Hodgkin's disease in adolescence: A psychoanalytical approach

As a general rule, adolescents suffering from severe organic diseases experience more difficulty than adults and children in recognizing the illness and undergoing treatment, because there is a conflict between accepting the sick body and the sexual body. Dependence on medical treatment, moreover, clashes with the normal drive to autonomy. Long experience as a consultant psychiatrist in the haematology department of a hospital enables the author to propose a hypothesis as to the emotional significance of Hodgkin's disease and chemotherapy, concentrating particular attention on the refusal reaction to the chemotherapy itself. The psychoanalytical psychotherapy of a female adolescent suffering from Hodgkin's disease is presented and discussed to illustrate the theoretical and technical implications.     

Impaired reception of nonverbal cues in women with premenstrual tension syndrome

The ability to perceive nonverbal facial cues was tested in 30 White, middle-class females. Pre- and post-menses responses of 15 subjects diagnosed as having Premenstrual Tension Syndrome (PMS) were compared to the responses of age-matched controls. Each subject was asked to interpret videotaped facial cues of individuals engaged in a gambling task. Interpretive ability fluctuated during the menstrual cycle and was significantly impaired during the premenstrual phase.     

Causal attributions in premenstrual syndrome

Abstract

The relationship between causal attributions and symptoms was investigated with self-report inventories in patients with premenstrual syndrome (n=38) and controls (n=26) during the premenstrual as well as the intermenstrual phase of the cycle. Patients with prospectively confirmed premenstrual exacerbations of physical and psychological symptoms more frequently attributed their complaints during premenstruum to the cycle than was the case during the intermenstrual period. Controls showed no differences in types of explanations for complaints in either phase of the cycle. It appeared that patients used not only the menstrual cycle, but also psychological distress and physical exertion, more often then controls as an explanation for complaints during both phases of the cycle. Implications of the finding that patients used medical as well as non-medical explanations for complaints during the cycle are discussed with regard to treatment strategies for PMS.     

A psychoanalytical phenomenology of perversion1

After stating that the current tasks of psychoanalytic research should fundamentally include the exploration of the analyst's mental processes in sessions with the patient, the author describes the analytical relation as one having an intersubjective nature. Seen from the outside, the analytical relation evidences two poles: a symmetric structural pole where both analyst and patient share a single world and a single approach to reality, and a functional asymmetric pole that defines the assignment of the respective roles. In the analysis of a perverse patient, the symmetry‐asymmetry polarities acquire some very particular characteristics. Seen from the perspective of the analyst's subjectivity, perversion appears in the analyst's mind as a surreptitious and unexpected transgression of the basic agreement that facilitates and structures intersubjective encounters. It may go as far as altering the Aristotelian rules of logic. When coming into contact with the psychic reality of a perverse patient, what happens in the analyst's mind is that a world takes shape. This world is misleadingly coloured by an erotisation that sooner or later will acquire some characteristics of violence. The perverse nucleus, as a false reality, remains dangling in mid‐air as an experience that is inaccessible to the analyst's empathy. The only way the analyst can reach it is from the ‘periphery’ of the patient's psychic reality, by trying in an indirect way to lead him back to his intersubjective roots. At this point, the author's intention is to explain this intersubjective phenomenon in terms of metapsychological and empirical research‐based theories. Finally, some ideas on the psychogenesis of perversion are set forth.     

Relationship between anxiety and premenstrual syndrome

The relationship between symptoms of the premenstrual syndrome and anxiety was assessed for 68 women. The syndrome as measured by a modified version of the Moos Menstrual Distress Questionnaire, was correlated significantly with trait anxiety, as measured by Spielberger's State-Trait Anxiety Inventory. Trait anxiety was correlated with all three subtypes from the questionnaire: behavioral, psychological, and physical, most strongly for the psychological subtype. These findings suggest a role for stress-management training in the treatment of the premenstrual syndrome.     

Women's beliefs about the prevalence of premenstrual syndrome and biases in recall of premenstrual changes.

The present study investigated the relationship between women's beliefs about the prevalence of premenstrual syndrome (PMS) and biases in recall of premenstrual changes. Forty-nine women completed the Moos Menstrual Distress Questionnaire (R. H. Moos, 1968) both retrospectively and prospectively. Afterward, they were asked about their beliefs concerning the prevalence of PMS. The women reported higher premenstrual changes when they completed the retrospective questionnaire. Seventy-five percent of the women believed that the majority of women have premenstrual changes. From this percentage, those who answered that the majority also experience PMS were more biased in their premenstrual changes in the retrospective assessment. Many women have a misperception about the meaning of PMS; consequently, they amplify their premenstrual changes in recall, reflecting women's cultural stereotypes rather than their actual experiences.     

