At the verge of unthinkable anxiety: On the relevance of a neurophysiologically informed relational perspective on meaning-making in psychosis

Abstract

This article examines the relevance of relationally oriented psychoanalytic phenomenology as a frame of reference for understanding psychotic states in schizophrenia. The etiology and structural characteristics of such states are examined from both a neurophysiological, and a relational and interpersonal point of view. Many findings indicate organic abnormalities in schizophrenia, acquired through an exposure to physical risk factors and genetic predisposition, but relational traumas also seem to have an impact on the form and content of psychotic states. This may happen through interruptions in the “use-dependent” maturation of the brain in a relational milieu. In addition, at the level of meaning-making, we find that the emotional and relational contexts—both past and present—give the substance or “raw material” for hallucinations and delusions. In a psychotic state, the person also tries to handle basic affects and relational needs, and to make meaning in states of overwhelming chaos and anxiety. Donald W. Winnicott's theory of “a holding environment”, Stephen Mitchell's theory of the relational matrix, and Stolorow, Atwood, and Orange's concepts of a “shattered world” and annihilation anxiety are used as a framework in the analysis of the phenomenology of psychosis. Two case illustrations, one from child psychotherapy and one from therapy with an adult patient, are used to illuminate the theoretical points of view.     

Discussion of “Nuturance and self-sabotage: Psychoanalytic perspectives on women's fear of success” by Ellen G. Ruderman

Abstract

Ruderman discusses the challenge that contemporary professional women still face in a sexist society and from their own inner critic. She shows how a relational approach to the treatment of women can empower women to overcome both external and internalized sexism. It is suggested that as patriarchy has been challenged, there has been a backlash against feminism. Urban professional men rebel against feminism by aspiring to become playboys who will never stop “playing the field.” The playboy mentality creates a challenge for contemporary professional women who may not wish their boyfriends or husbands to be spending so much time seeking sexual gratification through Internet pornography, lap dances at strip clubs, massages with happy endings, or clandestine affairs.

Lawrence Josephs. Diskussion von: ….

Rudermann diskutiert die Herausforderungen, denen heutige Frauen im Berufsleben begegnen. Einerseits haben sie in einer sexistischen Gesellschaft und andererseits gegenüber ihrer innerpsychischen Selbstkritik zu bestehen. Sie zeigt, wie eine psychotherapeutische Behandlung mit einem relationalen Ansatz, der externe und internalisierte Sexismus überwunden werden kann. Der Gedanke wird angeregt, inwiefern die Infragestellung der patriarchalen Gesellschaft eine Gegenbewegung auslöst, die auf den Feminismus zurückschlägt. Die berufstätigen Männer rebellieren gegen den Feminismus und haben den Ehrgeiz Playboys zu sein, die nicht aufhören können, das Feld zu beackern. Diese Playboy Mentalität ist eine Herausforderung für die heutigen berufstätigen Frauen. Sie sind nicht gewillt zuzulassen, dass ihr Freund oder Ehemann sich sexuelle Gratifikationen durch Internet-Pornographie, Nachtclubbesuche, Massagen und heimliche Affären beschafft.

Lawrence Josephs. Discusión de: Crianza y autosabotage: Perspectivas psicoanalíticas sobre el miedo al éxito en mujeres por

Ruderman discute el reto que las mujeres profesionales contemporáneas todavía enfrentan en una sociedad sexista y desde su propia crítica interna. Ella muestra como una aproximación relacional de tratamiento para mujeres puede fortalecer a la mujer para vencer el sexismo tanto externo como interiorizado. Se sugiere que así como el patriarcado ha sido cuestionado, existe un retroceso contra el feminismo. Hombres urbanos profesionistas se rebelan contra el feminismo aspirando a convertirse en playboys que nunca dejaran de jugar en ese campo. La mentalidad playboy representa un reto para las mujeres profesionistas contemporáneas quienes pueden no desear que sus novios o maridos, Dediquen tanto tiempo buscando gratificación sexual a través de la pornografía en internet, bailes en clubs de striptease, masajes con final feliz, o asuntos clandestinos.     

Discussion of Estelle Shane's “Girls,their fathers,and their mothers: Patterned links to ambition and prohibition in women”

Abstract

This discussion focuses on two potential dangers in our reaction to the problems associated with years of prejudice and constriction in female gender roles, holding women back from exploring and reaching their personal and career goals. One potential danger is that of creating an equally rigid, unitary system of gender roles that leaves equally little flexibility in women's choices by imitating traditional male gender roles. The other potential danger is that of attributing the main cause of psychological problems to social role constriction when greater pathology is at work.

