‘Battling with the unlaid ghost’: psychotherapy with a child traumatised in infancy

This paper attempts to explore the nature and consequences of early trauma on the mental development of a 9-year-old boy I have called Luke. The traumatic event occurred within the context of a more chronic and ongoing trauma, which was due to the lack of receptive and containing parental figures. The combination of these two kinds of traumatic experiences had a destructive impact on the making of Luke's internal world and greatly disrupted the development of his capacity for thought. I will specifically refer to the theory of trauma and to Bion's theory of thinking in order to illustrate the crucial link between trauma and mental work and the complex challenge it brings. I will describe how, during the course of 2 years of intensive treatment, Luke gradually became able to restore his capacity for mental functioning, which made it possible for him to begin to think about and make sense of his extreme emotional experiences.

Dans cet article, l'auteur cherche à explorer la nature et les conséquences, pour le développement psychique d'un garçon de neuf ans qu'il appelle Luke, d'un traumatisme précoce. L'événement traumatique s'est produit dans le contexte d'une situation traumatique plus chronique et plus globale en raison de l'absence de figures parentales réceptives et contenantes. L'association de ces deux types de vécu traumatique, avec leur impact destructeur sur la construction du monde interne de Luke, a créé des perturbations majeures du développement de sa capacité à penser. L'auteur se réfère tout particulièrement à la théorie du traumatisme ainsi qu'à la théorie de l'activité de pensée de W. R. Bion afin d'illustrer le lien fondamental qui existe entre traumatisme et travail psychique, ainsi que le défi complexe que ce travail doit confronter. L'auteur montre qu'au cours de deux années de traitement intensif Luke a progressivement retrouvé ses capacités de fonctionnement psychique, de sorte qu'il a pu commencer à réfléchir à ses vécus émotionnels insoutenables et réussir à y comprendre quelque chose.

Mots-clés: Traumatisme, “pare-excitation”, fonctionnement psychique, théorie de l'activité de pensée, fonction alpha, attaques contre l'activité de liaison

Riassunto: In questo articolo si cerca di esplorare la natura e le conseguenze del trauma precoce sullo sviluppo mentale di un bambino di nove anni che chiamerò Luca. L'evento traumatico accadde all'interno di un contesto di trauma pi[ugrave] cronico e duraturo dovuto all'assenza di figure parentali recettive e contenitive. La combinazione di questi due tipi di esperienze traumatiche ebbe un impatto distruttivo sul mondo interno di Luca e interferì enormemente con lo sviluppo della sua capacità di pensare. Farò principalmente riferimento alla teoria del trauma e alla teoria del pensiero di Bion per illustrare il legame particolare tra trauma e lavoro mentale e la complessa sfida che ne consegue. Descriverò come durante il lavoro intensivo di due anni, Luca divenne gradualmente capace di recuperare la sua capacità di funzionamento mentale che gli permise di incominciare a pensare e dare un senso alle sue esperienze emotive estreme.

Parole chiave: trauma, scudo protettivo, funzionamento mentale, teoria del pensiero, funzione alfa, attacco al legame

Der Artikel versucht, die Eigenschaften und Konsequenzen von frühem Trauma auf die psychische Entwicklung eines 9-jährigen Jungens, den ich Luke nenne, zu betrachten Das traumatische Ereignis passierte im Umfeld eines mehr chronischen und fortdauernden Traumas, wegen Mangel an rezeptiven und haltenden elterlichen Figuren. Die Kombination dieser zwei Arten von Trauma hatte eine destruktive Auswirkung auf das Entstehen von Lukes innerer Welt und störte erheblich die Entwicklung seiner Denkfähigkeit. Ich werden mich speziell auf Traumatheorie und auf Bion's Theorie des Denkens beziehen, um die entscheidende Verbindung zwischen Trauma und mentaler Arbeit und der komplexen Herausforderung, die das mit sich bringt, zu illustrieren. Ich werde beschreiben, wie Luke allmählich im Laufe einer zwei-jährigen intensiven Behandlung in der Lage war, seine Fähigkeit für mentales Funktionieren wiederherzustellen, was es ihm ermöglichte anzufangen, über seine extremen emotionalen Erfahrungen nachzudenken und Sinn herzustellen

