Loi de bioéthique du 2 août 2021 : analyse critique des dispositions relatives à l’assistance médicale à la procréation (AMP)

Whereas in France assisted reproductive technology (ART) was intended to respond to pathological infertility or the risk of transmitting a serious disease, the bioethics law of 2 August 2021 opens up technological procreation to fertile couples, to single women and women's couple. Procreation is thus disconnected from the carnal reality of the begetting of a child and is based solely on the will of the adult to realise his or her parental project. This is not without consequences for the rights of the child born of these technologies but also for the meaning of filiation in general.     

Transgender persons’ rights in Italy: Bernaroli's case

In April 2015, the Italian Court of Cassation decided on the case of a male to female transgender person to remain married to her wife. On that occasion the Court of Cassation decided that the married couple—Bernaroli, a transgender woman, and her wife, a cisgender woman—could remain married until the Italian Parliament institutionalized civil partnerships. This article presents the case study of transgender persons’ rights in Italy. In doing so, the article places the case study in the frame of the Council of Europe recognition of transgender persons’ rights, looks at the evolution of transgender persons’ rights in Italy, and finally, presents the groundbreaking decision in the Bernaroli's case.     

And Three Made One: Psychoanalytic Work with a Three-Year-Old Girl in the Context of Reproductive Assisted Technology

ABSTRACT

The subjective experience of reproductive assisted technology (RAT) and the conceptual and clinical challenges it presents to contemporary child psychoanalytic practice is explored. Clinical material seeks to illustrate the impact of a mother’s relational past and her experience of infertility on the quality of her relationship with her young child and its impact on developmental progression. The role of the body as both organizer and container of experience is emphasized, as well as the role of the father and the parallel process between the mother-child dyad and the parental couple.     

Through the Lenses of Gender, Race, and Class: Students’ Perceptions of Childless/Childfree Individuals and Couples

Earlier research has documented negative perceptions of childless couples, particularly the voluntarily childfree, among college students. In this project we used hypothetical vignettes to assess variations in students’ (N?=?478) perceptions of childless couples related to the couple’s race, occupations of husband and wife, and assumed reasons for childlessness. Perceptions were strongly influenced by occupational status and gender, but we found few race differences. Neither infertility nor chosen childlessness was rated negatively, but couples were rated more positively if they were perceived as temporarily rather than permanently childless. Our findings suggest that delayed parenthood is regarded as normative and that students have few negative biases regarding infertility or chosen childlessness. Perceptions were strongly conditioned by economic and employment considerations, which reflect current concerns about balancing work and family trajectories.     

Dystopian Narratives: Encounters with the Perverse Sadomasochistic Universe

ABSTRACT

In a number of dystopian novels that I explore, including Orwell’s (1949) 1984 and Huxley’s (1932) Brave New World, I identify themes of soul murder, destruction of differences, murder of reality, and attacks on the parental couple as a generative twosome. In my view, dystopian fiction captures, thus, many facets of the perverse sadomasochistic core. I demonstrate that the leaders of dystopian societies are fueled by a desire to debase and eventually eliminate the feeding mother, the Oedipal father, and the creative parental couple by becoming god-like creators of a new and idealized fecal universe. Although dystopian narratives tend to locate the catastrophe in a future social disaster, they represent a psychological breakdown that has already occurred in the past and is, therefore, present in the individual’s internal world. The dystopian narrative enables this internal catastrophe to be projected into a future plot and a cast of characters that stand for both victims and perpetrators in the internal object world. I offer a psychoanalytic perspective, which can help our understanding of the increasing popularity of dystopian fiction among the young adult readership.     

The facts and fictions of religion: make believe on Avatar Forums

Recent scholars of religion have begun to explore the relationship between religion and fiction. Within this context, Johan Huizinga’s theory of religion as make believe or play has received considerable attention. James Cameron’s film Avatar (2009) has inspired behaviour that can be thought of as religious, despite the film’s clear foundations in fiction. Scholarship on fan communities has debated whether such groups can be considered religions. This article develops Huizinga’s account using Kendall Walton’s theory of make believe. Walton’s theory enables the interpretation of fiction into overlapping games of make believe in fan communities. The conversational threads on Avatar Forums show how norms of discourse that preclude disagreement allow the frames of reality and fiction to blur. These norms of discourse provide a means of understanding the process by which media myths can become the basis of fiction-based value structures within the cultic milieu. However, the theory also presents significant problems for theorists of religion in terms of the structure of religious belief and religious experience.     

