Phallic narcissism, anal sadism, and oral discord: the case of Yukio Mishima, Part I

Thus far I have explored Mishima's traumatic childhood and the experiences leading him toward misogyny, phallic narcissism, and the drive to murder his own weakness and sexual vulnerability. Mishima suffered the extraordinary trauma of being separated from his parents and sequestered to the sickroom of a psychotic grandmother for the first twelve years of his life. Intense rage over abandonment and impingement engendered a disgust for femininity and the need to escape feminine messiness through homosexual pursuits. Mishima's entrenched feelings of shame and weakness gave rise to phallic narcissistic tendencies, as he idealized powerful men and eventually strove to become a powerful and beautiful male. In pursuing this erotic masculine image Mishima continued to fantasize about murdering his weak and shameful self-image, and commingled this sadistic impulse with fantasies of sexual merger with murdered love objects. Finally Mishima was the murderer erotically eradicating his sexual vulnerability as both subject and object. His suicide was a repetition of this erotic sadistic fantasy. In a further article I will continue the discussion by examining Mishima's fantasies of murdering beautiful and abandoning love objects. I will also address the complex nature of his ritual suicide as fantasy of rebirth, sexual merger, the murder of toxic introjects, and escape from death, decay, and regression to helpless infancy.     

Christian Bioethics: Challenges in a Secularized Europe

This article summarizes in three specific sections the key challengesfaced by Christian and, particularly Orthodox, ethics in a secularizedsociety. The first section, focusing on the task and aim ofethics, defines Orthodox ethics, which is linked with asceticism(man's attempt to keep the commandments of Christ) and aimsat overcoming death and encountering the personal God. Put differently,the purpose of Orthodox ethics is the deification of human beings.The second section defines secularization and explores its consequencesfor the theology and pastoral work of the Church. Europe isdominated by scholasticism and moralism, whereas Orthodox theology,without rejecting it, transcends such a narrow preoccupationwith our own world. Orthodoxy does not regard human beings solelyfrom the perspective of their biological existence but assiststhem in going beyond mechanistic theories and the pursuit ofhappiness. The third section briefly describes how what canbe termed "bio-theology" surpasses anthropocentric ethics withregard to the relationship between creation and grace, birthand rebirth, cloning and incarnation, transplantation and deification,and death and resurrection. The article concludes that Orthodoxtheology (a) does not reject the achievements of biotechnologyor biomedicine; (b) assists humans in overcoming mortality byfinding meaning for their existence and fullness of life, and(c) does not simply postpone death, but overcomes the fear ofdeath and leads people to deification by grace.     

“With you I’m Born Again”: Themes and Fantasies of Birth and the Family Circumstances Surrounding Birth as These are Mutually Evoked in Patient and Analyst

Themes of birth and rebirth, being born and born-again, can be readily observed in clinical psychotherapy and psychoanalysis even as they remain undertheorized. A clinical case is presented that traces the first four years of an analysis as seen through the lens of four consecutive supervisory experiences. This paper explores the central importance of fantasies and narratives of one’s origins and birth and the observations, fantasies, and expectations generated by one’s family circumstances at the time of birth. The paper examines birth narratives, fantasies, and myths of origination by following a clinical case across four supervisions. The patient’s birth-related fantasies are shown to interact with the analyst’s concordant and complementary fantasies as the analyst interacts with a series of supervisors in the process of being born as an analyst. The analyst’s personal birth narrative is linked to his fantasies about being born professionally as an analyst, and these are shown to interact with the patient’s birth fantasies. The paper suggests the ongoing significance of unconscious fantasy within the framework of contemporary relational psychoanalysis.     

