Reflections on trauma,symbolization and psychic pain in a case of neurosis and a case of psychosis

This paper seeks to advance some considerations on trauma, historical reality, its symbolization and the psychic pain generated by the investigation of unconscious processes in psychoanalytic treatment. These themes will be explored by demonstrating the differences arising between traumatic experiences and their expression in phantasy, as they occurred in a case of neurosis and another of psychosis. In each case, the differences in the features of the symbolization and the processes of working through shall also be taken into consideration. Particular attention shall be paid to the specific difficulties encountered by the analyst in the interpretative treatment of the trauma resulting from the amount of psychic pain induced in the patient, which at times proves to be an insurmountable barrier and a destructive distortion of the process.     

Nonword repetition and phoneme elision in adults who do and do not stutter: Vocal versus nonvocal performance differences

PurposeThe purpose of the present study was to enhance our understanding of phonological working memory in adults who stutter through the comparison of nonvocal versus vocal nonword repetition and phoneme elision task performance differences.MethodFor the vocal nonword repetition condition, participants repeated sets of 4- and 7-syllable nonwords (n = 12 per set). For the nonvocal nonword repetition condition, participants silently identified each target nonword from a subsequent set of three nonwords. For the vocal phoneme elision condition, participants repeated nonwords with a target phoneme eliminated. For the nonvocal phoneme elision condition, participants silently identified the nonword with the designated target phoneme eliminated from a subsequent set of three nonwords.ResultsAdults who stutter produced significantly fewer accurate initial productions of 7-syllable nonwords compared to adults who do not stutter. There were no talker group differences for the silent identification of nonwords, but both talker groups required significantly more mean number of attempts to accurately silently identify 7-syllable as compared to 4-syllable nonwords. For the vocal phoneme elision condition, adults who stutter were significantly less accurate than adults who do not stutter in their initial production and required a significantly higher mean number of attempts to accurately produce 7-syllable nonwords with a phoneme eliminated. This talker group difference was also significant for the nonvocal phoneme elision condition for both 4- and 7-syllable nonwords.ConclusionPresent findings suggest phonological working memory may contribute to the difficulties persons who stutter have establishing and/or maintaining fluent speech.Educational Objectives: (a) Readers can describe the role of phonological working memory in planning for and execution of speech; (b) readers can describe two experimental tasks for exploring the phonological working memory: nonword repetition and phoneme elision; (c) readers can describe how the nonword repetition and phoneme elision skills of adults who stutter differ from their typically fluent peers.     

Traumatic effects of political repression in Chile: A clinical experience1

The author examines psychic trauma resulting from human rights violations in Chile. Starting from trauma theories developed by authors such as Ferenczi, Winnicott and Stolorow, she posits the relevance of the subject's emotionally signifi cant environment in the production of the traumatic experience. She describes the characteristics of the therapeutic process on the basis of a clinical case. She emphasizes the need to recognize the damage that may be produced within the reliable link between patient and analyst, pointing out the risk of retraumatization if analysts distance themselves and apply ‘technique’ rigorously, leaving out their own subjective assessments. Therapists must maintain their focus on the conjunction of the patient's intersubjective context and inner psychic world both when exploring the origin of the trauma and when insight is produced. The author posits repetition in the transference as an attempt at reparation, at fi nding the expected response from the analyst that will help patients assemble the fragments of their history and achieve, as Winnicott would put it, a feeling of continuity in the experience of being.     

The traumatic memory debate: A failure in scientific communication and cooperation

Perhaps no other topic in recent history has generated such emotionality as the ongoing traumatic memory debate involving alleged reports of physical and sexual abuse. The literature on this topic is replete with reliance on anecdotal statements, unwarranted and grossly overstated generalizations, emotionally laden conclusions, attacks and counterattacks. This state of affairs has resulted in creating a polarization between cognitive memory researchers and clinical researchers who are attempting to resolve the debate through scientific inquiry. Unfortunately, the databases on both sides of the issue are weak. The purpose of this article is to highlight the key issues at the center of this debate in an attempt to move the debate forward. It is argued that resolution of this debate can only be achieved by conducting appropriately designed clinical research with a population of traumatically abused subjects. To achieve this objective, both sides need to suppress their emotional rhetoric, open lines of communication, and engage in cooperative research efforts. This issue is too important for both the field of psychology and society as a whole to remain polarized and unresolved.     

The traumatic memory debate: A failure in scientific communication and cooperation

Perhaps no other topic in recent history has generated such emotionality as the ongoing traumatic memory debate involving alleged reports of physical and sexual abuse. The literature on this topic is replete with reliance on anecdotal statements, unwarranted and grossly overstated generalizations, emotionally laden conclusions, attacks and counterattacks. This state of affairs has resulted in creating a polarization between cognitive memory researchers and clinical researchers who are attempting to resolve the debate through scientific inquiry. Unfortunately, the databases on both sides of the issue are weak. The purpose of this article is to highlight the key issues at the center of this debate in an attempt to move the debate forward. It is argued that resolution of this debate can only be achieved by conducting appropriately designed clinical research with a population of traumatically abused subjects. To achieve this objective, both sides need to suppress their emotional rhetoric, open lines of communication, and engage in cooperative research efforts. This issue is too important for both the field of psychology and society as a whole to remain polarized and unresolved.     

