Psycho-social aspects of thalassaemia a psychodynamic understanding

Abstract

I was recently appointed as counsellor for the UK Thalassaemia Society, based in London. Soon after I was to attend the first UK Thalassaemia Society's National Conference held in Leicester where, along with a genetic counsellor, I was asked to facilitate a two-hour group discussion entitled ‘Psycho-social Aspects of Thalassaemia'. The day made a strong impact on me, and the writing of this article has been an attempt to integrate my feelings and in turn gain a clearer insight into the psycho-social experience of thalassaemia major.     

Psychoanalytic treatment of a woman with anxiety attacks and conversion

This case study describes the psychoanalytic treatment of a young woman presenting with symptoms of overwhelming anxiety, panic, and conversion. The emphasis is on technique with detailed reporting on the psychoanalytic process. Attention is paid to transference-countertransference paradigms at critical junctures in the treatment. The role of clinical supervision in the unfolding of the process is described also. This patient developed an identifiable transference neurosis during the course of the treatment, which became the focus of the analysis. Follow-up observations on this patient are also presented, as she returned for a brief course of treatment 4 years following initial termination.     

A psychodynamic understanding of parental stress among parents of children with learning and developmental disability and behaviours that challenge

A significant minority of parents of children with learning and developmental disability experience elevated levels of parental stress, particularly when their children present with behaviours that challenge. A small but influential number of psychoanalytic authors have made significant contributions to the learning disability field of research, however, the psychological distress of parents whose children have behaviours that challenge has received scant attention. This paper posits that distressed parents of children with learning and developmental disability and behaviours that challenge often make use of primary defences, which are linked with their children’s behaviour, albeit in a reciprocal rather than causal manner.     

Case report of stuttering acquired in association with phenytoin use for post-head-injury seizures

Previous research indicates that stuttering and deficits in motor performance may be associated with the use of phenytoin (Dilantin). The present report concerns a case of stuttering acquired in association with phenytoin use for post-head-injury seizures. The extent and nature of dysfluencies and the motor performance of speech and nonspeech muscle systems were evaluated over an extended period during which changes in anticonvulsant medication were made. Reductions in dysfluency levels and improved motor performance were observed following a medication change from phenytoin to carbamazepine. Performance on tests assessing nonmotor functions, such as memory and attention, was equivalent before and after the medication change. The apparent association between dysfluency levels, motor performance deficits, and phenytoin suggest that in the present case stuttering resulted in part from a general impairment in motor control.     

Assessing a microswitch-based stimulation procedure for eye-blinking responses in a young woman with profound multiple disabilities

We applied a new microswitch-based stimulation procedure for eye-blinking responses with a young woman with profound multiple disabilities, and compared effects of this procedure on the eye-blinking responses and smiling with the effects of a caregiver-based stimulation condition. Analysis showed that the microswitch-based stimulation procedure, with stimulation occurring contingent on eye-blinking responses, increased the frequencies of these responses significantly above the levels recorded in baseline and caregiver-based stimulation conditions. No changes in smiling frequencies occurred. Implications of the findings in terms of alertness, learning, and quality of life are discussed.     

Epileptic seizures in young patients with hypodense lesions in the CT image

Progress in neurodiagnostic medical technology, and in computer tomography in particular, has raised fresh problems in connection with epilepsy. Among our patients we have observed three case of epilepsy, in whom the CT image unexpectedly revealed hypodense lesions of various sizes in the cerebrum. The three are young patients aged 20 to 25 years with negative neurological findings. The above changes in the CT image are extremely difficult to interpret. It is not even know whether the lesions must be considered the cause or a consequence of the epileptic seizures or whether the pathomorphological processes are basically identical or completely different in all three patients.     

Getting a clear picture: young children's understanding of a televised image

Previous research has established that very young children, unlike older people, often have difficulty using a televised image as a source of information about a real event. After watching on a live video monitor as an adult in the next room hid a toy, 2‐year‐olds usually did not find it, but after watching directly through a window, children of this age succeeded. In the first experiment reported here, 2‐year‐olds could see hiding events directly and on a video monitor at the same time. This video–reality training did not improve performance on subsequent standard trials with video as the only source of information. In a second experiment, an adult demonstrated correct search behavior using video, finding a toy as the child watched on the video monitor. Despite this training and assistance, most of the children did not appear to recognize the connection between a video image and reality.     