Keywords: Trauma, Schutzschild, mentales Funktionieren, Theorie des Denkens, Alphafunktion, Angriffe auf Verbindungen     

Risk-factor research and prevention programs for anxiety disorders: a translational research framework

The aim of the present essay is to discuss the interconnection between risk-factor research and prevention program development for panic-spectrum psychopathology. We argue that prevention of panic-spectrum psychopathology specifically, and anxiety disorders more generally, is likely to be best advanced through active, systematic translation of basic, risk-factor research. After operationalizing key terminology, we present some exemplar risk-factor candidates for panic-spectrum psychopathology, summarize research related to their role as risk-factors for panic problems, and link this discussion to risk-factor nomenclature. We then present a translational framework for extrapolating extant knowledge on these and other potential risk-factors for panic-spectrum psychopathology with respect to the development of preventative interventions. The proposed translational framework is intended to describe a forward-feeding process by which risk-factor research could be used by clinical researchers to inform prevention programs; and reciprocally, how such prevention knowledge could be most effectively utilized to drive new, clinically focused risk-factor research.     

Decision making in a case of mixed uncertainty: A normative model

We consider a case of uncertainty which is frequently met in various fields, e.g., in parametric statistics: Events {θ}, θ ∈ ∵, are members of family $\text{E}$ on which the decision maker possesses no information at all; however, conditionally on the realization of {θ}, he is able to affix probabilities to all members of another family of events, $\text{F}$. We assume that the decision maker: (1) has a rational behavior under complete ignorance, for decisions whose results only depend on events of $\text{E}$; (2) with {θ} known, maximizes his conditional expected utility for decisions whose results only depend on events of $\text{F}$; (3) has (unconditional) preferences which are consistent with his conditional ones. These assumptions are shown to be sufficient to ensure an approximate representation of the decision maker's preference by a real-valued function W which has the form $\text{W(f) = v[}\text{Inf}{}_{\mathrm{\theta \in \because }}\text{E}{}_{\mathrm{\theta }}\text{(u°f),}\text{Sup}{}_{\mathrm{\theta \in \because }}\text{E}{}_{\mathrm{\theta }}\text{(u°f)]}$, where u and v, respectively, characterize the decision maker's attitudes toward risk and toward complete ignorance.     

Three Orthodox Models of Christian Unity: Traditionalist,Mainstream, Prophetic

The assumption is often made that the Orthodox Church has a unified approach to ecumenical engagement with other churches. This paper argues that while there is a ‘mainstream’ model (reflected especially in the thought of Georges Florovsky), there is also a minority ‘traditionalist’ model. While having radically different attitudes towards the modern ecumenical movement (traditionalists are vehemently opposed), both of these accept the premise that the historical Orthodox Church alone is the fullness of the Christian Church and that doctrinal agreement and incorporation into the Orthodox Church must precede sacramental communion. A more open alternative model (‘prophetic’) reflects proposals made in the twentieth century by theologians such as Sergius Bulgakov, Nicholas Afanasiev, Anton Kartashev and Nicholas Zernov. These were not taken up at the time but it is argued that they deserve to be studied again by Orthodox bishops and ecumenical leaders as possibilities for bold prophetic action toward Christian unity.     