'Justified by the Spirit': Soteriological Reflections on the Resurrection

Justification of the Spirit has been too often overlooked in Protestant theology. This article asserts that the recovery of this aspect of New Testament theology offers the possibility of a fuller and more adequate soteriology than has often been the case in western theology. Part I provides a survey of the New Testament's witness to the resurrection and of the soteriological implications for the followers of Jesus. The focus of this survey is the relation of resurrection to justification. Part II develops some implications which follow for a theology of salvation today. The article here suggests a threefold possibility for a soteriology which reclaims the relation of Spirit to resurrection: first, soteriology could speak of the whole of the life, death and resurrection of Christ; second, soteriology could speak of the salvation of the whole of our life and death in resurrection; and third, soteriology could be concerned with the material, social and embodied from the outset.     

Unconscious fantasy and theories of cure

It has long been known that patients' wishes for cure by analysis give expression to unconscious wishes for instinctual gratification which originate in childhood mental life. Patients sometimes develop theories about how they believe analysis attains its ends; these are likely to affect the way they behave in the analytic situation, and analysis of them may therefore constitute an important contribution to progress in the analysis. Two illustrative cases are presented; in both, the unconscious determinants of the patients' theories turn out to be infantile sexual fantasies connected with their uncon scious wishes for instinctual satisfaction. It is further suggested that analogous unconscious fantasies also influence the theories of analysts and other therapists about how analysis works. In some instances these factors, while not affecting theory formation explicitly, may, without being recognized as doing so, contribute to decisions regarding the modification of analytic technique. Awareness of that possibility may aid analysts in assessing the indications for such proposed modifications.     

KIERKEGAARD'S "NEW ARGUMENT" FOR IMMORTALITY

This essay examines texts from Kierkegaard's signed and pseudonymous authorship on immortality and the resurrection, challenging the received opinion that Kierkegaard's account of eternal life merely connotes a temporal, existential modality of experience as a present eternity. Kierkegaard's thoughts on immortality are more complicated than this reading allows. I demonstrate that Kierkegaard's ideas on the afterlife emerge out of a context in which the topic had been vigorously debated in both Germany and Denmark for more than a decade. In responding to these debates, Kierkegaard establishes a "new argument" for immortality that stands as a robust account of the Christian resurrection and highlights the power of a personal God at the center of life, death, and post-mortem existence.     

The application of self psychology principles to long-term group therapy with schizophrenic inpatients

Concepts derived from a self psychology model are applied to an intensive long-term group therapy with hospitalized chronic schizophrenic patients. The clinical data suggest that initially patients' needs for safety and security predominate group process. Once an atmosphere of safety has been developed, patients begin to display needs for recognition and confirmation of themselves as unique, worthwhile individuals and for solace and consolation in regard to their traumatic life histories. A case study of the development of two group members reveals that these patients progressed from unshared, isolated, sometimes delusional visions of reality to the sharing of playful fantasies within the group and finally to an acknowledgement of painful life experiences. In their relationship with each other the patients moved from mutual isolation to a primitive relationship based on unconditional support, admiration and togetherness to a friendship in which they became increasingly able to confront each other with empathic failures and tolerate one another's separateness without withdrawal or decompensation.     

Playing dead: an unconscious fantasy, bodily focused defenses, and their roots in infancy

A patient's unconscious fantasy of being her mother's dead baby emerged during the course of a long analysis, and was understood as her expression and explanation, constructed and elaborated throughout her development, of a fundamental and formative early infant state and experience. This patient's identification with a baby who had died before she was born was connected to her major complaint, a pervasive feeling that she could not act with intention, and to her obsessive ruminations, compulsive actions, and masochistic attacks on her body. The bodily based aspects and focus of these defenses were autistic-like, self-directed activities that can be understood as having their roots in what was experienced as catastrophic loss in the earliest weeks and months of life. Infant research, particularly on contingency detection, is especially useful in clarifying the ways in which these defenses may form, and in reconstructing and tracing the trajectories and intricate transformations of body ego, self- and other representations, and defenses from their earliest beginnings to their current manifestations in patients' fantasies and symptoms.     

