?Du sollst dir kein Bildnis machen��

??The Progress in Spirituality??, a short section of Freud??s last major work ??Moses and Monotheism?? (1939) received special attention when his daughter read it on his behalf in 1938 at the last International Psychoanalytical Congress before the Second World War in Paris: it was almost like reading the will of the founder of psychoanalysis. ??The Progress in Spirituality?? is an implicit reflection on the core of psychoanalysis and its technique of eliminating vision. The image of God reflected there??the establishment of Jewish monotheism, of a nameless, aniconic, abstract God and the ethical demands imposed by him??exhibits all the characteristics of a cultural revolution in which all the existing traditions were thrown away. In it seems hidden what was for Freud the mysterious feature in the Jewish tradition. Through the prohibition of images Mosaic monotheism enforced a higher level of intellectuality and encouraged introspection. In the psychoanalytical setting the prohibition of images seems to reappear in the form of the ??cultural memory??. The denial demanded of the patient and the renunciation of instincts demanded from both corresponds to ??The Progress in Spirituality?? in which Freud??s Moses finds his culmination point.     

Zeitlosigkeit und Verg?nglichkeit (in) der Psychoanalyse

The author shows that the accessible psychoanalytic unconscious is not timeless. Freud??s ??timeless unconscious??, which was ontologized by himself and his successors, proves to be fiction with negative consequences. Assuming ??timeless?? primary processes psychoanalysis as a therapy would bite the hand which feeds it. Instead of contrasting linear time to the cyclic personal experience of time, the author suggests to speak about the ??emergence of lived time?? and the ??new moments?? of encounter in the therapeutic situation, to emphasize the importance of the opportune moment for change in contrast to the cyclic repetition of transference. In order to understand and approach disorders of time perception knowledge of unconscious conflicts and defense processes remains crucial. Even dreams are not timeless. While our conscious mind works according to chronological patterns, the pictorial representation in the particular form of thinking asleep, dreaming, makes it possible to map different memory traces simultaneously. Freud??s speculations about the ??timeless unconscious?? and Nirvana may originate from a longing for redemption. In contrast the author??s final chapter deals with the potential life span and transience of some central psychoanalytic concepts. Not even those who prove to be very close to observation can be attributed with ??eternal life??.     

Das Unheimliche der Ambivalenz

This essay??s main concern consists of a critical survey of the coherences, alliances and associative entanglement between psychic ambivalences, encounters of the uncanny and the connections to the issues of death. References for the considerations presented here are Freuds??s seminal papers ??The antithetical meanings of primal words?? (1910), ??The uncanny?? (1919) and ??Beyond the pleasure principle?? (1920). The axis formed by these essays is being crisscrossed by the phenomen of the uncanny valley, an issue widely discussed within the cyber scene which may introduce a new perspective in order to extend the analysis of the concept and structure of ambivalences with new questions. This approach adverts to an inherent paradox which seems to be constitutive for ambivalence itself.     

Ambivalenz und gleichschwebende Aufmerksamkeit

Starting from some aspects of a case study the clinical significance of the concept of ambivalence will be exposed. It will be shown that beyond all the different symptoms ambivalence plays an important role in evenly-suspended attention, a concept which was developed by Freud at nearly the same time as ambivalence itself. As far as this attention is not freely suspended, ambivalence means that the suspension is always threatened by the danger of a crash. When it is right, that from a psychoanalytical viewpoint the achievement of the subject lies particularly in a misachievement, in the Freudian slip, the promise of efficiency and cure in an analysis will prove itself in its failure. The young man in the case study tells the psychoanalysis about the ambivalences it is involved in and in this he is very efficient. Ambivalence as an essential part of the evenly-suspended attention will reveal itself as a strong means of deconstructing efficiency.     

Kommentare zu ?Ambivalenz weiterschreiben��

The authors comment on the results of the Zürich symposium with varied weighting. Ambivalence is brought into relation with a hypothetical genesis of human thinking and understood as a reflection of the fundamental dialogical structure, which owes itself to an exchange of symbolic messages. A further consideration describes that the ??valley of the uncanny??, whose connection to death Lilly Gast has shown, could also have a fundamental connection with sexuality bared of all bonds, which releases the same fears as death. A difficulty would lie in the inflationary use of the term: every ambiguousness or diversity would sometimes generally be subsumed under ambivalence and therefore all selectivity would become lost. Also discussed is the ambivalence of the term, or the question, whether the term has not lost significance. Finally its relevance in pediatric and adolescent-specific perspectives will be examined.     

