The internet and its role in the escalation of sexually compulsive behaviour

As increasing numbers of patients present with problems of compulsive use of internet sex and internet pornography, psychotherapists are challenged to develop models that address the powerful, and potentially disturbing effect of this stimulus. Internet sex does not just facilitate access to sexual materials but can act as a catalyst, affecting established defences and ego and superego functioning. Escalation in sexually compulsive behaviour, which affects a small proportion of those accessing online sex, may be thought of as a series of transitions: from casual to compulsive use, from compulsive use to illegal use, and from use of illegal pornography to contact offending. Drawing on clinical experience and the available research evidence, psychodynamic processes associated with movement through these transitions are considered. Internet sex has the potential to fuel manic defences, invites narcissistic and part-object relating, provides a vehicle for the expression and disowning of sadistic impulses and can potentially undermine superego functioning. The combined effect of these processes may lead to a breakdown of ego controls in vulnerable individuals.     

显性自恋与隐性自恋:自恋人格的心理学探析

自恋是一种形式多样化的综合性人格构造,它具有两种不同的形式,即显性自恋和隐性自恋。本研究在文献综述、开放式问卷调查和个别访谈的基础上,编制了自恋人格问卷。经对大学生被试进行测查,结果表明：（1）自编的自恋人格问卷具有较好的信度和效度。（2）因素分析得出显性自恋的四个维度是：权欲、优越感、特权感和自我钦羡;隐性自恋的三个维度是：易感质、特权感和自我钦羡。（3）显性自恋和隐性自恋与心理健康有着不同的关联：前者与心理异常症状不存在显著相关,而后者存在显著正相关。     

Fragmentation and Narcissism

The paper focuses on the articulation of two areas of theory: that of development of the self through fragmentation and differentiation and that of narcissism in early psychological development, and its pathology later in life. Jungian ideas concerning the self and individuation (including those developed by Fordham) are linked with psychoanalytic ideas, notably Kohut's, and related to the concepts of narcissism and ego-development. In this the focus is on a revaluation of the negative overtones of 'fragmentation' and 'narcissism' and an indication of their place in the process of individuation. It is pointed out that a varying emphasis in the analyst on what are called the biological and ethological aspects of these theories will have important implications for the treatment of patients. The theoretical position is illustrated by a lengthy clinical example involving a case of early injury to the self which suggests the pathology of narcissistic character disorder. But the case also illustrates the contribution to development of fragmentation and narcissism, which are revalued here as the 'part-for-the-whole' and as one of the 'motors' of individuation. Working within a perspective that prioritizes the importance of the drive towards relationship, it is recommended that the analyst learns to respect and value phenomenologically the contribution of fragmentation and narcissism to normal development, if true healing is to occur.     

The relationship between self‐perception of physical attractiveness and sexual bullying in early adolescence

The relationship between self‐perception of physical attractiveness and four measures of sexual bullying behavior (victimization, perpetration, having friends who sexually bully, and observation of sexual bullying among peers at school) was examined in a sample of 396 middle school age students. Students who perceived themselves to be more physically attractive than their peers reported sexually bullying others more, being sexually bullied by others more, observing more sexual bullying, and having more friends who sexually bully others than did students who perceived themselves as average looking. In addition, males who perceived themselves to be less physically attractive than their peers reported being victimized more and reported observing more sexual bullying in the school environment. These findings highlight the importance of physical attractiveness in the early initiation of sexual harassment. Implications for future research and interventions with early adolescents are discussed. Aggr. Behav. 36:271–281, 2010. © 2010 Wiley‐Liss, Inc.     

John Nash's Postdelusional Period: A Case of Transformed Narcissism

This article concludes the psychoanalytic study of mathematical genius John Nash begun in previous articles (Capps 2003a, 2003b) by focusing on his recovery from paranoid schizophrenia after more than a decade of being under control of his delusions. I develop the idea that Nash was a highly narcissistic personality, the primary focus of which was his beautiful mind, in the years preceding his mental breakdown. I attribute his recovery primarily to the transformation of his narcissistic personality and support this attribution by means of Heinz Kohut's identification of five major expressions of transformed narcissism in his classic essay on the forms and transformations of narcissism.     

