Clinical Assessment of Prementalizing Modes of Psychic Functioning in Children and Their Parents in the Context of Trauma

ABSTRACT

As psychoanalytic psychotherapy for children depends on their capacity to mentalize, it is essential to integrate this dimension in their psychological assessment. Mentalization refers to the capacity to identify and comprehend the mental states (feelings, thoughts and intentions) underlying and explaining one’s own behaviors and those of others. This vital ability, which develops during the first five or six years of life in the context of a secure parent-child attachment, is often impaired in children subjected to neglect and maltreatment. Based on rigorous and systematic clinical observations made in youth protection and child psychiatry services, the authors suggest that the children in these settings, along with their parents, frequently present a prementalizing mode of psychic functioning. Further, the authors propose operationalizing the teleological, psychic equivalence, and pretend modes as they might be observed in older children and their parents. To this end, they begin by identifying behaviors, attitudes, and relational patterns potentially linked to each of these modes within a theoretical framework. Next, they describe the characteristics of these children’s narratives, play, and artistic productions. Lastly, three clinical vignettes are used to illustrate how the prementalizing modes are manifested. The results of this clinical assessment can guide the choice of techniques to be used in child psychotherapy.     

Mentalization-based Interventions in Child Psychiatry and Youth Protection Services II: A Model Founded on the Child’s Prementalizing Mode of Psychic Functioning

ABSTRACT

The systematic and rigorous observations of children in child psychiatry and Youth Protection Services in Quebec revealed that most of these children presented multiple, complex and often severe problems, and did not seem to benefit much from classic psychodynamic psychotherapy. Owing to a poorly developed mentalizing capacity, many of these children did not use symbolic play as a means of expressing their intrapsychic conflicts and relational difficulties and did not communicate much verbally with clinicians. It was noted also that these children’s inner world was dominated by prementalizing modes of thinking, namely, the teleological mode, the psychic equivalence mode, and the pretend mode. This article is the last in a series of three. The first concerns the clinical assessment of prementalizing modes of psychic functioning in children and their parents. The second lays out the general objectives, principles and interventions of a mentalization-based treatment for children. This third article presents specific intervention strategies adapted to children’s predominant mode of thinking. The objectives and techniques regarding each mode are discussed. Three clinical examples serve to illustrate the interventions. The authors suggest that these children must develop a certain degree of mentalizing capacity before they can benefit from classic psychodynamic psychotherapy.     

Newborns modulate their crawling in response to their native language but not another language

Human newborns can propel themselves to their mother's breast when positioned skin to skin on her abdomen just after birth. For decades, researchers have considered this primitive crawling behavior a spinal reflex, immune to supra spinal control. However, recent research suggests that neonatal crawling is already responsive to visual and olfactory stimuli processed at a supra spinal level. Here we report that a few hours post birth, French newborns can also modulate their crawling in response to their native language – a source of information that is processed supra-spinally. The crawling patterns of 23 French-born newborns were recorded on video and via an infrared motion capture system during two randomly ordered 2-min trials. The newborns were secured on a mini skateboard to facilitate arm and leg movements during their crawling propulsion. They heard a repetitive sequence of the same sentences either in French, their native language, or in English, a rhythmically different and hence discriminable unfamiliar language, on each trial. In French, compared to English, crawling was enhanced, with significantly more arm and leg steps and significantly more and larger trunk rotations in the cephalo-caudal axis. Moreover, newborns rotated their heads and trunk toward the appropriate loud speaker when hearing French but not English. These preliminary findings suggest that newborn crawling is not a simple stereotyped reflex under spinal control, but a complex pattern that can be modulated in response to higher-order, supra-spinally processed stimuli. The findings open fascinating questions about the range of stimuli to which newborn crawling is responsive.     

Palatability shifts in taste and flavour preference conditioning

Changes in palatability of tastes and flavours as a result of flavour preference conditioning were examined. In Experiment 1, when tastes were paired with glucose in a reverse-order differential conditioning paradigm, rats acquired conditioned preferences for CS + and displayed more hedonic responses to CS + than to CS - in a postconditioning taste reactivity test. In Experiment 2, rats that received oral infusions of flavours as CSs during a reverse-order conditioning procedure expressed both palatability shifts and conditioned preferences for CS + . Rats that received a forward conditioning procedure acquired a preference for CS + , but the palatability of CS + was unchanged. In Experiment 3, hungry rats drank mixtures of a flavour CS and a calorific or sweet tasting reinforcer in a long-exposure conditioning paradigm. When tested hungry, rats preferred CS + whether they had acquired flavour-calorie or flavour-taste associations. However, CS + became more palatable only for rats that acquired flavour-calorie associations. These results suggest that acquisition of flavour preferences, as measured by 2-bottle tests, may not always be accompanied by enhanced palatability.     

What Love Is Not: Lessons from Martin Luther King,Jr.

Focusing on the concept and practice of love sheds light on Martin Luther King, Jr.’s negative political theology. King was fundamentally concerned with what love is not, and it is this negation that colors his political vision. I do not take King’s political theology to be either primarily derivative of American liberal Protestantism or primarily derivative of folk African American religion, or of some syncretism of these. Rather, I take King to be participating in a tradition of negative theology that pairs the critique of idolatry with attention outward and inward, to the marginalized and to spiritual life.