A Review of “Mind to Mind: Infant Research,Neuroscience, and Psychoanalysis”

Abstract

This article examines current research pertaining to the relationship between a mother and her children, and how this relationship may affect sibling interactions. Issues such as temperament, gender, and the age gap between children are also explored to ascertain their impact on the sibling relationship.

The displacement of the first-born child and the ensuing sense of loss and anger he may experience as a result of this is explored. The mother's second pregnancy is also discussed in regard to the impact of unresolved issues relating to her own sibling relations. The mother's interactions with each child, her role as a model for identification, and marital relations are discussed in light of their impact on sibling relations.

The evolution of a positive attachment between siblings is explored. Rivalrous behavior between siblings is also discussed, particularly in association to the mother's treatment of her own children and the manner in which the mother deals with her own aggression.     

Where the Rainbow Speaks and Catches the Sun

Abstract

Living with a neurobiological brain disorder, commonly known as a mental illness, requires a lifetime of diligent work toward recovery and wellness. This paper outlines the story of one occupational therapist's journey with her own mental illness. She prefers to call her own road of “recovery” one of “discovery,” as it has led her to discover true talents and gifts (strengths) even amongst encounters with old models that emphasize weaknesses and disability over abilities and capabilities. The following journey unfolds as advances in research, changes in services, increased focus on consumer as leader and increased tools and resources available lead the way toward a more positive ability to live a purposeful life, engaging in meaningful activities in spite of an illness. This paper gives a personal account as a tool to be used by other therapists as they travel along their own treatment journeyswhether with, or as consumers, of mental health services.     

Disbelief and Trust in Psychoanalysis - A Case Study

A case of unorthodox psychoanalysis with a 27-year-old woman, during the years 1994-1998 is presented. The patient, Silja, suffered from severe character neurosis with depression. She studied humanities at the University of Helsinki with poor results, because of severe inner demands of perfection. The therapy was unorthodox, because it was necessary to change the method a few times. After two years of psychoanalysis, a life-threatening crisis occurred in 1996, and I was obliged to take a more active role and even give direct advice concerning her studies. This was successful, and she could achieve her B.A., the lower university degree. The change of method was necessary to avoid suicide. In the end we could resume psychoanalysis and analyse what had happened. Suddenly in the summer of 1998 Silja's depression disappeared and her looks improved. Therapy ended in November 1998, when she was ready to try on her own. According to her both the holding and love and also the direct advice were the most important elements in her cure. After a three years' follow-up her condition had further improved, she was married, had a job and was expecting a baby.     

Parallel Process

Summary

This article addresses parallel processes between the author (a therapist) and client when each are mourning the death of their mother. Similarities and differences in their experience and reaction are discussed. The effect of the client's unexpressed grief from her early childhood loss is explored. The author also examines her own, more recent loss and develops a new perspective on its consequences. Tools are presented to help the client work on her grief, especially when the issue is “motherloss.” The impact of the therapeutic process on the client and author is delineated, and the client's reactions to ending her therapy are analyzed.     

Supportive psychotherapy of a psychodynamic orientation as an adjunctive treatment for drug-induced depression: A case study

Abstract

Treatment for drug-induced depression usually consists of cessation or reduction of the causative agent and psychopharmacologic management. In addition, psychotherapy can be useful as an adjunctive treatment. The author presents case material related to a young woman with an inborn physical illness, who became depressed during the course of interferon treatment for a medical complication, hepatitis virus infection. In addition to the cessation of interferon and pharmacologic management, supportive psychotherapy of a psychodynamic orientation was started in order to address the patient’s low self-esteem and anxiety about her future. During the course of psychotherapy, it was understood that the premature cessation of interferon was, to her, a narcissistic injury. It was also important to explore the meanings of her inborn illness and her guilty feelings. After reviewing various formulations of depression, the author discusses the case material from an integrative perspective, which describes vicious cycles of depression.     

Social criticism in the process of interpretation (discussion)

Abstract

The author comments on Horst Petri's case presentation and gives reasons why he sees social criticism within the process of interpretation as inappropriate. Firstly he contradicts Petri's view of the severity of his patient's illness. He thinks a supportive therapy was not appropriate and he would have treated her by using conflict centered interpretations. Secondly he assumes that the analyst's social criticism forms an alliance with the analysand which excludes essential issues from the analytic work. And thirdly he reminds us that psychoanalysis doesn't spare a supposedly progressive attitude from criticism. Within the framework of psychoanalytic theory, the relativity of all value judgements forbids the analyst to tie himself down in the way Petri suggests.     

