The non-symbolic level of psychical reality

Freud introduced the concept of psychical reality as a consequence of abandoning the theory of seduction, and although this meant a turning point in his theoretical thinking he never defined the concept concisely and systematically. Thus it is possible to delineate at least two meanings of psychical reality that run through Freud´s writings as well as the writings of contemporary analysts. On the one hand psychical reality encompasses the whole field of subjective experiences. On the other, it is understood more narrowly as a transformation of experiences in the unconscious.

Substituting the idea of different meanings ascribed to Freud´s concept this article proposes to differentiate between levels in the psyche with the main focus on the unconscious level of the dream and of phantasy and the real unconscious. Starting from the most superficial level of subjective reality the text moves to that of fantasy formation illustrated by primarily Freud´s text on `A child is being beaten´. Adding Laplanche´s translational model the article ends up at the deepest level represented by the late Lacan and his concept of the real Unconscious.

The paper concludes that the term real points to something exceeding symbolization and the imaginary—thus escaping comprehension—and yet is absolutely indispensable to the organization of unconscious processes.     

The conceptualisation of the psychical in psychoanalysis

This article aims to clarify the psychoanalytic conceptualisation of the psychical, which includes a discussion of the relationship between consciousness and the unconscious. The unconscious is conceived of as being on the border between the so-called 'ego's conscious intending' and a rudimentary body-ego experiencing. Phenomenological ideas on the essence of consciousness are used in order to help delineate the crucial differences between consciousness and the unconscious. Only consciousness is characterised by an awareness of itself, that is; self-consciousness. Furthermore, consciousness is characterised by an intentional, synthesising capacity, whereas the functioning of the unconscious, in its most radical form, is the opposite ofthe intentionality of consciousness. It is argued that the unconscious pre-supposes certain pre-sexual processes, in the form of a body-ego's formation of continuity, coherence and wholeness. The body-ego belongs to the sphere of consciousness/self-consciousness, even if self-consciousness is only given implicitly in the body-ego and not as a fully fledged ego cogito . Attention is drawn to neglected issues in psychoanalytic theorising, namely self-consciousness and the constitution of existence. The importance of this neglected area for the psychoanalytic process is illustrated with clinical examples.     

The concept of psychical trauma: A bridge in interdisciplinary space1

The concept of trauma currently occupies a central position in interdisciplinary dialogue. Using the concept of psychical trauma as a bridge, the author attempts an interdisciplinary dialogue with psychiatry, biology and neuroscience. Beginning with the concept of psychical trauma in Freud, the author reviews the evolution of Freud's thinking, and links it with the ideas of Ferenczi and post‐Freudian psychoanalytical authors. From a different framework, he considers the present state of research on post‐traumatic stress disorder in current psychiatric nosography and attempts an interdisciplinary approximation to the concept of psychical trauma. Interesting ideas like the traumatic situation, trauma spectrum and psychopathological spectrum emerge, which enable a better understanding of the concept of psychical trauma through its relatedness, as a bridge connecting a broad psychopathological range extending from normality to psychosis. The ensuing possible relative loss of nosographical rigour is more than compensated by the resulting increased understanding and enlarged therapeutic possibilities. In the second part of the paper, the author attempts a dialogue with neuroscience, taking into account new advances in current research on emotion and memory, and making them compatible with the psychoanalytical concept of trauma. In this sense, the paper underlines the importance of emotion and crucially of memory, regarded as a fundamental axis of the subject explored in this paper. Here a substantial distinction which is pertinent for analytical work appears: declarative memories versus non‐declarative or procedural memories. In a concluding discussion the author argues that, taking into account the implications of these current notions regarding a number of theoretical and technical aspects, psychoanalysis currently holds a privileged position, both in its potential for prevention and regarding the treatment of patients, in so far as, through interdisciplinary dialogue, psychoanalysis can be receptive to and be enriched by the contributions of other disciplines, just as it enriches them with its own contributions.     

A nice arrangement of heterodoxies: William Mcdougall and the professionalization of psychical research

Joseph Banks Rhine (1895–1980) is usually considered the founder of modern professional parapsychology. Through his work at Duke University in the 1930s, he established a working research program (in the Lakatosian sense) for the controversial discipline, setting down various methodological standards and experimental procedures. Despite Rhine's clear and important influence on modern parapsychology, this article argues that he came to a stage that had already been set. Adopting recent theoretical advances in the study of scientific professionalization, it is argued that Rhine's mentor, the controversial British psychologist William McDougall (1871–1938), has a stronger claim to the parenthood of modern parapsychology than is typically recognized. Following McDougall's attempts to carve out and establish an institutional space for professionalized psychical research in 1920s America, furthermore, takes us to little explored connections between psychical research, Lamarckism, neo‐vitalism and policies of eugenics. © 2010 Wiley Periodicals, Inc.     