Beyond his story: from interpretation to impact of stories from different cultures

This paper deals with the history of psychoanalysis (Freud) and analytical psychology (Jung) in the light of recent developments and considers the release of new creativity in the field after its deconstruction. Cross-cultural contributions in the form of teaching stories are estimated to be of relevance, while the emphasis will be on what we, as analysts, can learn from these teachings, rather than interpreting them in the more traditional way in which such stories can be shown to fit analytical theory.
The most crucial debate in psychoanalysis of the recent era centres around stories and the deconstruction thereof. It is the debate between Lacan and Derrida on the interpretation of a crucial story (Poe's story, The Purloined Letter). The core of their views will be discussed in this paper in the light of the major differences between Freud and Jung. Whereas Freud's theoretical core-complex is closely related to Lacan's phallocentric Truth, it is Derrida who speaks of germination and dissemination as the way in which Truth manifests itself. Derrida's thought on text and words is very close to Jung's conceptions of the image and symbol, in which there is no monotheistic paradigm ruling theory     

An alaryngeal stutterer: A case history

This case study describes an individual who as a stutterer underwent a total laryngectomy and right hemithyroidectomy. Following the Doehler method of esophageal voice training, the client continued to exhibit dysfluent speech behaviors. The Iowa “Stutterer's Self-Rating of Reactions to Speech Situations” and the “Checklist of Stuttering Behaviors” were used to ascertain whether the stuttering behaviors had changed and to what degree.     

汉语颠倒词加工中重复知盲发生的水平

以汉语中的颠倒词为材料, 探讨汉语重复知盲的发生水平。采用RSVP方式呈现包含颠倒词对(C1和C2)的句子列表或词语列表, 让被试对列表中的词进行全部报告或报告是否存在重复词, 记录报告C2的正确率。三个实验采用3 (词语的重复性: 颠倒重复、完全重复、不重复) × 2 (颠倒词对的意义相似性: 意义不同、意义相似)两因素被试内设计, 结果在全部报告和报告是否存在重复词的实验中都出现重复性和意义相似性的交互效应, 但不同实验任务, 数据模式不同。该结果表明, 在RSVP任务中, 汉语颠倒词加工存在RB效应, 该效应产生的水平受制于不同的实验任务, 在部分报告任务中, 颠倒词的RB效应发生在知觉水平, 在全部报告任务中, 颠倒词的RB效应发生在语义水平。     

Interpretation: signals from the analytic field and emotional transformations

Through numerous clinical examples and from a point of view focused on field theory the author reflects upon what are the main characteristics of ‘transformative interpretations’ and upon the mental and affective conditions that support it. He especially centers his attention on difficult patients who have experienced cumulative affective traumas in their lives.     

His mother-tongue: from stuttering to separation, a case history

This paper delineates the transference and countertransference experiences in the analysis of a patient whose presenting symptom and main concern was his stutter. I suggest that oral-sadistic rather than anal-sadistic hostile elements may be identified in this patient's particular stutter. I focus on its significance in terms of object relationship: my patient's struggle to 'get born', to emerge as a separate other. I argue that early symbiotic fusion needs in conflict with the need to separate produce his stutter. Speech and language are seen as the vehicle for separation and the stutter as a flight from separateness back to an illusion of fusion with mother.     

Case history of Farida: A year of psychotherapy with a girl who said she was sexually abused

This paper discusses how thinking about a playroom involves our thinking about the setting in psychoanalytical work with children in general - the physical as well as the human aspects - and how this encourages us to rethink some of the basic aims in psychoanalytic work. The paper describes the importance of the setting being such as to help the therapist to have the freedom to think and to feel what is going on in the child and himself. Links are then made with aspects of transference and counter-transference, and brief examples given.     

My subdued ego: A psychodynamic case study of borderline personality disorder following relational trauma

Recent advances in the conceptualisation of borderline personality disorder (BPD) have highlighted the role of relational trauma as central to the onset of the disorder, whilst observing deficits in the structure of the self-concept as a result of developmental adversity. Understanding borderline states within a psychiatric framework alone has attracted significant criticism due to the lack of the medical model’s explanatory properties, which fail to account for the complexity and variation of borderline symptomatology. A reliance on psychodynamic formulation instead, can provide an aetiological framework where BPD can be understood as a disorder of the sense of self, originating in the client’s relational matrix. The purpose of the current paper is to discuss a borderline case study with a focus on formulation rather than diagnosis, in an attempt to shed light on the relational and unconscious processes underpinning the disorder and thus inform treatment interventions.     