On procreating today

This work reflects on the suffering and difficulties that men and women often experience during the process of procreation, beginning with the decision to suspend the use of contraception. The shared project that a child represents involves difficulties that are also a consequence of the culture in which we live: subject to early tests, ultrasound scans and so on, a planned pregnancy is dominated, throughout its development, by the secondary process of monitoring. A delay in conception, at times deriving from intolerance towards a body that does not immediately fulfil one’s own desires, sets in motion the diagnostic inquiry. During this time, while the long‐awaited moment of conception is further delayed, the desire for a son/daughter changes in quality and intensity. In a substantial number of cases, infertility remains unexplained, a situation in turn characterized by the fear that not knowing implies. Although the excessively simplistic and limited notion of psychogenic infertility has faded, a residue of unexpressed horror, difficult to frame even in analysis, persists in the couple. The end of the diagnostic inquiry means that assisted conception must be eventually faced. Fortunately, nowadays in psychoanalytic culture the fundamentalist tendencies that, in the past, led to forecasts of catastrophe, have subsided. Yet this remains a highly problematic area with many questions and few answers.     

The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility

Infertility is a challenging experience, affecting individual and couples’ adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross‐sectional study, a total of 134 participants (67 couples with infertility) completed self‐report questionnaires assessing infertility‐related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes.     

Grant Me the Knowledge of What I Want Because All I Know Is That I Want: A Lacanian View of Hysteria

ABSTRACT

Freud’s work with hysterics led him to the discovery of the unconscious and the founding of psychoanalysis. The dream of the beautiful butcher’s wife, one of Freud’s patients, is examined following Lacan’s added insights that give full credit to his well known statement: “The unconscious is structured like a language.” Three basic identifications are presented by Lacanian analysis and I add a clinical vignette that exemplifies my work in the treatment of a couple.     

Response to MacIntosh’s Review and Discussion of the Psychoanalytic Couple Therapy Journal Literature: A Self Psychological,Intersubjective Perspective

ABSTRACT

After expressing my appreciation to Heather MacIntosh and highlighting her article’s significant contributions to the field, I comment briefly on some of the implications of her methodology and findings. I then elaborate on her summary of the history of the application of self psychology (Kohut, 1971) and intersubjective systems theory (Stolorow, Brandshaft, and Atwood, 1987) to couple therapy, highlighting the key contributions of both theories and describing the current state of the field.     

AGAINST RECORDING SESSIONS FOR SUPERVISION

The American Psychological Association’s (APA) 2014 injunction that supervisors must listen to recorded sessions of their supervisees’ work is based on a rich and thorough body of research, and yet it entails a narrative of psychotherapy as a discipline of Science. If psychotherapy is understood as an endeavor also of the Humanities, recording sessions may be anathematic to supervision and training. Developing ideas from Greenberg’s (2015) theory of “controlling fiction,” the writer presents a narrative of psychotherapy in which it is not wise to review recorded sessions in supervision.

     

The effects of anxiety and depression on in vitro fertilisation outcomes of infertile Chinese women

The object was to assess anxiety and depression during in vitro fertilisation (IVF) treatment and determine IVF-related psychological factors in infertile Chinese women. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate anxiety and depression among 842 patients, respectively. A univariate analysis was used to compare variables among three SAS groups and three SDS groups. Anxiety and depression were both represented in 21.3% of the cases. Patients <35 years tended to be more anxious. In women <35 years, the SDS scores were higher with lower educational backgrounds and female or couple’s infertility, while the SAS scores were higher in female or couple’s infertility. In older ones, the SDS scores were higher in those with lower educational backgrounds and longer time for infertility, while the SAS scores were higher in those with lower educational backgrounds. In SAS groups 1–3, the embryo availability was 5.0 (3.0–8.0), 5.0 (3.0–8.0), and 3.0 (2.0–4.5) (p = .013); and the fertilisation rate was 91.9, 90.4, and 81.8% (p < .001), respectively. We concluded that infertile women experience anxiety and depression during IVF treatment, especially in women <35 years. Younger women with female infertility would be more anxious and depressive while higher education can protect them from depression. In older ones, they would experience more depressive with longer time for infertility and be less anxious and depressive with higher education. Anxiety affects the fertilisation rate and embryo availability.     