Neuroscience,mind and meaning: an attempt at synthesis in a Relational Affective Hypothesis

This paper sets out a falsifiable Relational Affective Hypothesis, describing a neurological and relational pathway, through which affect and sensations arising from the interior of the body are translated, in a relational context, into language and a capacity for symbolisation. It describes the role of psychodynamic defences in narcissistic disorder, which can result in collapse in the function of this pathway. The hypothesis arose from clinical psychodynamic work with patients with severe and complex narcissistic disorders. They are characterised as severe, because they are at high risk of completed suicide and so are commonly treated in locked units, and complex because of their anorexic and bulimic eating patterns, tendency towards somatisation and the co-occurrence of autistic difficulties. A more or less profound failure of symbolisation is a feature common to these presentations. This interdisciplinary thinking offers a perspective on brain and psychological development, taking into account the complex interplay between genetic, environmental, relational and dynamic influences. It can be tested empirically and has implications for psychoanalytic thinking, psychiatry and neuroscience.     

Men's likelihood of sexual aggression: the influence of alcohol,sexual arousal,and violent pornography

Previous research findings have indicated that both alcohol intoxication and violent pornography exposure may contribute to increased sexual aggression by men. This study used an experimental paradigm to examine the effects of a moderate alcohol dose, alcohol‐related beliefs, and victim response on men's self‐reported likelihood of committing sexual aggression. A community sample of male social drinkers (N=84) participated in an experiment in which they read an eroticized rape depiction after completing an alcohol administration protocol. The stimulus story varied whether the victim, who initially expressed unwillingness to engage in sexual activity, expressed pleasure or distress in response to the man physically forcing her to perform several explicit sex acts. A path analytic model illustrated that participants' self‐reported likelihood of behaving like the sexual aggressor in the story was directly related to their own sexual arousal. Heightened sexual arousal was reported by participants who had consumed alcohol, those who read the victim‐pleasure story, and those who believed that drinking women are sexually vulnerable. Results suggest that sexual arousal to violent pornography, as influenced by acute alcohol intoxication and other factors, may be an important component of men's perceptions of their own sexual aggression likelihood. Aggr. Behav. 32:581–589, 2006. © 2006 Wiley‐Liss, Inc.     

X-rated material and perpetration of sexually aggressive behavior among children and adolescents: is there a link?

Longitudinal linkages between intentional exposure to x-rated material and sexually aggressive behavior were examined among youth 10-15 year olds surveyed nationally in the United States. At Wave 1 in 2006, participants (n = 1,588) were queried about these exposures and outcomes in the preceding 12 months. Wave 2 data (n = 1,206) were collected approximately 12 months after Wave 1 and Wave 3 data (n = 1,159) were collected approximately 24 months after Wave 1. Thus, data for this project represent a 36-month time frame. A marginal model with generalized estimating equations was used to represent the population-average odds of sexually aggressive behavior over the 36 months as a function of exposure to x-rated material over the same time and to account for clustering in the data within person over time. An average of 5% of youth reported perpetrating sexually aggressive behavior and 23% of youth reported intentional exposure to x-rated material. After adjusting for other potentially influential proximal (i.e., sexual aggression victimization) and distal characteristics (e.g., substance use), we found that intentional exposure to violent x-rated material over time predicted an almost 6-fold increase in the odds of self-reported sexually aggressive behavior (aOR: 5.8, 95% CI: 3.2, 10.5), whereas exposure to nonviolent x-rated material was not statistically significantly related (aOR: 1.7, 95% CI: 0.94, 2.9). Associations were similar for boys and girls (boys nonviolent x-rated material aOR = 2.0, 95% CI: 0.8, 4.7; violent x-rated material aOR = 6.5, 95% CI: 2.7, 15.3; girls nonviolent x-rated material aOR = 1.2, 95% CI: 0.5, 3.2; violet x-rated material aOR = 6.1, 95% CI: 2.5, 14.8).     

Narcissism, hypochondria and the problem of alternative theories

This paper is an experiment in conceptual integration and clinical theory testing. Its argument is that narcissism and sexual object love develop from a single source and continue to interact during childhood development and adult life (Freud) and that drives in their oedipal and other formations are not merely disintegration products of narcissism (Kohut). Material from two analyses, supplemented by material from two others, indicate that narcissistic injury was a significant factor in the neuroses of these patients but that aggressive and libidinal conflicts were also decisive such that their hypochondriac symptoms were compositions of their interacting causality. As a result these neuroses are negative instances of Kohut's theory of narcissism. The hypochondriac symptoms as they emerged could not have had the structure and dynamics they actually had nor could the analytic process these patients underwent have achieved the far-reaching and durable amelioration of these symptoms that occurred. On the positive side, these analyses are but two inductive instances that support Freud's theory. However, one major difficulty of the faddishness of psychoanalytic theorizing is that much of worth is lost from general theories that turn out not to be supportable. The clinical material from these two cases which disprove basic elements of self-psychology metapsychology also require adjustments to classical theory that integrate the contributions of self-psychology to psychoanalytic clinical theory.     