Cognitive differentiation, back pain, and psychogenic pain drawings

Two groups of subjects with back pain were studied (n = 67). All subjects underwent a battery of psychological tests which included a test of psychological differentiation (the Rod-and-Frame Test), a test of psychological defenses (Meta-contrast Technique), and the Eysenck Personality Inventory. In addition, the subjects drew a pain picture and answered a questionnaire on pain-related issues. Each group of subjects was then subdivided into 4 groups depending on the judged abnormality of their pain drawings. The two main groups were compared overall and the subgroups of the two back-pain groups compared with each other. The Meta-contrast Technique results show that depression was quite common among back-pain subjects as a whole compared to a painless group of subjects. Differences were found on field-dependence; subjects with abnormal pain drawings were more field-dependent than those with "normal" pain drawings. Few other between-group statistical differences were noted between the two back-pain groups. Expected scores on hysteria were not noted among the abnormal drawing makers, neither were there differences between the groups on the items of pain duration, physical functionings, or of depression.     

Pain and pain perception

Pain is both sensual perception and sense of touch, and it leads to emotional change of health, which has an effect back to a pain perception. Experience of pain is modified by intern and extern influences, and it can appear very multiformly in the chronicity. A part of these factors are described.     

Hypnosis and clinical pain

Hypnosis has been demonstrated to reduce analogue pain, and studies on the mechanisms of laboratory pain reduction have provided useful applications to clinical populations. Studies showing central nervous system activity during hypnotic procedures offer preliminary information concerning possible physiological mechanisms of hypnotic analgesia. Randomized controlled studies with clinical populations indicate that hypnosis has a reliable and significant impact on acute procedural pain and chronic pain conditions. Methodological issues of this body of research are discussed, as are methods to better integrate hypnosis into comprehensive pain treatment.     

Pain intensity and pain unpleasantness in triathletes: A study examining their associations with pain catastrophizing and pain expectations

ObjectiveTriathletes represent a growing and unique population of individuals willing to endure significant mental and physical stress to practice the sport they love. However, little is known about the pain experienced while training for and competing in a triathlon and how psychological factors influence this experience. This study will assess pain experienced by triathletes in training and competition, and investigate the association between pain catastrophizing and pain expectations with triathlon pain intensity and pain unpleasantness.DesignIn this observational study, a sample of 261 triathletes completed two online surveys before and after participating in a triathlon.ResultsModerate levels of pain intensity and pain unpleasantness were reported during training and competition. Pain catastrophizing was positively associated with expected and actual triathlon pain unpleasantness, but not with pain intensity. Expected pain intensity was also significantly associated with pain intensity experienced while competing, whereas expected pain unpleasantness was significantly related to both triathlon pain intensity and unpleasantness. Finally, regression analysis revealed pain catastrophizing and pain expectations to be unique predictors of triathlon pain intensity and pain unpleasantness.ConclusionThis study highlights the important role of psychological factors in triathletes' experience of pain and could eventually help tailor interventions aimed at improving the practice of triathlon.     

Conceptualizing suffering and pain

Background

This article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them (the mind-body dichotomy, Cassel’s idea of persons as “intact beings”) are critically discussed with such purpose.

Methods

A philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of what are found as better definitions of suffering and pain.

Results

Pain can be described in neurological terms but cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors have a decisive influence on pain perception. Suffering is proposed to be defined as an unpleasant or even anguishing experience, severely affecting a person at a psychophysical and existential level. Pain and suffering are considered unpleasant. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both perspectives can b e equally useful for managing pain and suffering, but they are not defining features of the same. Including the existential dimension in the definition of suffering highlights the relevance of suffering in life and its effect on one’s own attachment to the world (including personal management, or the cultural and social influences which shape it). An understanding of pain and suffering life experiences is proposed, meaning that they are considered aspects of a person’s life, and the self is the ever-changing sum of these (and other) experiences.

Conclusions

The provided definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding of how they are expressed and experienced. They lay the groundwork for further research in all these areas, with the twofold aim of a) avoiding epistemological mistakes and moral injustices, and b) highlighting the limitations of medicine in the treatment of suffering and pain.

     

God and animal pain

It seems that animal pain is an obstacle to belief in a good God, though Christianity has not been much concerned with the issue. A systemic approach to pain is not a complete answer, nor is there any merit in denying that God is subject to moral appraisal. Marilyn McCord Adams recommends that such investigations be located in the specifics of a religious tradition. Her advice eliminates a couple of radical solutions but there appear to be a number of ways in which progress might be made without doing violence to the tradition that is in need of a theodicy.