An adolescent and his imaginary companions: from quasi-delusional constructs to creative imagination

In this paper I shall describe the psychotherapeutic treatment of a 14-year-old boy, who suffered from mild Asperger's syndrome. This adolescent had a multiplicity of imaginary friends, which protected him from catastrophic feelings of loneliness and deadness, but at the same time interfered with the possibility of establishing meaningful relations with human beings. As the relationship with the therapist gradually gained the vitality and importance originally invested in his parallel fantasy world, the imaginary companions simultaneously faded away. His imagination then became more closely connected to inner reality and to creative processes. The psychoanalytic literature on imaginary companions is reviewed, and it is suggested that the concept of a self-protective device could be usefully applied to understanding the functions that this fantasy performed for the patient.

Dans cet article, l'auteur décrit le traitement psychothérapeutique d'un garçon de 14 ans qui présentait une forme atténuée du syndrome d'Asperger. Cet adolescent avait une foule d'amis imaginaires, ce qui, tout en le protégeant contre le sentiment catastrophique de solitude et de morne tristesse, l'empêchait d'établir des rapports authentiques avec des êtres humains. Au fur et à mesure que sa relation à sa thérapeute était investie de la vitalité et de l'importance initialement accordées à son monde fantasmatique parallèle, ses compagnons imaginaires s'effaçaient. Son imagination était alors davantage en contact avec sa réalité intérieure et avec sa créativité. Passant en revue un certain nombre de textes psychanalytiques sur les compagnons imaginaires, l'auteur suggère que le concept d'un dispositif d'auto-protection pourrait aider à comprendre le rôle que jouait pour son patient cet univers fantasmatique.

In questo articolo l'autrice descrive il trattamento psicoterapeutico di un ragazzo di 14 anni con sindrome di Asperger in forma leggera. Questo ragazzo aveva una molteplicita' di amici immaginari che lo proteggevano da sentimenti catastrofici di solitudine e senso di morte, ma che allo stesso tempo interferivano con la possibilita' che egli stabilisse delle relazioni significative con altri esseri umani. Con l'intensificarsi della relazione con la terapeuta, che gradualmente acquisi' la vitalita' ed importanza originariamente investiti nel suo mondo di fantasia parallelo, simultaneamente i compagni immaginari scomparvero. La sua immaginazione divenne allora piu' strettamente connessa con la realta' interna e con i processi creativi. Nell'articolo viene passata in rassegna la letteratura psicoanalitica sui compagni immaginari, e si avanza l'ipotesi che il concetto di manovra protettiva per il se' potrebbe essere utilmente applicato alla comprensione delle funzioni che tale fantasia fungeva per il paziente.

In diesem Artikel werde ich die psychotherapeutische Behandlung eines 14-jährigen Jungens beschreiben, der an leichtem Asperger Syndrom litt. Dieser Jugendliche hatte eine Vielzahl von imaginären Freunden, die ihn vor katastrophalen Gefühlen der Einsamkeit und Leblosigkeit schützten, aber gleichzeitig die Möglichkeit, bedeutsame Beziehungen mit Menschen herzustellen, beeinträchtigten. Als die Beziehung mit der Therapeutin allmählich die Vitalität und Bedeutung erlangte, die ursprünglich in seiner parallellen Phantasiewelt investiert war, verblassten gleichzeitig die imaginären Begleiter. Seine Phantasiewelt war dann näher mit seiner inneren Realität und kreativen Prozessen verbunden. Es wird die psychoanalytische Literatur über imaginäre Begleiter rezensiert und vorgeschlagen, dass das Konzept einer selbst-schützenden Vorrichtung nützlich zum Verstehen der Funktionen angewendet werden kann, die diese Phantasie für den Patienten erfüllten.     

To watch or not to watch: Infants and toddlers in a brave new electronic world

For some time now, questions have been asked about the impact of television and video materials on the cognitive and social development of preschoolers and older children. More recently, these same questions have been asked in relation to the extensive exposure to these media that infants and toddlers are currently experiencing. To answer these questions, we review current research that explicitly targets these concerns and provide new insights into the role these media play in early development.     

The influence of negative oriented personality traits on the effects of wind turbine noise

Concern about invisible environmental agents from new technologies, such as radiation, radio-waves, and odours, have been shown to act as a trigger for reports of ill health. However, recently, it has been suggested that wind turbines – an archetypal green technology, are a new culprit in explanations of medically unexplained non-specific symptoms (NSS): the so-called Wind Turbine Syndrome ( Pierpont, 2009). The current study assesses the effect of negative orientated personality (NOP) traits (Neuroticism, Negative Affectivity and Frustration Intolerance) on the relationship between both actual and perceived noise on NSS. All households near ten small and micro wind turbines in two UK cities completed measures of perceived turbine noise, Neuroticism, Negative Affectivity, Frustration Intolerance, attitude to wind turbines, and NSS (response N = 138). Actual turbine noise level for each household was also calculated. There was no evidence for the effect of calculated actual noise on NSS. The relationship between perceived noise and NSS was only found for individuals high in NOP traits the key role of individual differences in the link between perceived (but not actual) environmental characteristics and symptom reporting. This is the first study to show this effect in relation to a so called ‘green technology’.     

