Authenticity and the Analytic Process

In this paper we first make a differentiation between phenomena that can be defined as spontaneous and others that can be defined as authentic. We then attempt to present authenticity as a process rather than an outcome. Finally, we try to understand the location of authentic phenomena in the sensorial and pre-symbolic communicative register. We situate authentic phenomena in the register of sensorial and pre-symbolic communication. The authentic process becomes manifest, step by step in the analytic process (Borgogno, 1999), through the vivid iconic and sensorial elements that happen to cross the analytic field. Through two brief clinical vignettes, we seek to document the progression of the analytic process, in one case through the analyst's capacity for rêverie (Bion, 1962; Ogden, 1994, 1997; Ferro, 2002, 2007), and in the other through the sensorial elements with which analyst and patient are able to tune in to each other.     

Heart rate variability and drawing impairment in hypoxemic COPD

We studied 54 patients with hypoxemic chronic obstructive pulmonary disease (COPD). The Mini Mental State Examination and the Mental Deterioration Battery were used for neuropsychological assessment. Heart rate variability (HRV) was assessed based on 24-h Holter ECG recording. Mann–Whitney test was used to compare HRV parameters of patients performing normally or abnormally on individual neuropsychological tasks. Spearman’s rho was used to investigate the correlations between HRV parameters and neuropsychological scores, indexes of health status or COPD severity. Patients with defective performance at copying drawings with landmarks (CDL) test (N = 23) had lower very low frequency (VLF) power with respect to patients with normal performance (N = 31) (24 h: median 213; interquartile range 120–282 vs. 309; 188–431 ms², p = 0.043; daytime: 202; 111–292 vs. 342; 194–397 ms², p = 0.039). The CDL score correlated with the VLF power (24 h: ρ = 0.27, p = 0.049; daytime: ρ = 0.30, p = 0.028), and the normalized low frequency/high frequency (LF/HF) ratio (24 h: ρ = 0.27, p = 0.05; daytime: ρ = 0.33, p = 0.015). Sympathetic modulation decreased for increasing severity of COPD. In conclusion, drawing impairment correlates with depressed sympathetic modulation in patients with COPD, and both might be indexes of COPD severity.     

Alienating identifications and the psychoanalytic process1

The transmission of psychic life from one generation to the next can result in unconscious, alienating identifications when the parents have not been able to elaborate a process of mourning for their own childhoods. In this article, the author describes the nature of these identifications, constructed around insufficiently symbolized experiences, as revealed during the psychoanalytic process. These unconscious, alienating identifications raise some arduous technical problems for the psychoanalyst as they lead the patient to carry out complex enactments that erase the normal transference markers. The psychoanalyst may then be tempted to resort to pejorative theoretical concepts, such as the death drive. And yet, unknown to the analysand, the insufficiently symbolized psychic elements contain a potential for transformation that may lead to reconstructions and dis‐alienating interpretations. The author distinguishes between alienating identifications and fantasies of identification when the latter transiently appear during the psychoanalytic process. These identification fantasies symbolically register the emotional experience undergone during the analytic sessions and contribute to the integration of insufficiently symbolized psychic elements. These theoretical considerations are fully illustrated by the clinical report of some analytic sessions.     

Self-Regulatory Dysfunctions in Personality Disorders: The Role of Poor Self-Monitoring and Mindreading

To understand how persons self-regulate, we need, as Cervone, Shadel, Smith, and Fiori (2006 ) assert, to refer to personality science, with which it is possible to identify the multifarious psychological elements and processes helping or hindering action programming, overcoming difficulties, and error correction. Personality disorder research and personality science itself demonstrate that dysfunctions in two skills—self-monitoring and mindreading—worsen self-regulation and lead individuals to fail chronically to achieve goals in the social domain. Here we describe how poor self-reflection and biased mindreading impair self-regulation in personality disorders and other clinical conditions and make some suggestions about how to tackle them in psychotherapy.     

Self-awareness training associated with personality traits and sex: a pilot study

107 volunteers learning Reiki-Do self-awareness techniques participated in this study. Results indicate that personality traits in healthy participants might be affected by specific self-awareness training, such as Reiki-Do, with participants' sex playing an independent role.     

Depressive symptoms and one year mortality among elderly patients discharged from a rehabilitation ward after orthopaedic surgery of the lower limbs

The objective of the present prospective observational study is to evaluate the effect of depressive symptoms on 1-year mortality in a population of elderly patients discharged from a rehabilitation unit after orthopaedic surgery of the lower limbs. A total of 222 elderly inpatients were included, and stratified according to 12-months survival. 14 (6.3%) of the patients who were eligible for this study died during the 12-months period after discharge. As expected, patients who died were significantly older, lower cognitive performance, more depressive symptoms, poorer nutritional status and higher comorbidity in comparison to those who survived. Furthermore, they were generally more functionally dependent on admission to the Department, had worse functional recovery and were more disable at discharge, although a longer length of stay comparing to survived patients. In the adjusted logistic regression model, after adjustment for possible confounders and covariates, the presence of severe depressive symptoms significantly predicted a four-fold risk of death at 12 months. The only other factor associated poor 12-months survival was comorbidity, that predicted a 6-fold risk of death. In conclusions this study suggests that severe depressive symptoms on admission predicts 1-year mortality in elderly patients discharged from a post-acute care unit after orthopaedic rehabilitation.     

“I-ness” and the dissociative process. Working with defensive and creative dissociations in the analytic process

The American Journal of Psychoanalysis - We suggest that the analytic dialogue develops as a continuous movement that we call “Dissociative Process”, and that this process is the...