Working with incest survivors

The purpose of this paper is to convey more widely the existence of this kind of specialist group in the NHS. We also wish to show some of the advantages and disadvantages in setting up such a group to other professionals who may be considering the possibility of starting an incest-survivors group. The paper describes the group which ran at the Psychiatric Day Hospital at the Whittington Hospital for forty weeks: how we adopted the group structure; some of the problems we faced; and some of the emotional issues generated in therapists and patients. Conclusions are drawn about the usefulness of such a group.     

Development of the concepts of transference and counter-transference

SUMMARY

This paper traces the development of the concepts of transference and counter-transference over nearly a hundred years, from the origin of the concepts to current understanding of them. Clinical material will be given to illustrate some of the ideas held today.     

The Implicit Domain in Couples and Couple Therapy

At this point in the evolution of our field, developments in psychoanalysis and family systems, as well as findings from cognitive neuroscience and research in infant development are pointing to convergences in our understanding of the human experience. One central point of convergence has been the understanding of implicit modes of experience, particularly as this relates to affective communication. Through the lens of couples and couple therapy, this paper examines the ways in which the patterning of couple and family relationships takes place in the enactive domain through nonconscious, implicit communication processes. With the understanding that it is in the nature of implicit experience that it must be enacted to be accessed, this paper argues that some of that which is stored in the implicit domain remains embedded and enacted in one's most intimate relationships and therefore can only be accessed within the context of those relationships. This paper then explores some of the implications of implicit processes as this relates to the triad of the therapist and the couple in couple therapy.     

Imaginary bodies and worlds

In this paper I distil a concept of the imaginary with which to make good the claim that our mode of embodied subjectivity is an imaginary embodiment in an imaginary world. The concept of the imaginary employed is not one in which imaginary worlds are contrasted with the real, but one in which imagination is a condition of there being a real for us. The images and forms in terms of which our imagined bodies and worlds are constituted carry, in an interdependent way, cognition and affects. Imagined configurations have a resilience which makes their displacement more than a matter of appealing to considerations of truth or falsity. It involves encounters with alternative imagined configurations which can be recognized as making both cognitive and affective sense.     

Psychoanalyse und Traumatherapie

The author is of the opinion that for patients with combined traumas of commitment and violence a psychoanalytical long-term treatment which takes into consideration the peculiarities of this group of patients will continue to be the therapy of choice. Special ??trauma therapies?? may be useful after acute traumas and in cases in which external conditions exclude psychoanalytical treatment. Depending on the situation of the individual case, though, specific modifications of the technique may be necessary, which possibly include proven specific trauma therapeutic techniques as parameters. Based on the parallelism of the economic aspect of the trauma and the aspect of object relationship, a decisive role in the therapeutic process befits the recognition of the traumatic reality and the working out of traumatic transference, which, however, must not traumatize under any circumstances. This is accompanied by the restitution of a good interior object, which only becomes possible within a frame giving security and support. The establishment and preservation of this frame may also be due to especially required parameters derived from trauma therapies, the psychodynamic significance of which must be analyzed with the individual patient. The author's approach is clarified by two case vignettes in which the theoretical reflections have led to very different technical procedures. The author comes to the conclusion that the psychoanalytical trauma therapy shows how therapeutic concepts aiming at an optimum result must still be tailored to the individual case.     

Soziales Netzwerk Psyche

In six steps I attempt to show how modernized psychoanalysis contributes to a ??social theory of mind?? (Mitchell, pp.?17?f.). First of all, the pluralism of schools is reflecting the lack of a psychoanalytic core theory, a shortcoming which is merely concealed by its conceptional oversupply and can only be overcome by scientific research. Secondly, I suggest to give up the inclination towards deep thinking, typical of our profession always on the lookout for new metaphors of the psyche, and to replace this inclination by the precise observation of interactions. Thirdly, I discuss the suggestion to understand the unconscious as a hidden link between self and the real world, as a relational tendency of the psyche to connect??a legacy of symbiotic experience??the inside with the outside not only in dreams but in reality. This is, fourthly, my understanding of the unconscious drive of human mind to express itself in a social world whose interactive platforms only allow that building of mental structures we call mentalization, according to Fonagy. Fifthly I point out that the monadic theory of mind implicated in classical drive theory is obsolete in a scientific sense in order to plead, sixthly, for a modernization of psychoanalysis replacing its central metaphor of the mental apparatus by that of a mental network: The modernized psyche is nowadays less in charge of managing intrapsychic drive-economy; its main duty in the age of modern reflexivity seems to be the skilful management of self-relation in the broadly stretched network of interpersonal relationships.     

Community responses to a suicidal crisis: implications for suicide prevention

We conducted a cross‐sectional, random‐digit‐dial survey to evaluate public responses to a hypothetical question: “If someone you knew was suicidal, what would you do first?” Younger people were more likely to call a suicide hotline, and less likely to go to an emergency room (ER) or call 911; immigrants (in the U.S. <15 years) were more likely to call 911, and less likely to call a suicide hotline; African Americans were more likely to go to the ER and call 911; Hispanics were more likely to call 911 but less likely to call a suicide hotline. These results suggest that public messages about hotlines and emergency options for suicidal patients need to be tailored to relevant population characteristics including age, education, ethnicity, and language preferences.     

Psychosoziale Arbeitsbelastungen und depressive Symptome bei F��hrungskr?ften

Background

The present study examines the associations of psychosocial stress at work with depressive symptoms among managers.

Methods

In a cross-sectional study, 154 managers were questioned by means of standardized questionnaires measuring effort-reward imbalance at work and the German version of the CES-D scale. In addition to the effort-reward ratio separate ratios of the three reward dimensions were computed to analyze the effects of the three dimensions separately.

Results

After controlling for relevant confounders logistic regression analysis indicated an odds ratio of 4.4 for depressive symptoms among managers defined by an imbalance of high effort and low reward.

Conclusions

The results indicate that the three reward dimensions are of different relevance. Concerning prevention less significant health restrictions by depressive symptoms are to be expected by reducing the imbalance of effort and esteem reward at work.