The Analyst and the Significant Other: Two's Company,Three's a Crowd: Commentary on Paper by Carla Leone

My response to Carla Leone's paper focuses on how psychoanalysts perceive the significant others of their patients is an attempt to both endorse raising this important question and to augment our thinking about it. Leone identifies the dynamic backdrop for the tendency of individual therapists to unquestionably accept their patient's representation of the significant other. From an interpersonal-relational and family systemic perspective, I raise other dynamic possibilities regarding transference and countertransference, the self as co-constructed with the significant other, introduce the importance of attachment theory, and suggest creative ways to keep a balanced view of the partner who is not known to the analyst except through the patient's representation.     

A neo-Piagetian investigation of the serial position effect in children's motor learning

Children's serial motor skill acquisition was studied within a neo-Piagetian framework. High and low M-processors performed on a curvilinear repositioning task. A primacy-recency effect was evidenced for both groups on the age-related task, while a recency effect occurred for only the high M-processors on the task one stage beyond the developmental processing capacity of the subjects. High M-processors were more accurate and less variable than low M-processors. Although low M-processors performed better on the more complex task than on the simpler one, their performance never exceeded that of the high M-processors. Implications of these results for future research were discussed.     

The Nootropic Properties of Ginseng Saponin Rb1 are Linked to Effects on Anxiety

Previous studies have shown that crude ginseng extracts enhance performance on shock-motivated tasks. Whether such performance enhancements are due to memory-enhancing (nootropic) properties of ginseng, or to other non-specific effects such as an influence on anxiety has not been determined. In the present study, we evaluated both the nootropic and anxiolytic effects of the ginseng saponin Rb1. In the first experiment, 80 five-day-old male chicks received intraperitoneal injections of 0, 0.25, 2.5 or 5.0 mg/kg Rb1. Performance on a visual discrimination task was evaluated 15 minutes, 24 and 72 hours later. Acquisition of a visual discrimination task was unaffected by drug treatment, but the number of errors was significantly reduced in the 0.25 mg/kg group during retention trials completed 24 and 72 hours after injection. Animals receiving higher dosages showed trends towards enhancement initially, but demonstrated impaired performance when tested 72 hours later. Rb1 had no effect on response rates or body weight. In the second experiment, 64 five-day-old male chicks received similar injections of Rb1 (0, 0.25, 2.5 or 5.0 mg/kg) and separation distress was evaluated 15 minutes, 24 and 72 hours later. Rb1 produced a change in separation distress that depended on the dose and environmental condition under which distress was recorded. These data suggest that Rb1 can improve memory for a visual discrimination task and that the nootropic effect may be related to changes in anxiety.     

The supervisory field and projective identification1

Taking as their starting point the Baranger and Baranger model of the ‘psychoanalytic field’, the authors extend the notion of intersubjectivity in the analytic relationship to the supervision process. They use a practical example of a supervision to show the development of what they term the ‘supervisory field’, formed from the superimposition of the two fields of analyst‐patient and supervisor‐supervisee. They emphasize the interplay of projective identifications with objects emanating from the inner world of the patient that are relived in the analytic relationship and transposed to the supervisory field. They believe that the concept of the ‘supervisory field’ contributes to a deeper understanding of the unconscious processes occurring in the mind of analysand, supervisee and supervisor during supervision, particularly regarding the identification, comprehension and resolution of persistent disturbances in the supervisory process.     

Neurocognitive outcomes in children with chronic kidney disease: Current findings and contemporary endeavors

Given the rise in chronic kidney disease (CKD) in both children and adults, CKD has recently been targeted as a public health priority. Childhood onset kidney disease is generally a noncurable and progressive condition that leads to kidney failure by early adulthood. Fortunately, improved identification of kidney problems allows for early intervention, which is thought to slow progression toward end-stage renal disease. In addition, medical interventions for pediatric end-stage renal disease have also improved, allowing children to take advantage of lifesaving renal replacement treatments such as dialysis and kidney transplantation. In spite of improvements in identification and treatment, CKD causes both direct and indirect insults to a variety of organ systems. This paper reviews recently published studies pertaining to the neurocognitive and psychosocial impact of CKD on children of various ages and at various stages of kidney failure. Specific attention is focused on summarizing peer reviewed research that describes associations between kidney functioning and cognitive functioning, language acquisition, visual spatial abilities, memory, and executive functioning. In addition, peer reviewed research describing psychosocial outcomes associated with CKD related to academic achievement, social-behavioral functioning, and quality of life are summarized. The authors also identified disease-specific factors that likely mediate neurocognitive outcomes (e.g., anemia, hypertension, cardiovascular) and endorse the importance of continued interdisciplinary research collaborations that will provide a better understanding of the mechanisms responsible for improved neurocognitive functioning after transplantation. The authors conclude this review by describing a multicenter, prospective, longitudinal, National Institutes of Health funded study that is currently examining the developmental outcomes of children with mild to moderate CKD. The authors speculate that the Chronic Kidney Disease in Children Prospective Cohort Study (CKiD) findings will provide additional evidence-based guidance for clinicians and researchers working with children and adolescents with deteriorating kidney function to improve medical and developmental outcomes.     