The double-edged pen: Omnipotent fantasies in the creativity and addictions of Stephen King

The legendary debate over whether a connection between creativity and addictions exists is one that is shrouded in mystery and intrigue, but also one that continuously returns to the circuitous metaphor of the chicken and the egg. In an effort to better understand nuances in the relationship between creativity and addictions, this paper examines the life of Stephen King, and the omnipotent fantasies from which both his creative processes and addictive behaviours emerged. Since the early twentieth century, psychodynamic thinkers have highlighted omnipotent fantasies as a psychological force driving creative processes as efforts towards personal transformation. Similarly, numerous psychodynamic theories have highlighted omnipotent fantasies as playing a cardinal role in the psychological processes that propel substance abuse. And yet, the construct of omnipotence has yet to be examined as a theoretical bridge to bind such theories of creativity and substance abuse together. While fostering personal meaning and self-transformation when manifested in his creative writing processes, omnipotent fantasies have also lead Stephen King down a precarious path of addictive behaviours. Through a narrative analysis of the life of Stephen King, who has written in great depth about both his creativity and substance abuse, I will illustrate how omnipotent fantasies often shape and foster both healthy, creative processes towards growth and maladaptive, addictive impulses towards self-destruction.     

Identity, sexuality and the self in late adolescence

This paper explores the concepts of identity, sexuality and the self within the context of adolescent development. The development of the identity concept in adolescence is traced in Jung's theoretical, clinical and autobiographical writings. Jung's adolescent development is viewed as the matrix out of which the identity concept emerged within analytical psychology. This was later elaborated theoretically by Jung in Symbols of Transformation (1912/1956). One of Jung's clinical cases of a late adolescent is discussed in which themes related to the development of identity and sexuality emerged. An adolescent case from the author's analytic practice is presented where similar themes of identity, homosexuality and self emerged. The developmental and symbolic themes which emerged in the analysis are viewed within the context of the transference/countertransference relationship.     

School context and health in adolescence: The role of sense of coherence

The aim of this study was to examine the role of school variables and sense of coherence (SOC) in the explanation of health. For this purpose, data were collected from a representative sample of adolescents, aged 13 to 18 years, selected for the Health Behavior in School‐aged Children survey in Spain. Using Structural Equation Modelling, three nested models were tested that represented different hypothesized models of the relationships among school factors, SOC and health. According to goodness‐of‐fit indices, in the best model, school‐related stress and SOC mediated the influence of support from classmates and teachers on health, and SOC had a direct effect on stress. The results supported the idea that a supportive school climate and SOC are relevant to adolescents' health. Furthermore, SOC was the most influential variable; apart from its direct positive effect on health, SOC seemed to condition the degree to which students perceived school demands to be stressful. Specifically, students with a high SOC were less likely to suffer from high levels of school‐related stress.     

The Embodied Self. Movement and psychoanalysis

Increasing numbers of patients presenting problems with internet pornography have led to changes in the culture and practice of group analytic therapy at the Portman Clinic. The addictive element of this new form of artificial, sexual stimulation has to be recognised as part of the harm it produces. Group members spontaneously develop some of the principles and practice of established methods of addiction treatment, especially the 12-step programme, by helping each other manage their compulsion. This self-help function of the group coexists alongside the psychodynamic perspective, in which the meaning of harmful sexual behaviour is explored and understood. Certain individuals are more vulnerable to excessive use of pornography because of early developmental problems and current difficulties in their sexual relationships, resulting from internal conflicts about their sexuality. The group provides intimacy without sexualisation, primarily through a sibling transference. The therapist embodies an ability to think about the complexity of the sexual abuse that the pornography portrays. He or she works towards a truer perception of reality for group members, in which the false solutions of compulsive sexual behaviour are seen to be what they are: impediments to healthy development.     