Self in time and language

Time has been considered a crucial factor in distinguishing between two levels of self-awareness: the “core,” or “minimal self,” and the “extended,” or “narrative self.” Herein, I focus on this last concept of the self and, in particular, on the relationship between the narrative self and language. In opposition to the claim that the narrative self is a linguistic construction, my idea is that it is created by the functioning of mental time travel, that is, the faculty of human beings to project themselves mentally backwards in time to relive, or forward to anticipate, events. Moreover, I propose that narrative language itself should be considered a product of a core brain network that includes mechanisms, such as mental time travel, mindreading, and visuo-spatial systems.     

The effect of Multi Convergent Therapy on the psychopathology,mood and performance of Chronic Fatigue Syndrome patients: A preliminary study

Objectives: Multi Convergent Therapy combines approaches such as Cognitive Behaviour Therapy and Graded Exercise Therapy in an holistic treatment of Chronic Fatigue Syndrome. Initial follow‐up data showed that patients were benefiting from this individualised form of therapy. The objective of the present study was to evaluate this Multi Convergent approach, developed at a specialised Chronic Fatigue Syndrome Outpatient clinic in Cardiff, and compare it to Relaxation Therapy and control groups using multiple outcome measures. Design: Thirty‐five participants fitting the Centre for Disease Control criteria for Chronic Fatigue Syndrome were recruited from two outpatient clinics and members of our existing patient panel. Patients were assigned to Multi Convergent Therapy (N=12), Relaxation Therapy (N=14) or recruited as controls (N=9). Methods: Each patient completed a battery of mood and performance tasks along with comprehensive set of questionnaires at baseline, post‐treatment and at six‐month follow‐up. These measures had been validated in previous studies on untreated patients and matched healthy controls. Results: Patients attending the Multi Convergent Therapy clinic showed statistically significant improvements in many of our measures. Most importantly we have produced data indicating that Multi Convergent Therapy provides improvements in objective measures of psychomotor performance and cognition. Discussion: The outcomes of this small study are encouraging. Multi Convergent Therapy has not only produced results indicating significant improvements in standardised questionnaire based measures but also in objective cognitive performance tasks. The next step would be to assess Multi Convergent Therapy at the primary medical care level, with a greater number of patients to further evaluate its efficacy as a treatment for Chronic Fatigue Syndrome.     

‘Making Room for the Other(s)’: A consideration of psychodynamic counselling with women with Asperger’s Syndrome

This paper explores psychodynamic therapy with young women with Aspergers Syndrome through the use of a composite case study. It seeks to make sense of a female patient’s obsession with a figure from celebrity culture – ‘Tom’ from ‘Britain’s Got Talent’. The potential use of ‘Tom’ by the patient as an idealised object, an autistic object, a transitional object and a transformative object is considered. Drawing on Rosenfeld’s concept of pathological narcissism and Meltzer’s concept of ‘aesthetic reciprocity’, the paper seeks to make sense of both the defences that the patient utilises and the impact of the deficits she has experienced. Attention is given to the development of the therapy through the use of play and work in the transference. Gradually, the patient becomes more able to tolerate separateness and in doing so becomes more connected to her own internal world and the feelings of others. In so doing, she becomes more aware of her actual social marginalisation and gains a greater sense of awareness of her diagnosis.     

Parental Refusal of Medical Treatment for a Newborn

Theoretical Medicine and Bioethics - When there is a conflict between parents and the physician over appropriate care due to an infant whose decision prevails? What standard, if any, should guide...     

New Beginnings–an experience-based programme addressing the attachment relationship between mothers and their babies in prisons

Data about the quality of attachment between infants and parents in high-risk populations suggests that early intervention may be advantageous for positive developmental outcomes for the child. Mothers in prison represent a high-risk parenting population in terms of both attachment histories and economic and social risk factors. New Beginnings was constructed as a short term, experience-based programme for mothers and infants in the Mother and Baby Units of two UK women's prisons. It is based on the early intervention model developed at the Anna Freud Centre. The programme was piloted in 2004–5, with 27 participating dyads. This paper presents an overview of the pilot stage. Our aim is to introduce the thinking that went into the programme and to present initial observations concerning the effect of the programme. We describe the development of a framework for the programme and its preliminary evaluation using pre- and post-interview protocols concerning the mothers' thoughts and feelings about their babies. We used the Parent Development Interview, for both a qualitative analysis of the major themes in connection to child rearing and quantitative measures of reflective capacity in relation to the child on the part of mother-participants.     

Causal attributions in premenstrual syndrome

Abstract

The relationship between causal attributions and symptoms was investigated with self-report inventories in patients with premenstrual syndrome (n=38) and controls (n=26) during the premenstrual as well as the intermenstrual phase of the cycle. Patients with prospectively confirmed premenstrual exacerbations of physical and psychological symptoms more frequently attributed their complaints during premenstruum to the cycle than was the case during the intermenstrual period. Controls showed no differences in types of explanations for complaints in either phase of the cycle. It appeared that patients used not only the menstrual cycle, but also psychological distress and physical exertion, more often then controls as an explanation for complaints during both phases of the cycle. Implications of the finding that patients used medical as well as non-medical explanations for complaints during the cycle are discussed with regard to treatment strategies for PMS.