Living with Hereditary Haemorrhagic Telangiectasia: stigma,coping with unpredictable symptoms,and self-advocacy

Abstract

Objective: Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic condition causing frequent nose bleeds, skin lesions (telangiectasia) and arteriovenous malformations. Approximately, 50% of people experience life-threatening HHT symptoms including haemorrhages in the brain, lungs and liver. This study aimed to gain a qualitative understanding of the psychosocial impact of HHT over time. Design: Using a phenomenological framework, a rigorous narrative analysis was performed on 20 semi-structured interviews with individuals with HHT aged 20s–60s. Main outcome measures: Qualitative themes explaining life experiences prior to and following a clinical diagnosis of HHT. Results: Narratives highlighted four psychosocial themes: (i) the psychological impact of visible symptoms was significant and related to experiences of social stigma, (ii) individuals struggled to identify triggers of symptoms in order to reduce unpredictability, (iii) an illness identity was rejected by minimising HHT when talking about the present self, and by positive reframing as ‘lucky’ and (iv) self-advocacy was necessitated due to lack of expert coordinated care. Conclusion: HHT has a demanding impact on social, physical and psychological well-being. These findings have significant implications for health care, as narratives about interactions with health professionals often used the terms ‘frustrating’ and ‘not being heard’.     

Hope

Summary

The author describes her treatment of her first alcoholic client and observes how the process of providing hope to this client heightened the author's personal capacity to hope. Hope as an aspect of healing is considered and personal reflections on psychotherapeutic work with alcoholics are discussed.     

An Analysis of the Effectiveness of the Intervention

SUMMARY

In this chapter, I examine the specific problem Betty had with her children because, in many ways, it represents the problems most of the volunteers had with their children. Her problem was the most extreme among the participants, and she involved the other volunteers in helping her look for a solution. The vignette that follows comes from my field logs, and it is followed with a layered response from Betty's peers. The vignette offers a close look at Betty's problems with her daughters and the dilemma she experienced in relation to coming to work when her children needed her. Betty told her story to Esther, Dolores, and me one morning in the dayroom.     

Life Experience Is Not a Disease or Why Medicalizing Madness Is Counterproductive to Recovery

Abstract

The author draws on her personal experience as the family member of an individual with mental illness, on her anthropological research and on that of others to argue that medicalizing madness can be counterproductive to recovery. The medical model is sometimes used in a way that strips away the meaning of the illness experience. Analogies drawn to diseases do not help the understanding of mental illness. Psychiatry is a social practice embedded in a social milieu and that renders it less than objective. It is useful to recognize that the experiences called symptoms have meaning and may have positive and pleasurable aspects.     

And Three Made One: Psychoanalytic Work with a Three-Year-Old Girl in the Context of Reproductive Assisted Technology

ABSTRACT

The subjective experience of reproductive assisted technology (RAT) and the conceptual and clinical challenges it presents to contemporary child psychoanalytic practice is explored. Clinical material seeks to illustrate the impact of a mother’s relational past and her experience of infertility on the quality of her relationship with her young child and its impact on developmental progression. The role of the body as both organizer and container of experience is emphasized, as well as the role of the father and the parallel process between the mother-child dyad and the parental couple.     

Health Locus of Control Beliefs in Low Back Pain Patients

Abstract

Associations between health locus of control (HLC) beliefs, illness characteristics, psychological distress and self-care behaviour were studied in a group of subjects (n=459) aged 35 to 54 years suffering from chronic or recurrent low back pain (LBP). The results showed that younger subjects and men were more internal in their beliefs, and that duration and severity of LBP, psychological distress, and back care were associated with the individual's beliefs in his/her control over illness. The associations found were, however, of a low magnitude. More conclusive evidence on the development and modification of HLC beliefs are required before practical applications are possible.     

