Dimensions of verbal denial in myocardial infarction: Correlates to 3 denial scales

The concept of denial in medical patients was reviewed, and problems in the past research on denial was noted. A questionnaire developed to assess different aspects of denial in myocardial infarction was tested in a group of 367 patients. A factor analysis of the questionnaire gave 3 independent factors, termed Denial of Illness, Denial of Impact, and Suppression. This finding gave support to the model that guided the construction of the questionnaire, and also casted some doubt on the validity of using either single specific or global criteria in assessing denial. Multiple regression analyses, including a series of medical, psychological and social variables, showed that social desirablity and external health locus of control contributed to the prediction of high scores on all 3 scales. Denial of Illness was furthermore associatd with less previous cardiac disease and a less severe index MI, whereas Denial of Impact was related to indicators of more optimistic attitudes. Suppression was related to indicators of lower socio-economic status and less cardiac health knowledge. The 3 scales should be further examined in relation to outcome after a myocardial infarction.     

Unconscious fantasy: introduction

Freudian psychoanalysis has long been a depth psychology with devotion to the idea that unconscious fantasies dictate behavior. That concept is traced from its origins to the present to expose its various forms as ego psychology has emerged.     

Effort denial in self-deception

We propose a mixed belief model of self-deception. According to the theory, people distribute belief over two possible causal paths to an action, one where the action is freely chosen and one where it is due to factors outside of conscious control. Self-deceivers take advantage of uncertainty about the influence of each path on their behavior, and shift weight between them in a self-serving way. This allows them to change their behavior to provide positive evidence and deny doing so, enabling diagnostic inference to a desired trait. In Experiment 1, women changed their pain tolerance to provide positive evidence about the future quality of their skin, but judgments of effort claimed the opposite. This “effort denial” suggests that participants’ mental representation of their behavior was dissociated from their actual behavior, facilitating self-deception. Experiment 2 replicated the pattern in a hidden picture task where search performance was purportedly linked to self-control.     

Construction and subjectivity of fantasy

Abstract

De Robertis D, Tricoli ML. Construction and Subjectivity of Fantasy. Int Forum Psychoanal 1997;6: 167-174. Stockholm, ISSN 0803-706X.

The authors point out that in Freud's thought fantasy surpasses ontogeny, becoming history of phylogeny through collective and prehistoric Oedipus. Unlike Freud, who followed a positivistic epistemology, the authors emphasize the individual meanings of fantasy, according to the present constructionistic epistemology.

First, an outline of this point of view is presented. Secondly, a theoretical approach between fantasy and repression-in the light of the concept of “compulsion to know”-is suggested. A clinical vignette follows to illustrate the above mentioned principles.     

An investigation of the fantasy predisposition and fantasy style of children with imaginary companions

In this study, the author tested whether children with imaginary companions (ICs) have a different fantasy life than do children without ICs. To measure the fantasy life of the 74 children aged 3.2 to 8.7 years, the author modified the Children's Fantasy Interview (E. Rosenfeld, L. R. Huesmann, L. D. Eron, & J. V. Torney-Purta, 1982) to make it suitable for young children and focused on 5 aspects of fantasy life: (a) ICs, (b) dreams, (c) daydreams, (d) scary thoughts, and (e) pretend games. Consistent with the hypothesis, children who had ICs were more likely than were children without ICs to report (a) vivid imagery when daydreaming, (b) vivid imagery when playing pretend games, (c) mythical content for dreams, and (d) mythical content for pretend games.     

The screen function of unconscious fantasy

Although being a fundamental concept in psychoanalysis, fantasy is an ambiguous term. It covers a vast field of conscious and unconscious phenomena, from daydreaming, the manifest narration of the patient’s world of imagination to unconscious fantasy and primal fantasy. Further, it introduces the delicate alternatives of imaginary versus real, subject versus object and internal versus external. Following Freud’s reflections on the ambiguity of fantasy, we arrive at an idea introduced by Freud himself, but elaborated years later by Lacan. Fantasy, accordingly, is seen as a screen which both reveals and conceals. Our aim is to demonstrate, theoretical as well as clinical, how unconscious fantasy serves as a window into not only repressed wishes and conflicts, but also the most primary scenes where the subject may not even have a specific place. Simultaneously, it is the site of protection and defence, including projection and denial, but also repetition of what we will call the identical. A clinical case will be presented to illustrate our theoretical ideas and their clinical implications.