Analytic process and dreaming about analysis

Dreams about the analytic session feature a manifest content in which the analytic setting is subject to distortion while the analyst appears undisguised. Such dreams are a consistent yet infrequent occurrence in most analyses. Their specificity consists in never reproducing the material conditions of the analysis as such. This paper puts forward the following hypothesis: dreams about the session relate to some aspects of the analyst's activity. In this sense, such dreams are indicative of the transference neurosis, prefiguring transference resistances to the analytic elaboration of key conflicts. The parts taken by the patient and by the analyst are discussed in terms of their ability to signal a deepening of the analysis.     

Roots and vicissitudes of psychic bisexuality

Sigmund Freud considered the difficulty in defining masculinity and femininity from a psychic point of view as a hiatus in psychoanalytic theory. I contend that masculinity pertains to the centrifugal (to that which goes out, and ultimately to that which one loses), and femininity to the centripetal (to the appetency for taking the object into one's own internal space), whether one is considering their archaic roots or their genitalized culmination. The masculine/feminine pair draws support from the body (and, through anaclisis, from the subjective space), identified with a container that is liable already in the first psychic stages of life to empty itself of its own content and to be filled by a foreign content: the content is subjective in the masculine and object‐related in the feminine. The conflicts of ambivalence related to these two movements (desire/anxieties linked to active and passive penetration) lead to the setting up of the rigid and labile poles of the personality, and they are liable to give rise to obsessional and hysterical solutions respectively. My hypotheses will be examined in the light of the two key cases of hysteria and obsessional neurosis in Freud's work: Dora (1905e) and the Rat Man (1909d).     

Coping variables as predictors of perioperative emotional states and adjustment

Abstract

Surgery, regardless of its kind and severity, can be regarded as a major stress situation for any patient. High preoperative emotional arousal may negatively influence adaptation during surgery and, consequently, rate of postoperative recovery. In a series of previous studies, our research group analyzed the influence of dispositional and actual coping on subjective and objective stress indicators before, during, and after surgery. The present study investigates the influence of the dispositional coping variables vigilance and cognitive avoidance on actual surgery-related coping, state anxiety, and indicators of intra- and postoperative adjustment. The sample consisted of 42 male and 42 female patients undergoing elective maxillofacial surgery under general anaesthesia. Dispositional coping was measured on the dimensions vigilance and cognitive avoidance with the Mainz Coping Inventory. Actual surgery-related coping was assessed by means of a newly constructed inventory containing items to measure the four dimensions avoidance, vigilance, positive restructuring, and seeking social support.

Self-reported state anxiety was differentiated according to the cognitive, affective, and somatic components. The patients' adaptation was assessed by measuring doses of the narcotic agents used for induction of anaesthesia, the intraoperative status, and the amount of postoperative (analgesic and psychotropic) medication. Significant effects of coping mode, gender, and time of measurement were observed on the cognitive, affective and somatic component of state anxiety, the indicators of intraoperative adaptation and on postoperative medication. Also, patients' actual coping behavior could partly be predicted by dispositional coping. Results indicate that actual coping behavior and gender should be taken into account when trying to predict adaptation and developing psychological preparatory intervention programs.     

Transference,triangles and trajectories

In this article the author addresses the issue of the need to lessen the likelihood of a regressive transference neurosis in short-term therapy. He examines the role that active interpretation of the transference can have in shaping the transference so that it remains at the level of the transference that is ubiquitous. He explores the relationship between such an active interpretative approach and the need for the therapist to be empathic and sensitive to the patient and to allow space for a patient's independent discoveries. The author describes the role of the Central Therapeutic Focus, as a constellation of the Triangles of Insight, in guiding the therapist to select those manifestations of the transference to interpret, and in enabling the therapist to retain a stance that is sensitive and empathic. The Central Therapeutic Focus is contrasted with the concept of the Central Issue, and with the latter's more specific attention to the contribution that it makes to the therapist's communication of their empathic understanding of the patient's difficulties. The nature of the relationship between the therapist and the patient in short-term therapy is explored further and the connections between companionable interaction, ego-relatedness and the matrix of the transference are outlined. The author proceeds to consider the nature of the process of working through in short-term therapy and of the need to attend to the patient's external world as the place in which this can occur. The contribution of the Central Therapeutic Focus in shaping the trajectory through which the patient and therapist attend to the external world is examined. This in turn is linked to the identification of a patient's ordinary solution to their problem as a means of resolving their Dilemma. The article concludes with a case example that illustrates these themes.     

干扰任务对说谎影响的研究

摘要:本文将干扰任务对记忆的影响同测谎结合起来,试图运用这一方法来对求职者的真实学历和虚假学历进行区分。实验采用模拟面试的方式,对被试在有或无干扰任务条件下进行两次提问,结果发现,四种任务条件对被试真实经历和虚假经历都具有区分度,其中双双条件的区分度是最高的。并且,被试在双双任务条件下虚假经历的得分显著低于其他三种任务条件。     

师范生对教学能力的自我评价、他人评价和反射性评价的关系研究

通过对36名师范生进行问卷调查,考察师范生在教学反思过程中对教学能力的自我评价、他人评价和反射性评价之间的关系。结果发现,在对教学能力的评价中：（1）师范生的自我评价和反射性评价显著低于他人评价;（2）相对于具体他人,泛化他人评价和泛化反射性评价对个体自我评价的影响更大;（3）自我评价与他人评价存在中低相关,而与反射性评价存在中高相关;（4）反射性评价在他人评价和自我评价之间起着完全中介作用。本研究表明,师范生对教学能力的自我评价、他人评价和反射性评价并不完全一致,他人评价通过反射性评价间接影响个体的自我评价。     

神经症躯体症状的特点与诊断原则

作为临床医生,难免与一些难以解释的躯体症状打交道,这其中有些最终可以确定是精神障碍的躯体症状。从躯体症状识别精神障碍,没有捷径可走,除了良好的医学基础,更要了解精神障碍的特点。这样即便是躯体疾病同样存在的情况下,也能发现精神障碍。套用政治术语,叫做"两手抓,两手都要硬"。即便如此,还有一些医学难以解释的症状,其发生基础无论从生物学医学还是精神病学角度都还不清楚,而这正是需要我们着力研究的学科交叉点。     

综合医院抑郁症和神经症诊疗决策的思考

抑郁症和神经症是一种慢性易复发性精神疾病,发病率高,疾病负担重,多数患者都就诊于综合医院非精神专科,而目前的现状是综合医院的各科医生对此类疾病的识别率低、治疗率低,患者依从性差。结合临床提出了关于综合医院如何提高抑郁症和神经症的识别率,医生在精神疾病诊疗中应注意的问题以及如何提高患者治疗依从性等临床亟待解决的问题。     

产褥期抑郁症的高危因素及防治措施的分析

产褥期抑郁症是指产妇在产褥期内出现抑郁症状,是产褥期精神综合征中最常见的一种类型.国外报道发生率达30%,国内资料较少,防治措施亦少.通常在产后6周内发病,产后2周出现症状,表现为易激惹、恐怖、焦虑、沮丧等,有时还会陷入错乱或嗜睡状态.既往无精神病史,包括抑郁症在内的抑郁症史.现对我院2004年6月～2005年6月分娩产妇中随机抽取有随访条件的1824例产妇进行调查,有产后抑郁症状者达289例,发生率15.84%.