Reconsidering Self and Identity Through a Dialogue Between Neuroscience and Psychoanalytic Theory

The terms self and identity have figured prominently in psychological and psychoanalytic writings despite a lack of consistent definitions. Whereas most attempts to clarify the terms have been in the context of a particular theoretical model such as ego psychology, self-psychology, or object relations theory, these clarifications were limited to that particular frame of reference. This paper presents evidence from the dynamic systems models of neuroscience as a foundation to inform psychoanalytic theory toward a clarification of these terms. The neuroscience data supports a distinction between self and identity relative to right hemisphere, reflexive, nonlinguistic experience and left hemisphere, reflective, linguistically mediated experience. A parallel between the empirical study of consciousness in terms of ownership, agency, unity, and continuity is also made with contemporary psychoanalytic concepts and their relationship to self and identity. Additionally, the article offers suggestions for a mutually informing dialogue between psychoanalysis and neuroscience in the hopes of promoting interdisciplinary research.     

Clinical Implications for the Expressions of Self and Identity in Adolescent Psychotherapy: Case Studies of a Vampiress and a Gangster

Self and identity are examined as significant complementary processes in the psychoanalytic psychotherapy of two adolescent patients. The distinction between these processes is underscored as emergent from neuropsychological developmental changes while being expressed within a shared unconscious process. These cases examined how the analyst and patients fostered their co-constructed potential space for therapeutic transformation. Each patient had adopted compensatory identities in response to profound psychic conflict. The treatments explored the function of their identities as objectified processes to cope with psychic trauma while also addressing an essential respect for the subjectivity of self as a vehicle for psychological truth.     

Object Relations Psychoanalysis as Political Theory

This article examines the political contents of object relations psychoanalysis, a theory that perceives dependence as the natural state of all humans. Unlike the views advanced by the classical state-of-nature models of Locke, Hobbes, and Rousseau, object relations perceives humans in their original state as already grouped and driven by an urge to associate. Company (rather than privacy, property, or political participation) stands out as the basic right, and all the other rights follow on it as instruments for fulfilling it. The primacy of care lends itself to the justification of distributive measures meant to bolster family cohesion and individual confidence at the expense of the open market. The theory is therefore compatible with the premises of the social-democratic welfare state.     

Associative symmetry by pigeons after few-exemplar training

The present experiment investigated whether pigeons can show associative symmetry on a two-alternative matching-to-sample procedure. The procedure consisted of a within-subject sequence of training and testing with reinforcement, and it provided (a) exemplars of symmetrical responding, and (b) all prerequisite discriminations among test samples and comparisons. After pigeons had learned two arbitrary-matching tasks (A-B and C-D), they were given a reinforced symmetry test for half of the baseline relations (B1-A1 and D1-C1). To control for the effects of reinforcement during testing, two novel, nonsymmetrical responses were concurrently reinforced using the other baseline stimuli (D2-A2 and B2-C2). Pigeons matched at chance on both types of relations, thus indicating no evidence for symmetry. These symmetrical and nonsymmetrical relations were then directly trained in order to provide exemplars of symmetry and all prerequisite discriminations for a second test. The symmetrical test relations were now B2-A2 and D2-C2 and the nonsymmetrical relations were D1-A1 and B1-C1. On this test, 1 pigeon showed clear evidence of symmetry, 2 pigeons showed weak evidence, and 1 pigeon showed no evidence. The previous training of all prerequisite discriminations among stimuli, and the within-subject control for testing with reinforcement seem to have set favorable conditions for the emergence of symmetry in nonhumans. However, the variability across subjects shows that methodological variables still remain to be controlled.