Responses to false physiological feedback in individuals with panic attacks and elevated anxiety sensitivity

Participants with elevated anxiety sensitivity and a history of panic attacks were compared to a low anxiety comparison group with respect to physiological and subjective reactivity to false heart-rate feedback and reactivity to a priming procedure. Whereas accurate heart-rate feedback elicited minimal responses, participants across groups showed significant physiological and subjective responses to false feedback. High risk and low risk participants did not differ in heart-rate responses to false feedback, though panic attack frequency did predict physiological and subjective reactions to false feedback in the high risk group. Self-reported nonspecific anxiety was significantly higher in high risk female participants than in low risk female participants, while males did not different in general subjective anxiety. However, high risk participants reported more panic-specific symptoms during the false feedback task than low risk participants, regardless of the sex of the participant. Therefore, although the experimental paradigm appeared to trigger nonspecific anxiety in high risk female participants, panic attack symptoms in reaction to the task were specific to risk group, not sex, and consistent with hypotheses. Surprisingly, the priming procedure did not influence physiological or subjective responses to false feedback in either group. These results raise additional questions regarding the process and impact of interoception in individuals with panic attacks, and suggest that false perception of internal changes may contribute to risk for panic disorder when exposed to believable cues.     

Flashbulb memories of the Paris attacks

Flashbulb memories are vivid autobiographical memories of the circumstances where an individual first learns about emotionally significant public events. Our paper assesses whether these memories were triggered by the attacks of Friday 13 November 2015 in Paris. Two hundred and ninety‐one participants answered a web‐based questionnaire that assessed their memory of the circumstances in which they first learned of the attacks. The questionnaire also assessed vividness, rehearsal, emotion, surprise and novelty. The results showed substantial and vivid recall of the context in which the participants first learned of the event. This recall was associated with fair rehearsal, negative emotional valence, surprise, and novelty. Regression analysis showed that the flashbulb recall was predicted by negative emotion. Negative emotion seems to play a key role in the formation of flashbulb memories, at least those associated with the Paris attacks.     

Making Meaning of the September 11 Attacks: Spanish- and Mandarin-Speaking Focus Groups

This article examines experiences and perceptions related to the September 11, 2001, attacks among members of two immigrant groups (Spanish-speaking and Mandarin-speaking) in New York City. Focus groups were conducted 1–2 years after the attacks. Qualitative analysis was conducted using ATLAS.ti. Three major themes emerged: (a) Immediate Experience of the Attacks, (b) Evolving Psychological Adjustment, and (c) Long-Term Issues of Public Concern. The groups’ discussions diverged with temporal progression across these themes, reflecting increasing congruence with broad conceptualizations of their respective cultures. The findings suggest that, over time, culture increasingly influenced the meaning these people made of the disaster.     

An Evolutionary Account of Suicide Attacks: The Kamikaze Case

Explanations for suicide attacks abound. Yet the literature remains conceptually fragmented, with different authors focusing on different attitudes, incentive structures, values, psychological processes, strategic imperatives, and cultural, historical, and personal circumstances. Curiously, however, there have been few efforts to cast suicide bombing within the extensive evolutionary literature on human altruism—in which it clearly belongs. Neither have there been more than occasional efforts to mobilize the distinction between “proximate” and “ultimate” explanations, with most proposed explanations being proximate. Here we draw on content analyses from materials written by Japanese Kamikaze pilots to propose an evolvable cognitive algorithm—by hypothesis, species typical—that (1) specifies environmental circumstances under which such “heroic” behavior is likely; (2) is consistent at the proximate level with the Japanese data; and (3) that is not inconsistent with many of the diverse proximate attitudes, values, and psychological mechanisms that dominate discussions of contemporary suicide campaigns. The evolutionary perspective is not an alternative to most of the proximate explanations offered in discussions of contemporary cases but is, rather, a paradigm around which diverse proximate explanations can be organized.     

A Functional Analysis of 2004 Ukrainian Presidential Debates

Political leaders’ debates are an important and highly visible instances of public argumentation. As such, they merit scholarly attention. This essay applies the Functional Theory of Political Campaign Discourse to analyze televised presidential debates from the Ukraine in 2004. Overall, this analysis revealed that acclaims were the most common function, followed by attacks and then defenses. Policy was addressed more often than character in these debates, as expected. The incumbent candidate acclaimed significantly more and attacked less than the challenger. The incumbents used past deeds significantly more often to acclaim – and less to attack – than the challengers. Finally, general goals and ideals were used more as the basis for acclaims than attacks in these debates. Implications of these results are discussed.