Schmerz ist nicht gleich Schmerz

Not all types of pain are the same. For successful treatment of pain, acute pain must be distinguished from chronic and nociceptive must be distinguished from neuropathic pain. Selection of the right medication is based on the severity of the pain. Despite all efforts to standardize treatment, there is still no consensus on the optimal treatment method. The effective drug must be determined for each patient by taking into account the patient’s symptom profile, the pain intensity and duration as well as the side effects and contraindications. In chronic pain syndromes, only after 6–8 weeks with adequate dosage can the ineffectiveness of a drug be assessed. Single doses, intervals between administration and routes of administration must be selected depending on the pharmacokinetics and interaction profile and the age and needs of the patient.     

Autoimmun-Enzephalitiden – eine Erkrankungsgruppe mit vielen Gesichtern

During the last 10 years a number of syndromes with antibodies against neuronal surface antigens have been characterized. Adults as well as children can be affected. Patients may suffer from amnestic syndrome, other cognitive deficits, seizures, or psychiatric symptoms. Some patients develop generalized encephalopathy with altered levels of consciousness, hyperkinesias, and hypothalamic disorders. In some patients, ovarial teratoma, thymoma, or small cell lung cancer can be diagnosed. However, in most patients no tumor is found. These syndromes were previously called autoimmune channelopathies. In fact, most antigens are not part of an ion channel but proteins or part of protein complexes on the cell surface of neurons, axons, dendrites, or synaptic terminals. These proteins are expressed throughout the nervous system. Interestingly, in limbic encephalitis very circumscribed brain regions are affected. This may be due to an increased vulnerability or accessibility of the affected brain regions. Limbic encephalitis is a well-characterized form of autoimmune encephalitis, which can be associated with different antibodies. Anti-NMDA-receptor encephalitis is not restricted to the limbic system. Characterization of other syndromes and auto-antibodies are expected in the future. In this review, aspects of limbic encephalitis and anti-NMDA-receptor encephalitis will be discussed.     

Die Hysterie im neuen Gewand und im Wandel der Zeit

Classical symptoms of hysteria – especially symptoms of hysterical neurosis (conversion type) – are not commonly seen any more. On the one hand, general knowledge about the function of hysterical has led to suppression of the underlying hidden conflicts, possibly up to resomatization. On the other hand, those affected may have rather subtle symptoms, e.g., vague pain, circulatory disorders, or fatigue. Overall, the hysterical phenomena have not become less common but have become “contemporary” and, therefore, more difficult to identify. Reliable epidemiological data, however, are difficult to obtain. Rough estimates indicate that 2–6?% of all people have dissociative disorders (ICD-10 definition). Histrionic personality disorder is estimated to occur with a frequency of 2–3?%. In 75?% of cases, the disease manifests relatively early, between the ages of 17 and 32 years and with a 3:1 female to male ratio. An average of 7 years elapses between first manifestation and the start of psychiatric–psychotherapeutic treatment.     

Lumbale Radikulopathie

Back pain is a common pain syndrome in the general population. The most common cause is lumbar disc disease and only rarely bony degenerative changes of the spine. Other causes of lumbar radiculopathy include local lesions. Inflammatory changes or meningeal carcinomatosis may also lead to lumbar nerve root damage. With pronounced clinical symptoms, motor deficits of the associated muscles can occur, including weakening of muscle reflexes. In addition to thorough education of the patient about the origin, likely duration, and treatment of the disease, a combination of physical therapy and pharmacotherapy is the basis for successful treatment of lumbar radiculopathy. In cases of severe paralysis, bladder and rectal paralysis, and corresponding compression of nerves, urgent spinal surgery is inevitable.     

Eine erfolgreiche Behandlunsgkette bei Zwangsstörung

Obsessive-compulsive disorder (OCD) belongs to a group of disorders with an estimated lifetime prevalence of 2?%, associated with a high socio-economic burden and the risk of chronification. In the latest version of the DSM-5, OCDs were detached from the chapter of anxiety disorders, similar to the ICD-10. Consequently, the fifth revision of the DSM highlights the fact that scientific results so far, like the overactivation of basal-ganglia thalamocortical circuits, basically support a common model for OCDs. Although in the past, OCDs have been ignored as a diagnostic entity, in the DSM-5, the concept of obsessive–compulsive spectrum disorders according to Hollander was partly realized. The present case report outlines an example of a successful therapeutic chain in the treatment of a severe case of OCD with a 90?% reduction of symptoms throughout a calendar-year, emphazising the importance of efficient treatment chains within psychiatric disorders.