Susan Klebanoff. Diskussion von Estelle Shanes “Mädchen, ihre Väter und Mütter: Verbindende Muster zu Erfolgsstreben und Verboten im Leben von frauen”.

Die Diskussion konzentriert sich auf zwei mögliche Gefahren in der Reaktion auf Probleme in den ersten Jahren der Entwicklung des weiblichen Geschlechtsverständnisses, die von Vorurteilen und Einschränkungen geprägt sind. Frauen werden in ihrem Erproben und Erreichen von persönlichen Karrierezielen zurückgehalten. Die eine Gefahr besteht darin, dass Frauen durch Imitation der männlichen Geschlechterrollen in ein ähnlich rigides Selbstverständnis wie diese geraten. Die andere Gefahr besteht darin, bei psychischen Problemen als Grund lediglich die Einschränkungen in den sozialen Rollen zu sehen und dabei eine schwerwiegendere psychische Pathologie zu übersehen.

Susan Klebanoff. Discusión de: “Las niñas, sus padres, y sus madres: Modelos de vinculos hacia la ambición y la prohibición en mujeres” de Estelle Shane.

La presente discusión se enfoca en los dos peligros potenciales de nuestra reacción a los problemas asociados a los años de prejuicio y constricción en los roles de género femeninos, impidiendo a las mujeres explorar y alcanzar su metas personales y profesionales. Uno de los peligros potenciales es crear un sistema unitario igualmente rígido, sobre roles de género, que deje igualmente poca flexibilidad en las opciones de las mujeres al tener que imitar los roles tradicionales masculinos. El otro peligro es atribuir la causa principal de los problemas psicológicos a la constricción del rol social cuando se pudiera tratarse de una mayor patología en funcionamiento.     

Responding to partners' expression of anger: the role of communal motivation

The effects of communal motivation on reactions to relationship partners' expressed anger were examined. In Study 1, married couples reported on the communal strength of their marriage, their expressions of anger to their spouse, and relationship satisfaction. In Study 2, college students reported on the communal strength of their best friendships, those friends' expressions of anger, and their evaluations of and provision of support to those friends. In Study 3, communal motivation toward a stranger who expressed mild anger was manipulated and evaluation of that stranger was measured. In all three studies, low communal motivation was associated with more negative evaluations of angry partners, lower relationship satisfaction, and, in Study 2, lower support provision. In contrast, when communal motivation was high, these decreases either did not occur (Studies 1 and 3) or were diminished (Study 2), and in Study 2, partners' anger was associated with increased provision of social support.     

Approximate entropy used to assess sitting postural sway of infants with developmental delay

Infant sitting postural sway provides a window into motor development at an early age. The approximate entropy, a measure of randomness, in the postural sway was used to assess developmental delay, as occurs in cerebral palsy. Parameters used for the calculation of approximate entropy were investigated, and approximate entropy of postural sway in early sitting was found to be lower for infants with developmental delay in the anterior-posterior axis, but not in the medial-lateral axis. Spectral analysis showed higher frequency features in the postural sway of early sitting of infants with typical development, suggesting a faster control mechanism is active in infants with typical development as compared to infants with delayed development, perhaps activated by near-fall events.     

Why Do Men Benefit More from Marriage Than Do Women? Thinking More Broadly About Interpersonal Processes That Occur Within and Outside of Marriage

In this commentary we return to the original question of Wanic and Kulik??s paper, ??Why do men benefit more from marriage than do women??? We suggest that trying to understand why women suffer more than men in marriage (from conflict or for any other reason) will not, by itself, answer the question. The answers are certainly multifaceted and complex, and there is little reason to pit one possible answer against another. We highlight that when examining gender differences in health in marriage it is important to (a) consider the helpful processes in combination with hurtful ones, b) take a broad view on this question including many types of social processes, and c) consider processes that occur outside of marriage as well as those that occur inside of marriage.     