Self-starvation and the performance narrative in competitive sport

ObjectivesTo provide an alternative to medical understanding of disordered eating in sport through an emphasis on personal perspectives.DesignThis study draws on narrative theory to interpretively analyse the life of Holly, a female athlete who engages in severe self-starvation.MethodsMore than 7 hours of life history data was gathered over a period of 8 months through unstructured interviews. Holly's story was analyzed through principles of narrative analysis, with attention afforded to both narrative content and structure.ResultsHolly's life is characterized by a struggle to align her life experiences with a culturally specified “performance narrative” that lauds normative success. When neither her academic nor sporting endeavors are perceived to fulfil the achievement narrative, Holly is thrust into emotional turmoil and begins to conceive of self-starvation as a means to achieve.ConclusionsThe performance narrative spans both academic and sporting cultural domains and it can play a role in athlete disordered eating.     

Toward a Reconstruction of Medical Morality

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary.     

The subjectivity of the mother in the mother–son relationship. Attachment,separation, and autonomy

Abstract

Margaret Mahler and John Bowlby's positions are crucial in understanding the tensions that can arise in mother–son relationships. A more recent development of a systems view illuminates the co-construction of this relationship that occurs mainly out of awareness. A systems model of development that describes the co-construction and bi-directional influence between mothers and sons will be used in this paper. The often-neglected subjectivity of the mother is the focus, and the relationship between the mother and her adult son is viewed as a process whereby all participants strive to achieve a balance among attachment, separation, and autonomy. In addition, the contributions of the mother and the impact on her of the son's difficulties in attachment, separation, and autonomy are highlighted. In a case illustration, the subjectivity of the mother in relation to her son is explicated, showing how the son distances himself from his mother and why themother is at a loss to understand how and why this has occurred. The mother's perspective was dominated by anger and disappointment toward her son as well as by self-blame and self-justification. As a result of psychotherapy, the mother was enabled to come to terms with the estrangement of her son.     

Illness intrusiveness and quality of life in end-stage renal disease: comparison and stability across treatment modalities

Investigated the degree to which chronic, life-threatening illness and its treatment interfere with continued involvements in valued activities and interests--that is, illness intrusiveness--and its impact on quality of life in end-stage renal disease. Data were collected on two occasions separated by a lag of 6 weeks. Mixed analyses of variance indicated that life domains were affected differentially across treatments. Perceived illness intrusiveness correlated significantly with treatment time requirements, uremic symptoms, intercurrent nonrenal illnesses, fatigue, and difficulties in daily activities. Significant quality-of-life differences were observed across treatment modalities for satisfaction/happiness and pessimism/illness-related concerns but not for depression/distress. Perceived illness intrusiveness correlated significantly with each of these quality-of-life measures. Results were stable over time. These findings substantiate the construct of illness intrusiveness as a mediator of the psychosocial impact of chronic, life-threatening illness.     

Relationships between personality characteristics of people who stutter and the impact of stuttering on everyday life

ObjectiveThis study investigates the association between the five-factor model of personality measured by the NEO Five-Factor Inventory (NEO-FFI) and the Overall Assessment of the Speaker's Experience of Stuttering (OASES). The OASES measures the adverse impact of stuttering on a person's life.DesignParticipants in the present study were 112 persons who stutter from Germany.MethodsAll participants filled in both the NEO-FFI and the OASES questionnaires.ResultsResults revealed a strong positive correlation between the personality trait Neuroticism and scores on the OASES. Moreover, Extraversion was negatively correlated with the OASES scores.ConclusionsThe findings suggest that people with higher Neuroticism and lower Extraversion scores experience a greater impact of stuttering on their daily life. The results underscore the importance of considering personality as a potential moderator or mediator factor in future stuttering research and, potentially, also in treatment.Educational objectives: The reader will learn (a) about the different personality dimensions reflected by the NEO-FFI, (b) why it is important to consider the impact of stuttering on everyday life from the perspective of the people who stutter and (c) how personality is linked to the Overall Assessment of the Speaker's Experience of Stuttering (OASES).     

Eve in early Reformation exegesis: the case of Iohannes Oecolampadius

Abstract

Iohannes Oecolampadius stood at the forefront of the Reformation in Basel. He not only worked tirelessly for the reform of the city's churches, but also authored pioneering evangelical works of theology and exegesis. The interpretation of Eve found in his late lectures on Genesis showcases both a new emphasis on Eve's goodness and original equality with Adam, as well as a parallel insistence on her subordination to her husband after the Fall. His conception of husband and wife as partners of equal dignity on the path toward salvation moves in the direction of companionate marriage, but it stops short of calling for women's equality in the public sphere.