The relationship of neuropsychological impairment to conduct disorder in adolescence: A conceptual review

This review is an attempt to expand the understanding of the neuropsychological mechanisms that may influence the expression of violent or aggressive behavior in adolescents. Although a relative large literature of adult studies examining the relation of neuropsychological impairment and aggression exists, the research literature investigating this relationship in adolescents is much smaller. With a few exceptions, the delinquent literature suffers from methodological problems, including biased sampling methods, small numbers of subjects, failing to objectively diagnose conduct disorder, incorrect use of specific statistical procedures, and lacking of appropriate control groups. In general, a mixed pattern of neuropsychological deficits are displayed across studies, depending on the sampling method, methodological design, statistics employed, control groups, and assessment tools that were utilized. Verbal deficits have been frequently displayed across the literature, while evidence for executive dysfunction varies, depending on the specific construct being evaluated (e.g., attention, cognitive flexibility, concept formation, planning abilities) and the specific population. Relatively inconsistent findings have been observed for visuospatial, sensory, and motor deficits. This article provides a critical review of this literature and discusses the varying impact that any neurological insult will have, depending on premorbid personality and cognitive functioning, location of the lesion, age at which the injury occurred, child's pre- and postinjury environment, and ability of the brain to adapt to acquired deficits as the result of the insult. On the basis of this review and neuropsychological theory, four subgroups within this population are proposed (i.e., adolescents with subcortical injuries, dominant hemisphere temporal-parietal injuries, nondominant hemisphere temporal-parietal injuries, and injuries to the prefrontal regions), which may better explain the neuropsychological and behavioral outcomes exhibited by this heterogeneous population. Recommendations for future research are offered.     

The transcendent function in adolescence: miracle cures and bogeymen

Abstract: This paper proposes that Damasio's mental images, Stern's moments of meeting and Tronick's dyadically expanded consciousness refer to different aspects of the same psychological process as Jung describes in the transcendent function. This proposition is illustrated with two case vignettes of adolescents who functioned on a pre‐symbolic level, but who through a transformative experience were catapulted into new developmental trajectories and the beginning of symbol formation.     

Cross-informant consistency in externalizing and internalizing problems in early adolescence

The concept of cross-informant consistency has long been a topic of interest for those involved in assessment of behavior problems in adolescence. The purpose of the present study was to replicate and expand the existing literature by including four informants (mother, father, teacher, and adolescent self-report) and examining correlations among them as well as differences between reporters on an absolute level of both internalizing and externalizing problems. Fifty-two young adolescents (ranging in age from 11 to 15 years) and their mothers, fathers, and social studies teachers participated in the study. The Conduct Disorder subscale, Socialized Aggression subscale, and Anxiety/Withdrawal subscale of the Revised Behavior Problem Checklist were used. Results indicated that teachers showed little agreement with other informants on conduct problems (teachers reporting fewer problems), while parents and adolescents showed significant agreement. Informants showed no agreement on the measure of covert problems (socialized aggression), and all reports showed agreement on internalizing problems (although teachers continued to report fewer problems). Implications for assessment of young adolescents are discussed.This research was supported, in part, by the William T. Grant Foundation and the University of Georgia's Institute for Behavior Research.     

Empathic accuracy: age differences from adolescence into middle adulthood

ABSTRACT

This study investigated age differences in empathic accuracy, the ability to correctly perceive others’ emotions, in a sample of 151 boys and men from three age groups: adolescents (M_age?=?16 years, SD?=?1.04), young adults (M_age?=?29 years, SD?=?2.78), and middle-aged adults (M_age?=?50 years, SD?=?3.07). All participants viewed nine newly developed film clips, each depicting a boy or a man reliving one of three emotions (anger, sadness, or happiness), while talking about an autobiographical memory. Adolescents and middle-aged men were less accurate than young men, and these age differences were associated with parallel age differences in fluid-mechanical abilities. In addition, age differences in vocabulary, one indicator of crystallized-pragmatic intelligence, were associated with age differences in empathic accuracy in adolescent and young, but not middle-aged, men. Within the limitations of cross-sectional data, this study provides evidence for the idea that empathic accuracy is an effortful task that requires cognitive resources and, thus, may show a normative increase until young adulthood followed by periods of stability and decline in subsequent decades.     

It's more than skin‐deep: The relationship between social victimization and telomere length in adolescence

This study examined the relationship between peer victimization and telomere length (TL), an indicator of biological aging that is associated with stressors (Epel, 2009). It was predicted that social victimization would have a greater impact upon TL, as well as the frequency and severity of health complaints than physical victimization. Adolescents (M_age = 15.91 years, SD_age = 1.65) and their parents completed measures of peer victimization and physical health problems; adolescents also submitted a DNA sample for telomere analysis. Greater instances of being socially, but not physically, victimized were associated with shorter telomeres, as well as more frequent and severe health complaints. TL was also negatively related to both the frequency and severity of health problems, even after controlling for BMI, age, and sex of participant. The relationship between social victimization and health complaints via TL held only at higher levels of social victimization. These findings are the first to find an association between peer victimization and shortened telomeres.