The edge of chaos: A nonlinear view of psychoanalytic technique

The field of nonlinear dynamics (or chaos theory) provides ways to expand concepts of psychoanalytic process that have implications for the technique of psychoanalysis. This paper describes how concepts of “the edge of chaos,” emergence, attractors, and coupled oscillators can help shape analytic technique resulting in an approach to doing analysis which is at the same time freer and more firmly based in an enlarged understanding of the ways in which psychoanalysis works than some current recommendation about technique. Illustrations from a lengthy analysis of an analysand with obsessive‐compulsive disorder show this approach in action.     

Dreams: Fifty Years and Counting

I have been following my dreams since I was a child. Jung says that a single dream may give the dreamer a lot of information; however, a series of dreams over time will show where the dreamer needs to do additional work, where and how the dreamer's life may be headed, and how the dreamer is dealing with this knowledge that comes from a realm of wisdom that is both numinous and mysterious. In my life, spirit has become a profound partner by pointing me in directions that were not conscious to me. I have had a wonderful opportunity to work with a fellow dream worker for the past ten years. We use active imagination and amplification until the meaning of the dream becomes clearer. Often our dreams produce parallel images, feelings, and actions, which to my eye confirms the deeper psychic connection we all have with one another. I have used images to capture the impact of the dreams on my psyche, and poetry to confirm and augment the deeper level of wisdom that unfolds in our dreams. Dream interpretation can only encourage dreamers to allow themselves to become comfortable with working with their dream material, but does not necessarily show them the final answers.     

Identity-Related Dysfunction: Integrating Clinical and Developmental Perspectives

Recent changes to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders highlight the importance of identity dysfunction within several psychiatric diagnoses. Despite a long-standing tradition of identity research and theory in the developmental literature, there is limited work establishing intersections between clinical and developmental conceptualizations of identity problems. The relative lack of integration between decades of clinical and developmental work is unfortunate, and likely limits progress in both areas. In this commentary, the authors argue for greater interdisciplinary collaboration and highlight contributions from developmental and clinical theories, which, if integrated, could enhance identity scholarship. The developmental psychopathology perspective is introduced as an ideal framework to promote these goals.     

Knowledge of and Interest in Genetic Results Among Parkinson Disease Patients and Caregivers

The purpose of the study is to investigate Parkinson disease (PD) patients’ and caregivers’ knowledge of and interest in genetic testing. Gaucher disease (GD) results from recessive mutations in glucocerebrosidase (GBA). Both heterozygote GBA carriers and GD patients are at greater risk for PD. Studies regarding knowledge of and interest in genetic testing have been limited and have not offered genetic results to participants. In this study, 353 PD patients and 180 caregivers were recruited to a PD genetic study. The association between GD, GBA mutations and PD was described to participants who reported their familiarity with genetic terms, answered questions on genetic concepts, and indicated their interest in knowing if they may have GD (two GBA mutations) and other genetic information that could impact their health. Ninety-three-percent of participants were interested in receiving GBA results; however, only 51.6 % of PD participants and 55.6 % of caregivers knew that “scientists have identified genes associated with a higher risk of developing PD.” PD patients may benefit from education and genetic counseling on the implications of genetic testing.     

Sartre and Ricoeur on Productive Imagination

Commenting on Jean‐Paul Sartre's theory of imagination, Paul Ricoeur argues that Sartre fails to address the productive nature of imaginative acts. According to Ricoeur, Sartre's examples show that he thinks of imagination in mimetic terms, neglecting its innovative and creative dimensions. Imagination, Ricoeur continues, manifests itself most clearly in fiction, wherein new meaning is created. By using fiction as the paradigm of imaginative activity, Ricoeur is able to argue against Sartre that the essence of imagination lies not in its ability to reproduce absent objects, but rather in the ability to transform reality through creative acts. Motivated by the intuition that Sartre the writer could not have forgotten to address such crucial dimensions of imagination, I examine Sartre's philosophical and literary work, showing that not only does he develop a notion of productive imagination, he also puts this notion to work by articulating the relationship between imagination, narrative, and identity formation, well before Ricoeur advanced his narrative‐identity theory. I argue that Sartre, like Ricoeur and MacIntyre, another representative of narrative‐theory whose criticism of Sartre I address in this essay, views imagination and narrativity as necessary conditions for the formation of a coherent and meaningful sense of self.     

Body-image,quality of life and psychological distress: a comparison between kidney transplant patients and a matching healthy sample

The purpose of the current study was to assess the uniqueness of the condition of kidney transplant recipients in comparison to a sample of matching healthy peers in relation to body-image dissatisfaction and identification, quality of life and psychological distress. Participants were 45 kidney transplant recipients who were under follow-up care at a Transplant Unit of a major Medical Center, and a sample of 45 matching healthy peers. Measures were taken using self-report questionnaires [Body-Image Ideals Questionnaire (BIIQ), Body Identification Questionnaire (BIQ), Brief Symptoms Inventory (BSI), and the SF-12]. The major findings were the following: (i) kidney transplant recipients reported lower levels of quality of life and higher levels of PsD when compared to their healthy peers; (ii) no difference in body-image dissatisfaction was found between the two studied groups; (iii) significant correlations between body-image dissatisfaction quality of life and PsD were found only in the kidney transplant recipients. The kidney transplantation condition has a moderating effect in the association between body-image dissatisfaction PsD but not in the association between body-image dissatisfaction and quality of life; (iv) kidney transplant recipients experienced higher levels of body identification than did their healthy peers. Taken together, these findings highlight the unique condition of kidney transplant recipients, as well as the function that body-image plays within the self.     

Misrecollection prevents older adults from benefitting from semantic relatedness of the memoranda in associative memory

Memory for episodic associations declines in aging, ostensibly due to decreased recollection abilities. Accordingly, associative unitization - the encoding of associated items as one integrated entity - may potentially attenuate age-related associative deficits by enabling familiarity-based retrieval, which is relatively preserved in aging. To test this hypothesis, we induced bottom-up unitization by manipulating semantic relatedness between memoranda. Twenty-four young and 24 older adults studied pairs of object pictures that were either semantically related or unrelated. Participants subsequently discriminated between intact, recombined and new pairs. We found that semantic relatedness increased the contributions of both familiarity and recollection in young adults, but did not improve older adults' performance. Instead, they showed associative deficits, driven by increased recollection-based false recognition. This may reflect a “misrecollection” phenomenon, in which older adults make more false alarms to recombined pairs with particularly high confidence, due to poorer retrieval monitoring regarding semantically-related associative probes.     

Taking responsibility for health in an epistemically polluted environment

Proposals for regulating or nudging healthy choices are controversial. Opponents often argue that individuals should take responsibility for their own health, rather than be paternalistically manipulated for their own good. In this paper, I argue that people can take responsibility for their own health only if they satisfy certain epistemic conditions, but we live in an epistemic environment in which these conditions are not satisfied. Satisfying the epistemic conditions for taking responsibility, I argue, requires regulation of this environment. I describe some proposals for such regulation and show that we cannot reject all regulation in the name of individual responsibility. We must either regulate individuals’ healthy choices or regulate the epistemic environment.