Sibling loss, guilt and reparation: A case study

Psychoanalysis has shown that the death of a sibling is likely to have a long-standing impact on the character development of a surviving child. Among common adult manifestations are the identifi cation with the deceased sibling, repetitive self-punitive behaviors, and the development of masochistic trends. In treatment, these patients can become entrenched in a negative therapeutic reaction that compromises the outcome of their analysis. In this paper, the author discusses the analysis of a woman with a history of losses that included the loss of a sibling at an early age. A critical part of the treatment focused on helping this patient overcome a negative therapeutic reaction that emerged as she became aware of hostile and vengeful fantasies, not only as they related to her deceased brother but, more importantly, as they related to her parents.     

Joseph Ratzinger's Debates with Gisbert Greshake: An Argument for the Resurrection of Matter

Debates in eschatology have been unresolved regarding the place of earthly matter in the resurrection. I analyze the positions of Joseph Ratzinger and Gisbert Greshake and argue in favor of Ratzinger's position. He defends a transphysical bodily resurrection that involves the matter of this world over against Greshake's resurrection in death eschatology and anthropology that entails the resurrection of a phenomenological but not a physical body. What is at stake in this debate is nothing less than the meaning of creation in God's salvific economy.     

Coping and quality of life after tumor surgery: personal and social resources promote different domains of quality of life

Personal and social resources facilitate the adaptation to critical life events. The present study investigates whether general self-efficacy beliefs and received social support elevate cancer patients' physical, emotional, and social well-being directly, or whether these effects are rather mediated by active or meaning-focused coping. Gastrointestinal, colorectal, and lung cancer patients were approached at 1 month and at 6 months after surgery (N=175). Structural equation models indicate that self-efficacy at 1 month after surgery exerted a positive direct effect on all three domains of health-related quality of life at 6 months after surgery, but indirect effects through active and meaning-focused coping were also observed. Initial received support elevated later emotional well-being, but not the other two quality of life domains. This effect was not mediated by coping. Results suggest the development of interventions to increase optimistic self-beliefs and coping skills in tumor-surgery patients.     

Controlling,Avoiding, or Protecting the Object: Three Reactions to the Breakdown of Psychic Retreats

In working psychoanalytically, it is common to encounter patients who need to carefully manage their immediate objects. This is evident in their stories about external life at home, at work, and with friends as well as in how it emerges within the transference. While a frequent theme in many analytic cases, the motives behind this need are varied.

Case material is used to show how these reactions emerge when psychic retreats fail. When unable to find refuge in pathological organizations or psychic retreats, patients are exposed to the worst of paranoid and depressive anxieties with only a fragile foxhole to withdraw into or defend from. In such a precarious psychological state, fantasies of unbearable self and object danger emerge, leading to various forms of acting out, overreliance on projective identification, and perverted images of giving and receiving. These fantasies result in the desire for idealized objects, the drive to resurrect fallen objects, and the need to avoid cruel and attacking objects that have taken over and replaced the sought out ideal.     

Understanding and Treatment of Narcissistic Personality Disturbances

The author discusses how sexuality on the one hand develops and changes during childhood, but on the other hand, holds onto the old residues of different, earlier phases. In adult sexuality, there always remain enigmatic, regressive, even borderline emotions and feelings from earlier experiences. These residues make sexuality incomprehensible and primitive, but also offer possibilities for dreams, fantasies and creativity later in life. Autoerotic fantasies, object fantasies, enigmatic knowledge, sexuality fantasies and creative thinking are realised via these developmental residues.     

Myths,metaphors, and mentors

This article begins with a discussion of myths as visions that transform life. The primary myth is that of death and rebirth. Metaphors are images which illumine our myths. Therapists are thus both scientists and poets. The process of being a mentor occurs in a variety of relationships. Our search is for an understanding of this process which then transcends the positions of master and disciple. Mentors need to have a sufficient degree of self-transcendence to enable the focus to be on the person's own unique vision. Mentors light sparks which ignite our myths and metaphors and thereby expand our understanding of ourselves. Mentors become catalysts for our growth and thereby facilitate the process of transformation.The author would like to express his gratitude to Anne Nelson, who helped with editing this article.     