Hannah Gadsby’s Nanette: Connection Through Comedy

Hannah Gadsby: Nanette (2018) is a brilliant and masterful work of comedy in which Gadsby announces she is quitting comedy. In this article, I draw on classical and contemporary humor theory to explore the comedic content of Nanette and critique Gadsby’s reasons for quitting. Although I largely agree with Gadsby’s concerns about comedy, I argue that the very show in which she presents them, Nanette, stands as evidence against their universal truth. Gadsby argues that comedy is no longer conducive to her health for at least three related reasons. First, the self-deprecatory comedy out of which she has built her career is a symptom of her humiliation which she is no longer willing or able to showcase for the pleasure of others. I argue that while self-deprecatory humor can, of course, be a sign of humiliation, it needn’t be. Comedians, including those on the margins, can and do effectively employ self-deprecation without humiliation or denigration of self, and one way comedians do this is as a ruse to expose the ignorance of the audience or of comic targets not present. Second, Gadsby analyzes jokes and argues their two-part structure, set-up and punch line, is inadequate for telling the whole story of the trauma she has endured as a lesbian who, as she puts it, presents as “gender not-normal.” However, I maintain that, although jokes may not be, stand-up sets are often complete wholes with beginnings, middles, and ends. In fact, Nannette is a prime example of such complex comedy. Finally, she argues that the comedian’s job is to create and dispel tension, but she is no longer willing to take responsibility for or do anything to dispel the tension created when she speaks of her past trauma. But I discuss how Gadsby, as a true master of her craft, is able to create a highly successful and very funny comedy show in which she completely controls the tension while explicitly choosing to leave significant portions of it with the audience. In fact, super stand-up comedy can introduce tension it neglects to remove without sacrificing the humor. Indeed, Hannah Gadsby’s Nanette is a prime example of comedy that powerfully does precisely this.     

Description and First Steps Toward the Empirical Validation of the Plan Formulation Method for Couples

The aim of this paper is to empirically assess the reliability of the plan formulation method for couples, a procedure for formulating the case, planning, and monitoring the couple therapies according to control-mastery theory. We hypothesized that when couples are looking for couple therapy, they have an unconscious couple’s plan for the therapy, which includes the couple’s goals; the pathogenic beliefs that the partners want to disprove; the traumas from which these beliefs originated and that the partners want to master; the vicious relational circles that make the couple suffer and that the couple wants to break; the virtuous relational circles that are expressions of the couple’s resources and that the couple wants to fuel; and the relational insights that may help the couple get better. Our study involved 15 couples treated by four experienced therapists. Four raters independently formulated each couple’s plan based on the first three sessions following a standard procedure, and we calculated the intraclass correlation for pooled judges’ ratings. For a subsample of three couples—who before and after treatment had completed the dyadic adjustment scale (DAS) and the outcome questionnaire-45.2 (OQ-45.2)—the compatibility of the therapists’ interventions with the couples’ and partners’ plans was assessed. The relationship between the ratings of compatibility, DAS and OQ-45.2, was assessed. The results showed excellent interjudge reliability for each couple’s plan formulation (average ICC?=?0.82), attesting to the validity of the procedure; and preliminary data on the therapeutic process suggested that therapists’ interventions compatible with couple’s plans could help partners achieve good outcomes.

     

Living in the soap bubble: the infertile couple and the standstill of the transcendent function in the treatment of an adolescent girl1

Abstract: This paper considers disturbances of identity and developmental breakdown in the phase of ‘emergent adulthood’ with young adults together with a disturbance of the capacity of the Self for coniunctio. It is proposed that the capacity for effective intrapsychic linking as conceptualized in analytic psychology with the concepts of the coniunctio and the transcendent function, is disturbed because of an unconscious identification with an infertile ‘couple’. This unconscious couple fantasy can lead to a standstill of the transcendent function and prevents the growth of meaning via the linking between parts of the psyche. This can lead to considerable clinical disturbances. A clinical vignette from the treatment of an adolescent girl should illustrate these hypotheses. The patient had developed a not good enough internal space and she suffered from fragmentation anxieties. She tried to control these anxieties by obsessive behaviour and by forms of adhesive identification. The standstill of the transcendent function was manifested when the patient developed a negative therapeutic reaction.     

夫妻问题解决和社会支持、依恋安全性与婚姻质量的关系

以41对新婚夫妻为研究对象,采用观察法与问卷法相结合的方式,对夫妻冲突和支持、依恋安全性和婚姻质量之间的相互机制进行探索。结果显示：（1）妻子的婚姻质量更受到问题解决情境中（而不是社会支持）夫妻的积极行为（而不是消极行为）的影响;丈夫的婚姻质量更受到社会支持情境（而不是问题解决）中夫妻的消极行为（而不是积极行为）的影响;（2）妻子的依恋安全性显著预测妻子的婚姻质量,但丈夫的依恋安全性不能显著预测丈夫的婚姻质量;（3）妻子的依恋安全性在丈夫和妻子的问题解决积极行为对妻子婚姻质量的影响中起完全中介作用,而丈夫的依恋安全性在夫妻问题解决、社会支持行为与丈夫婚姻质量的关系之间不起作用。     

From Maternal Impressions to Eugenics: Pregnancy and Inheritance in the Nineteenth-Century U.S.