A framework and two sketches concerning psychoanalytical training and practice

The author discusses the mode of knowledge production in psychoanalysis based on a reflection on the psychoanalytical education and its relationship to clinical practice. She points out that there is a risk in a form of clinical activity found in our education, which, under the fascination of the analyst's power of operating in the metaphorical domain of words, loses sight of the material dimension of the clinical action. In other words, this form of clinical activity loses sight of the meeting with another human being, of the repertoire of theories and experiences that informs this action and the patient's and the analyst's concrete life situation. The author highlights the role of writing as a privileged way of dealing with the material and immaterial facts that constitute the clinical action and reflects on some of the forces that structure nowadays the reception of knowledge production inside the psychoanalytical field. She uses the notion of 'minor literature', by Franz Kafka, to express the possibility that a live circuit of writings exchanged among psychoanalysts can offer to an interchange of experiences and ideas that is the live expression of the history of the psychoanalytical groups. A clinical session is presented in order to promote considerations about the psychoanalytical education, theory and practice.     

Menstrual-related perceptual changes in women with premenstrual syndrome: Factors to consider in treatment

The state-dependent model of premenstrual syndrome (PMS) suggests that women's perceptions of daily stressors are affected by menstrual cycle phase. Our objective was to further examine the applicability of this model to perceptions of specific kinds of daily stressors and to explore its generalizability to perceptions involving significant others. Thirty-two undergraduate women, 10 PMS and 22 asymptomatic controls, completed the Daily Stress Inventory (DSI) and the Daily Rating Form (DRF) for 35 days. Questionnaires measuring perceived social support and self-esteem were completed premenstrually and postmenstrually. Results indicated that all women perceived a greater number of stressors as being severe premenstrually as compared to postmenstrually. Furthermore, all women perceived a lesser number of signifcant others as being present in their social support network premenstrually. However, only the PMS women were less satisfied with their social support and had more negative self-esteem premenstrually as compared to postmenstrually. Results are discussed within the context of designing treatment intermentions for women with PMS.     

Approaching countertransference in psychoanalytical supervision: A qualitative investigation1

A recent examination of the literature concerning countertransference and its developments reveals its clinical usefulness in different psychoanalytical cultures. Nevertheless, a shortage of publications is apparent with respect to its approach in supervision. The authors aim in this study was to examine the concepts of transference and countertransference and how countertransference is approached in supervision, in the training of candidates, at an institute of psychoanalysis belonging to a society affiliated to the International Psychoanalytical Association (IPA). Qualitative research was carried out, interviewing supervisors and supervisees. Through analysis of the material acquired, the authors classifi ed the data into initial, intermediate and fi nal categories. The principal fi ndings were subdivided into three categories: the concepts of transference and countertransference, psychoanalytical listening and the complementarity of the phenomena, and the approach to countertransference. The concepts of transference and countertransference predominantly used by those interviewed are based on the totalistic outlook. Countertransference in supervision has been approached in a more direct and objective way when compared with the previous period, although great care is taken to delimit the boundaries between supervision and personal analysis. The main aim of supervision is to broaden comprehension and to deepen the interpretations directed towards the patient. These fi ndings suggest that the evolution of the concept of countertransference in different psychoanalytical cultures and developments in the analytical fi eld are contributing to this change.     

Effects of the premenstrual syndrome on facial expressions of sadness

This study examined the relationship between PMS and emotion-related electromyographic facial activity at different phases of the menstrual cycle. Twenty-four women of reproductive age (12 with PMS, 12 controls) participated in two EMG sessions (T1 and T2) in which they were shown photographic images that can elicit various emotions (IAPS stimuli). T1 took place in the follicular phase, T2 in the luteal phase. The activity of the musculus depressor anguli oris ("depressor", expression of sadness) was measured. Depressor activity was compared to activity of musculus orbicularis oculi ("orbicularis"; expression of joy). ANOVA yielded a significant increase of the activity of the depressor at T2 in the PMS group. The PMS group showed more frequent depressor activity during the luteal than the follicular phase. Orbicularis activity did not change from T1 to T2. Conclusions: The PMS group experienced various visual stimuli in a more depressed way during the luteal phase.     

The effects of rational-emotive therapy and relaxation training on premenstrual syndrome: A preliminary study

Six female subjects who were between 31 and 44 years of age attended a premenstrual syndrome (PMS) clinic and participated in a group therapy program designed to alleviate their premenstrual symptoms. Rational-emotive therapy (RET) and relaxation training were offered in addition to ongoing progesterone treatment in an effort to alleviate severe psychological symptoms thought to be occasioned by the hormonal changes occurring during the premenstrual week. Pre-treatment assessments were carried out using Moos' Menstrual Distress Questionnaire, Broadbent's Cognitive Failures Questionnaire, and Eysenck's Personality Questionnaire. Additionally, levels of self-reported psychological and physical menstrual distress symptoms were estimated by the subjects at each premenstruum throughout the ten-week therapy program. At the end of the ten week therapy program hormone treatment was discontinued. Significant pre-test to post-test differences were found in a number of psychological and physical symptoms of menstrual distress, in cognitive functioning and neuroticism, following the combined group treatment. Improvements in psychological functioning during premenstruum were observed at a one-year follow-up. RET and relaxation together with hormonal therapy produced a substantial reduction in PMS symptoms in comparison with drug treatment alone.