Grief,Death, and Longing in Stoic and Christian Ethics

The Stoic rejection of the passion of grief strikes many ethicists writing on dying as inhuman, selfish, or lacking appreciation for the world. This essay argues that Stoics rejected grief and the fear of death because these passions alienated one from the present through sorrow or anxiety for the future, disrupting one's ability to fulfill obligations of care for others and to feel gratitude for the gift of loved ones. Early Christian writers on death, such as Ambrose, maintained much of the substance of Stoic doctrine but transformed it through their belief in the resurrection and their corresponding revaluation of the future. While these writers rejected grief as an affective response to death, they affirmed longing for lost loved ones. These authors provide an example of how contemporary religious ethicists can use Stoic insights for recovering the tradition of the art of dying.     

Rebirth fantasy and the psychoanalytic process

In this paper, Jungian and Freudian perspectives on the fantasy of rebirth are explored and a brief review of the literature on the theme is used to show how that the rebirth fantasy seems to be a universal fantasy in the human mind, connected with the experience of both destruction and creation. In the psychoanalytic process the rebirth fantasy is connected with initial hopes for a better life, but is also a vehicle for creating the analytic pair and for separating from the 'totalitarian object'. An account of clinical work with a patient is given to illustrate the mutual and parallel process of rebirth in both the patient and the therapist. For the patient, the therapy was experienced as an awakening or a birth. The therapist was initially doubtful about the patient's capacity to engage in the analytic process but his involvement and interest were 'born' during the early sessions, enabling the patient to rely on him to lead her out of the claustrophobic power of the totalitarian object.     

Aggressive fantasies, thought control strategies, and their connection to aggressive behaviour

The present study examined the relations between aggressive fantasies, thought control strategies and aggressive behaviour in a sample of non-clinical female participants (N = 72). First, the nature and prevalence of aggressive fantasies and thought control strategies were examined. Then, the relation between these constructs and aggressive behaviour was studied by means of correlations and regression analysis. Results indicated that aggressive fantasies were a common experience in these non-clinical participants, and that suppression, distraction and cognitive reappraisal were prevalent strategies to control aggressive intrusive thoughts. Most importantly, it was found that thought suppression and aggressive fantasies were positively correlated with aggressive behaviour. A regression analysis underlined the link between thought suppression and aggressive behaviour, but the relation between aggressive fantasies and aggressive behaviour was no longer significant. Further, some indications were found for distraction being an adaptive strategy for controlling aggressive intrusive thoughts.     

高龄患者心脏手术围术期处理要点

随着高龄心脏病患者日益增多,不断总结高龄患者心脏手术围术期处理经验,是我国心脏外科的一个重要课题。虽然,高龄患者心脏手术非致命性并发症发生率、住院时间长、手术死亡率高,但手术后将近2／3的患者生存超过5个年头,完全摆脱了心脏疾病的症状,没有了心脏疾患的束缚和限制,享受着手术后的独立的舒适生活。高龄患者进行心脏手术是可行...     

心脏病外科治疗之趋势——微创

在近20年间,伴随着科学技术的发展以及医疗水平的提高,微创已经成为了外科医生行使手术的重要选择之一;由于国家生活水平的提高,患者不但追求高生存率,同时提出了更高的要求——低病痛,快恢复期,伤口美观等,微创外科得到了越来越多的人的青睐。本文主要探讨了微创心脏外科的分类(小切口技术,电视胸腔镜辅助心脏外科技术,机器人辅助心脏外科技术)以及各种新技术在心脏外科领域所存在的优势和不足,同时辩证地指出了心脏外科的未来发展趋势以及在发展过程中可能存在的一系列矛盾,同时指出了医疗为患者个体服务的观点。