Passion, countertransference enactment, and breakdown in the psychoanalysis of a young woman

Transference-countertransference involvement with patients the analyst finds "pleasurable" is examined. Analysis of such patients courts the danger that pathological identifications will go unrecognized and the analysis end at a point where the opportunity for decisive change, which to the patient appears physically and psychically catastrophic, is forgone. A presentation of one aspect of the analysis of a young woman reveals the psychic pain experienced by analysand and analyst when the feared breakdown places a pathological identification in doubt, and the difficulties that can ensue in treatment. Other psychodynamic lines of interpretation and differential diagnostic considerations are put aside in favor of an examination of the special role of enactment and countertransference enactment and their impact in promoting development or strengthening defense.     

A linear relationship between postnatal geomagnetic activity and self-reports of epileptic seizures in young adults

To test the hypothesis of a linear relationship between the intensity of geomagnetic activity during the first two days after birth and the development of epilepsy, the responses of the item "I have had an epileptic seizure" was obtained from the Personal Philosophy Inventories of 1,453 students who had been enrolled in first-year psychology courses over a 13-yr. period. The only statistically significant effect was linear and was between the successive 10 nT (nanoTesla) increments of the intensity of geomagnetic activity during the two days after birth and the percentage of students who reported epileptic seizures. The percentage of subjects reporting a history of seizures ranged from 1% for those born when the activity was less than 10 nT to 4% for those born when this activity exceeded 40 nT.     

Silent voices: Notes from a young Muslim woman on acculturation in the United States

This paper examines the gap between a researcher's positionality and theory building; seeing research through the lens of women of color in academia. Drawing on the autobiographical approach in feminist geography, I argue how a researcher's background and life events influence how we produce knowledge in the field by sharing my personal journey. Specifically, I share what it means to be a Middle Eastern Muslim academic conducting research on female immigrants' cultural adaptation process in the U.S. I urge readers to uncover the power of self-reflection, embodied subjectivity and emotions in expanding geographic research and conclude how the future research will benefit from the motives behind each study, as well as giving a reflexive researcher a platform to be heard.     

What enhances the development of emotion understanding in young children? A longitudinal study of interpersonal predictors

We studied potential determinants of the development of children's emotion understanding (EU) from age 4 to 6 in a Norwegian community sample (N = 974) using the Test of Emotion Comprehension. Interpersonal predictors included the accuracy of parental mentalization, parental emotional availability, and teacher‐reported child social skills. Intrapersonal child factors were child gender and verbal skills. Overall, children's EU increased significantly over time. After adjusting for child gender, age‐4 EU, and parental socio‐economic status, greater child verbal and social skills and greater parental mentalization each uniquely predicted growth in EU. Results are discussed in terms of theory and research on children's EU and parents' emotion socialization.     

The piloting of a brief relational psychodynamic protocol (psychodynamic addiction model) for problem gambling and other compulsive addictions: A retrospective analysis

The paper describes a treatment pilot for gambling and compulsive addiction within an NHS problem gambling clinic. The pilot study used a brief relational psychodynamic treatment protocol specifically designed to meet the needs of a group of patients who had not responded to CBT and who had other addictions or co‐morbidities. Seventy‐two (n = 72) patients were offered 12 sessions of therapy by four psychodynamic counsellors. Results were assessed using scores from a pre‐ and post‐treatment patient health questionnaire, the generalised anxiety disorder—7 (GAD‐7) and the Problem Gambling Severity Index (PGSI). Weekly feedback and supervision from counsellors and patients were used to assess the treatment model. The results highlighted that the psychodynamic addiction model was associated with reduced depression (Mean = 14.9; SD: 6.7), anxiety (Mean = 11.5; SD: 5.9), and gambling severity (p < .001), suggesting that a relational psychodynamic treatment is needed for complex patients with compulsive addiction, where CBT had not been successful. These results also highlight the importance of the therapeutic relationship as a critical factor in the treatment of patients with compulsive addiction problems.