Multiple trajectories of depressive symptoms in middle and late life: racial/ethnic variations

This research aims to identify distinct courses of depressive symptoms among middle-aged and older Americans and to ascertain how these courses vary by race/ethnicity. Data came from the 1995-2006 Health and Retirement Study which involved a national sample of 17,196 Americans over 50 years of age with up to six repeated observations. Depressive symptoms were measured by an abbreviated version of the Center for Epidemiologic Studies Depression scale. Semiparametric group based mixture models (Proc Traj) were used for data analysis. Six major trajectories were identified: (a) minimal depressive symptoms (15.9%), (b) low depressive symptoms (36.3%), (c) moderate and stable depressive symptoms (29.2%), (d) high but decreasing depressive symptoms (6.6%), (e) moderate but increasing depressive symptoms (8.3%), and (f) persistently high depressive symptoms (3.6%). Adjustment of time-varying covariates (e.g., income and health conditions) resulted in a similar set of distinct trajectories. Relative to White Americans, Black and Hispanic Americans were significantly more likely to be in trajectories of more elevated depressive symptoms. In addition, they were more likely to experience increasing and decreasing depressive symptoms. Racial and ethnic variations in trajectory groups were partially mediated by SES, marital status, and health conditions, particularly when both interpersonal and intrapersonal differences in these variables were taken into account.     

Does adolescent risk taking imply weak executive function? A prospective study of relations between working memory performance,impulsivity, and risk taking in early adolescence

Studies of brain development suggest that the increase in risk taking observed during adolescence may be due to insufficient prefrontal executive function compared to a more rapidly developing subcortical motivation system. We examined executive function as assessed by working memory ability in a community sample of youth (n = 387, ages 10 to 12 at baseline) in three annual assessments to determine its relation to two forms of impulsivity (sensation seeking and acting without thinking) and a wide range of risk and externalizing behavior. Using structural equation modeling, we tested a model in which differential activation of the dorsal and ventral striatum produces imbalance in the function of these brain regions. For youth high in sensation seeking, both regions were predicted to develop with age. However, for youth high in the tendency to act without thinking, the ventral striatum was expected to dominate. The model predicted that working memory ability would exhibit (1) early weakness in youth high in acting without thinking but (2) growing strength in those high in sensation seeking. In addition, it predicted that (3) acting without thinking would be more strongly related to risk and externalizing behavior than sensation seeking. Finally, it predicted that (4) controlling for acting without thinking, sensation seeking would predict later increases in risky and externalizing behavior. All four of these predictions were confirmed. The results indicate that the rise in sensation seeking that occurs during adolescence is not accompanied by a deficit in executive function and therefore requires different intervention strategies from those for youth whose impulsivity is characterized by early signs of acting without thinking.     

Dynamics of the general factor of personality in response to a single dose of caffeine

General Factor of Personality (GFP) research is an emergent field in personality research. This paper uses a theoretical mathematical model to predict the short-term effects of a dose of a stimulant drug on GFP and reports the results of an experiment showing how caffeine achieves this. This study considers the General Factor of Personality Questionnaire (GFPQ) a good psychometric approach to assess GFP. The GFP dynamic mechanism of change is based on the Unique Trait Personality Theory (UTPT). This theory proposes the existence of GFP which occupies the apex of the hierarchy of personality, and extends from an impulsiveness-and-aggressiveness pole (approach tendency) to an anxiety-and-introversion pole (avoidance tendency). An experiment with 25 volunteers was performed. All the participants completed the GFPQ and the Sensation-Seeking Scale list of adjectives from the trait version of MAACL-R (Multiple Affect Adjective Checklist Revised) on an empty stomach. The participants in the experimental group (20) received 330 mg of caffeine. All the participants filled in a state version form with the sensation-seeking adjectives every 4.5 minutes. This study considers that the Sensation-Seeking Scale list of adjectives from the MAACL-R, available in both trait and state versions, is a good psychometric approach to assess GFP. The results show that GFP is modified by a single dose of caffeine in the direction predicted by the UTPT.     

The impact of weight, sex, and race/ethnicity on body dissatisfaction among urban children

The purpose of the current study was to examine the relative contributions of weight status, race/ethnicity, sex, and age on body dissatisfaction in a large group of diverse children. Participants were 4th–6th graders (N = 1212) in ten inner-city schools who participated in an obesity prevention study previously published. Children completed the body dissatisfaction subscale of the Eating Disorder Inventory-2 (EDI-2), and weight status was assessed by measured weights and heights. Multiple regression analyses were conducted. Relative weight status was the strongest predictor of body dissatisfaction, followed by race/ethnicity, and sex. Body dissatisfaction was greatest in obese, Asian, and female children. Overall, results indicated that children's body dissatisfaction varies based on relative weight status, as well as race/ethnicity and sex among urban children. Results highlight the strong need for additional research so that more definitive conclusions may be drawn regarding the development of body image among diverse groups of children.