Psychotherapy of a man with panic,somatization, and traumatic anxiety: A psychoanalytic case study

This is the case of a 42-year-old Englishman who suffers from acute anxiety attacks and panic episodes. His professional life is severely limited because he cannot tolerate separation from home and family. The relationship between himself and the significant others in his life has deteriorated and he is continually made to feel like the inadequate outsider. The roots of the psychopathology presented in adulthood are frequently found buried in the past. In this case, the traumatic episodes experienced in the first five years of life are being replayed over and over in the present. Whether he is home watching television, driving to work or in a store with other shoppers, he is alone—deserted, abandoned, lost. The first five years of this man's life were spent on an island during World War II. He experienced nightly bombardments. The patient recovers fragments of past episodes: darkness, lonely roads, uniformed men and the overriding feeling of helplessness. As he proceeds through his analysis, the shadowy places become illuminated for brief moments, as he relives the feelings of the past as they seem to be reenacted before him.     

The Negative Therapeutic Reaction (NTR): A Review and Synthesis for Practitioners

This article explores some of the major theories concerning the negative therapeutic reaction (NTR), presenting the convergences and divergences found among the various theoretical perspectives on this most important clinical phenomenon. The article also summarizes Robert C. Lane's NTR typology. He discusses ten categories of response tendencies he has observed clinically over decades of psychoanalytic practice. This article, moreover seeks to synthesize the views of various classical and contemporary theories, treatment approaches, and thoughts on future research into NTR dynamics.     

The invariance of sentence performance structures across language modality

Native users of American Sign Language were asked to manipulate sentences in four different ways: sign them at slow rate, parse them, make relatedness judgments of pairs of signs taken from each sentence, and recall the sentences. The data obtained from these four tasks (pause durations, parsing values, indices of relatedness and probe latencies) were used to construct hierarchical performance structures for each of the sentences. The resulting structures were highly similar across tasks; that is, performance structures are not task specific. The four measures at each sign boundary in each sentence were well predicted by a performance model, elaborated by Grosjean, Grosjean, and Lane for speech, that combines a parsing measure with a symmetry measure. Thus performance structures appear to be founded in the processing of language, be it visual or oral, and not in the properties of any particular communication modality.     

Preventing Reading Difficulties: Reading Between the Lines

Preventing Reading Difficulties in Young Children, the report of the Committee on the Prevention of Reading Difficulties in Young Children sponsored by the National Research Council, provides a comprehensive examination of the reading process and of reading instruction in the early grades. Although lacking in several areas, such as the development of fluency, appropriate practices for students with learning disabilities, and recommendations for teacher education, the report is based on sound research and is likely to have a substantial impact on the field of reading.     

The Narcissistic Injury and Psychopathology of Migration: The Case of a Nicaraguan Man

Cultural and ethnic issues commonly surface as important therapeutic themes among many minority patients. Identity formation, self-concept, perception, and the effects of migration on the aetiology of psychiatric symptomatology are reviewed. Trauma resulting from migration, stress, and prolonged affect-laden situations in the precipitation and onset of physical disease and illness is discussed. A clinical presentation of a 68-year-old Nicaraguan man is presented to highlight the aforementioned issues, i.e., traumatization, the development of psychopathology, and the onset of physical illness as a result of forced migration.     

Auditory attention switching: a developmental study

The developmental course of the ability to rapidly allocate attention was studied using a dichotic listening task with 8-year old, 11-year old and college age subjects. In this task, subjects were instructed to listen to one ear for predescribed targets and then were later signaled (on some trials) to switch their attention to the other ear. Reorientation was assessed by comparing the pattern of subjects' omission and intrusion errors on trials following a command to switch ears with the pattern of errors on no-switch trials. Older subjects were better able to reallocate their attention in accordance with task demands, with the greatest gains in performance occurring between ages 8 and 11. This developmental change appears to be generally continuous and quantitative in nature. Since successful performance of this task requires flexibility in subjects' ability to control their focus of attention, these results support the hypothesis that the basis of the developmental improvement in the ability to ignore irrelevant information is linked to the ability to use active attentional strategies.     

Psychoanalytic perspectives on the treatment of early adolescent girls

Psychotherapy of girls between the ages of 10and 14 years presents specific difficulties which originate in the rapid physiological changes and intrapsychic demands for psychological differentiation, causing considerable anxiety and inner turmoil. The introduction of therapeutic intervention at this juncture is discussed along with its risks, benefits, limitations, possibilities, and implications for psychoanalytic theory.     

Autoerotism in patients with borderline personality organization: A case of wristcutting and bulimia

This paper is an investigation of some manifestations of autoerotism in patients with borderline personality organization. Symptoms involving somatic sensations and experiences are prominent in Kernberg's list of presumptive diagnostic elements for borderline conditions. It is postulated here that many such symptoms are autoerotic attempts to represent and resolve the difficulties around primitive aggression and associated lack of self-other differentiation that are central to borderline pathology. This is illustrated using case material from the treatment of a young woman who presented with symptoms of wristcutting and bulimia.Early versions of this paper were presented at the Eleventh Annual Symposium of the New York Center for Psychoanalytic Training in April, 1986, and the Mid-Winter Meeting of the Division of Psychoanalysis, American Psychological Association, April, 1987.