Interpretive acting-out: Unavoidable and sometimes useful

Abstract

Using one detailed case presentation, this paper examines the clinical hardship of making accurate and helpful interpretations that do not become part of the patient's defensive system. The author argues that interpretive acting-out is inevitable in the psychoanalytic process. But, if properly monitored, understood, and contained, these interpretive enactments can sometimes actually be a profit to the overall treatment. Issues of projective identification, countertransference, and the importance of realizing our transference role in the patient's changing phantasies are discussed throughout the case material.     

Sleep Symptoms as a Partial Mediator Between Combat Stressors and Other Mental Health Symptoms in Iraq War Veterans

Sleep symptoms are a prominent feature of mental health disorders like PTSD and depression. However, it is unknown whether sleep symptoms mediate the relationship between combat stress and these disorders. We examined the mediating role of sleep symptoms on the relationship between combat stress and PTSD; and the relationship between combat stress and depression using data from 576 Army veterans of the Iraq War surveyed in 2004. Correlational analyses revealed that when insomnia was included in the model, the correlation between combat stressors and other depression symptoms decreased by 65%; and when nightmares were included in the model, the correlation between combat stressors and other PTSD symptoms decreased by 69%. We replicated these analyses using individual items assessing PTSD and depression and found that the insomnia and nightmare items had the largest and second largest mediation effect between combat stressors and PTSD and depression symptoms. Our result support the theory that sleep symptoms contribute to the development and/or maintenance of other mental health symptoms and that early treatment of sleep symptoms may mitigate the other mental health consequences of combat stress.     

Transpersonal Psychology: Defining the Past,Divining the Future

Retrospective analysis of definitions published over some 35 years suggests the major subject areas of the field can be summed up in three themes: beyond-ego psychology, integrative/holistic psychology, and psychology of transformation. Theme frequency analysis reveals that early emphasis on alternative states of consciousness has moderated into a broader approach to human transcendence, wholeness, and transformation. This expanded definition of transpersonal psychology suggests the field has much in common with integral psychology. As a comprehensive, historically based content summary, this tripartite definition contributes a small but vital piece to the foundation of a transpersonal vision that is spreading across the globe. While transpersonal psychology still needs to embody the inclusiveness and diversity that it represents, its vision is one of great relevance to the contemporary human condition.     

A Review of “Trauma and Human Existence: Autobiographical,Psychoanalytic and Philosophical Reflections”

Abstract

The author sets out to locate Bion's model of the mind within the developmental history of psychoanalysis, from Freud to Klein to Bion, using biographical material and clinical case examples, to illustrate Bion's concepts of container/contained, his understanding and use of projective identification, his extension of the use of the countertransference, and his differentiation between the psychotic and non-psychotic aspects of the mind. Links, and attacks against linking are discussed, as well as Bion's thoughts about learning versus knowing, being versus becoming and his emphasis on the essential importance of the development of the capacity to think.