Psychological distress and coping in nasopharyngeal cancer: an explorative study in Western Europe

Nasopharyngeal carcinoma (NPC) is the head and neck cancer with the greatest impact on patients’ quality of life. The aim of this explorative study is to investigate the psychological distress, coping strategies and quality of life of NPC patients in the post-treatment observation period. Twenty-one patients disease-free for at least two years were assessed with a medical and a psycho-oncological evaluation. Clinically relevant depressive symptoms (CRD) were present in 23.8% of patients and 33.3% reported clinically relevant anxiety symptoms (CRA). Patients with CRD and CRA showed a significantly higher score in the use of hopelessness/helplessness and anxious preoccupation coping strategies and a worse quality of life. Even in the post-treatment period, about a quarter of patients showed CRD and CRA. Results showed that patients with high anxiety or depressive symptoms seem to use dysfunctional coping strategies, such as hopelessness and anxious preoccupation, more than patients with lower levels of anxiety and depression. The use of these styles of coping thus seems to be associated to a higher presence of CRA or CRD symptomatology and to a worse quality of life.     

Unrepressed unconscious and unsaid in addictive symptomatology

The aim of this work is to understand, from a developmental-relational perspective, the emotional nature of addictive symptoms. Many studies have shown that addictions are linked to traumatic emotions that, once activated, could cause a feeling of emotional confusion that in the most severe cases could be connected to the fear that the Self might disintegrate. Before understanding the relationship between dissociation and addictions, it is essential to distinguish disintegration (désagrégation, in the language of Pierre Janet) and dissociation. Indeed, if the disintegration is a structural and pathological condition of the personality caused by early and chronic emotional traumatic memories, the dissociation is a defensive reaction to a stress: this reaction can be normal (flexible and adequate) or pathological (rigid and inadequate). Thus, addictive behaviours could be associated to a dissociative reaction in individuals with a structural dissociation of the personality (désagrégation). This disintegration would be linked to traumatic emotions: unconscious and unsymbolised emotions. On the unconscious nature of these emotions, the author of this paper underlines the role of the unrepressed unconscious, which in addicts would seem to be impaired.     

Improving left spatial neglect through music scale playing

The study assessed whether the auditory reference provided by a music scale could improve spatial exploration of a standard musical instrument keyboard in right‐brain‐damaged patients with left spatial neglect. As performing music scales involves the production of predictable successive pitches, the expectation of the subsequent note may facilitate patients to explore a larger extension of space in the left affected side, during the production of music scales from right to left. Eleven right‐brain‐damaged stroke patients with left spatial neglect, 12 patients without neglect, and 12 age‐matched healthy participants played descending scales on a music keyboard. In a counterbalanced design, the participants' exploratory performance was assessed while producing scales in three feedback conditions: With congruent sound, no‐sound, or random sound feedback provided by the keyboard. The number of keys played and the timing of key press were recorded. Spatial exploration by patients with left neglect was superior with congruent sound feedback, compared to both Silence and Random sound conditions. Both the congruent and incongruent sound conditions were associated with a greater deceleration in all groups. The frame provided by the music scale improves exploration of the left side of space, contralateral to the right hemisphere, damaged in patients with left neglect. Performing a scale with congruent sounds may trigger at some extent preserved auditory and spatial multisensory representations of successive sounds, thus influencing the time course of space scanning, and ultimately resulting in a more extensive spatial exploration. These findings offer new perspectives also for the rehabilitation of the disorder.     

Transformation of flow in rehabilitation: The role of advanced communication technologies

Authentic rehabilitation requires the active participation of patients and their involvement with opportunities for action and development. Within this framework, in this article we outline the possibility of using two emerging computing and communication technologies—ambient intelligence (AmI) and virtual reality (VR)—for a new breed of rehabilitative and clinical applications based on a strategy defined astransformation of flow. Transformation of flow is a person’s ability to exploit an optimal (flow) experience to identify and use new and unexpected psychological resources as sources of involvement. We identify the feeling ofpresence—the feeling of being in a world that exists outside oneself—as the theoretical link between the technology and rehabilitation. AmI and VR are used to trigger broad empowerment processes induced by a strong sense of presence, leading to greater agency and control over one’s actions and environment.     

