From psychic holes to psychic representations

Abstract

In this essay, I will explore the term “psychic hole,” and compare it to similar terms from the world of astrophysics and terms used in the psychoanalytic literature. I will then present my own conception of the “psychic hole” in cases of Holocaust survivors' offspring. I will explain how this “hole” is created, and describe a particular aspect of the “psychic hole” that is unique to Holocaust survivors' offspring, namely the enactments (termed “concretization” by Bergman) generated by the negated traumatic themes that reside in it. I will illustrate these enactments using clinical material taken from case studies of Holocaust survivors' offspring that I have previously published. The clinical vignettes reveal the transgenerational impact of the memory hole resulting from negation of survivor parents on the lives of their offspring, up to the third generation. They also show the painful journey from enactments to psychic representations, a journey which exposes the traumatic events that have been denied or repressed, and facilitates the work of mourning and the eventual achievement of a better integrated self. Finally, I will offer technical suggestions for analysts to help patients transform psychic holes into psychic representations.     

Global Collaborative Team Performance for the Revision of the International Classification of Diseases: A Case Study of the World Health Organization Field Studies Coordination Group

Background/Objective: Collaborative teamwork in global mental health presents unique challenges, including the formation and management of international teams composed of multicultural and multilingual professionals with different backgrounds in terms of their training, scientific expertise, and life experience. The purpose of the study was to analyze the performance of the World Health Organization (WHO) Field Studies Coordination Group (FSCG) using an input-processes-output (IPO) team science model to better understand the team's challenges, limitations, and successes in developing the eleventh revision of the International Classification of Diseases (ICD). Method: We thematically analyzed a collection of written texts, including FSCG documents and open-ended qualitative questionnaires, according to the conceptualization of the input-processes-output model of team performance. Results: The FSCG leadership and its members experienced and overcame numerous barriers to become an effective international team and to successfully achieve the goals set forth by WHO. Conclusions: Research is necessary regarding global mental health collaboration to understand and facilitate international collaborations with the goal of contributing to a deeper understanding of mental health and to reduce the global burden of mental disorders around the world.     

Measuring motor speed through typing: a surrogate for the finger tapping test

Motor speed is an important indicator and predictor of both cognitive and physical function. One common assessment of motor speed is the finger-tapping test (FTT), which is typically administered as part of a neurological or neuropsychological assessment. However, the FTT suffers from several limitations, including infrequent in-person administration, the need for a trained assessor and dedicated equipment, and potential short-term sensory–motor fatigue. In this article, we propose an alternative method of measuring motor speed, with face validity to the FTT, that addresses these limitations by measuring the interkeystroke intervals (IKI) of familiar and repeated login data collected in the home during a subject’s regular computer use. We show significant correlations between the mean tapping speeds from the FTT and the median IKIs of the nondominant (r = .77) and dominant (r = .70) hands, respectively, in an elderly cohort of subjects living independently. Finally, we discuss how the proposed method for measuring motor speed fits well into the framework of unobtrusive and continuous in-home assessment.     

Gender influences on age cognitions and preferences: sociocultural or sociobiological?

The present article reviews research concerned with gender effects on cognitions and evaluations of people varying in age. Sontag's (1979) article on the double standard of aging--the purportedly more negative consequences of aging in women in contrast to men--serves as a point of departure for the review. Research using attitude-scale, semantic differential, and person-perception methodology points to sex-of-target, sex-of-subject, and target-subject interaction effects in response to a diversity of age-relevant stimuli. Though the reported studies are not completely consistent, there is much suggestive evidence that age is a more salient dimension for men than for women when judging others. Furthermore, men exhibit a stronger youth bias. The overall evidence is consistent with an evolutionary hypothesis, but further research that focuses on the proximal determinants of the observed effects is urged.     

Behavior therapy for drug abuse: A controlled treatment outcome study

82 Ss were studied in a comparative evaluation of a behavioral vs supportive treatment for illegal drug use. Behavioral treatment included stimulus control, urge control, contracting/family support and competing response procedures for an average of 19 sessions. 37% of Ss in the behavioral condition were drug-free at 2 months, 54% at 6 months, and 65% at 12 months vs 20 ± 6% for the alternative treatment during all 12 months. The behavioral treatment was more effective across sex, age, educational level, marital status and type of drug (hard-drugs, cocaine, and marijuana). Greater improvement for this condition was also noted on measures of employment/school attendance, family relationships, depression, institutionalization and alcohol use.