The perversion of language in the analyst's activity: Navigating the rhythms of embodiment and symbolization

Abstract

In this short text, the problem of how “the talking cure” itself can become a perverse relation is considered and illustrated with a brief clinical vignette. Contributions coming from the work of Stern in infant research and Lacan in post-Freudian thought illuminate the potential for experience to be split off through the use of language itself. These perspectives are brought to bear on thinking about representation, splitting, and perversion as a basis for considering a clinical instance in which patient and analyst enact a perverse relation constituted by the way in which the patient uses the analyst's language to construct a sado-masochistic perversion of the treatment process. Within the clinical episode, Stein's reformulation of perversion, informed by Ogden's observations and expanding Stoller's earlier contribution, provides a basis for considering how the analyst was able to use attention to the body-based countertransferential experience to repair a sense of “erasure” that was being accomplished for both analyst and analysand through the enactment.     

Conceptualization of hostile psychopathy and sadism: Drive theory and object relations perspectives

Abstract

Turkel A.R. The Gender of the Analyst. Int Forum Psychoanal 1992;l:ll-19. Stockholm. ISSN 0803-706X

The importance of understanding the gender-related aspects of our clinical work should not be underestimated. The problems associated with the choice of the analyst by gender are explored with particular focus on three therapeutic dyads: women treating women, women treating men, and men treating women. While the analyst's gender may contribute to resistance and to negative transference, it may also facilitate treatment. Research studies are examined and clinical material is utilized to illustrate the major points.     

From “disciplined subjectivity” to “taming wild thoughts”: Bion's elaboration of the analysing instrument

Abstract

Freud encouraged the analyst to use his unconscious “as an instrument of the analysis,” but did not elaborate on how this should be done. This recommendation opened the door to a consideration of unconscious communication between the analyst and patient as an intersubjective exchange. Both Wilfred Bion and Erik Erikson emphasised the importance of the analyst's intuition, and the author compares and contrasts these two approaches. Erikson advocated a more cautious attitude regarding the analyst's subjectivity, while Bion promoted a broader application of the analyst's various private reactions to the analysand. A brief vignette from the analysis of a five-year-old boy is offered to illustrate the importance of the analyst's reveries, the mutual process of containment and transformation between analyst and patient, and the co-creation of an analytic narrative.     

On paradoxes and the experience of duality

Abstract

Opposing attitudes, emotions, or perceptions of self and other that set the stage for experiences of duality influence our interactions and self–other schemas. The experience of duality that has been conceptualised as “conflict,” “self state,” and “paradox" in psychoanalytic theory has been extensively considered, particularly in terms of its manifestation in transference–countertransference relations and in the analytic material from patients' experiences. They have not, however, been compared and contrasted as entities that lead to similar kinds of experience. Scant attention has been paid, moreover, to paradox as a mental organisation that underlies certain experiences of duality. The concept of paradox has thus been emphasised and developed in this paper.     

Insomnia symptoms are associated with elevated C-reactive protein in young adults

Abstract

Objective: Insomnia is associated with elevated inflammation; however, studies have not investigated if this relationship is confounded with depression and neuroticism, which are associated with insomnia and inflammation. The current study examined the association of insomnia symptoms with C-reactive protein (CRP) and with interleukin-6 (IL-6), independently and after controlling for depressive symptoms and neuroticism. Design: Fifty-two young adults (mean age?=?25.2?±?3.9 years, 52% female) completed a baseline survey to assess psychological characteristics, followed by a plasma blood draw. Main outcome measures: Plasma CRP and IL-6. Results: When examined alone, insomnia symptoms were significantly associated with elevated CRP (β?=?0.52; R²?=?0.27), as was neuroticism (β?=?0.41, R²?=?0.17), but not depressive symptoms (β?=?0.21, R²?=?0.05). The association between insomnia symptoms and CRP remained significant when depressive symptoms and neuroticism were entered into the model simultaneously; this model did not explain more variance than the model with insomnia symptoms alone. No variables were associated with IL-6. Conclusions: Results suggest that insomnia symptoms are independently associated with elevated CRP in young adults, even after controlling for presumed overlapping psychological constructs. Findings highlight the potential importance of treating insomnia to reduce systemic inflammation.     