Introducing counselling in secondary schools: A case study with reference to frame issues

Abstract

I am a deputy headteacher in a comprehensive school. I believe that the widespread re-introduction of counselling into secondary schools offers possibilities for great benefit, both in terms of the personal well-being and emotional health of students, and also in terms of academic results and other educational indicators. It is my view that, currently, this may particularly be true for boys.

This paper is a double case study: first, of the failure of a student to cope with ordinary schooling because of his emotional difficulties; and, second, of the establishment of a counselling service which resulted from his permanent exclusion from the school.

I allude to some of the theoretical issues which meshed with the practical details of establishing the counselling service, and offer some tentative conclusions about the rationale for counselling in secondary schools and the kind of model which seems most likely to be beneficial.     

Recovering memories of trauma: A view from the laboratory

The controversy over the validity of repressed and recovered memories of childhood sexual abuse (CSA) has been extraordinarily bitter. Yet data on cognitive functioning in people reporting repressed and recovered memories of trauma have been strikingly scarce. Recent laboratory studies have been designed to test hypotheses about cognitive mechanisms that ought to be operative if people can repress and recover memories of trauma or if they can form false memories of trauma. Contrary to clinical lore, these studies have shown that people reporting CSA histories are not characterized by a superior ability to forget trauma-related material. Other studies have shown that individuals reporting recovered memories of either CSA or abduction by space aliens are characterized by heightened proneness to form false memories in certain laboratory tasks. Although cognitive psychology methods cannot distinguish true memories from false ones, these methods can illuminate mechanisms for remembering and forgetting among people reporting histories of trauma.     

Dynamic relationships between phonological memory and reading: A five year longitudinal study from age 4 to 9

We reconcile competing theories of the role of phonological memory in reading development, by uncovering their dynamic relationship during the first 5 years of school. Phonological memory, reading and phoneme awareness were assessed in 780 phonics‐educated children at age 4, 5, 6 and 9. Confirmatory factor analyses demonstrated that phonological memory loaded onto two factors: verbal short‐term memory (verbal STM; phonological tasks that loaded primarily on serial order memory) and nonword repetition. Using longitudinal structural equation models, we found that verbal STM directly predicted early word‐level reading from age 4 to 6, reflecting the importance of serial‐order memory for letter‐by‐letter decoding. In contrast, reading had no reciprocal influence on the development of verbal STM. The relationship between nonword repetition and reading was bidirectional across the 5 years of study: nonword repetition and reading predicted each other both directly and indirectly (via phoneme awareness). Indirect effects from nonword repetition (and verbal STM) to reading support the view that phonological memory stimulates phonemically detailed representations through repeated encoding of complex verbal stimuli. Similarly, the indirect influence of reading on nonword repetition suggests that improved reading ability promotes the phoneme‐level specificity of phonological representations. Finally, the direct influence from reading to nonword repetition suggests that better readers use orthographic cues to help them remember and repeat new words accurately. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=70LZfTR0BjE .     

Making a case for case studies in psychotherapy training: A small step towards establishing an empirical basis for psychotherapy training

The evidence debate in psychotherapy pays little attention to developing an evidence base for training practices. Understanding effective training requires an examination of what makes training work. This article examines the role of case studies in psychotherapy training. This has not been articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory in action; access to whole courses of therapy; access to different approaches; access to significant moments; access to the therapeutic relationship; access to a wide range of client types; access to working in different contexts; and the opportunity of identifying with therapists and clients. Writing or presenting cases offer students the opportunity of: learning to integrate information into a relevant whole; being in the ‘hot seat’; learning to give appropriate feedback; assessing the validity of interpretations, inferences, and interventions; adapting methods to suit the client; and learning to collaborate with other professionals. The paper presents directions for future research into psychotherapy training, specifically proposing an international survey of training practices at psychotherapy training institutions.     

The impact of the new wine common market organization (CMO) on behavioural loyalty towards product attributes: A case from Italy

This paper explores the changes in consumers' loyalty towards wine after the launch of the new common market organization (CMO) (European Council Regulation (EC) No. 479/2008) in 2008. The analysis of wine purchases in the AC Nielsen Consumer Panel in 2009 and 2010 was compared to analogous work conducted in 2003–2005 and 2006–2008. Loyalty towards wine attributes— price, quality designation and packaging format—was measured using standard brand performance measures together with a newer metric, the polarization index, which has not been used before to highlight or explain the factors behind shifts in loyalty. The analysis revealed that post‐CMO reform increases in consumer loyalty towards the following: (i) standard 0.75‐L wine bottles; (ii) quality‐classified, protected designation of origin wines; and (iii) higher‐price‐point wines. The paper elaborates these findings, explaining how changes in consumers' loyalty patterns can be used to quantify the success of recent policy changes, which can be tracked in a reasonably short time frame thanks to the polarization index. Copyright © 2014 John Wiley & Sons, Ltd.