first two episodes of clinical experience. Kelly's personal construct theory was used and two repertory grids were constructed by the group. One grid examined processes and change in intrapersonal construing, and the other grid examined processes and change in construing about certain patients. These grids were completed by the students at the beginning and at the termination of the groups. Notes were taken after each group meeting, which recorded impressions and processes; these were discussed once weekly with supervision. The notes were analysed using a grounded theory methodology. The results show some changes in patterns of constructing in relation to self which indicate an increase in anxiety and reluctance to self-reflect. The need for defensive structures in order to facilitate self-reflection is discussed in the light of the qualitative analysis. Finally the value of this type of work is supported by evidence of the group working as a social microcosm. The limitations and indications for further research are noted, but this project supports the contention that in order to be truly effective those who come in contact with the emotional needs of patients need some support and reflection for themselves. The arena for this type of self-reflection and support could be small group discussion. However, it may be necessary for those who facilitate this type of group to be aware of the need for some defensive structure. [ABSTRACT FROM AUTHOR]

The article focuses on the symbol of self that has been expressed by alchemical symbolism in its final operation of "proiectio," rendered by the last woodcut of the Rosarium. In the twentieth and final woodcut of the Rosarium series of the opus the alchemist is raised from his tomb in the shape of Christ Resurrected waving the banner of victory while making the sign of the Trinity. The alchemical proiectio covers the occult phenomenon known as the out-of-body experience. Other terms descriptive of the phenomenon as it varies in specific instances are traveling clairvoyance, extrasensory perception, projection, self-projection, bilocation and extrasensory travel.

The article focuses on the importance of the method of amplification in understanding the archetypal patterns of the individuation process. The author tries to interpret the picture series of the Rosarium which he suggested at least two conclusions. First, the author regards the series as an imprint of the entire individuation process crystallized into this form through centuries of alchemical experience. Second, the author assumes that the regressive psychodynamics of the Oedipus complex are the fuel of the individuation process. It appears that the individuation process has a certain psychodynamic structure and a certain developing pattern, the method of amplification must respect the context of unconscious symbolism since the context will probably reflect the specific stage of the individuation process.