Dramatology in life,disorder, and psychoanalytic therapy: A further contribution to interpersonal psychoanalysis

Abstract

Action and interaction, and emotion and thought as the inner wellsprings of action, play a central role in the lives of individuals, families, and society, spanning the continuum between everyday life and disorder. Until now, the narrative tradition has been the main methodology for portraying and formulating human action and interaction, and little has been written about the dramatic approach to life, disorder, and therapy. Since the essence of drama is action, dialogue, character, and emotion, it is time to give drama its due. The author proposes a methodological concept – dramatology – analogous to narratology, to highlight the dramatic method of investigating action and interaction in life, disorder, and therapy. Breuer and Freud presented both aspects of dramatology: dramatization in dream and fantasy, and dramatization in act, focusing on the person. This approach was elaborated by psychoanalysts with an interpersonal orientation, focusing on the person and speech as action. Dramatology is applied to exploring ongoing patient–therapist interactions as reality and as transference. Analyzing unconscious and latent dramatization in dream, fantasy, and enactment with free association is enhanced by utilizing clarification and confrontation, focusing on the manifest and mutually observable expressive form and style of actions and enactments, defenses and resistances, and the discharge and meaning of emotions. Dramatology puts forward a new paradigm for psychiatry, psychotherapy, and psychoanalysis.     

The analysand and analyst team practicing reciprocal free association: Defenders and deniers

Abstract

By 1900, Freud had formulated an original and operational method of psychoanalytic treatment and research: the technique of free association. In 1912–1915 and later writings, he recommended it as a fundamental procedure and process, called the fundamental rule, in psychoanalytic therapy. In recent years, free association as a method has been variously misrepresented, misunderstood, and denied by some schools of psychoanalysis. This paper reviews the history of free associations and argues for upholding the continuity and relevance of Freud's fundamental methodology and for a renewal of interest in reciprocal, i.e., interactive and interpersonal, free association.     

Why Should We Care About Nietzsche's ‘Higher Men’?

This paper offers a new interpretation of Nietzsche's ‘higher men’ doctrine, which explains how he can simultaneously hold the following two positions: first, that higher types are especially important or valuable; and second, that all moral claims are false (i.e. a crude error theory regarding morality). Nietzsche can coherently subscribe to both views by arguing that higher types have wide inter‐subjective (prudential) value to lower types. More specifically, higher men, who are mainly characterized by their strong, commanding nature, fulfill a psychological need, common in most humans—the need to obey. The paper develops this conception of higher types and shows how it relates to Nietzsche's insights on culture, nihilism, and becoming.     

Depression Screening in Medically Ill Homecare Elderly

PURPOSE: This article provides data on a depression screening model (HOME) in acute home health care designed to detect clinical depression among medically ill homebound older patients. The model was developed to address the lack of mental health services in home health care settings and to specifically improve geriatric depression screening as part of routine care. Authors report on the concordance of homecare and research interview ratings of depression in older homecare patients. DESIGN AND METHODS: Using a prospective cohort design, data were collected from 289 elderly patients, aged 65 and older, from a large home health care agency to examine depression, cognitive functioning, medical comorbidity, functional status, and social isolation. Research interviews used the depression module of the structured clinical interview for DSM (SCID). RESULTS: The overall prevalence of major depression was 5.7 percent according to both homecare and research raters. The prevalence of subthreshold depressive disorder was 16.4 percent as reported by research raters. Observed agreement was 73 percent and kappa agreement was 0.42, indicating a fair to moderate agreement. We identified patient characteristics that may influence the accuracy of homecare worker estimates of depressive symptoms. IMPLICATIONS: Findings suggest that depression continues to be underdetected in medically ill homebound elderly patients. Ongoing training in depression screening methods, patient follow-up interviews, and appropriate referral would improve care of depressed elderly homecare patients.     

Book Review

Abstract

Walter Hans Joerg ed., Psychoanalyse und Universität. Wien: Passagen Verlag, 1994.

“Even In the Night You See The Papaya Shining” Reichmayr J: Einführung in die Ethnopsychoanalyse, Geschichte, Theorien und Methoden. Frankfurt am Main: Fischer Taschenbuch Verlag, 1995.     

The Feud Between Freud and Ferenczi Over Love

The American Journal of Psychoanalysis -     

Using the Diffusion Model to Explain Cognitive Deficits in Attention Deficit Hyperactivity Disorder

Slow, variable, and error-prone performance on speeded reaction time (RT) tasks has been well documented in childhood ADHD, but equally well documented is the context-dependent nature of those deficits, particularly with respect to event rate. As event rates increase (or, as the interstimulus intervals become shorter), RTs decrease, a pattern of performance that has long been interpreted as evidence that cognitive deficits in ADHD are a downstream consequence of a fundamental difficulty in the regulation of arousal to meet task demands. We test the extent to which this is a misinterpretation of the data that occurs when RT and accuracy are considered separately, as is common in neurocognitive research. In two samples of children aged 8–10 with (N?=?97; 33 girls) and without (N?=?39; 26 girls) ADHD, we used the diffusion model, an influential computational model of RT, to examine the effect of event rate on inhibitory control in a go-no-go task. Contrary to longstanding belief, we found that fast event rates slowed the rate at which children with ADHD accumulated evidence to make a decision to “no-go”, as indexed by drift rate. This in turn resulted in a higher proportion of failed inhibits, and occurred despite increased task engagement, as reflected by changes in the starting point of the decision process. Thus, although faster event rates increased task engagement among children with ADHD, the increased engagement was unable to counteract the concurrent slowing of processing speed to “no-go” decisions. Implications for theoretical models of ADHD and treatments are discussed.     

The Power of the Spoken Word in Life,Psychiatry, and Psychoanalysis—A Contribution to Interpersonal Psychoanalysis

Starting with a 1890 essay by Freud, the author goes in search of an interpersonal psychology native to Freud's psychoanalytic method and to in psychoanalysis and the interpersonal method in psychiatry. This derives from the basic interpersonal nature of the human situation in the lives of individuals and social groups. Psychiatry, the healing of the soul, and psychotherapy, therapy of the soul, are examined from the perspective of the communication model, based on the essential interpersonal function of language and the spoken word: persons addressing speeches to themselves and to others in relations, between family members, others in society, and the professionals who serve them. The communicational model is also applied in examining psychiatric disorders and psychiatric diagnoses, as well as psychodynamic formulas, which leads to a reformulation of the psychoanalytic therapy as a process. A plea is entered to define psychoanalysis as an interpersonal discipline, in analogy to Sullivan's interpersonal psychiatry.