Agreement between Parents and Children on Ratings of Post-Concussive Symptoms Following Mild Traumatic Brain Injury

The level of parent-child agreement on post-concussive symptoms (PCS) was examined in children following mild traumatic brain injuries (TBI). As part of a larger longitudinal study, 186 children with mild TBI and 99 with orthopedic injuries (OI), from 8 to 15 years of age, were recruited prospectively. Parents and children completed the PCS Interview (PCS-I) and the Health and Behavior Inventory (HBI) at 2 weeks, 1 month, 3 months, and 12 months postinjury. Item-level correlations between child and parent ratings on both measures of PCS were significant but modest in both groups. Parent-child correlations for composite scales on the HBI and the total score on the PCS-I were significant in both groups, but somewhat higher in the OI group than in the mild TBI group. Mean symptom ratings tended to be significantly higher for children as compared to parents, especially for somatic symptoms. Parents and children display modest agreement when reporting PCS; their ratings correlate significantly, but children report higher mean levels of symptoms than parents.     

Long-Term Executive Function Deficits in Children With Traumatic Brain Injuries: Assessment Using the Behavior Rating Inventory of Executive Function (BRIEF)

Long-term deficits in executive functions following childhood traumatic brain injuries (TBI) were examined using the Behavior Rating Inventory of Executive Function (BRIEF). Parents completed the BRIEF approximately 5 years postinjury as part of a prospective study of children injured between the ages of 6 and 12. The children were between 10 and 19 years of age at the time of the assessment, and included 33 with severe TBI, 31 with moderate TBI, and 34 with orthopedic injuries. Parents also rated children's adaptive functioning and completed several other measures of parent and family functioning. Children were administered a neuropsychological test battery that included several measures of executive functions. The groups displayed a significant linear trend in BRIEF scores, with the largest deficits in executive functions reported in children with severe TBI. BRIEF scores were related consistently across groups to a test of working memory, but not to other neuropsychological measures. BRIEF scores also predicted children's adaptive functioning and behavioral adjustment, as well as parent psychological distress, perceived family burden, and general family functioning. The findings indicate that TBI results in long-term deficits in executive functions that are related to children's psychosocial outcomes, as well as to parent and family functioning.     

Hospital referral patterns in pediatric neuropsychology

The practice of pediatric neuropsychologists was examined by reviewing all referrals made in 1 year to neuropsychology programs located in three children's hospitals. The review identified 472 cases, 75% of whom were between the ages of 7 and 11. The sample included 86 inpatients and 386 outpatients. The most common diagnoses, accounting for 87% of the cases, were learning disability, traumatic brain injury, attention deficit-hyperactivity disorder, seizure disorder, primary psychiatric disorder, phenylketonuria, idiopathic mental retardation, brain tumor, leukemia, stroke, and encephalitis. The most common referral sources, accounting for 92% of the cases, were neurologists, pediatricians, parents, physiatrists, neurosurgeons, oncologists, specialists in metabolic disease, psychologists, rheumatologists, and psychiatrists. The distribution of diagnoses and referral sources differed significantly for inpatients and outpatients and across the three hospitals. The results may distinguish child neuropsychology from adult neuropsychology and highlight the diversity that characterizes its practitioners.     

The Dark Triad and animal cruelty: Dark personalities,dark attitudes,and dark behaviors

Research examining the interpersonal interactions of those high on the Dark Triad has proliferated in recent years. Extant research, however, has not examined other types of relationships such as attitudes and behaviors towards animals. Further, there has been limited research examining the associations between personality and attitudes and behaviors towards animals generally. In this study, participants (N = 227) completed an online survey measuring the Dark Triad, attitudes towards animals, and acts of animal cruelty. The results revealed that individuals with higher levels of the Dark Triad demonstrated less positive attitudes towards animals and reported engaging in more acts of animal cruelty. Age and sex were found to be significant predictors of less positive attitudes and behaviors towards animals, independent of the Dark Triad. These results suggest that those callous and manipulative behaviors and attitudes that have come to be associated with the Dark Triad are not just limited to human-to-human interactions, but are also consistent across other interactions.     

Gendered Training: Men and Men's Issues in Marriage and Family Therapy Programs

Few studies examine men's experiences in becoming a therapist. Only a modicum of attention appears to be paid to men's professional training needs in MFT training programs as expressed in the family therapy literature. Five recommendations, based on the author's experiences and male student voices, are provided for how to best meet the needs of male students in MFT training programs. These recommendations are (1) be aware of men's experiences and don't assume silence means disinterest, (2) develop depth in clinical training on men's issues, (3) incorporate theories of masculinity into curriculum, (4) engage male students in the training process, and (5) provide support to male students through mentorship and support groups.