This essay examines the theory of maternal impressions, the belief that a woman’s experiences or emotions during pregnancy could explain congenital disability or emotional/ behavior differences in her child and asks why this theory circulated as an explanation for disability seen at birth by both medical doctors and in literature for far longer than it did across the Atlantic. By presenting examples from nineteenth-century medical literature, popular fiction, maternal handbooks, and two canonical works of literature, Nathaniel Hawthorne’s The Scarlet Letter and Harriet Jacobs’ Incidents in the Life of a Slave, I argue that maternal impressions worked to maintain anxiety for women, and particular white women, to ensure they felt responsible if anything was “wrong” with their child. Ultimately, I show how maternal impressions was both an ableist and racialized understanding of inheritance that wouldn’t be discarded until the emergence of eugenics in the early twentieth century.

     

Judgment in Fiction

Abstract

In this paper, I show that in order to gain an understanding of the facts about fiction it is more fruitful to pursue an analysis of judgment in fiction than an analysis of truth in fiction. I do so in two steps. First I take the analyses of truth in fiction which David Lewis provides in “Truth in Fiction”, which are formulated in terms of possible worlds, and provide counterpart analyses of judgment in fiction, formulated in terms of (mental) models and rules for the construction of (mental) models. In the course of discussion I identify various problems for Lewis’s account of truth in fiction and solve or dissolve them using the account of judgment in fiction. Second, I show that once we have an analysis of judgment which appeals to rules, we can extend the account of judgment by using Lewis’s account of accommodation and resistance in “Scorekeeping in a Language Game” to explain the evolution of the genres of fiction, construed as systems of rules. The result is to provide a dynamic account of judgment which does justice to modern poststructuralist observations in the philosophy of literature.     

Infertility-Related Stress and Life Satisfaction among Chinese Infertile Women: A Moderated Mediation Model of Marital Satisfaction and Resilience

The present study investigated the effects of infertility on Chinese women’s life satisfaction. Infertile women (n?=?466) who were seeking medical help completed a survey that included the Fertility Problem Inventory (FPI), the Dyadic Adjustment Questionnaire (DAS), the Connor-Davidson Resilience Scale (CD-RISC), the Satisfaction with Life Scale, and demographic variables. We used a moderated mediation model to test our hypotheses, with life satisfaction as the dependent variable, representations about the importance of parenthood as the independent variable, the impact of infertility on life domains as a mediator, and marital satisfaction and resilience as moderators. Results showed that representations about the importance of parenthood and the impact of infertility on life domains are two main types of infertility-related stress, which could play independent roles in predicting life satisfaction. Representations about the importance of parenthood had a negative indirect effect on life satisfaction through the impact of infertility on life domains, and the indirect effect of the impact of infertility on life domains was moderated by marital satisfaction and resilience. Specially, representations about the importance of parenthood had a weaker indirect effect (through the impact of infertility on life domains) on life satisfaction in individuals with higher marital satisfaction or resilience. Therefore, the type of infertility-related stress and both marital satisfaction and resilience should be addressed in psychological interventions for women coping with infertility in mainland China.

     

“Doubly Mother”: Heterologous Artificial Insemination Between Biological and Social Parenthood: A Single Case Study

In heterologous artificial insemination, the donation of gametes (either sperm or eggs) from a third person allows infertile and same-sex couples to become parents. Therefore, the child is genetically related to one parent, while the other parent is referred to as the social mother or father. This current single case study aimed at investigating this double access to parenthood in a lesbian couple who had two children after heterologous artificial insemination. In this couple, both women delivered one of the two children, so that each partner is either biological or social mother. The Clinical Generational Interview was used to assess the quality of family relationships, with a specific focus on three dimensions: the origins of each partner, the constitution of the couple, and the generational passage. Paper and pencil textual analysis was conducted following the principles of Interpretative Phenomenological Analysis and led to the identification of six dominant themes (and subthemes): (a) relationship with the family of origin; (b) couple relationship; (c) generational passage; (d) heterologous artificial insemination and “double motherhood”; (e) donor/biological father; and (f) children identity and the disclosure of their origin. This study’s findings revealed the importance of using research techniques aimed at in-depth exploration of this phenomenon consistently with the specificities of the new filiation forms. The adoption of a transgenerational perspective allows articulating conception coordinates with the history of the couple and each partner’s origins.