Cognitive changes following subthalamic nucleus stimulation in two patients with Parkinson disease

The limits of a drug therapy in severe forms of Parkinson disease have led to refining neurosurgery on the basal ganglia. Deep brain stimulation of the subthalamic nucleus has been recognized as one of the most promising techniques to decrease "off" motor symptoms and motor fluctuations, allowing a reduction of drug therapy and limiting side effects of the drugs. There is still open debate on the possible consequences of chronic subthalamic stimulation in other ways, apart from motor symptoms, of general cognitive performance. We examined and followed two patients with Parkinson disease for 9 mo. after surgery for deep stimulation, studying their cognitive performances. There is a general amelioration of cognitive performances, in particular as far as linguistic capabilities is concerned. We discuss the possible significance of these results, reminding strenuously that only two patients were involved, so the potential for generalization is seriously limited.     

Analysts in Search of an Author: Voltaire or Artemisia Gentileschi? Commentary on “Field Theory in Psychoanalysis,Part 2: Bionian Field Theory and Contemporary Interpersonal/Relational Psychoanalysis” by Donnel B. Stern

The authors comment on Stern's characterization of differences between interpersonal and relational psychoanalysis and Bionian field theory. The critical points on which a consensus is not, for the time being, readily possible concern the relationship between the external and internal worlds and the various conceptions of unconscious experience. They believe that, before forging a link with the external world (whose role we would be foolish to deny), it is clinically more useful to apprehend this internal world as rigorously and over as wide a range as possible—which they do by radically transforming the external world into a dream of the field. Conversely, in their view we may be reassured but partly misled by the concept of a dialectic between the external and internal worlds that fails to take account of the utter pervasiveness of the unconscious and the fact that it speaks even when seemingly silent—not only negatively in micro- and macroenactments but also positively in waking dream thought, which is an expression of its poetic activity that unceasingly confers meaning on experience.     

Offline and online data: on upgrading functional information to knowledge

This paper addresses the problem of upgrading functional information to knowledge. Functional information is defined as syntactically well-formed, meaningful and collectively opaque data. Its use in the formal epistemology of information theories is crucial to solve the debate on the veridical nature of information, and it represents the companion notion to standard strongly semantic information, defined as well-formed, meaningful and true data. The formal framework, on which the definitions are based, uses a contextual version of the verificationist principle of truth in order to connect functional to semantic information, avoiding Gettierization and decoupling from true informational contents. The upgrade operation from functional information uses the machinery of epistemic modalities in order to add data localization and accessibility as its main properties. We show in this way the conceptual worthiness of this notion for issues in contemporary epistemology debates, such as the explanation of knowledge process acquisition from information retrieval systems, and open data repositories.     

Orthodox Christianity in Italy: historical continuity and social discontinuity

From the historical point of view, the presence of Orthodox churches in Italy is a reality established over several centuries; from the sociological point of view, however, their presence is a new phenomenon. As a result of the significant processes of immigration from Eastern Europe over the last 15 years, their importance within the social and religious contexts has grown considerably, to the point that Orthodoxy is rivalling Islam as the second-largest religion in the country. In this article I aim first of all to provide a historical framework for the relationship between the ‘Western world’, especially Italian, and the ‘Eastern world’ of Orthodoxy. Then I shall briefly analyse two examples of different interactions between Orthodoxy and the Roman Catholic context in Italy: the Montaner parish and the monastic community of Bose. Finally I shall present some outcomes from the first research project on the presence of Orthodox churches carried out in Italy during 2011, illustrating the mapping of the spread of the various jurisdictions in the Italian regions, and deepening some elements such as the relationship with the Italian state, the leadership of the various communities and the dynamics of interaction between the Orthodox churches and Catholicism.     

Transformations in hallucinosis and the receptivity of the analyst

Bion describes transformation in hallucinosis (TH) as a psychic defence present in elusive psychotic scenarios in which there is a total adherence to concrete reality: as the hallucinatory activity which physiologically infiltrates perception and allows us to know reality, setting it off against a background of familiarity; and then, surprisingly, as the ideal state of mind towards which the analyst has to move in order to intuit the facts of the analysis. When hallucinosis is followed by ‘awakening’, the analyst gains understanding from the experience and goes through a transformation that will inevitably be transmitted to the analytic field and to the patient. In this paper I illustrate Bion's concept and underline its eminently intersubjective nature. Then I differentiate it from two other technical devices: reverie, which unlike hallucinosis does not imply the persistence of a feeling of the real, and Ferro's transformation in dreaming, i.e. purposeful listening to everything that is said in the analysis as if it were the telling of a dream. Finally, I try to demonstrate the practical utility of the concept of transformation in hallucinosis in order to read the complex dynamics of a clinical vignette. Though not well known (only two references in English in the PEP archive), TH proves to be remarkably versatile and productive for thinking about psychoanalytic theory, technique and clinical work.